Get me off-a this Bus!

Early this morning as I was scrolling through my Facebook® status feeds I came across a link to a clever animated video that sought to explain the need for a government plan to cover the gap in health care coverage in this country. I thought about this for a long time because, in my opinion, the rationale behind some of the arguments in favor of a government plan is fundamentally flawed. The basic argument, as best I could discern, is that since we trust the government to provide a whole array of other “essential services” (like education, police protection, clean water, etc.) what makes the essential service of health care any different?

Contemplating this argument for most of the morning caused me to devise an analogy to help explain at least one perspective of the health care debate/argument. Consider transportation. Some might not consider transportation to be a fundamental human right but bear with me while I expand on this. If we were to agree that transportation is a fundamental human right then we must somehow account for how we can guarantee that right to everyone. I think this is accomplished in three broadly defined ways: by the private individual, by individuals acting jointly, by the government.

A private individual, let’s call him Bob, may purchase or lease a vehicle with his own money and, as long as he stays legal he is free to drive pretty much wherever he pleases. The private option can be expensive, depending on the desires and resources of the individual but Bob is not forced to own or lease a car and he is free to give it up whenever he so chooses. The costs of participating in this option are borne entirely by Bob, the owner of the car. But let’s say Bob wants to travel from New York to LA and he wants to be there by tomorrow. Knowing that he can’t possibly drive that distance in less than a day Bob chooses to…

…cooperate with other individuals who also want to travel cross-country. By joining with fellow travelers, Bob can, in effect, rent a seat on a commercial airplane that will take him and others like him, to their destination. By agreeing to voluntarily combine resources, they split the costs among them, thereby making affordable to a group what would be prohibitively expensive to do alone. But let’s say Bob can’t afford a car or an airplane ticket but still needs to travel. There is a third way…

…the government option. Say Bob doesn’t earn enough to make payments, even on a “beater”. Perhaps he’s unemployed or disabled; he still needs to travel but there’s no way he can afford a plane ticket. The government option may very well send a bus by Bob’s place so he can catch a ride to wherever it is he needs to go. Individuals with sufficient incomes, understanding there are good folks like Bob out there who need help with getting around, contribute (through taxation) to the purchase and operation of a bus service. Bob has to pay a fee of course, but it’s not nearly enough to cover the actual costs of the service. The taxpayers in general don’t mind paying for the bus service because they do understand that Bob and others deserve to have some access to transportation.

Are you with me so far? (“Are you getting’ this camera guy?”) Seems a pretty reasonable summation wouldn’t you say? Well, if we continue with the transportation analogy you will soon see where we start running into trouble with the government option.

Let’s say the government option includes not only public bus service but all services that would be required to achieve a “standard” for transportation. Unable to deny that car and plane travel are standard services the government would have to expand the existing and legitimate bus service to include automobile and air travel services as well. Subsidizing the costs of operating this expansion in services would require huge outlays of revenue (in the form of taxes paid by those who have little need for the government transportation option.) As the government transportation system becomes larger and more expensive, Bob may decide that it would just be cheaper for him to use the government system instead of driving his own car or flying aboard a commercial aircraft.

Now let’s imagine that Bob and millions of his fellow travelers decide that they will do ALL their traveling on the government-run transportation system and abandon private and commercial transportation altogether. Bob can still move around, but not as fast as he would like and he can only travel on the schedule that the bus company devises, not on his needs. Sometimes there are not enough seats on the bus and so Bob has to wait for the next bus – or the next one – or the one after that. The government assures him that there is a seat for everyone but that priority seating goes to those who can adequately demonstrate their need. Bob can wait for a seat but it may be that when his bus finally arrives, he no longer needs to travel.

Meanwhile, the commercial airlines and the car makers that used to provide the convenient, fast and efficient travel for Bob and his friends can no longer do so. They cannot compete against a transportation system that is so heavily subsidized by the taxpayers. Gone is the incentive to innovate, to invent ways to make travel faster, safer, and cheaper. Instead, everyone in the land rides the government bus….they don’t want to – but they have to. And since there is only one bus company there is little need to improve the quality of the system. A bus is a bus is a bus.

But that can’t be the end of the analogy? Just like the animated video in favor of the government option, it can’t be that simple can it? No, it can’t. But the analogy is illustrative of one the fears that honest, intelligent Americans have about the government option in health care. Is it ridiculous to think that, despite the best intentions of policy makers and bureaucrats, we could still find ourselves on an over-crowded, chronically underperforming and EXPENSIVE health-care bus?

P.S. – We DO need the “bus system”. Coming away from the analogy now, we already have a public health care option, called Medicare/Medicaid. Is it perfect? Not by a long shot. But it can and should be expanded and improved.