Yet I remember a similar "historic" inflexion point. Way back in the 1960s I was working for the New York City Department of Welfare. As a caseworker, part of my job was to inform the public about our programs. This put me square in the middle of an earlier liberal crusade.
The War on Poverty was then at its height, hence I was required to distribute brochures explaining that welfare was a personal "right." The poor needn't be ashamed of applying for assistance because this was a benefit to which they were entitled.
The result of this publicity blitz was a huge deluge of new applicants. Many thousands of people literally lined up to procure their share of the promised bounty. Soon, however, the system was overwhelmed. Money was leaving the city's coffers more quickly than it was coming in.
Something had to be done, so the city fathers got creative. Instead of the usual three receptionists at each welfare center, they reduced the number to one. This created a bottleneck, with the resultant queues stretching clear around the block. Indeed, the waiting time became so daunting that many prospective clients voluntarily dropped out. They decided that the gain was not worth the inconvenience.
A parallel occurrence subsequently took place in Canada and Great Britain. The demand for their government provided medical services outstripped its availability; hence they too resorted to circuitous rationing. They did this by instituting literal waiting lists. Now their patients often had to delay treatment for many months.
This, unfortunately, is what happens when a "good" is converted into an unlimited moral "right." The demand eventually goes through the roof such that indirect means must be employed to restrict it.
Something else also happens. Those who possess the right become obsessed with receiving their due. Back in New York, this became evident during my talks with clients. Time and again they fretted about how to retain their eligibility. Instead of contemplating methods for getting a job or starting a business, they plotted techniques for keeping their cases open.
Nor could I blame them. Free money was, after all, free money. Nonetheless the consequence of this attitude was passive dependence. Instead of taking care of their needs, they surrendered their futures to the goodwill of their protectors. In the end, rather than moving up in society, they became trapped in their own impotence.
Sadly, this may also be the effect of a health care entitlement. Once medical assistance is solely delegated to government bureaus, people may be less concerned with doing for themselves what only they can do.
Quality healthcare is not just a matter of going to the doctor. It also concerns how we eat, exercise and follow medical advice. This being the case, a lack of personal responsibility can be devastating. It can turn a benefit into a curse.
Were availability of physicians the only constituent of good health, the poor would currently be far better off than they are. Medicaid - which is already free - would have produced much better results than it has. No, what is also needed is the mindset to take advantage of opportunities. Ironically, personal responsibility tends to be undermined by an entitlement mentality.
Medical care can be expensive, hence there is no doubt some form of social insurance is necessary.
Nevertheless, to go from circumscribed assistance to an indefinite "right" is a huge step. This is a measure we may wish to rethink before endorsing ObamaCare's blank check.
If we do not, we may shortly be replaying the War on Poverty. And soon thereafter we may be contemplating the effects of national - and personal - bankruptcy.
Melvyn L. Fein. Ph.D., is a professor of Sociology at Kennesaw State University.
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