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Wednesday, January 27, 2010

Can We Have “Universal” Medical Care Without Coercion?

"Good government" isn't so good.

The recent loss of what supposedly was a “secure” U.S. Senate seat by Democrats in Massachusetts has triggered a firestorm of speculation about the future of the Democrats’ “health care” bill. For the current legislative season, so-called ObamaCare looks to be dead or at least dormant.

“Politically dead” is a temporal term, however, and there is no doubt that President Obama and his congressional allies are going to formulate an alternative strategy and then try once again to ram “universal care” through the legislative process. In this piece, I don’t deal with the politics of universal care, but rather with the larger collectivist and coercive reasoning that accompanies its implementation.

Ever since the Progressive Era, Americans have been told that there is a difference between “good government” and “bad government.” “Good government” provides all sorts of services that poor people cannot afford, such as medical care, transportation, housing, education, and even food. (“Bad government” arrests, imprisons, and generally acts like an occupier.)

Obviously, “universal care” falls under the “good government” label, and when conservatives or libertarians complain about “government on our backs,” the “Progressives” are quick to reply that government “gives” us all sorts of goodies that we never would have unless there were intervention by the State. While this sounds good, I remind readers that government provides nothing without coercion, so when someone speaks of “good government,” that person really is claiming there is “good coercion.”

What comprises “good coercion”? It is the application of force that supposedly serves a “greater public good,” the “greater good” being medical insurance for those who did not have insurance before. Clearly, a philosophical issue is before us. Should government force someone not only to pay for health insurance for someone else (through taxation), but also to purchase a government-approved health insurance policy for himself?

Advocates of such coercive measures are quick to accuse private enterprise of being “exploitative and oppressive.” (Listen to a speech by Ralph Nader or read the latest issue of The Nation or the editorial page of the New York Times.) Something does not quite make sense, however.

No one has forced me to purchase the vast amount of things that I own and use. Instead, I choose to purchase them, and that includes health insurance. (I would prefer that the health system not be dominated at all by third-party payments, so I could purchase insurance for potential catastrophic events, but nonetheless I do purchase my insurance voluntarily.)

Contrast what I just have described to the purchase of government-produced goods. As a taxpayer I am forced to pay (on pain of arrest and imprisonment) for products that other people use, from roads (which, at least, I use myself), public schools, Social Security and Medicare, and, of course, “national defense.” It does not matter if I wish to use those products or support them; I have no choice but to help pay for them.

Thus it is with “universal” medical care. The plan is for the government to force everyone to purchase an “insurance plan” and pay for others to purchase such plans as well. No one is permitted to opt out (unless one is part of an old-order Amish sect).

Proponents of such a policy claim that unless everyone is forced to participate, the system will not provide “equal care,” and therein is the lynchpin of the whole system. From taxation of “Cadillac” plans to forcing everyone, regardless of health, to purchase policies, the government is attempting to enforce an egalitarianism that is in the best interests of no one but the political classes.

There is no way that the plan can make everyone better off. Instead, like so many other tax-and-spend schemes, it seeks to make some people better off by making a lot of other people worse off, and such a plan can be put into place only with brute force. It is a truism in economics that people won’t deliberately and knowingly make themselves worse off. The political classes know it, and perhaps maybe others are beginning to understand.

  • Dr. William Anderson is Professor of Economics at Frostburg State University. He holds a Ph.D in Economics from Auburn University. He is a member of the FEE Faculty Network.