When the Iraq War was a live issue in American politics, some of the supporters of the war made the following strange argument: Saddam Hussein was a bloodthirsty dictator; he had jails where opponents of the regime were tortured and killed. Therefore, those who opposed the Iraq War were personally responsible for the torture and death of those innocent individuals.
I mention this because in the debate over health care, one often hears from liberals a different version of that infantile argument.
For example, in the King v. Burwell case that was recently accepted by the Supreme Court, a number of conservative and libertarian activists argue that the text of the Affordable Care Act does not allow subsidies for health care plans to flow to exchanges set up by the federal government.
The legal merits of the case are interesting. But what is particularly fascinating is the attempt by some liberals to say that if the case were to succeed, the activists would be responsible for the deaths that would purportedly follow. This has been a case put forward by the progressive writer Jonathan Chait.
The absurdity here is manifold.
The first layer of absurdity is the implicit notion that, whatever it is that the law actually says, courts should choose in favor of what meets the purported utilitarian calculus. (And, indeed, opponents of the law have made a very coherent case that their reading is right and that this is how the law was purposefully designed.) There's only one slight problem with this idea: it undermines one of the very foundations of modern civilization, namely the rule of law.
The idea of the rule of law (and progressives sometimes struggle with the concept) is that countries should be governed by laws, not by the whims of individuals. If the text of the law says something, that's what you should do, regardless of the consequences. Because if you do it any other way, the consequences of that are, over the long run, chaos: everyone overrides the law in favor of their preferred ethical principle.
This disdain for the rule of law, by the way, is not an aberration of the progressive mind, but rather, the rule. In legal jurisprudence, the progressive tradition has been to interpret the Constitution as a "living document," one that should say whatever justices want it to say, rather than what the Constitution says.
The second layer of absurdity is the weird idea that one should not apply cost-benefit equations to questions of public policy. Yes, if the Iraq War had not occurred, Saddam Hussein would have continued to torture and murder innocent people. But hundreds of thousands more innocents have been killed as a result of the Iraq War.
Here's a story. The father of a business executive named David Goldhill died in a hospital because of a nosocomial disease, or a hospital-acquired disease. The U.S. health care system, in other words, killed Goldhill's father. This led Goldhill on a quest to learn how the U.S. health care system could be so dysfunctional, and his answer was, essentially, that it has become a bureaucratic nightmare due to a disastrous lack of choice, competition, and innovation — the very complaints that conservatives constantly make about the U.S. health care system, and the very nightmare that ObamaCare exacerbates.
One in 10 people visiting a U.S. hospital will acquire a nosocomial disease (read that again). The Centers for Disease Control and Prevention estimates that 100,000 people die every year from hospital-acquired diseases. This is just one specific consequence of the over-regulated brokenness that is the U.S. health care system.
If conservatives' intuitions about the power of decentralized decision-making are true — as they are true in almost every other sector — you can easily come up with a death toll for central planning in health care reaching into the millions. Is the blood of all those people on Jonathan Chait's hands? I don't think so, because I'm not a moral imbecile. But given this backdrop, I will be forgiven for being annoyed at his trying to pin a single death on my fellow conservatives.
On this point, the work of the evolutionary psychologist Jonathan Haidt might be useful. He identifies five dimensions of moral intuition, and notes that self-described liberals are stunted in all dimensions but one, the care/harm dimension, which seeks to avoid the pain of others, whereas conservatives are more equally balanced. While conservatives think caring for other people is important, they also value the other dimensions of the moral universe. Progressives see only in one color.
This progressive disability leads predictably to two outcomes.
The first is what I'll call moral childishness: a petulant tendency to throw temper tantrums based on mere feelings that are totally impervious to reason. One person just might die! Therefore...therefore, what, exactly?
The second is both more obvious and more pernicious: if caring for other people is the only value in your system, then, almost by definition, you will come to believe that the ends justify the means. Conservatives have a strong respect for authority, and progressives rightly point out that this, unchecked, can lead to moral atrocities. But a caring worldview leavened by a respect for authority is what allows things like the rule of law and republican governance to endure.
If it is simply unacceptable that someone somewhere might suffer, then everything else must be thrown in the fire. If the law says federal health care exchanges shouldn't get subsidies, too bad. If you have to lie to the public to get your health care bill passed, too bad. If granting amnesty to illegal immigrants would precipitate a constitutional crisis (and give sweeping new powers to the next Republican administration!), well, someone somewhere is hurting, so we know what needs to be done.
Of course, all human beings, conservative, progressive, and everything else, are susceptible to that most human of temptations. But it stands to reason that an unbalanced moral worldview will be even more susceptible to it.
Jonathan Chait has written that he wouldn't let his daughter marry a conservative, because they "live in a different moral universe." Perhaps they do; if so, that universe is called "adulthood." In a temper tantrum, a small child will break even the thing he loves. The point of growing up is to be able to guide our feelings through reason.
In the meantime, moral children should spare us their self-righteous lectures.