What is more important, liberty or happiness? Certainly the two are not mutually exclusive, but neither are they invariably coextensive, for what we want and what will make us happy are often two different things. And so we must ask ourselves whether a man should be allowed to make bad choices that will result in his misery and ruin, or whether we should compel him to do what we know will conduce to his happiness and well-being.
A particular instance of this issue may be found in the ongoing health care debate. Should we allow people who can afford health insurance to go without it, or should we force them to have coverage and make them pay? Speaking as someone who is unabashedly paternalistic, I say the latter. Though they may not be minors, yet many adults often lack the wisdom and maturity to know what is best for them in the long run. And thus it is the role of the state to see to it that they have good health insurance. It is for their own good.
Needless to say, there are those that are of a different opinion. After criticizing President Obama for making promises regarding the Affordable Care Act that he could not keep, Philip Klein argues that the Republicans are in danger of doing the same thing when they try to deny or minimize the extent to which people will lose health care coverage when Obamacare is repealed and replaced with their own plan.
Republicans are in serious danger of repeating Obama’s mistake, because they are having a tough time stating a simple truth, which goes something like this: “We don’t believe that it is the job of the federal government to guarantee that everybody has health insurance.”
According to Ian Millhiser, some Republicans are taking Klein’s advice to heart:
A handful of GOP lawmakers are now taking up Klein’s charge — with one of them even claiming that a Republican plan that leads to a higher national uninsurance rate would be a good thing.
“If the numbers drop,” Rep. Mike Burgess (R-TX) said Thursday at the Conservative Political Action Conference, “I would say that’s a good thing.” He went on to argue that more people without health care would be a positive thing for the United States because it would mean that “we’ve restored personal liberty in this country.”
Millhiser then went on to quote another congressman in this regard:
Burgess’ prediction that Republican health plans will lead to a drop in the national insurance rate was echoed by Rep. Dennis Ross (R-FL) in an interview with Bloomberg this week. “Not everybody is going to have health care” under a Republican health plan, Ross said. “Some people just don’t care enough about their own care.”
In other words, the people that drop their health care coverage given the opportunity to do so without penalty will be better off, not because they won’t get sick and rue the day they decided to go without health insurance, but because they will have been free to make that bad decision.
But Jake Novac gets the award for taking the strongest position on this subject: even when people are stupid, they should be free to make bad decisions. The title of his essay is “CBO report on Trumpcare confirms it—You can’t fix stupid.” He argues that “most of those 24 million people projected to ‘lose’ coverage will be doing so of their own free will.”
In other words, now that the government can’t make them do it, a lot of people who can afford to buy health insurance simply won’t do it anymore. And therein lies the problem. The role of government is to operate under the consent of the governed, not to act as the nanny state.
In addition to the word “stupid” appearing in the title, it occurs twice more in the essay. In a perverse kind of way, you have to admire someone who advocates letting admittedly stupid people act of their own free will.
A friend of mine visited an uncle of his on a ranch for a few days. During the visit, he saw some cowboys castrating calves. “Doesn’t that hurt?” he asked. “Sure,” his uncle replied, “but it’s their own damn fault for being cows.” Along those lines, I guess Novac would say of those who choose not to have health insurance, “It’s their own damn fault for being stupid.”
A lot of democrats may try to shift the discussion to those who want health insurance but will no longer be able to afford it, if the Republicans get their way. And indeed, there will be millions of such people. But we should not shy away from the fact that many others that can afford health insurance will choose not to have it.
Klein said that the Republicans will be making a mistake if they don’t accept the fact that it is not the government’s job to guarantee that everyone has health insurance. Democrats are in danger of making a similar mistake if they don’t openly acknowledge the position that it is the government’s job to compel people to have health insurance whether they like it or not.