A national health policy for all? Free medicine will not be free

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Attlee’s parsimonious habits cling to the memory. I had a personal taste of them when lecturing at the University of Wisconsin in 1959. The evening before my own appearance — to plead the cause of Barry Goldwater, whose name was being dangled as fit for the presidency — Attlee had spoken. After his lecture, some of the kids drove him to the airport. On presenting his ticket to New York, he was told by the steward that he would need to supplement the ticket fare by $55.

Why? Attlee asked.

Because that was the price of a first-class ticket. And the flight on which he was ticketed was first-class only.

To the alarm of his student hosts, Attlee demanded to know at what time there was a flight that had tourist-class seats. Answer: at 3 o’clock in the morning. Attlee asked that he be awakened in time for that flight, intending to doze in the waiting room. No expostulation would change his course. There was a wan smile, and Clement Attlee, father of British socialism, went with his overnight case to the waiting room and bade his hosts goodnight. I told the kids that if Goldwater had been there, he’d have come up with the $55 from his own pocket.

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The socialist government was widely considered to be the disaster that Winston Churchill, running in 1951 to replace Attlee as prime minister, insisted it was. But the British socialists made one contribution to modern democratic practices that stuck: free medicine.

It was uproariously popular. I raised the point with Sen. Goldwater before his own appearance in Wisconsin, and he told of his vehement opposition to the program, a version of it having been introduced in a Senate bill by Estes Kefauver and Hubert Humphrey. Goldwater summoned his deepest reserves of gravity and said to me that if enacted, the Kefauver-Humphrey bill would end up costing $5 billion.

I thought the sum indefensibly exaggerated, but last week’s New York Times examined the health-reform measures being advocated in the current season by the leading Democratic contenders for president. The plans were briefly described, and one section was devoted to cost. The estimated annual cost of Sen. Hillary Clinton’s plan is $110 billion. Of Sen. Barack Obama’s, "$50 to $65 billion." Of John Edwards’, "$90 to $120 billion."

Applying the inflation factor ($1 in 1960 had become $16 by 2005), we can fiddle with the economic details but still quickly realize that "free" medicine (which is what the Democrats are essentially talking about) exceeds the cost of such programs as estimated 50 years ago.

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The best analytical breakdown of the public question is this:

(1) The British established, with their ringingly popular National Health system, that politically it is unbeatable. No matter what was done with nationalized steel or other industries, you had to hang onto free medicine.

(2) The politicians on this side of the Atlantic acknowledge that free health care, or its equivalent (there are differences among the Clinton, Obama and Edwards proposals), is an economic luxury that is demanding a primary lodging in the political programs of the major parties. So is it an economic luxury? Yes. And the country can afford an economic luxury, the analysts will tell you.

It will be very hard to allocate the cost. Except that it will be assigned to — the rich. That is an indispensable feature of any redistributionist scheme: figure out a way to conceal the cost and place the burden, to the extent it cannot be hidden, on others than those who are benefiting from the program. It is not surprising that all the candidates surveyed in the New York Times story recommended that the burden of the cost should be assigned to those taxpayers who earn more than $250,000 — yes, the people who benefited from the tax-reduction packages of President Bush.

The adage of Milton Friedman that there is no such thing as a free lunch is undamaged by the circumlocutions of the politicians. Is the challenge to the Republicans simply a matter of parsing the subtle march, by the opposition, toward collectivist policies?