Where Charity is Right and Wrong

I worked in Washington, D. C., with Congress virtually every day for nine years. I know how the place works, and I have come to the findings that most government activity can be boiled down to two words: coerced charity.

How can any human being be against charity for others in genuine need? Do we tell people without health insurance to go ahead and suffer or die? But charity coerced through increased taxes comes at the expense of:

* Individual liberty.

* Progress-which is humane. It’s not “people not profits.” It’s “people because of profits.” As Fabian Socialist George Bernard Shaw argued in Major Barbara, “Poverty is the world’s greatest evil,” and it is money that comes to the rescue.

* Leveling up. Those seeking the social justice of a level playing field generally level down.

* “Creative destruction,” as economist Joseph Schumpeter observed. Capitalism brings competition, which creates while it destroys. Capitalism and competition created the automobile industry while destroying the horse-and-buggy industry. Today, capitalism and competition appear to be creating the automobile industry in the South while destroying it in the North.

John Stuart Mill observed in On Liberty, “The initiation of all wise or noble things comes and must come from individuals; generally at first from some one individual.” There’s an apt story where an assistant rushes into the laboratory of Charles Kettering, exclaiming, “Mr. Kettering, Charles Lindbergh just crossed the ocean-all by himself,” to which Kettering responded, “Tell me when he does it by committee.” The automobile industry was founded by one man.

We must remember when it comes to coerced charity that government does not make one dime money: it can only collect and redistribute it. Therefore, in giving “social justice” to some, government must necessarily take a commensurate amount from others.

The present administration in Washington, for example, seeks to implement “social justice” by means of universal healthcare. Who can be against the intent? But it comes with a steep price and the following flaws:

* It will be staggeringly expensive, paid for by others through coerced charity.

* It will prove to be, as always, far more expensive than anticipated or budgeted.

* Abuse will be rife. A recent news article reported that nine patients had a total of 2,678 emergency room visits during a period of six years. Look for this kind of hypochondria to run rampant with free universal health care and no co-pay.

* The “comparative effectiveness” of health care that the current stimulus bill now mandates will necessarily lead to rationing and limitations of medical service. Patients will be told that they must take this generic drug, not that brand one; that they can get this screening, but not that one. Today, for example, Medicare covers periodic colonoscopies, but not effective virtual colonoscopies, so patients put off the exam at their peril.

And doctors will be limited to Medicare reimbursement rates, so they will make up for lost private- sector revenue by dint of increasing patient volume, which means that patients will have to wait longer for shorter appointments. Boding ill is a 2008 survey by the Texas Medical Association that found that only 38 percent of primary-care doctors in Texas took new Medicare patients.

* It will be painfully inefficient. My wife died March 7, 2006. More than three years passed before the Centers for Medicare and Medicaid Services reported to her Medicare insurance provider that she had died. You want these folks in sole control of managing your mandated health care?

“Coerced charity” is good and bad. Today, we are much further along on the spectrum toward coercion than toward individual liberty, progress, or choice. I am not omniscient enough to know precisely where the line between the two should be drawn, but neither is the government. But it is fair to say that government has gone much too far in one direction.

Ronald L. Trowbridge, Ph.D., is a visiting research fellow at the Texas Public Policy Foundation, a non-profit, free-market research institute based in Austin. Dr. Trowbridge formerly served as vice president of Hillsdale College in Michigan.