David Davenport and Gordon Lloyd, authors of the op-ed: Health care debate about liberty vs. equality, argue that the debate over health care is part of a poltical agenda to push for equality as the primary frame for thinking about policy in general. The two major opposing frames in America are individual liberty, which emphasizes equality of opportunity, property rights, and a limited role for government, and social justice or equality, which proposes to institutionalize equality by emphasizing equality of outcome and by utilizing government to restrict free markets and redistribute wealth from the rich and the middle class to the poor. Essentially, the debate takes place between those who believe in “liberte, egalite et fraternite,” and those who advocate for “life, liberty and the pursuit of happiness.”
The authors point out that these opposing groups have cooperated on health care in the past, and they suggest one way of doing so again:
Two classic caricatures from American political life — the “rugged individual” and the “forgotten man” — personify the liberty and equality health care narratives. When the present health care structure was created during Lyndon Johnson’s “Great Society” of the 1960s, Medicare and Medicaid took care of the forgotten man, and employer-employee health insurance programs covered the health care of the rugged individual. Thus a political compromise between the two narratives allowed health care policy to move forward.
Perhaps there is still room for a compromise between the liberty and equality folks [today] — the most obvious possibility is the removal of the public option, in which government inevitably reduces competition in the name of providing it.
The authors acknowledge, that if health care is indeed part of a larger agenda to promote the social justice/equality frame of thought, that this compromise is unlikely.
[…]if this is now a moral crusade, and an opportunity for the Obama administration to use a crisis to advance its political worldview, the heated battle will continue.
If this debate were really about reducing the costs of, and increasing access to, health care for more people in America, it would focus on increasing competition in the health care market place and on aligning the incentives between doctors and patients through market reforms. Possible market solutions include pre-tax health savings accounts, extending tax benefits for employer provided health insurance to individuals purchasing their own plans, and allowing insurance companies to compete for patients across states. Unfortunately this debate is more about furthering ideology than improving the conditions for consumers in the health care market.