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Will universal health care erode our freedom?

by Greg Krehbiel on 15 July 2009

After reading an article Gordon sent along — Universal Health Care Isn’t Worth Our Freedom — the following thoughts ….

Would you want to pay the life insurance policy on someone who smokes, sky dives, races formula cars and frequents houses of ill repute?

If you don’t do those things, would you want your life insurance premium to include the costs of insuring that guy?

Is there something analogous re: health insurance?

Let’s say, for the sake of argument, that we’d all like to distribute the costs of truly random health problems, like breast cancer and leukemia.

What about diseases people get from their own stupidity? Do you want to pay for that?

If we move toward a system where everybody pays for everybody else’s health care, what incentive do people have to stay healthy?

I used to live in a neighborhood where we had a common water meter and split the cost by household. Nobody had any incentive to fix their leaky faucet or running toilet because everybody else paid for the waste.

Universal health care will lead to one of two things. Either people will lose some of the incentive to stay healthy, because everybody else has to pay for the cost, or the government will become even more of a nanny state and will start monitoring our exercise and Twinkie intake. (Remember how the government monitored daily exercise in 1984?)

2009-07-15  »  Greg Krehbiel

Talkback x 4

  1. pentamom
    15 July 2009 @ 2:21 pm

    The problem is, there are no diseases that are solely the result of stupidity. Cirrhosis of the liver comes close, but even that can be occasionally caused by weird stuff. My mom never smoked once in her life, and has terminal lung cancer. People’s hearts give out because they had the wrong father. So even now, there is really no bright line distinction between behaviorally caused health problems, and “truly random” ones. Yes, the behaviors can be distinguished, but not the things that can be treated. Denying treatment for diabetes because it’s frequently behaviorally-induced also affects people who just happened to pick the wrong parents, and thereby eliminates the perceived pressure of uninsurability — what’s the insurability incentive to eat healthy and exercise if I avoid heart disease and lung cancer and get diabetes anyway, which insurance won’t cover either?

    So it seems to me that while there is a slight effect in the direction you speak of, having insurance for medical problems at all (which 90% of people eventually will have) means you’re already going to have to pay for treatment for things that could have been avoided. Even now, who’s going to join a private group that won’t pay for lung cancer treatment, thinking that at least that way they’ll be saving the cost of treating smokers, unless they’re stupid enough to think that only smokers get lung cancer, which is really, really stupid? The only way to remove the risk of paying for stupidity-related diseases is to join insurance plans which effectively monitor and enforce behavior, which don’t exist now. You might be right that Gov-care would attempt to do this, but that would be the real difference — having to pay for people’s stupidity is already part of the deal, any way you slice it.

  2. Clint
    16 July 2009 @ 4:34 pm

    “Let’s say, for the sake of argument, that we’d all like to distribute the costs of truly random health problems, like breast cancer and leukemia.

    What about diseases people get from their own stupidity? Do you want to pay for that?

    If we move toward a system where everybody pays for everybody else’s health care, what incentive do people have to stay healthy? ”

    I don’t want to pay for it, but I’m willing to because I’d rather see an ill person get treated than deny him treatment or indebt him for several years to come.

    I think universal health care would, first of all, prevent a lot of these diseases by allowing regular check-ups (more patient-doctor interactions should allow the average person to make better choices about their own health).

    I wrote a short essay critiquing Sasz, if you’re interested.

  3. Greg Krehbiel Greg Krehbiel
    16 July 2009 @ 4:49 pm

    Part of the problem with discussing health care is that it gets mixed up with charity.

    I agree with you that I want sick people to be treated. I also want them to have safe cars, clean teeth and so on, but resources are finite and have to be rationed. The problem is that we don’t want to ration health care. We want to treat it as an inexaustible resource that we can dole out with good intentions.

    You may be right that universal health care could actually lower costs through prevention. That’s entirely possible. If we could get people to go to the clinic rather than the emergency room, that would help lower costs.

  4. Gurdur
    31 March 2010 @ 2:38 am

    Except there are many different aspects of freedom. The examples quoted in the above blog post are mostly trivial ones, ones that in practice cost the nation’s tax-payers very little; and the blog post does not tackle just why the USA’s health system costs its tax-payers double what say Sweden’s health system costs its own tax-payers — yet the Swedes get far more bang for their buck.

    Also, please see my own blog post here for an example of how universal healthcare can increase freedom.