[I originally published this essay in December of last year, before I started blogging for PJM. I was planning to write a new last-minute plea for sanity as we approach the zero hour for the health care vote in Congress — but I inevitably ended up just re-phrasing the ideas contained in my original essay. So rather than repeat myself, I present below a reprise of what many have said is the one and only essay you’ll ever need to read about universal health care.]
Zombie’s argument basically boils down to this: a nontrivial percentage of healthcare expenses are due to unhealthy diet, self-intoxication (tobacco, alcohol, illicit drugs,…), high-risk behavior (DUI, dangerous sports, unprotected and/or promiscuous sex,…), cultural habits (deep suntanning, first-cousin marriages,…), and the like. All else being equal, a social libertarian would say “live and let live”. But once we get to foot the bill for fixing the damage wrought by somebody else’s irresponsible behavior, this will turn all of us into the type of nannies every social libertarian loathes. “Freedom to do your own thing” or “protecting you against yourself”: pick one.
The question is not whether Zombie envisages a libertarian utopia. (S)he doesn’t. A person who, through no fault of their own, ends up with crushing medical expenses (accident, genetics dealing a bad hand, or just sheer bad luck) is still dependent on the mercy of strangers, and (s)he realizes that as well as any. (S)he merely argues that the ‘solution’ for this problem will involve a price American society is unable and unwilling to pay — not so much in money as in freedom.