The main topic area where liberals are basically agreed amongst ourselves on a fairly clear goal is health care. There's a wide variety of programmatic and tactical disagreement, but at the middle level of analysis liberals think that all Americans should have health care and that the government should spend and/or regulate in necessary and proper ways to achieve this goal. And I don't think it's a surprise that health care is consistently the Democrats' strongest issue.The problem with the healthcare debate is that the the solution is always "socialize it." It might be at the federal level or the state level like the system in Tennessee that just shut down. Perhaps it will be called socialized medicine or "a single payer system" but thats the answer. For at least the last decade it gets trotted out thinking that the taxpayers and voters want it.
The problem is that it is a horrible answer that few people like. Why?
- The whole paradigm of the thing is wrong. If there is anything the Cold War taught us its that the free market kicks centralization's ass. Anyone who wants to can see what government run health care will look like, just go to a VA hospital. It's not a pretty sight.
- We can't afford it. The costs of these socialization schemes are immense and the country is already in debt. Or you can make the states pay for it, which didn't work in Tennessee and is just moving the costs around anyway. It all amounts to higher taxes nobody wants.
- Equality in health care is a fiction. Doctors are not milspec cookie-cutter men stamped out at the MD factory. I worked in biomedical engineering long enough to know that the most important variable in care is the ability of the doctor and there are only so many good ones.
- So, it all comes down to scarcity. There is only so many medical resources (doctors, drugs, money, etc). There is a nigh-infinite demand for them because we are all mortal. Good medical care means you live through one disease to get sick again with something else. So what you are really fighting for is who gets to make the decisions. Is it a government beaurocrat, an insurance industry beaurocrat, or a hospital beaurocrat? Getting the point?
If the liberals really want to get on top in this country again, they'd look around and realize the cusp of where they are. They have accomplished all their major goals. The intelligent path is running on a fiscal responsibility ticket based around shrinking the deficit and increasing government efficiency. You know, like Clinton did. They'd look at reforming their current programs to run less expensively using more modern management principles.
But I don't see this happening. They'll just move on to more and more unrealistic goals like the aforementioned socialized medicine, eradicating poverty, ending all bigotry. You know, the kind of stuff you can't actually do in the real world and still respect the vital individual rights liberalism used to stand for.
Liberals unfortunately don't seem to get this turning point we have reached. So instead the deficit reduction and government rebalance will likely occur under a peacetime Republican. I won't be crying.