If you’re a progressive or a communitarian—and I think the majority of readers of this website are both—you may find this blog a little obvious. Feel free to say “duh” under your breath. But it’s a big deal for me.

I strongly prefer that social interactions of all kinds be handled privately. That is, I don’t want the government, at any level, managing and regulating any process unless there is a very, very strong argument that something must be done and it is clear that individuals or smaller, private groups cannot do it for themselves.

I believe the smallest, simplest, most local, most efficient solution is probably best. If you want to see the medieval precedent for this, check out the idea of Occam’s Razor.

In most cases, I find it unlikely that government management—including enormous bureaucracy—will be the most efficient, simplest solution to a social problem. Moreover, I tend to see government as a contract among individuals rather than as the embodiment of some supposed “community”, so I’m even less likely to think it should be making decisions for all of us.

So the theory is individualism and freedom of choice, but the reality is that sometimes there are, in fact, very, very strong arguments that government must do what individuals and private groups cannot. Military force is one good example. Government has to have a monopoly, although sometimes the consequences of that are ugly. Police protection, for the most part, is another example, although those who can afford them hire private police (security guards) all the time.

A more debatable example is education. This could be left to individual choice and private groups, but our society has reached a very broad consensus that universal education is so desirable that we’re willing to manage it, and pay for it, through government. This doesn’t mean it’s always fair or equal or that the rich don’t get better public schools and better private schools. But it does mean that we agree education is a POSITIVE right. It’s not just that government can’t prohibit you from getting educated, government must guarantee that education will be provided.

To be honest, I think that’s right. Because I’m not a communitarian, I’m not as concerned as some people about the community-building aspects of public schools. And I’m distrustful of putting too much educational power in the hands of unionized teachers. But I agree that the social benefits of making sure everyone gets an education are worth the risks of letting the government manage the system, including taking my money and redistributing it to provide education to others.

So you know where this is going. It’s time to acknowledge that healthcare is a parallel case. Letting individuals and private groups handle this on their own isn’t working. Too many people—17% is the going figure—aren’t insured at all. Too many others get inadequate care. Too much money is eaten up in the administrative system. Coordination of information and services is just too poor. And besides, businesses are already pushing their employees and especially their retirees toward government-funded services by cutting back on privately-funded ones.

If you’ve read this far, you probably already think universal, government-managed healthcare is a good idea (say “duh” here) so you have no idea how hard it is for me to write this. My first reaction is always to say no to government aggrandizement. I lived in the UK for 2 ½ years and I do not want the full-blown public clinic model they have there. And on the big scale of life, I can afford to subsidize and upgrade my healthcare just as I have done with my children’s education.

But it’s time to say healthcare needs to be a POSITIVE right and society must guarantee its availability. It’s more like military protection and education, less like personal choice concerning jobs, family, or lifestyle.

A lot of people fear bigger government; they shot down Hillary Clinton’s short-lived healthcare reforms the first time for just this reason. I’m not telling them to stop fearing big government. I still fear it and will continue to do so. And I still believe the burden should be on those who argue “for” government involvement to make the very, very strong case that no smaller, private, option will work. I’m just saying healthcare has reached that stage and we need to acknowledge this and get on with it.

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