The Left's Real Problem With our Healthcare System: No One is in Charge

On Wednesday April 27th the Democratic Committee of Burlington held a forum on the proposed healthcare reform legislation being rushed through our political process. True North Reports covered the forum and provided videos to go with the commentary. Some of what was caught on video reveals an interesting insight into the progressive mindset.

I have written previously about how Vermont’s left sees their efforts at healthcare reform as a model for national reform. In making their argument in support of more government control over our healthcare system, they have unwittingly encapsulated the progressive argument for a centrally managed society, run by an enlightened few. The central premise of liberalism/progressivism is that a more efficient and harmonious social order can be achieved by putting an enlightened few in charge of the ignorant masses. Those who take this view see chaos as the only possibility if there is no central authority to manage society.

The alternative view is that a “spontaneous order” is possible among free people in a free society if they are left to pursue their own affairs with a minimum of government interference. This order is made up of the planning and decisions of numerous people freely interacting with one another. The assumption behind this view is that most people are capable of planning for their own needs but no one is capable of centrally planning for the needs of the society as a whole. Society is just far too complicated for the social order to be centrally planned. Those who take this view see the notion that a select few can centrally manage society as “the fatal conceit.”

This fatal conceit is an ancient notion that is most famously presented in Plato’s Republic, where the perfect society is to be run by “Philosopher Kings,” or “Guardians.” There have been numerous variations on this theme from Lenin’s “Vanguard” to Hitler’s “Leadership Principle,” but the call for society to be run by a select few is common to them all. In order to effectively run the society, those in charge need to have control over the totality of human interactions. This is where the term totalitarian comes from. In extreme cases totalitarian regimes resort to violence and genocide to maintain that control. Such measurers, however, are not the essence of a totalitarian society. The essence is the notion that society must be centrally controlled by a select few if any semblance of a social order is to be maintained.

If one keeps this in mind, one of the critiques of our current healthcare system given in the videos from the True North story should set off a few alarm bells. In part one where the speakers are laying out the case for the reform proposal, at least twice there was a reference to the fact that no one is in control of the current system. One reference was made by Dr. Deb Righter, who is a long time advocate for a single payer system. The other reference was made by State Representative Mark Larson, who is the Chair of the Healthcare Committee. Representative Larson characterized the current system as fragmented and complex with no one in charge. In part two, where the speakers are answering questions from the audience written on post cards, the matter of the accountability of the five-panel board empowered to design the system was brought up. The response was that it was important that the board be free of political pressures.

What are the implications here? First of all there is the fact that they see a problem with no one being in charge. The reality here is that there is someone in charge. Each person is in charge of making their own decisions, or at least they would be if we had a true free market based system. So the real problem for them is that a select few are not in charge with the power to impose upon society their notions of how the system should work. Second is the importance in their minds that those making the decisions not be subject to political pressures. They are to make their decisions based on their own rational judgment, rather than be swayed by the irrational impulses of the masses. What most of us see as accountability and the “consent of the governed,” they see as political pressure likely to corrupt the decision process of the few experts to be put in charge.

To sum things up, what we have here is not simply a debate about how to reform our healthcare system, but how best to run society and create a just social order. Is a just social order more likely to come about by the enlightened rule of a select few, or by free people making their own decisions in a free society? Are we capable of governing ourselves, or do we need someone “in charge”? Are those who will be chosen to be “in charge” so much smarter and more capable than the rest of us that they can manage the affairs of the whole society, while we are not seen as able to even manage our own affairs? That is the real question being put before us and Vermont is providing small-scale venue for this debate that the entire nation needs to take part in.