What Healthcare Is Like
R.R. Reno makes a fair point that our pre-Obamacare healthcare system ultimately created “an ad hoc mechanism for extracting payments from the insured to finance a haphazard effort to provide at least emergency and critical care for the uninsured as well as decent care for the underinsured.”
Seeing this as socialization, Reno argues that something like the individual mandate is preferable, to explicitly provide general care (cheaper than emergency) to the uninsured and those with preexisting conditions. I’m not so sure, first of all, that forcing the involvement of young adults and others who opt not to insure themselves — effectively looking to one segment of the “uninsured” to pay for another — will make for an even swap.
More to the point, though, I don’t think avoiding the excesses is possible when government gets involved. We’re sure to find, for example, that those young adults will be permitted onto their parents’ plans at ever older ages. We’re also sure to see mandatory coverage expanding, redistributing wealth from the healthy to the ill (and those who treat and advocate for the ill). Given Reno’s reliance on “political realities” for his argument, that he doesn’t anticipate this response and address it in greater detail suggests that some of his premises require reconsideration, such as:
Think about getting hepatitis or breast cancer. The risk of suffering from these misfortunes is similar to the risk of being mugged or shot. It’s a life-and-death matter, and if human government has any justification for its power over citizens, then surely it rests in its unique capacity to pool resources to protect life. As Albert Camus recognized, one moral source for solidarity can be found in our common struggle against the dehumanizing power of suffering and untimely death.
In circumstances of interpersonal violence, government is arbitrating between people. That’s not the same as arbitrating between a person and a virus or cancer. That government can exert force to stop individuals from doing the same in an acute act of assault does not mean that it’s appropriate for government to step in as a life manager.