The Only Good Use Of Subsidized Healthcare Is My Use Of Subsidized Healthcare

It’s a tale as old as time, or at least as old as Ayn Rand collecting Social Security checks. A right-libertarian finds themselves in a situation in which — surprise! — they need to rely on government programs to help themselves or someone they care about.

Over the weekend, “non-partisan” op-ed site Tangle published an essay titled “When Your Karma Runs Over Your Dogma” from an anonymous libertarian who suddenly discovered the magic of government subsidized health programs when his own child’s health was at risk.

Let’s call him Al, because it just works on multiple levels.

Here, allow Al the Anonymous Libertarian to explain his worldview to you:

I believe in a government of limited scope with strictly defined powers, and I view almost every government program with skepticism if not outright antipathy, from the federal government all the way down. Even when government programs start with good intentions, I tend to see them as simply crowding out more effective charities, commercial groups, or other private actions. And that’s not even getting into my concerns about regulatory capture, bureaucratic overreach, etc. Whenever I hear someone looking to the government for help, my instinctive question is “What else have you tried first?” Suffice it to say that I don’t have a very favorable view of government programs and those who try to make them bigger.

I want you to keep in mind here, as we fisk this essay, that the operative phrase here is “more effective.”

Alas, one day, Al the Anonymous Libertarian and his wife had a child — a child born with cerebral palsy, unable to move the left side of his body.

Luckily, we caught it early (credit where credit is due, my wife caught it early) and, through the miracle of neuroplasticity and a lot of hard work, our son was able to “rewire” his brain and gain full function on both sides of his body. These days, you’d probably never notice that anything was ever wrong if you didn’t know to look. We may never know what caused his cerebral palsy; neither of us smokes, neither of us drank for months before we started trying to get pregnant, my wife ate everything right, she took all the recommended supplements, and we did everything else to give our son the best shot at a fully healthy infancy. And still something happened in utero or during birth.

Yes. Incredibly enough, “doing all the right things” is not actually any guarantee that everything will work out in one’s favor. Lots of people do all of the right things and still end up in very bad situations, which is actually the precise reason why “people just need to take personal responsibility” is a deeply irresponsible alternative to a robust social safety net.

Now, rather than utilizing the “more effective” private health insurance and private doctors — or even non-government-funded charities — Al and his wife discovered that the best way they could help their child was actually through California’s system of Regional Centers, which provide assistance for developmentally disabled children and are funded by state and federal tax dollars.

That’s all well and good, you ask — but how did the karma run over the dogma? The last piece of the puzzle is California’s system of Regional Centers, non-profits primarily contracting with the State Department of Developmental Services. The Regional Centers work with families like mine, with children who have lifelong disabilities or behavioral challenges including cerebral palsy, autism, and many others. So there I was, a proud libertarian suddenly in need of government support, like Ron Swanson cutting his checks from the Department of Parks and Recreation. Yes, we had insurance and our own money to cover some of the costs, but the Regional Center provided access to resources we didn’t even know we needed. They continue to help us coordinate with medical providers, therapists and schools, plus they reimbursed us for some of our costs. 

So, some might say that they were … “more effective” than private healthcare?

It seems that Al’s question of “What else have you tried first?” has been answered here for him. When people are dealing with a serious health issue, the last thing they should have to do is try a bunch of other options before doing the thing that is most effective.

Very often, libertarians suggest that the solution to our healthcare woes are for hospitals and other medical services to provide upfront pricing so that consumers can compare and to drive prices down by making things competitive. The problem with this plan, however, is that it is fucking stupid.

Upfront pricing is fine, considering our current situation — I surely would not have gotten tested for anemia that one time, had I known it was going to cost me $600 and not be covered by my insurance. However, in the grand scheme of things, it is fucking insane to expect people bleeding out in an ambulance to compare the pricing schemes of various hospitals in the area (especially the 16 percent of Americans who live 30 miles or more away from an emergency room).

So what do you do when your child needs help, but that offer of help conflicts with your closely held beliefs? You take the money. You receive the help. You say thank you, and you don’t ask yourself too many questions. What parent would do any different?

No parent! And he made the absolute right decision for his child in this case, as he should have. Except …

What have I learned from my experience? Have I had an Ebenezer Scrooge-like complete change of heart? Am I now a fan of Big Government? Sorry to disappoint, but beliefs are stubborn things: I’m still skeptical of most government programs, I still wish there were more limits on government power, and I still grumble about how high taxes are (even though I got some of my money back, so to speak). But I have become a little wiser and more compassionate, especially toward those who find themselves genuinely dependent on the help — or at least beneficiaries of help that probably wouldn’t come from any other program.

So — he learned that his ideas did not work, but he’s sticking to them. The compromise here is that he’ll be less judgy about people making the exact same choices he did. Nice!

He caps it off with this:

Now I understand that when you’re hit with a difficult situation, you may not have the time or mental capacity to go looking for other avenues of help when you already know a government program exists to do just that. And I’ve met too many genuinely caring therapists and other wonderful staff to simply dismiss the whole lot as soulless bureaucrats; you have to take them as they are, individuals just like everyone else. I may still intellectually believe that private insurance and charity would be better without government programs crowding them out, but I fully understand why someone would take the help from the government and not ask too many questions.

Sir, I hate to tell you this, but that does not actually help anyone else who might find themselves in a situation similar to yours. Your empathy, unacted upon, is not remotely helpful to anyone, for any reason.

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The reasons this Al the Anonymous Libertarian chose to utilize California’s Regional Centers instead of sticking with what he could piece together with charities and private health insurance was that, at the end of the day, it was the most simple, direct solution to his problem. Nothing is ever going to be more effective than that.

I always say that Americans are weirdly committed to doing things the most ass-backwards, needlessly complicated, expensive and ineffective way possible. I stand by that. People, for the most part, are fiercely uninterested in the shortest journey from Point A to Point B. But there is a caveat! When it comes to their own shit, even people like our friend Al the Anonymous Libertarian actually prefer things that way.

Perhaps someday, those who have learned the lessons that Al should have learned here will outnumber those who refuse, and … nah, the private health insurance companies will still have more lobbying money and power than the rest of us.

OPEN THREAD!

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