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Slippery Slopes and the Health Care Debate August 27, 2009

Posted by Dwight and Lynn Furrow in Dwight Furrow's Posts, politics.
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Most of the objections to the various Democratic plans for health care reform that have received media attention are quite frankly lies. Claims that the government is planning to take over health care, that it will cost the taxpayer $1 trillion per year, that undocumented immigrants will get free care, that bureaucrats instead of doctors will decide treatment options, and that “death panels” will pull the plug on grandma are cynical attempts to scare misinformed voters into opposing any health care reform.

None of the plans under consideration propose any of this.

But there are versions of these arguments that are not merely paranoid rants. For instance, one could argue that a government-run insurance plan will have incentives to save money by providing sub-standard care or will set payment rates too low to encourage medical innovation. Or the government might prevent people who can afford it from buying better private insurance plans that would make up for what the government plan doesn’t cover.

It might be the case that a government-run insurance plan would be so efficient that it would drive private insurance companies from the market.

Or one could argue that panels of medical experts charged with deciding what treatments are most effective will have some sort of systematic bias that would prevent legitimate procedures from being performed.

The government could decide to give free medical care to undocumented immigrants or to place severe constraints on end-of-life care.

All these outcomes are conceivable. But these are all slippery-slope arguments. They have the form if we do X, then Y will inevitably follow, and Y is really bad. But slippery-slope arguments are notoriously, well, slippery.

The problem is that if you are going to claim that if we do X then Y will follow, you have to provide some plausible mechanism by which X will lead to Y. It is not sufficient to say that if we do X, Y could happen. Of course it “could”; but if this kind of argument is to be persuasive we need to know why “Y” is a plausible outcome.

If a government-run health insurance plan is sub-standard, why would people opt for it in lieu of their private insurance? Why would the government give free health care to illegals or cut-off end-of-life-care? And why would the government prevent people from buying better health insurance if the government plans are minimal?

Furthermore, even if a plausible mechanism for “Y” is discovered, opponents would still have to show that “Y” has negative outcomes that would outweigh the positive outcomes of health care reform.

But this kind of reasoning about how to create a plan with appropriate incentives and the right benefits is lacking in much of the health care debate. I’m sure there are conservative economists who can supply plausible slippery slope arguments. But instead all we get are lunatic rants or vague, unsupported allusions to government incompetence.

book-section-book-cover2 Dwight Furrow is author of

Reviving the Left: The Need to Restore Liberal Values in America

For political commentary by Dwight Furrow visit: www.revivingliberalism.com

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