Circulating on Facebook today as a veritable "Internet Meme" is what seems to be a sort of credo in unum deum for supporters of a broadly leftist agenda for health care reform. (Let's get something straight right now: Virtually nobody is "anti-reform"; most opponents of the "public option" plan support fixing the market.) As follows:
No one should die because they cannot afford health care, and no one should go broke because they get sick. If you agree, please post this as your status for the rest of the day.
This sounds nice, but let's think about it for a moment.
- "No one should die because they cannot afford health care" ("one...they" is grating to the eyes, but that's not the trouble.) The trouble is that this is unattainable unless we go down really nasty paths. There are a few ways to interpret this statement.
One is as an expression of dissatisfaction with living in a world of finite abundance. Our grandparents are older than molecular biology. Things are getting better and less expensive, but we would always wish them to be better still. This doesn't have any policy implications for health care reform aside from preventing government from thwarting progress by breaking the mechanisms which drive it. It's more of a pro-market than an anti-market sentiment.
The other way to interpret it is as a call for market abolitionism. I'm not saying that the people posting this this are old-time socialists. It's more slouching toward market abolitionism. Everyone should be entitled to all lifesaving treatments. There should be no way of obtaining lifesaving treatment by paying, because that means that some will go without lifesaving treatment because they cannot pay. This entails a ban on paying for new and better care. Rationing, in other words.
And don't be so glib to say "but insurance companies ration already." They don't. An insurance company cannot forbid one from paying for treatment. (I support very drastic insurance reform, which would have us shopping around for policies with less uncertainty in what is covered, but that's neither here nor there. I say it because some jerk will say something stupid, nasty, and bizarre if I do not. Times are strange and ideology clouds minds!)
If you do not support a ban on paying for care, you should not have posted this statement. - "No one should go broke because they get sick." "Fewer people should go broke because they get sick" is something I could sign on to. Get rid of every silly mandate that makes it difficult to purchase cheap health insurance. Mandatory purchase of insurance is something I'm ambivalent about. On the one hand, if someone chooses to not purchase something and assume risk himself, that should be taken seriously. On the other hand, Americans are not going to let people go without basic treatment even if they chose to not hedge against risk, so mandatory purchase may be better than free riders.
But here's something to consider: What if I get sick and I choose to go broke to purchase the newest, best treatment? Should I be forbid from doing that? Should the State step in and subsidize my choice, transferring from others to me to support a luxury?
The lesson? Think hard before making statements about "no one". More often than not they are far too strong and have you committed to things you probably don't support.
My posted response:
No one should die because redistributionism prevented development of care that could have saved his life. Nobody should go without treatment due to rationing intended to prevent bankruptcy of a government monopsony. Nobody should go bankrupt becaus...e the government prevented purchase of affordable insurance. If you understand this--even if you disagree--you are approaching health care reform intelligently.
Not as catchy, but at least one other person picked up on it.
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