Conservatives, Health Care and Fire Departments

President Obama recently characterized the Republican governing philosophy as nothing but "social Darwinism."

"If you get sick, you're on your own," Obama said. "If you can't afford college, you're on your own. If you don't like that some corporation is polluting your air or the air that your child breathes, then you're on your own. That's not the America I believe in. It's not the America you believe in."

While this speech may be viewed as a bit of campaign hyperbole, it does lay out the essential philosophical differences between the political parties. A purely objective look at the American political system, of course, would reveal that it is pretty much in line with other liberal democracies, albeit with a rightward cultural slant. So true social Darwinism is not in the cards; however, global economic realities are forcing us as a nation to decide how we will govern ourselves going forward.

The current fight is over health care reform. The insurance-based individual mandate, originally a conservative idea, has raised the philosophical issue once again. While the wrangling over the "mandate" language has dragged in distracting constitutional issues, the federal government clearly has the power to tax citizens to pay for services like health care, even though conservatives would prefer the market-based, insurance model, which has so far failed miserably.

This philosophical argument over the role of government has been going on in America since colonial days, and in Europe long before that. One of the most interesting debates was over firefighting services. In ancient Rome, there were public fire services, paid for by taxpayers, but later societies in Europe left people to fend for themselves. However, as European cities grew in the Middle Ages and whole municipalities were destroyed by fire, people wanted help in putting out the fires.

Both volunteer and private fire brigades sprang up in the 18th century; however, by the 19th century, insurance companies saw a market for private fire insurance, and that market boomed. But the problem remained that if you didn't get fire insurance, no one came if your house caught on fire. While most people didn't care if someone else lost their home to fire, they became concerned that if no one arrived to put out the fire at their neighbor's house, then their own house would catch fire and burn. Thus the first public fire departments were born in the United States around the time of the Civil War.

Still, conservatives were not convinced, and there have been efforts to privatize fire services ever since. Some are based on insurance -- the insurance giant AIG, for example, now provides private fire services to policy holders. Other efforts involved privatizing fire departments, which have been successful in some cases, and failures in other cases. In the end, it all comes down to what kind of fire services people want, and what they are willing to pay for.

The same goes for health care. What do we want, and what are we willing to pay for? Do we want only those who are insured to get medical care? If so, what do we do about the social and economic costs of 50 million uninsured Americans? If not, how much are we willing to pay to treat those who cannot afford to pay? These are century-old arguments that came up in debates over income taxation, Social Security, Medicare and virtually every other program that either levies taxes or bestows benefits.

Again and again, it comes down to what we want, and how much are we willing to pay for. Unfortunately, the debate over health care -- and over other government programs through the years -- has not focused on that simple question. Conservatives don't seem to be willing to pay for anything, while liberals don't want to cut anything. So we get a stalemate. Politicians bicker and slam each other, all the while kicking the can down the road.

Eventually, as with fire services, people realize that if their neighbor's house burns down, then their house could catch fire, and they finally decide to do something to solve the problem. Sure, the solution is never perfect, but whatever they decide will be better than watching both houses burn.Only the most self-destructive society wants that. And, hopefully, America has not -- and will not -- descend to those self-destructive depths.