Thursday, January 5, 2012

The Real World: The Health Insurance Mandate

It has been said by Mitt Romney that a Health Insurance Mandate is a conservative idea.  His supporters tend to back him up on this and, while I haven't been able to speak to Mr. Romney directly ('cause he even knows who I am, or something), most of his supporters suggest that it is a conservative idea because it requires everyone to be responsible.

This false idea rests on three false premises: First, that health care is a right, second that increased purchase of health insurance will reduce the costs of health care, and third that someone can be forced to be responsible.  I will consider these three premises in reverse order.

Simple Truth (yes, look for this in a ST post at some point): Responsibility cannot be forced or mandated.  I can force my children to put some of any money they earn into a savings account.  That doesn't make them "responsible" for having done so.  I can force my children to clean their rooms, that doesn't make them responsible for having done so.  Indeed, responsibility only exists when an option for irresponsible behavior exists.  We call that existence of an irresponsible option "Liberty," and it is generally to be desired.  Further, someone "forced" to do something "responsible" does not, as a rule, have the actual temperament or character that makes them responsible.  Simply purchasing health insurance will not make them significantly less of a drain on the medical system.  At best (and empirically, this has proven false in Massachusetts) it helps prevent meteoric rises in health care costs, because everyone "has skin in the game."

Health care costs and health insurance are linked in myriad ways, and attempting to decipher all of them is far beyond the scope of this blog, let alone a single post.  However, one thing I can say with surity: providing more people broader cost-deferment for health care will only increase the demand for that health care.  Given the relatively fixed supply of care, due to various regulatory issues, barrier to entry, and so forth, that will always force the price of healthcare hire.  At best, forcing everyone to be insured simply means that everyone bears a slightly more "equal" burden of the cost of care.  But, to be sure, someone is paying that cost- either through higher premiums, higher prices in general, or through reduced access to, and quality of, care.

Finally: Simple Truth (yep, I'll be doing this one, too): You have no right to what someone else must provide.  I'll say that again because it is so important: you have no right to what someone else must provide.  Whether its a house, a car, a job, health insurance, health care, a hot-air balloon, or a cup of coffee, if someone else had to provide it for you, you have no right to it.  This gets to the heart of the matter.  For decades, at least, we have  premise that Healthcare is a right.  We have accepted that all people, regardless of circumstance, can demand healthcare.

It is easy to see how this premise arose: medical professionals themselves are notoriously generous in the face of suffering and sickness, and Western Civilization, especially with its Christian-influenced values, is just as generous, as a whole.  We ache in sympathy for those who are ill.  Just the term "the uninsured," conjures images of poverty stricken families living in hovels, dying for lack of care.

For all that it is easy to understand how we came to believe this, that doesn't make it any less wrong.  What "right"to Medical care does a lone man in the forest have when a tree has fallen on him?  Certainly he desires care.  Certainly if someone knows and can get to him on time he will receive care.  If he cannot provide it himself, then his situation does not just mean some doctor magically appears to save him.

It is this premise that we must fight, and we must be ready for the hyperbolic and emotional black-mail tactics of the Liberals.  The fact we wish to provide everyone with care does not mean that anyone has a right to it.  And the simple fact is there will always be more demand for healthcare than there will be a supply of it.  How do we distribute that supply?  The liberal way- of health insurance mandates, insurance coverage mandates, and, ultimately, socialized healthcare- will lead, as it always has, to the same "equality of misery" that any other form of Socialism does.  It is only the Capitalist, Conservative method of distributing based on prices and the market that will ensure the highest quality of care gets to the most people. 

And don't be afraid of that method of distribution.  It will do what it promises: the best care will get to the most people.  And few, if any, will have to do with no care.  Doctors and the American People will remain as generous as they ever were: they will assist those who need assistance.  By removing the Government Leviathan from the equation, they'll be able to assist more people, and fewer will need the assistance.


  1. I have been without medical insurance for 8 years. During this time I have only needed care once and I was lucky it was only for a broken arm. I paid as I went and received a 30% discount at each and every stop along the way.
    Granted, I did not opt for the surgical procedure that the Ortho wanted ( this made him angry for some reason) but I wouldn't go into debt willingly.
    One problem that speaks directly to your argument is the number of people who urged me to go whole hog and blow off the resulting bills. I must have heard the phrase "Everyone does it" a dozen times.
    Also, I notice that you didn't address the illegal health care issue at all. It sure makes it harder to argue for personal responsibility when lawbreakers receive better care than citizens. And free at that.

  2. I don't address it directly, no. That's because this post wasn't a full "health care omnibus" post. The way to address it is alluded to, however- if Health Care is not a "Right" then Doctors and Hospitals should not be required to provide care "regardless of ability to pay." One of the very first things that would stop is illegal immigrants using the ER like their Primary Care Physician. And, as I mention, the doctors and hospitals themselves will still be as giving as ever- it'll just be their choice, and not some government mandate.