Wednesday, September 05, 2007

No free health care

So what do proponents of government health care think of John Edwards' proposal for mandatory doctor visits and diagnostic tests? Isn't there a certain logic to this? If health care costs are going to be collectivized, then don't the rest of us have the right to demand that you behave in a way that does not waste our money? If I am to be my brother's keeper, then don't I also become his master?

Why would these mandates be limited to things like annual check-ups and mammograms? Why wouldn't I also want to insist that you stop smoking on my dime? Lose weight?Stop having unprotected (or promiscuous) sex? Limit your drinking?

It reminds me a bit of Ann Coulter's response to Libertarians who wanted her to endorse the legalization of drugs in return for the party's nomination for Congress. She said that she would do so as soon as she was no longer required to pay for the social costs of drug use.

We hear that they don't do these things in other single-payer systems and that may be so. But they do place a collective cap on health care costs and then ration care in a way that makes HMOs look warm and fuzzy. I keep hearing that we aren't going to do that. In any event, we see employers increasingly concerned with the personal behaviors of their employees and a major presidential contender proposes that we start down that road.

If you believe in collective responsibility for the cost of health care, what are the principles limiting collective judgments about behavior that affects the cost of care? Do we draw a clear line and say that people can do whatever they want to themselves? Is it really possible to maintain that position?

6 comments:

John clinton said...

Great Blog....You can also give your valuable answer in Health Questions.

JesusIsJustAlrightWithMe said...

"Why wouldn't I also want to insist that you stop smoking on my dime?"

Health care costs for smokers are lower than for non-smokers because they die before they get old.

"It reminds me a bit of Ann Coulter's response to Libertarians who wanted her to endorse the legalization of drugs in return for the party's nomination for Congress."

Coulter's position here is very libertarian. It's odd that you would say it was a response to Libertarians.

Rick Esenberg said...

They wanted her to come out for the legalization of drugs. She would not and this was her reason.

JesusIsJustAlrightWithMe said...

No libertarian that I've ever met believes we should be required to pay for the social costs of drug use.

Rick Esenberg said...

Right, but her point was that, since I do today, I'm not going to advocate legalizing drugs.

Libertarian Girl said...

I agree that if health care is collectivized, we all have a reason to monitor our neighbor's health. The UK does this; they recently hired people to go around and give stop smoking lectures to those smoking in public.

As far as Ann Coulter's comment, it's a good one. Of course almmost any libertarian is going to think that Medicare brings down the level of healthcare in this country and would be in favor of getting rid of it. Whether it should be gotten rid of before drugs are legalized, I don't know. First of all, we're paying much more per year to incarcerate people for non-violent drug crimes than we are for drug addicts' treatment. Secondly, the huge argument for drug legalization is that it would lower rates of drug addicts and decrease a lot of those social costs-- crime mostly, but also chronic homelessness and other ravages of drugs on society. Our police officers are mostly drug officers who solve drug crimes and arrest those involved with drugs; imagine how many murders, rapes, and violent crimes could be solved if their time was freed up and the immeasurable returns to society it would cause.

People now try these drugs because they're forbidden fruit, and the drug sold in whatever form has to be jam-packed with the drug in question because it's illegal to buy it and those buying and selling have to lower their risk. With legal drugs, less of the drug in each dose would mean less addiction and much fewer overdoses-- and we certainly pay for those now in emergency rooms.

There's also that $20 billion or so we spray over Colombia every year, and I don't know how many billions fighting poppies in Afghanistan. That could buy a lot of health care over here.

So there are a lot of counter-arguments to Ann Coulter's idea (as there usually are with her ideas).