Erin Wengrovius

There are at least a hundred good arguments against socialized medicine.

For one, it’s expensive. Hillary Clinton’s plan comes with a price tag of $110 billion a year at a time when Social Security teeters on insolvency and the national debt is over $9.4 trillion.

Then there’s the issue of incentives—it destroys them. Patients have no economic reason to seek out healthcare that is anything less than the absolute best available, expenses be damned. For that matter, patients have no incentive not to consume as much healthcare as they possibly can, no matter what they truly need. Doctor’s no longer have an incentive to offer superior services at competitive prices; the government will pay them regardless of their skill level.

There’s the notion that increased access necessarily comes with increased prices or decreased quality—Kling’s Iron Trilemma.

Finally, there’s the concern that if we can’t trust the government with the war in Iraq, Hurricane Katrina, it’s own fiscal responsibility, education, the war on drugs, welfare, and the environment, why, exactly, would we trust them to provide proper healthcare for over 300 million citizens?

But none of these things necessarily concern me. Increased prices, gross inefficiency, longer wait times, leviathan bureaucracy; they all pale in comparison to what I believe is the larger problem, the truly troubling long term prospect of socialized medicine. There was a time in our nation’s history when one’s health was a private concern. It had to do with freedom and it had to do with responsibility. A citizen was free to live his or her life as he pleased with the understanding that he, ultimately, would have to face the consequences of his actions. Want to eat a diet consisting solely of Twinkies and McDonald’s? Interested in smoking two packs of cigarettes a day? Exercise not really your thing? Fancy taking up the street luge? Fine. It’s your life. It’s your body. But the implicit understanding was that, at the end of the day, you would reap the benefits or bear the costs of your actions.

Socialized medicine changes that dynamic. To be clear, neither Clinton nor Barack Obama are proposing full-on socialized medicine. But they set the stage for a shift wherein an individual’s health moves from what was once a private concern to one now completely public. No longer do you exclusively bear the costs for your actions.

All Americans, through taxation, foot the bill for your behaviors. What you do, the status of your health, and how you take care of yourself are now all legitimate interests of society and, even more so, legitimate interests of the government. Here, the true costs of “free” universal health care become clear. Forfeit your responsibility to pay and you subsequently forfeit your freedom as well. As the federal government tries to limit expenses, it only makes sense that they’ll also try to limit those behaviors that result in high costs downstream.

The arguments will be straightforward and invasive. “Why allow citizens to engage in high-risk behaviors when it only increases the tax burden?” “If we limit the amount of junk food in vending machines, we can reduce health care expenditures by $2 billion.” “What gives you the right to smoke when I, ultimately, will have to pay for the results?” To be sure, we’ve already seen encroachments of government in this area. New York State has outlawed smoking in most public spaces. New York City has banned trans fat from food served in restaurants. Socialized health care only accelerates these encroachments and provides a new and compelling justification for regulation.

Ever since “no taxation without representation,” who has to pay and who has a say have been, appropriately, intimately linked. Socialized medicine, however, opens up a Pandora’s box concerning legitimate interest in an individual’s health and behavior. Increased prices, gross inefficiency, longer wait times, leviathan bureaucracy; these don’t concern me. What does concern me is the perfectly justifiable regulation—the shift to the public purview of what was once only private—socialized health care invites and may even require.