The State Isn’t Us

by Don Boudreaux on September 16, 2011

in Charity, Civil Society, Health, Man of System, Myths and Fallacies, Other People's Money

Washington Post columnist Eugene Robinson reports Ron Paul’s answer to a question about taxpayers’ responsibility for paying for medical care to keep alive a man who irresponsibly refused to buy health insurance for himself:

in Paul’s vision of America, “our neighbors, our friends, our churches” would choose to assume the man’s care – with government bearing no responsibility and playing no role.

Robinson is appalled by Paul, accusing him of being part of an “immoral” movement that would interpret the Constitution’s Preamble to read “We the unconnected individuals who couldn’t care less about one another . . . .”

I don’t get it.  Why is Robinson’s call to force Smith to care for Jones an exhibition of compassion, while Paul’s endorsement of arrangements under which Smith voluntarily cares for Jones a display of heartless indifference to the plight of others?

Reasonable people can disagree over whether or not voluntary charity would be sufficient.  It’s a mistake, however, to classify coerced ‘giving’ as “compassion,” and downright bizarre to accuse those of us who would rely more upon genuine compassion – evidenced by people giving from the goodness of their hearts rather than from a desire to avoid imprisonment – as endorsing a society without compassion.

….

And a follow-up point: To the extent that government programs such as Medicare and Social Security were enacted, and survive, because the beneficiaries of these programs support them, then even on Eugene Robinson’s own premises they cannot be said to reflect “compassion.”  Quite the opposite.  To that extent these programs reflect greed: give me what you have because I want it and I’m willing to hire people with jail cells and guns to take from you what I want for myself.

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{ 95 comments }

Kevin L September 16, 2011 at 7:58 am

I like the title. I’ve been trying to keep myself from using collective first person pronouns when referring to government actions.

Michael September 16, 2011 at 8:16 am

Why is it, in Eugene’s opinion, OK for one individual to choose not to pay for healthcare, (so they can buy a bigger house, nicer car, more crap …) and then expect everyone else to pay for their healthcare needs if they get sick?

The question was not “Who should pay for the healthcare of an individual who CANNOT afford insurance?” Which at least poses a more interesting moral question.

Ken September 16, 2011 at 9:41 am

Michael,

There aren’t any people in the US who cannot afford health insurance. Decent health insuance policies can be purchased for as $100/month and catasophic only plans for less, which is around the cost of a smart phone plan. This is why it’s so galling to have to pay for others. It’s not that they can’t pay. It’s that they can and refuse to, then claim they are victims.

Regards,
Ken

Mikenshmirtz September 16, 2011 at 10:18 am

Not entirely true. I, for one, can’t buy health insurance for my family. I’ve gotten quotes—anywhere from $1500-$2500/mo—but applications never make it past underwriting. (My three year old son has had more hospital bills than most people ever will.)

Therefore the only way for me to get health insurance is through a group plan. Considering my company only has two full-time employees, this puts an insane burden on our company. Our company premium (for two small families) is $37,008 per year, and on top of that each employee has to meet a deductible of $4,000 before claims are covered.

I say this just to make a point that not everybody can afford insurance. Indeed, my belief is that people need to be responsible for their own health care. I agree with Ron Paul. But I also think at least two branches of the federal government are responsible for the insanely high costs of healthcare. Obamacare is just going to make the problem worse and make it harder for families like mine to get covered, unless I’m willing to go back to work for a huge company that doesn’t feel the pain of having a high-risk family on their group plan.

Ken September 16, 2011 at 10:41 am

Mikenshmirtz,

I’m curious what type of coverage and deductible you’re looking at. I found a plan for $190/mo for a family of four with a $5K deductible. Most I found were around $350 – $450 per month. The more you want covered and the lower you want your deductible the higher your monthly premiums.

Regards,
Ken

SweetLiberty September 16, 2011 at 11:08 am

Ken,

You are looking at plans that don’t take into account all the pre-existing conditions Mikenshmirtz apparently has to deal with. A healthy family can generally afford health insurance with reasonable jobs, but a family with a history of medical problems can find the health care costs exorbitant.

Ken September 16, 2011 at 11:34 am

SL,

Anything that “covers” pre-existing conditions is NOT insurance.

Regards,
Ken

Mikenshmirtz September 16, 2011 at 2:50 pm

Ken,

Nor is “health insurance” actually “insurance”.

Mike

Jon Biggar September 16, 2011 at 5:19 pm

The real problem here is the system that attaches healh care insurance to employment. Replace this with a system where I buy my plan when I’m young and healthy (or “buy” into my parents plan when I’m born) and keep as long as I decide I need it. If employer subsidy of insurance could be kept the same as today by giving employees a tax-free cash lump sum to use to pay for their current plan (or the employer takes over the payments).

