It has always been clear to me that the most loathed part of healthcare reform for the right was the individual mandate. For too many, abortion was a smokescreen to gloss over the real objection, an objection with no real grounding in Catholic teaching. And when you see challenges to health care reform, they nearly always zero in on the individual mandate. This is the issue close to the heart of the particularly repulsive attorney general of Virginia, Ken Cuccinelli, who said the issue was “more about liberty than it is about health care”. And Missouri put a specific measure on the ballot targeting the individual mandate, which passed (although, as Michael Sean Winters notes, it passed with only 10 percent of the population).
What is especially sad is to see so many Catholics jumping on this misguided “liberty” bandwagon. Referencing Missouri, Catholic Key is ecstatic. Pewsitter headlines it. First Things declares that “Missouri Overwhelmingly Rejects Obamacare Mandatory Insurance Scheme” and that it “adds to the rising wind in favor of repeal and should aid candidates that make rejection of Obamacare a central plank of their campaign”. Referencing Virginia, the same outfit says that the flaw with the reform is “forcing private individuals to engage in it” [purchasing health insurance]. The conclusion: “This issue is bigger than Obamacare. It literally could determine whether the Founders’ concept of “limited government” will continue to endure.”
Let’s boil this down. Pretty much every health care expert argues that universal cost-effective care implies the twinning of some variant of the community rating with the individual mandate. In other words, if insurers are not to charge based on individual risk, they need a large pool of healthy people to make it work. Without that, everything falls apart.
This is a perfect example of solidarity in action – younger and healthier people are subsidizing older and sicker people, with the promise that they will be helped out in their time of need. Unfortunately, those who call themselves “conservative” do not see it that way. They see health care as a matter of individual responsibility. They raise liberty to idolatrous levels, and downplay the common good. As Jonathan Chait puts it, it is a “principled opposition to the idea the fortunate should be forced to subsidize the unfortunate” and that it reflects the “increasingly widespread belief that good health, like other forms of prosperity, is a matter of personal responsibility.” In other words, it’s the Calvinism, stupid.
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