I’m pretty sure it’s all Bob Kerrey’s fault. When he ran for president in 1992, his slogan was something like “Healthcare Is A Right.” In other words, the original Nebraska narcissist was saying that government had the affirmative duty to provide healthcare for all of its citizens.

When the Clintons came to office, they acted on Kerrey’s popular rhetoric and attempted to socialize the 16% of the American economy that the healthcare sector represented. As has always been the case, the American public rejected socialism and the Clintons from that point forward hunted smaller game like midnight basketball, school uniforms and zaftig interns.

But the damage was done. Somehow a lot of Americans got the idea that someone owed them healthcare. Many thought it was their employer’s responsibility, although they could of course up and leave their employer for a competitor across the street if the new guy promised a small raise and a key to the executive washroom. Others thought the buck rested with the government. Regardless, too few Americans thought it was their own responsibility to do all that they reasonably could to see to their own healthcare needs.

TWO OF THE COUNTRY’S MOST prominent Republican governors have taken on the health care monster. One is current presidential candidate Mitt Romney, the other is the country’s funnest governor, Arnold Schwarzenegger. Their approaches could not be more different.

“Romneycare” is modeled on the premise that the ultimate responsibility for getting health care should rest with each individual citizen, just as it does with auto insurance. For those who can’t afford health insurance, the state will help. (Massachusetts has long since made it illegal for health insurance companies to not take people with pre-existing conditions, so that’s one consideration that Romney’s team didn’t have to deal with.) For those with the means to purchase health insurance but who decline to do so and thus become free-riders when a health crisis occurs, the state offers healthy “incentives” to get themselves into an insurance program. Okay, let’s be honest – if you’ve got the means to get insured, Romneycare will make it in your interest to do so.

Schwarzenegger, on the other hand, puts all of the responsibility on the Golden State’s employers. Employers have to provide health insurance. If they don’t, they get whacked. The individual citizen is thereby infantilized, treated as if he can’t tend to his own needs.

But it’s worse than that. The Schwarzenegger plan, by putting the onus on employers, suggests to the citizenry that there will be a free ride. “Great,” the plan’s proponents imagine a typical Californian thinking. “I won’t have to pay for health insurance and I’ll still get it anyway. Whoopee!”

This is the kind of thinking that could only come from people who have very little experience in the business world. Any encumbrance on the business class will drive businesses on the margin out of business. That means fewer jobs. It also means that California businesses that can conduct their affairs in a state that doesn’t insist they expensively swaddle their employees like helpless infants will choose to do so.

BOTH GOVERNORS ARE RIGHT in their tacit assumption that addressing the uninsured is a necessary first step towards reforming our health system. But Arnold’s plan will be a dreadful failure because it completely ignores the most fundamental flaw in the system – our entire health care industry has become completely estranged from free market principles over the last 50 years.

So how do you fix that? You evolve towards a system where the citizenry behaves as rational consumers rather than spoiled brats awaiting handouts. A healthy rational consumer wouldn’t insure himself against catching a bug and needing to plop down $200 for some Cipro anymore than he would take out an insurance policy on his barbecue.

That’s part of the beauty of Romneycare. Massachusetts residents can buy insurance policies that fit their needs. A healthy 24 year old doesn’t need and, rationally speaking, shouldn’t buy a $12,000/yr. comprehensive PPO from Blue Cross/Blue Shield unless he’s a hypochondriac who wants to indulge his pathologies. Assuming that’s not the case, he’ll opt for a barebones policy that covers just catastrophes.

There will be an auxiliary benefit to having a lot of 24 year olds out there with that kind of medical insurance: Ordinary, non-emergency but necessary healthcare will begin to develop a consumer market. The clinic that will treat a sprained ankle for $200 will do a better volume than the one that charges $800. As ordinary consumer incentives seep into the healthcare industry, there will be a salubrious downward pressure on prices.

ArnoldCare will provide just the opposite incentives to healthcare providers. Why will people care about how much the services they consume cost since, at the end of the day, their employer is picking up the tab?

The lynchpin of Arnold’s plan is that people will be so stupid that they’ll think their employers will be required to plunk out more for their healthcare and yet that new tax will have no effect on their salaries. Or potentially, their jobs themselves.

Are people that dumb? Is the American public so doggedly determined to not take any responsibility for its own health? Arnold thinks so. Romney thinks not. For all of our sakes, let’s hope Romney’s right.

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