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Tuesday, April 5, 2016

Canada Won’t Take Some Immigrants with Disabled Children, because of Single Payer

Welfare, Nationalism, and the Nanny State

Over at the Daily Beast, Elizabeth Picciuto writes:

If Trump wins, we could always up and move to Canada. Right?

Well, maybe you can. My family can’t. At least, not if we want to bring my son. My son has Cri du Chat Syndrome, a genetic disorder with developmental and physical disabilities.

Canada, it turns out, has something of a habit of unwelcoming immigrant families with children with disabilities.

The rationale here is that admitting people with known genetic disorders tends to weigh down a society with a single-payer healthcare system:

David Baker, a Canadian disability rights lawyer … agrees that Canadian prospects are bleak for my family.

He says that according to Canadian law, preventing disabled children from entering the country is not considered discrimination. Rather, it’s a question of preventing excessive demand on resources.

That’s a fairly ad hoc definition of “discrimination,” is it not? Of course it’s discrimination whenever we treat two different groups differently. That’s just what the word means.

The question is, rather, whether the discrimination is justified. Perhaps it can be justified, though not necessarily, with reference to an increased demand on resources.

It remains for Canadians to decide what Canadians can afford, but it does somewhat beggar belief that that the Canadian system of single-payer healthcare will sink or swim on this particular margin. The ungenerosity is rather stunning, even for me, and I get called a crypto-plutocrat all the time.

On that note, I can’t help but observe that publicly provided healthcare makes people go funny in the head in all kinds of closely related ways. Admitting immigrants with genetic disorders seems of a kind with a host of other policies: Much like government controls on smoking and the mandating of motorcycle helmets, there is a horse sense to this policy that begins with single-payer healthcare and winds up in restrictions on individual behavior, in the name of taxpayer savings.

Perhaps, though, these are precipitous moves, unsupported by the actuarial math.

In the case of smoking, it’s a well-documented fact that seemingly bad behavior actually improves the government’s overall financial position: Grimly, what it loses in up-front healthcare costs, it recoups in long-term pension savings. The dead collect few pensions.

Still, the impulse to collectively police behavior seems to grow stronger in the presence of a collectively provided social safety net, regardless of how the math shakes out. I suspect that a disposition is being unleashed here that has nothing to do with numbers, and everything to do with symbolic affiliation and tribalism writ large. Single-payer to some degree makes us pennypinching, pound-foolish busybodies.

Such a disposition likely has more to do with our evolved monkey brains than it does with modern demographic measurements. Thousands of years ago, the reckoning of resources was simple, the groups were small, and the inputs and outputs of all economic activity were easy to understand. Another mouth to feed would have to justify itself if it were ever to be admitted to the tribe.

The instinct seems to have evolved to play it safe, and to reject people in all cases of doubt. From here we also get the closed-border policies that are weighing down the world economy to the tune of hundreds of billions of dollars, because the globalized economy just doesn’t work the same way as a band of hunter-gatherers.

Finally, and as much as I might be inclined to argue the contrary, this disposition is not obviously a sufficient argument against the public provision of a social safety net. It does however suggest that any such safety net must be designed with the likelihood of a tribalist failing in mind.

Safety nets cause us to circle the wagons, and to exclude both behaviors and people whom we might otherwise tolerate, or even welcome. They incline us, in short, to a kind of illiberalism.

Cross-posted from Ordinary Times.