On Friday, President Obama announced an “accommodation” to the Health and Human Services (HHS) contraceptive mandate: Rather than requiring religious organizations that provide group health insurance to cover sterilization, contraception, and some abortion-inducing drugs, those religious organizations will now likely pay higher premiums to insurance companies who will provide these “free services” to employees. This accommodation doesn’t remedy the religious liberty problem.
But no partial change to the HHS regulations alters the fact that, within Obamacare, health insurance decisions are dictated by the federal government rather than by individuals and businesses. Tweaking the relationships within this system will not change the underlying problem: the federal government’s authority to control who must pay for insurance and what that insurance must cover.
In such a system, government wields extraordinary power to promote certain causes, advance certain agendas, endorse certain values and beliefs, and encourage certain expectations. This power is particularly dangerous when coupled with a statist approach to civil society.
The Administration appears to conflate the federal government with American society at large. In the words of Representative Barney Frank (D–MA), “Government is simply the name we give to the things we choose to do together.” In this view, all of society’s responsibilities can become government’s responsibility; sovereign authority to pursue any legitimate social goal falls to the state.
Viewing itself as the central and primary expression of “the people,” the paternal state assumes authority to define the roles and responsibilities of other social institutions. Businesses, banks, schools, and charitable organizations are seen as agents or extensions of the state and thus regulated to serve the state’s goals and values.
Obamacare exemplifies this mindset. Having identified care for the sick as a legitimate public goal, the Obama Administration seems to view the federal government as the primary agent responsible for that goal. The Administration therefore reaches for the power to regulate and control the provision of health care according to its own values, beliefs, and agendas—even at the cost of undermining the authority of other social institutions and the personal freedom of all.
But the American people aren’t synonymous with the federal government. As Abraham Lincoln articulated the relationship between the two, government is of, by and for the people. He did not say that government is the people.
A free society is primarily defined not by its government but by its members’ shared beliefs, values, stories, language, and experiences. A free society is more than—and exists prior to—the government that represents it. The members of such a society act together by freely forming institutions such as associations, clubs, neighborhood groups, guilds, and businesses. The people decide which institutions best serve their individual purposes and the common good in accord with their values.
Obamacare’s very structure facilitates a different kind of social arrangement. Regardless of how the President defines or tweaks the relationships within his health care system, the outcome is the inevitable expansion of government, crowding out of civil society, and undermining of liberty.
Obamacare should be repealed. In its place the American people should debate and pursue a better way to care for the sick in our society. A healthy society must be bound together by thicker bonds than just political or legal bonds; such an approach will seek to protect rather than undermine the freedom and authority of individual citizens and non-government institutions. After all, those institutions are best-equipped to generate a sense of mutual responsibility and to care for those in need.