Stuart Butler: Cited by David Brooks in NYT column on health care





Few have thought about these matters [national health care] as long or as well as Stuart Butler of the Heritage Foundation. Butler grew up in Shrewsbury, England, got a doctorate in American economic history in Scotland and became a U.S. citizen in 1996. As a result, he’s acutely aware of what makes American civilization unique, and which policies fit the national character.

As you read his work, you quickly see what priorities the new social contract should embrace. It should offer basic security, so Americans will feel comfortable enough to move around and seize new opportunities. It should demand reciprocity; if you contribute to society, you’re protected from catastrophes no one can control. It should foster personal responsibility, stimulating private savings and self-insurance among those who can afford it.

Finally, it should foster self-sufficiency; if people do slip and require government support, they should be induced to rebound and take care of themselves. If you are fortunate enough to be upper-middle class, you shouldn’t be rigging the game so you grab benefits that should properly be allocated to the needy.

Butler is no libertarian. He doesn’t believe individuals should just be given Health Savings Accounts and then sent off to shop for health care. Nor does he believe that the primary social relationship is between individuals and government.

He sees America as a thick society, and believes that unions, churches and community groups should be involved in health care and social support. He sees America as a decentralized society. The worst thing we could do is get the smartest people in a room and build one system from Washington. Instead, Washington should set parameters and states should be left free to innovate and compete.

He also sees society as a continuum between the dead, living and unborn. We shouldn’t disrupt the lives of those who are happy with the insurance they have. On the other hand, it’s immoral to shift the costs to our children and grandchildren. Long-term expenses should be calculated into every decision we make.


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