I like to think of the big tradeoff as being between community and liberty. From this perspective, the health reform bill offers more community (all Americans get health insurance, regulated by a centralized authority) and less liberty (insurance mandates, higher taxes). Once again, regardless of whether you are more communitarian or libertarian, a reasonable person should be able to understand the opposite vantagepoint [Dr. Greg Mankiw, "Healthcare, Tradeoffs, and the Road Ahead," blog, 2010.03.22].
I understand the opposite vantagepoint, but I see a more complex equation than "more community = less liberty." It's not a zero-sum game. Community does not take away liberty; community is the basis of liberty.
Health care reform gives us more economic liberty. Consider job lock: right now, lots of people are sticking with jobs they don't like, jobs they aren't optimally suited for, simply to cling to their employer health plans. Make health insurance easier to get and keep, and people will feel more free to pursue new jobs and even self-employment. And what's more liberating than being your own boss...
...or growing your own food?
The reforms banning practices such as denying coverage due to pre-existing conditions also will affect farmers, Tolbert said.
Doug Sombke, president of the South Dakota Farmers Union, said he likes the bill. He said his sons had trouble coming back to the family farm due to pre-existing conditions from football injuries.
“This will fix that sort of coverage and help us as young people want to come back and get into agriculture,” Sombke said [David Montgomery, "Experts: Be Patient with Health Care Changes," Pierre Capital Journal, 2010.03.23].
Young people living and working where they want: that's liberty. Even as we increase community. Neat trick!