Reihan: Healthcare and Family Values

I'm late to the story of the Frost family, but it perfectly illustrates the tension between "pro-family" conservatism and "anti-statist" conservatism. I use scare quotes because both terms are of course self-serving. Anti-statists could claim to be the real pro-family faction because they want to place families and not the state at the heart of economic life. On the other hand, it's not obvious that the present US healthcare regime is in fact less statist than a lot of the plausible alternatives: huge amounts of money are being shaped and spent by the state, but in a decidedly inegalitarian way. Real anti-statists need to do more than defend the status quo, and to their credit they generally do. (The solutions proposed are sometimes dotty, but that's another matter.)

Here's my question: Would the world really be better off if, say, the four Frost children saw far less of their parents than they already do? I ask because we could imagine a world in which the Frost parents worked (even) longer hours a jobs that provided health care benefits, which would take an emotional toll not only on them but on their children, particular in light of the impact of the car accident. The children of parents who work night shifts, for example, tend to do worse in school, and they tend to have more behavioral problems. And we're talking about run-of-the-mill families, facing no sudden medical catastrophes.

I realize that this will strike some readers as absurd: tough luck, you'll say. My own parents worked four jobs between them until my father lost his public sector day job, at which point he concentrated full time on his small business. My mother kept working two jobs until health concerns made that impracticable. From fairly early on, I was a latchkey kid and my two older sisters did a lot of the things (attend PTA conferences, monitor my homework) parents normally do. We were well cared for, and I think the three of us turned out reasonably well. So I can see, in theory, the source of resentment: we have to work, and so should you. But who thinks the Frost parents aren't doing their best to balance all of the needs of their children?

When small-government advocates argue that S-CHIP is supposed to be public assistance for the poor, they make an excellent point. Targeting aid to those who need it most makes sense when we're talking about scarce resources. But this begs the question: how scarce are the resources we're talking about, namely federal health care dollars? Are we really distributing these dollars in the smartest, most equitable way? Should a family like the Frosts have to plead poverty when they're raising four kids, who will grow up to make contributions to our tax coffers (to put this in the crudest possible terms) that more than outweigh the costs of keeping them healthy?

If S-CHIP is the wrong way to help families like the Frosts, and I don't dismiss this possibility, this requires an alternative strategy to meet their needs, not Dr. No politics. For me, the most relevant fact is the asymmetric shock: the impact of a car crash on the family's economic well-being.

I'm pretty uncomfortable talking about a particular family in this way. There's no way to fully understand the choices they've had to make. I will say that demonizing them is a lot worse than dumb, and I hope the person who cooked up the idea of putting a 12-year-old in the spotlight has a better appreciation of the dangers, not least of them exposure to crazy vitriol, involved.