Critical Condition

The Shamelessness of Obamacare

There continues to be a lot of confusion on the Left, some it genuine and some of it willfully obtuse, regarding the public outbursts of frustration all over the country directed towards Obamacare. I’ve already argued that much of it is an expression of powerlessness on the part of a citizenry that has been deprived of a genuine opportunity for national debate on the one of the biggest and most important pieces of legislation in modern history. While Democrats are behind this shocking dismissal of public opinion, Republicans are complicit, too, given their lackluster leadership: public anger has only been exacerbated by the lack of direction provided by the GOP.

Still, much of this explosive frustration can be explained by the peculiar nature of health care as a political issue — no other topics of political debate so thoroughly blur the line between public good and private interest like the questions that make central the individual body, that last bastion of privacy in an increasingly exhibitionist culture. Health problems are often intensely personal and are attached to feelings of embarrassment; in fact, a common complaint from physicians is that the primary obstacle to formulating a diagnosis is the reticence of the patient who often conceals information out of shame. If patients are slow to discuss their bodies with their physicians, they are understandably mortified at the prospect of their medical history being subject to the condescending scrutiny of government bureaucrats, who then get to render judgment about their worthiness for treatment.

Health care has become a signature issue for Democrats in part because the umbrella subject of health encompasses the more contentious areas of sexual morality and the family — those who get to decide who gets treated for what implicitly become the moral superintendents of which private behaviors get praised or blamed. So one typical feature of the Left’s technocratic view of governance — the reduction of real moral and political problems to ones of specialized bureaucratic expertise — finds a congenial home in a health-care system that transforms private issues of morality into clinical issues for public determination.

The Left has often embraced a robust sense of privacy, going so far as to invent Constitutional protections for it, to advance their liberationist sexual agenda. Now they plan to abandon that precious right to advance their health-care agenda. The vigorous resistance to Obamacare provides a window into the limits of liberal paternalism — the privacy of the body is much more obviously personal than issues of commerce or taxation and so the public is much less inclined to comfortably trust its regulation by the government as benign.

— Ivan Kenneally is an assistant professor of political science at the Rochester Institute of Technology in Rochester, N.Y. He is currently writing on technocracy and American politics.