Freedom’s just another word for nothin’ left to lose

Comparing America’s patchwork health care system to Europe’s social democratic paradise is a bit of a hackneyed genre at this point, but this op-ed by writer Anu Partanen does a good job of re-framing the rhetoric of “freedom” that Republicans have used as a rationale for reducing government’s role:

The trouble with a free-market approach is that health care is an immensely complicated and expensive industry, in which the individual rarely has much actual market power. It is not like buying a consumer product, where choosing not to buy will not endanger one’s life. It’s also not like buying some other service tailored to individual demands, because for the most part we can’t predict our future health care needs.

The point of universal coverage is to pool risk, for the maximum benefit of the individual when he or she needs care. And the point of having the government manage this complicated service is not to take freedom away from the individual. The point is the opposite: to give people more freedom. Arranging health care is an overwhelming task, and having a specialized entity do the negotiating, regulating and perhaps even much of the providing is just vastly more efficient than forcing everyone to go it alone.

What passes for an American health care system today certainly has not made me feel freer. Having to arrange so many aspects of care myself, while also having to navigate the ever-changing maze of plans, prices and the scarcity of appointments available with good doctors in my network, has thrown me, along with huge numbers of Americans, into a state of constant stress. And I haven’t even been seriously sick or injured yet.

As a United States citizen now, I wish Americans could experience the freedom of knowing that the health care system will always be there for us regardless of our employment status. I wish we were free to assume that our doctors get paid a salary to look after our best interests, not to profit by generating billable tests and procedures. I want the freedom to know that the system will automatically take me and my family in, without my having to battle for care in my moment of weakness and need. That is real freedom.

Conservative and libertarian thought tends to see freedom as a zero-sum game: the more the government does, the less free the citizenry is. But people without the material conditions to exercise meaningful choice lack an essential component of freedom. Accordingly, government action–to alleviate poverty, to provide public goods, to ensure a clean and safe environment, and to provide the framework for a well-functioning economy–can make people more, not less, free.

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