Individuals versus Institutions in U.S. Healthcare Debate

With the surprising results of the latest election cycle, where Republicans won the New Jersey governorship (beating incumbent Jon Corzine), perhaps some voters are getting a bit more suspicious of President Barack Obama's message of change. Perhaps some are beginning to wonder if change is always good, even when you don't know what the change is going to be. Many of the proposals we've been hearing lately from Washington are downright scary.

As a long-time Republican, with many Democratic friends, I am perplexed at the seemingly blind trust that so many people seem to have in our political leadership. Many seem willing to give our leaders the benefit of the doubt when others are very much "Doubting Thomases."

So that got me thinking. Why can Republicans be so cynical and Democrats so trusting?

Republicans believe much more in individual freedom and responsibility. If someone commits murder, they made a choice and they deserve to suffer the consequences. If someone takes a business risk, they deserve the rewards if they are successful. People are responsible for their own behavior and the choices they make.

Democrats seem to believe more in institutions. If the members of the institution are trustworthy and honorable, then the institution can be trusted. Large, government-run programs are not to be feared; instead, they are the way for society as a whole to move forward.

Republicans like smaller government. They don't trust the institutions that have developed to wield political power (Congress, the Mass. State House), and they don't trust the individual players who seem to get corrupted by power too easily.

Corruption definitely cuts across party lines. It seems to be an affliction of power. People are imperfect. That may be the reason why Republicans don't trust these institutions. They know that corruption exists and they want to minimize it by making sure the institutions don't get too powerful. Democrats, on the other hand, don't seem to mind giving more and more power to these institutions because the individuals within them are (they believe) trustworthy and perhaps share the same goals as they do.

Republicans see public institutions as extremely inefficient. We believe in capitalism and we think corporations make rational decisions based on earning a profit. The government has no such profit motive.

When government institutions make mistakes, there are few repercussions for the individuals involved. Political leaders are not necessarily aligned with what is best for voters and citizens. On the other hand, private corporations are made up of willing investors who are free to sell their investment if they don't like what is going on. So private institutions and government institutions are fundamentally different.

This may be one reason why many Republicans don't support a major bureaucracy to control health care. Yes, our current healthcare system doesn't work perfectly and change is needed. But a large system that centralizes power is almost certainly going to suffer from major abuse and perhaps failure. We want a better system without the risk of destroying what is working now.

If a perfect large-government system were devised and started working well, we believe that, over time, it would start to break down and the inefficiencies and corruptions would certainly occur. We don't believe it is likely for imperfect humans to construct a working bureaucracy outside the laws of capitalism that will prevent corruption and work efficiently.

Our healthcare system is far from perfect, but a large government bureaucracy could be a change for the worse. It is one thing to have a program like Medicaid, which only covers a small part of the population, where current and future losses can perhaps be shifted elsewhere. But if the government is in control of the entire healthcare system, a failure of that institution could lead to much worse repercussions. We simply don't want to put our eggs in one basket, especially in the government bureaucracy basket.

We need to keep a free-market component in our healthcare system where there are choices and controls that naturally occur only in the free market. Once the government is in total control, we will likely have a system that doesn't work as well, costs more, and is rife with corruption.