Over at the Huffington Post, Keli Goff wrote an interesting, yet disturbingly short sighted piece about particular health care costs which exist in large part due to personal private choices.
She begins the piece titled Mad at Greedy Insurers for This Health Care Mess? Then Why Aren’t You Mad at Your Greedy Neighbors discussing the government’s bail out of private businesses:
Raise your hand if you are still filled with anger when you hear the name AIG and picture the more than $100 million of your tax dollars that were delegated–without your consent–for employee bonuses there.
Now raise your hand if you were angry when you learned that Citigroup (which has received so much bailout money that American taxpayers have been dubbed “its major stockholder”) was planning to spend $50 million of your money on a luxury jet….
Even though the numbers she sights are a far cry from the actual tax dollars given to private business, she uses the anger over the bail outs to compare with the lack of anger of health care costs related to personal choice:
…There is something inherently distasteful about being expected to foot the tax bill for someone else’s personal choices–particularly bad ones–and not being given any choice of your own in the matter. Which is why I am so surprised that there has been so little anger expressed by leaders on either side of the health care debate when it comes to the issue of personal choice and responsibility in health care…
…According to the Centers for Disease Control, “obesity costs our nation as much as $147 billion per year in direct health care costs and lost productivity.” And according to the nation’s oldest anti-smoking organization smoking costs taxpayers a whopping $300 billion dollars annually, or 1,000 times the amount of the AIG bonuses….
Utilizing this ratio of anger levels contrasted with actual dollars, she follows through by discussing the trait both costs have in common, personal responsibility:
…Some health care reform advocates will argue these costs would be lower if there were government subsidized health care, but my question is why should the government, specifically taxpayers, subsidize health care costs for conditions that are not only preventable but essentially chosen by the patient? With all of the anger surrounding the health care debate, at town halls, in the House and Senate, where is the anger about personal responsibility?…
Like many before her, she perfectly frames the clear distinction between individual actions which don’t harm others and societal responsibility. She uses our innate disgust of having to foot the bill for the negative consequences of others and sees the fundamental issue of both problems.
If only she had stopped there. If only she understood clearly that when I hurt myself, I should be the only one liable for the resolution, we’d be in total agreement. Instead, she illogically assumes that individual responsibility is shared among all citizens:
…To be clear, personal responsibility is not only up to consumers. Mayor Bloomberg’s success in curbing smoking in New York is due to a multi-pronged strategy of aggressively fining bars and restaurants that allow patrons to flout the anti-smoking ban and raising the cost of cigarettes, in essence targeting the dealer as much as the addict….
Not only is responsibility shared in her view, but government force is also the solution. Therefore since targeting these “bad smoking” behaviors has coincided with a decrease in the number of smokers , why not continue these policies to control other “bad” behaviors?
…A similar strategy should be undertaken federally against fatty foods and drinks (including many of the ones I love). But as long as groups like the AFL-CIO oppose efforts to hold Americans financially accountable for their personal health choices, so that the system can afford to treat those who do not choose to be sick…
Thinking more critically though, this turns out to be very short sighted thinking devoid of any historical context and antithetical to fundamental human behavior. Indeed, I think most people agree with her that when people make bad decisions that affect only themselves, they should be solely responsible for the consequences.
Where she fails is in properly analyzing government as the solution. If one fully analyzes her solution, the lack of follow through in her thinking becomes easily spotted.
First, we know that human behaviors are heavily influenced by incentives. It’s natural and obvious; we do things that benefit us. For those willing to see reality for what it is, examples are all around us. We can see it in the use of commission programs for corporate sales force. We see it in TV commercials and marketing campaigns. We even see it in the tax code. Through denial or lack of contemplation though, some fail to see that this same fundamental human behavior also affects our decisions as they relate to health care.
In fact, one of the reasons for rising health care costs and bad personal choices is individual consumers have been moved further and further away from the actual cost. In the US, part of rise in health care costs can be attributed to government incentives which pushed health care plans away from individuals and towards employers. For the same reason, others countries with socialized medicine also see rapidly rising costs of health care.
Second, we also know that historically, when governments are given the power continue to assume more and more control over individual lives, it ends in tyranny. As we allow government to assume more responsibility for individual actions, we necessitate their ability to control those actions.
Assuming we still believe in a free society, one of the prices we pay is having the responsibility for the negative consequences brought about by our choices.
For instance, if you smoke – society doesn’t owe you CHEMO. If I you eat 30K calories a day – society doesn’t owe you gastric bypass surgery. If you drink a bottle of whiskey a day – society doesn’t owe you a liver.
However, by not of following the logic of her solutions and ignoring historical contexts, she can safely and happily assume government control is the answer:
…So the next time you are reminded of how angry you are at AIG or any other institution that was “bailed out” with your money, just remember that AIG may have mugged you once, but McDonald’s and your neighbor keeping them in business (and whoever invented the doughnut, bacon cheeseburger), will be sucking your wallet dry for decades to come….
Which only leaves us in the end with nothing more than a false dichotomy as if we only have two choices: either we pay for it or we control it.
Really, due to faulty logic, she has unwittingly made a very cogent argument against government provided health care. IE – we don’t need to control that behavior if we are not paying for it.
But I don’t know if she understands that by continuing to promote societal responsibility for individual choices, she is also logically promoting less freedom and more government intrusion. I don’t know if she even believes in the value and morality of freedom. I also don’t know that she doesn’t fully understands all of this, but due to value differences only, still believes government control to be the answer to health care problems. And I really don’t know which is worse – being wrong based upon ignorance or understanding the full ramifications of increased government control, but not caring.
The truly concerning part should be that it doesn’t matter which is worse as the results are always the same. For as long as we have enough people with these types of beliefs, we will continue to lose more and more individual freedoms.
As Hayek stated:
“We must show that liberty is not merely one particular value but that it is the source and condition of most moral values. What a free society offers to the individual is much more than what he would be able to do if only he were free.”