Thursday, July 14, 2005

An argument against national healthcare

Many people my age, and of all ages, are enamored with the idea of socialized medicine (although they would rarely call it that.) “Everyone should have healthcare,” the refrain goes, “it’s a human right.” It seems at first, without delving into dull talk of economics and supply and demand, that arguments against universal health coverage are hard to make. Those that do make them are caricatured as hard-hearted, greedy opponents of the poor. As a result of this difficulty in arguing against socialized healthcare schemes, I am always on the lookout for simple, elegant arguments that drive home the threat posed by those that would put into the hands of the state the control of something as personal as a person’s health.

NY Time's Paul Krugman (hat-tip to the always insightful Café Hayek) recently provided one such elegant argument against socialized healthcare (although being a closet-socialist, this surely wasn’t his intention). In this column, Krugman is incensed that people are free to choose what they want to eat, even if this might make them fat. Searching for a legitimate way to restrict the freedom of people to choose what they eat, he writes:

How can medical experts who see obesity as a critical problem deal with an ideological landscape tilted in the direction of doing nothing?

One answer is to focus on the financial costs of obesity, and the fact that many of these costs fall on taxpayers and on the general insurance-buying public, rather than on the obese individuals themselves. […] [Emphasis added]

It is more important, however, to emphasize that there are situations in which "free to choose" is all wrong - and that this is one of them.

At least Krugman is forthright in his dislike of freedom (actually, that’s not exactly a fair characterization of Krugman—Krugman is just fine with freedom, as long as people choose exactly what he wants them to choose). But the appeal that Krugman makes here, in the bolded portion, to the fact that everyone will have to shoulder the financial burden of other people’s lifestyles, takes an amazing amount of chutzpah coming as it does from Krugman, an advocate of just-such schemes to make me pay for other’s health problems. First Krugman says we should have a national healthcare scheme; then, he complains that because this scheme would make us pay for other people's lifestyle mistakes, we must curtail those aspects of their lifestyle which would cost us.

With a truly national healthcare system, cries—like Krugman’s here—to restrict or tax people’s choices of food would increase in number and seeming desirability. But rather than nationalized healthcare being, as Krugman sees it, a reason for restricting food choices, it is actually the aforementioned elegant argument against socialized medicine.

With a national healthcare system, your previously private medical care becomes my business—I’m helping pay for it, so I have a vested interest in what goes in and out of your body, and how you treat yourself. National healthcare would, probably inevitably, lead to increased restrictions on our freedom (and not just the inherent restriction on our freedom of choice of healthcare that national healthcare would itself represent). If I have to pay for Joe Blow’s heart medication and diabetes treatment, then I’m gonna want laws passed preventing him from eating certain foods.

This would itself be a horrible infringement on freedom, although some would welcome it, like Krugman. But this logic extends in directions food-Nazi’s probably wouldn’t, or at least hopefully wouldn’t, agree with. For example, if certain foods increase the cost of healthcare, and this is a legitimate pretext for banning or heavily taxing them, then why not other behaviors? Medication for AIDS is incredibly expensive, and those that contract AIDS usually do so through homosexual, or promiscuously sexual, acts. So we should prohibit these then, as well, right?

National healthcare is bad for many reasons, one being, as stated above, that it would lead to further restrictions on freedom. When other people are made to care about my state of health, don’t be surprised when they begin dictating how I am able to treat myself. That “liberals” would advocate such a measure antithetical to “liberty” is appalling, but, sadly, not surprising in the least.

The recent controversy surrounding Teri Schiavo also highlights this trouble with a nationalized healthcare scheme. Imagine the reaction from, not only conservative Christians, but also libertarians and the so-called "South Park Conservatives" if the decision to end Teri's life wasn't made by her husband, but was rather made by the government, against the wishes of both her parents AND her husband. But these are the sort of things that would happen if my health becomes a concern of the state.


Also, as a quick note here, another thought occurred to me about national healthcare systems, although I am not sure of the validity of it. Surely such a system would require a centralized database of healthcare records? And, surely, such a system would lead to huge infringements on our right to privacy in matters concerning our own health.

It would be interesting to know if countries that do have a national healthcare system (i.e. Canada) have troubles with privacy of medical records. But, while this would seem logical and expected, I add this only as a quick note, because I truly do not know. If anyone out there does, I would be interested in hearing it.


Anonymous Blue Cross of California said...

I think national health care would be a great aspect to our health care system and help many receive more coverage.

12:29 AM  
Blogger Grant said...

Sure. I mean, if you don't care about freedom. Which, no one said you had to, I guess.

12:38 AM  

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