At a family gathering this weekend in New Orleans — as I enjoyed a rich, very yummy, and sodium-laden bowl of okra gumbo — I complained to a cousin about the recent calls to have the government force food-preparers to use less sodium. Karol — sitting nearby and enjoying her own sodium-enriched Cajun dish — lamented with me the fact that our freedoms are increasingly under assault (pun intended). But, she pointed out, the alleged justification for such intrusions isn’t so much a simple nanny-state itch to treat us as children but, rather, the need to control health-care costs.
Of course Karol is correct. This "stop each of us from imposing costs on others" justification is typically used to support motorcycle-helmet regulations, smoking bans, and, now, eat-less-salt commands. And as more and more of Americans’ health care is provided collectively, the ring of validity to such justifications increases in volume. As Russ points out, if you’re paying, I’m ordering the expensive menu items.
If you are obliged to subsidize the costs of my behavior, then you clearly have an interest in restricting any of my behaviors that might potentially raise the costs you bear as my subsidizer.
But a question: if the proponents of greater collectivization of health-care provision not only recognize this fact but cite it as a justification for restricting personal freedoms that would otherwise be no one else’s business, it seems to follow that these proponents of collectivization of health-care provision would recognize also that the problem is so general that it indicts the very idea of collectivization of health-care provision.
Because such collectivization creates a giant tragedy of the commons – because such collectivization enables each of us at each moment of making health-care choices to impose most of the costs of our choices on others – such collectivization will require not only that government restrict our access to fun but unhealthy life choices (such as eating lots of Cajun food), but also restrict our access to medical-care.
So the idea that a young mother whose child has a runny nose will be able to skip off to the pediatrician pronto for a diagnosis and treatment is chimerical. Just as collectivization of health-care provision will encourage people to eat too much sodium and too much bacon, it will also encourage people to seek medical treatment too frequently and too frivolously. And in both cases, these attempts to free-ride on the largess of the collective will oblige the protectors of the collective to restrict personal freedoms and personal choices lest the collective be utterly ruined.