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
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
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.