"It profits me but little that a vigilant authority always protects the tranquillity of my pleasures and constantly averts all dangers from my path, without my care or concern, if this same authority is the absolute master of my liberty and my life."

--Alexis de Tocqueville, Democracy in America

Friday, June 29, 2012

Responsibility and the Individual Mandate

The level of vitriole from some on the right aimed at John Roberts for the decision on the individual mandate is interesting.   One thing that bothers me though is the degree to which some conservatives have elevated the right not to buy health insurance to something almost sacred.   How dare the federal government require me under threat of a penalty to buy health insurance?   I should have the right not to have health insurance if I want to!

Well, of course, you have that right, and ought to have that right, and the federal government shouldn't be able to take away that right.   But let's not forget that it's a right to be extraordinarily stupid and irresponsible and selfish.   There's a word for adults who "choose" not to purchase insurance and then expect the rest of us to pick of the tab when they show up at the emergency room.   The word is... assholes.

To me the most effective mandate would be this... instead of penalizing people with a modest financial penalty if they don't have insurance, how about we just refuse to give them medical treatment if they can't pay for it?   If you don't have fire insurance and your house burns down, you're out of luck.   If you don't have flood insurance living next to the Mississippi, sometimes we do bail you out, but we shouldn't.   If you don't have life insurance when you die, your wife and children are probably going to be screwed.   So why should you be able to get away with spending health insurance money -- for the Regular Guy, it's about $23,000 a year for his family -- on cars and computers and vacations and crack cocaine for all I know, and still be able to get world-class health care if you get cancer, and all of it on my nickel?

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Oh, and by the way, the talk of the "right" not to buy health insurance on the right reminds me a good deal of the talk of the "right" to an abortion on the left.   They are both "rights" to do something that is extraordinarily mean, selfish, irresponsible and stupid.   You can argue that people ought to have that right without acting like it's a good thing that they exercise it.

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In other words, the following are not mutually exclusive positions:

1. Roberts arguably got it right as a matter of constitutional law.  
2. Obama and the Democrats got it very, very wrong as a matter of public policy.
3. Although the federal government has the power under the constitution to tax individuals to coerce them into preferred behaviors (not smoking, not using gasoline, not going without health insurance), it's a power the government ought not to have and ought to use only very sparingly.
4. Just because the federal government ought not to be able to tell you to buy health insurance doesn't mean that you're not a jerk for going without it.

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