Mark Steyn has a column on the Canadian health care system (written for Canadians). He makes a point that I had never thought about before:
When health care is the government’s responsibility, it becomes its principal responsibility. Imagine if we [in Canada] had as many high-profile conferences on national security as we do on health. But we don’t. Because the minute you make government the provider of health care, you ensure that, come election time, the electorate identifies health as its number one concern. Thus, in a democracy, the very fact of socialized health care seduces government away from its prime responsibility – the defence of the realm. In the Canadian cabinet, the Health portfolio is more prestigious than Defence. Think Donald Rumsfeld would regard it as a promotion if he were moved to Health?
This line of thinking is interesting–that when the government takes over health care, health care becomes the primary concern of government. It also explains one of the odd differences between European and American conservatives. European conservatives tend to be strongly anti-immigration; American conservatives are not. In the General Social Survey, conservatives differ insignificantly from political moderates on favoring more or less immigration. Liberals are slightly but significantly more pro-immigration than either conservatives or moderates.
Once almost everyone in a country accepts that the primary concern of government is providing things that individuals and employers might provide (as may be true in parts of Europe), then opposition to the liberal consensus becomes focused on keeping others (immigrants) from sharing in the country’s seeming largesse. In the US, on the other hand, political conservatism is focused, not on immigration, but on the size of government–as well as, of course, moral and social issues.
My comments were not about the current election, but rather about conservatives and their views in the general public. I would strongly recommend Stuart Benjamin’s post above, which points out what a disaster on smaller government George Bush has been. While I don’t believe that Kerry would be any better on this than Bush, Benjamin offers some genuine reasons (not just speculations) on why Kerry should theoretically be better than Bush on this. I suppose it depends mostly on whether Kerry gets his wishes on health care. Also, one should figure in not just legislation, but the appointments to the courts and the agencies. Which candidate’s appointments would favor smaller government? I, for one, like the current slightly left of center orientation of the Supreme Court and the lower courts (eg, abortion, affirmative action, free speech), and would not like to see a significant shift one way or the other.