Why Universal Health Care Is Consistent with Minimal Government
I'm sensitive to arguments that government should be small; that it should protect individual freedoms rather than supporting institutions; that the best policy is often for governments to remain uninvolved unless they're protecting their constituency from outside forces (and not from ourselves). I'm especially sympathetic to this notion because of the distinction between positive and negative rights. The statements "You have a right to live" and "you have a right not to be killed" are fundamentally different, and taking one or the other as a premise will lead to radically different political actions. The case for negative rights, as I've heard it made, is based on the idea of noninterference and self-determination: that we are each in the best position to make decisions about our own lives (which, as a student of psychology, I must point out is a highly debatable claim! Most people are terrible, at least in lab settings, at predicting what we want, unless we've seen someone else go through the same process.). Given that A) people can be crap at knowing what we'll actually enjoy, and B) the world is so complex that no single person can understand all its relevant parts, at least by the time they're old enough to vote, it may be the case that a government's making certain decisions about large-scale policy is appropriate; perhaps self-determination is actually a silly and outdated notion. HOWEVER! Given that there are hundreds of millions of individuals in the U.S. alone and that every trend has outliers, I think that (at least for now) what's most important is to be sure that, whatever happens, that one person who doesn't fit the curve can still survive and make her own choices. So, long story short, I'm currently committed to the idea of individual freedom and self-determination, because, hey - who doesn't want that, and (more importantly) since none of us have direct access to the mind of any other, who's informed enough to make decisions for other individuals? No-one.
Anyway. That's not the argument I started off making, it's the premise. The point I want to discuss is, does it make sense for our government to pull cash out of our bank accounts in bucketfuls in order to provide the poor and middle classes with affordable health care, given a premise of individual freedoms? Why should the government legislate the use of my money, simply so that someone in Seattle can get cheaper medical care? It's not the military, which potentially protects every individual from other countries' armies; it's not the police, who protect us from fellow citizens who want to infringe on our rights to go unbeaten or unrobbed. Those expenditures are justified by this model of government because they protect us from outside forces that would infringe upon our negative rights. If spending money on any government program is justified under this premise, these expenditures are among the necessary ones. And health care? Yeah, that's one, too.
What? Did I just say that universal health care is just as justified as the military? OH SHI-
Here's my thinking. The military protects us from other countries' encroachments, to which we do not consent. The police protect us from other individuals' encroachments, to which we do not consent. Health care protects us from the world's encroachments on our bodies. Do you know anyone who consented to cancer? No. Anyone who opted in to the flu? I suspect not. Of course, anyone who did end up injured or sick of their own volition - the insane practice of the "Russian Roulette" bareback party comes to mind - should not be covered. I have to admit that many other problems fall under this category (lung cancer caused by smoking is the obvious instance). Life has consequences. Clean up after yourself. Private companies might well offer insurance that would cover such cases, but the government has no such obligation. The government does, however, have a responsibility to protect someone who falls ill with a disease that they didn't go out of their way to invite or is injured by the action of another person or through environmental factors - at least, it has that responsibility if we operate from the principle that individuals have the right to self-determination and thus the right to live their life without attacks from outside forces, and that the government's role is to protect those rights. I'm looking at you, Libertarian party. (Not the anarchist wing, though. We'll talk later.)
You may now begin the trolling.
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Ok, wow, my views seem to have changed on this subject in the subsequent years -- most substantially, in my acknowledging that an individual-level analysis of responsibility fails to take into account multi-generational factors that influence and constrain a person's options, perceptions, and agentive faculties, and that therefore it's inappropriate to blame or judge our fellow humans, especially given that none of us are unassailable and that people in already vulnerable or marginalized positions tend to catch the worst of whatever judgmental attitudes a community allows. (2013)
Anyway. That's not the argument I started off making, it's the premise. The point I want to discuss is, does it make sense for our government to pull cash out of our bank accounts in bucketfuls in order to provide the poor and middle classes with affordable health care, given a premise of individual freedoms? Why should the government legislate the use of my money, simply so that someone in Seattle can get cheaper medical care? It's not the military, which potentially protects every individual from other countries' armies; it's not the police, who protect us from fellow citizens who want to infringe on our rights to go unbeaten or unrobbed. Those expenditures are justified by this model of government because they protect us from outside forces that would infringe upon our negative rights. If spending money on any government program is justified under this premise, these expenditures are among the necessary ones. And health care? Yeah, that's one, too.
What? Did I just say that universal health care is just as justified as the military? OH SHI-
Here's my thinking. The military protects us from other countries' encroachments, to which we do not consent. The police protect us from other individuals' encroachments, to which we do not consent. Health care protects us from the world's encroachments on our bodies. Do you know anyone who consented to cancer? No. Anyone who opted in to the flu? I suspect not. Of course, anyone who did end up injured or sick of their own volition - the insane practice of the "Russian Roulette" bareback party comes to mind - should not be covered. I have to admit that many other problems fall under this category (lung cancer caused by smoking is the obvious instance). Life has consequences. Clean up after yourself. Private companies might well offer insurance that would cover such cases, but the government has no such obligation. The government does, however, have a responsibility to protect someone who falls ill with a disease that they didn't go out of their way to invite or is injured by the action of another person or through environmental factors - at least, it has that responsibility if we operate from the principle that individuals have the right to self-determination and thus the right to live their life without attacks from outside forces, and that the government's role is to protect those rights. I'm looking at you, Libertarian party. (Not the anarchist wing, though. We'll talk later.)
You may now begin the trolling.
---
Ok, wow, my views seem to have changed on this subject in the subsequent years -- most substantially, in my acknowledging that an individual-level analysis of responsibility fails to take into account multi-generational factors that influence and constrain a person's options, perceptions, and agentive faculties, and that therefore it's inappropriate to blame or judge our fellow humans, especially given that none of us are unassailable and that people in already vulnerable or marginalized positions tend to catch the worst of whatever judgmental attitudes a community allows. (2013)