Health Fascism on It's Way

Tibor R. Machan

Paul Krugman, Princeton economist and columnist for The New York Times, has no problem with coercing people to do what they'd rather not do. So it's no surprise that he favors the universal health case system advocated by Democratic presidential hopefuls Hilary Clinton and John Edwards. He is worried that under the more modestly coercive system advocated by Barack Obama, "healthy people could choose not to buy insurance--then sign up for it if they developed health problems later." Under this system, argues Professor Krugman, "People who did the right thing and bought insurance when they were healthy would end up subsidizing those who didn't sign up for insurance until or unless they needed medical care." The old free rider problem, nothing very novel at all.

Yet the problem arises only if there is coercion involved in the first place. If not, all those who buy insurance when they are doing well would know that some others would purchase it only once they suspected that they are getting sick. Knowing this, they could still carry on with their risk-aversive policy of buying insurance when they are quite healthy without worrying about whether others may later become free riders. Not everyone frets about free riders. It's a concern mostly of administrators of a system, such as those who manage a health care insurance business. They dedicate themselves to working out such problems, leaving clients to worry about other matters except now and then--for example, when they are shopping for insurance or for politicians who pretend to be able to solve all of our problems for us.

Now once you coerce everyone into a system, everyone is faced with the free rider issue, like it or not. No one is free to just stay out and, as a worst case scenario, fail to be insured when health problems arise. Such people could very well have laid cash aside for such circumstances, so they would quite justifiably not bother with insurance. They could be managing their money well enough to have plenty for health emergency situations. But if the likes of Krugman have their way with us all, they would not be allowed by the national health czars to take risks.

Krugman says that "The whole point of a universal health insurance system is that everyone pays in, even if they're currently healthy, and in return everyone has insurance coverage if and when they need it." Never mind that different folks may have different ideas as to how to go about managing their sickness and health. Never mind that many may choose to handle things in ways not approved of by Professor Krugman. Their choices don't matter, free country or not. What matters is that the utopian ideals, never successfully realized as a workable health care system anywhere in the world, at anytime in human history, be coercively implemented. Once again the imagined perfect becomes the enemy of the realistic good.

Let us not be like Professor Krugman and his cohorts. Let's refuse to believe the mirage of a one-size-fits-all, universal health care system for every American. In a free society the right approach to health care isn't some Platonic ideal but preserving the freedom for each person or family to identify and then shop for what they judge to be sound for them. And if some people refuse to, in a free society they need to live with the consequences. That's a choice free individuals may want to make, be it the right one for them or not.

In a free system there can be untold number of solutions to people's problems, including those they have with their health. Some might even prefer spending what they would under Krugram & Co. be compelled to spend on health insurance on, say, their children's or grand children's education or membership in an sport association or some other objective that they value above securing themselves against health emergencies. We all make such choices all the time, as we drive, travel by air, engage in sports, undertake business ventures and so forth. To insist that no such thing must be permitted when it comes to our management of our health care betrays the mentality of the dictator, the one who knows it all for everyone.

But then Professor Krugman and his pals in the American welfare statist, quasi-socialist movement have been blind to the issue of the evil of compelling people to act as they do not choose to act, so why would they do something else when it comes to health care? You might be able to teach new tricks to olod dogs but to stubborn old dogs very unlikely.