PrintJune 27, 2009
Socialized Healthcare is a Severe Threat to Individual Liberty
The doctrine of the safety net, to catch those who fall, has been made meaningless by the doctrine of fair shares for those of us who are quite able to stand. - The Economist
The Declaration of Independence grants every individual the inalienable right to "life, liberty, and the pursuit of happiness." According to the classic liberal definition, an "inalienable right" is something you have unless someone takes it away from you. It is easy to understand that if someone physically harms you or steals from you then they are infringing upon your rights. Therefore, to secure these rights the framers designed a government with the purpose of protecting people and their property.
Nowhere in our founding documents does the provision for government-funded healthcare appear -- mainly because one individual's health cannot be taken away by another. (In cases where it can be, individuals are entitled to remuneration through the law.) This piece will address the common liberal argument in support of socialized healthcare and explain why socialized healthcare represents a severe infringement on the individual rights our founding documents were established to protect.
Nowhere in our founding documents does the provision for government-funded healthcare appear -- mainly because one individual's health cannot be taken away by another. (In cases where it can be, individuals are entitled to remuneration through the law.) This piece will address the common liberal argument in support of socialized healthcare and explain why socialized healthcare represents a severe infringement on the individual rights our founding documents were established to protect.
What if someone argues, "There are some things in life that capitalism should not be allowed to structure for profit. Human life and quality of life are two such things. How can you look someone in the eye and tell them that their bank account dictates that they aren't worth helping?" This argument is severely flawed. One, it assumes that if you are against socialized healthcare then you are against the concept of a safety net; two, it ignores the fact that healthcare is already provided to those threatened by poverty and old age; and three, it fails to recognize that the amount of healthcare a person consumes over the course of a lifetime is significantly correlated with how much responsibility they take for their own health.
In a recent WSJ Editorial Steven Burd, founder of the Coalition to Advance Healthcare Reform, stated that 70% of all healthcare costs are the direct result of behavior. How can a government pretend that it can determine the correct level of taxation and healthcare appropriation that will be fair to every individual based on their behavior? Quite simply, it can't. What the government can do is determine the average amount of spending for an individual of a given age and then determine the amount of taxation necessary to keep the system solvent. On top of this, it can increase taxation on the younger/healthier to lessen the burden on the older/sicker and ration medical care to instances where the state finds it appropriate.
Regarding shifting costs to younger/healthier patients: Isn't this what private insurers do when they pool risk for large companies? Yes, however, an individual can opt out of this risk pool and purchase insurance coverage that may be more tailored to their needs that will ultimately cost them less - sometimes much less. Low premium, high deductible healthcare plans are structured to cover individuals in catastrophic circumstances. By not paying completely or sharing in the cost of routine healthcare consumption these plans are structured like a "fee for service" model and are able to maintain affordable premiums and reward healthy behavior whereas a government run healthcare system cannot.
Let us consider two hypothetical characters under a socialized healthcare system: Jack and Sam who are both construction workers. Jack eats an unhealthy diet, does not exercise, smokes a pack of cigarettes a day, and drinks 3-4 beers 4 or 5 nights a week. Sam eats a healthy diet, exercises 5 days a week, does not smoke, and drinks alcohol on social occasions. It is pretty obvious that over the course of a lifetime, unless Jack has incredibly good genetics, that he will consume more healthcare than Sam; however, they will have paid about the same amount in taxes - does this seem fair to Sam? The answer is obvious but the exercise is necessary to prove the point that healthcare consumption is tied to personal behavior and therefore, a government cannot determine the level of individual taxation fairly.
To take this example further, let us assume Jack is on 6 medications to treat diabetes, heart disease, and high blood pressure and Sam is on no medications. Jack will be on these medications for life and in all likelihood will require more as time goes on. Jack will also require multiple hospitalizations when these chronic conditions are exacerbated. When Sam is 65 he sprains his knee chasing his grandkids. While the damage won't kill him, he's upset he can't do the activities he enjoys anymore and would likely benefit from an elective orthopedic procedure. Unfortunately, Sam's procedure is not considered medically necessary and therefore denied. Sam has not only paid the same as Jack over the course of his lifetime and consumed much less medical care but when a medical need arises it gets denied - does this seem fair to Sam? Again, the answer is obvious but proves the point that the government cannot allocate resources fairly.
This hypothetical example demonstrates two serious infringements on individual liberty that happen on a regular basis where socialized medicine exists. The money that Sam could have saved on taxes represents real lost-opportunity costs to Sam - he could have used it to invest in starting his own business, buy a bass boat, go on a few extra vacations, donate to charity, put it in a medical savings account to pay for his knee operation, or a million other possibilities of his own choosing. In addition to lost opportunity, when Sam actually could have used coverage, he was denied and had no choice in the matter.
To be clear, the plan Obama and the Democrats are offering is not a complete socialization of our healthcare system but it might as well be. A broad-based tax increase will be necessary to pay for the new public "option" (that private insurers won't be able to compete against). While this public option may benefit some it will come at the expense of others and therefore be fraught with all the same threats to individual liberty that socialized medicine has to offer.
Over the previous weeks and months, there have been many excellent reports detailing why the Administration's healthcare plan will increase total government spending on healthcare without improving overall healthcare outcomes. Unfortunately, this information alone is not enough. In Radicals for Capitalism Brian Doherty stated Ayn Rand's belief that, "people don't care if something doesn't work as long as the dominant morality of altruism tells them that it is right." For opponents of government-run healthcare to succeed they must not only convince the public that the Administration's plan will fail to deliver on its promises but also explain how the plan will severely infringe on individual liberty, which the government of this country was designed to protect.