Then you have *real* insurance that is underwritten like life insurance. You could choose between plans that have a guaranteed fixed periodic premium, or one that increases or even one that decreases, all calculated by actuary principles to give the insurance company its necessary ROI.

This would also require ditching the (IMO) unconstitutional state and federal laws prohibiting inter-state purchasing of insurance.

The problem with health insurance in the US is *not* a consequence of the “free market”, it is a consquence of government interference.

John Dewey September 16, 2011 at 5:47 pm

Jon Biggar,

I agree with some of your comment. Government does greatly interfere with private health insurance by mandating coverage for a huge variety of treatments and by prohibiting interstate sales of health insurance.

I disagree that employer-provided health insurance is a problem. Rather, such insurance developed as a solution to another problem: adverse selection.

Contrary to arguments which have been provided by some at cafe hayek, employer-based health insurance did not result from government interference. Certainly the tax treatment of employer-provided health insurance accelerated the sales of such programs. But employer-provided health insurance was growing at a fairly rapid clip before such tax deductibility was enacted.

If private markets can find a solution to adverse selection, then such markets could, in the absence of government interference develop a better solution than employer-provided health insurance and medicare. I have yet to hear such a solution from the Cafe Hayek crowd or anywhere else.

Ken September 17, 2011 at 5:00 pm

Mike

“Nor is “health insurance” actually “insurance”.”

Actually it is.

Regards,
Ken

Mark September 16, 2011 at 10:47 am

Mikenshmirtz,

Many people think that libertarians believe that the State has absolutely no place in society (a comic strip from the New Yorker comes to mind, in which a man standing in front of his burning house waves off arriving firemen, saying “No thanks, I’m a libertarian”.)

On the contrary, I believe that there is an important role for government to play, in providing law and order, a good court system, and other limited public goods. I also believe that there is a place for government in addressing real market failures, such as providing reasonable health insurance for a family like yours. Unfortunately, government has grown so big, and has intruded into so many places that where it has no role, that it is failing to address areas where it really does have a role and can make an important contribution.

Good luck

Anotherphil September 16, 2011 at 11:19 am

Is the insurance market a “market failure”?

Its among the most highly regulated industries around. The government (through Sec 106 of the internal revenue code) has encouraged employer-based group coverage.

We need to be asking, how can we make HEALTHCARE available to the individual, rather than saying how can we make HEALTH INSURANCE available to the individual. Insurance might be part of that answer-but it can’t be the whole answer.

As long as the government encourages third-party payment (where nobody gives a rat’s patoot about cost at the delivery point) mechanisms, the healthcare mess is a failure of government interfering in a market, rather than a market failure.

cthorm September 16, 2011 at 12:38 pm

I think there is room for a reasonable compromise on the issue of health insurance, a middle ground between Ron Paul’s outline of a health system (which I agree with in principle) and Obamacare. I think we should have a publicly-funded program that ONLY offers catastrophic health insurance (high deductible plan) to cover those kind of health problems that are rare, difficult to plan for and extremely burdensome financially (e.g. sudden impact by bus, leukemia etc). For the rest of the health system I would go further and eliminate medicare/medicaid (this plan would supersede them), the tax exemption for health insurance compensation, cross-state competition barriers and introduce malpractice reform. These solutions would significantly reduce the endogenous cost inflation that is insanely rampant in the industry, reintroducing the discipline of market pricing and comeptition. I see the catastrophic plan being paid for in a voucher system with plans administered by private insurers, but selected by the individual.

Mikenshmirtz September 16, 2011 at 2:58 pm

Mark,

Well stated. Being libertarian minded myself, I am conflicted at where government support should begin. Interestingly enough, my son qualifies for Medicaid coverage. But Medicaid isn’t insurance, either, and he only qualifies while he has primary insurance coverage through another provider.

On one hand it’s easy for me to take the support. (He’d miss out on most of his care otherwise.) On the other hand, I don’t like the idea of government supporting people in ways they can support themselves.

The whole point of my original message is to help other libertarians understand the reality of extenuating circumstances, because we don’t need non-libertarians thinking we’re stupid enough to believe EVERYBODY can afford the health care they need (be it through insurance or otherwise).

Seth September 16, 2011 at 1:02 pm

If the gov’t hadn’t been interfering in health insurance for so long, you may had been able to privately buy long-term, blanket policies long before son’s health problems.

Credit card companies would probably have made that a perk for using their card to pay for a health checkup, like how some include travel and accident insurance if you use their card to buy plane tickets.

You would likely have remained with the same health insurer for longer periods as well — much like your car and home insurance.

It’s important to recognize that the problems you face are caused by previous government intervention, not by failures of the market, and they can be fixed by removing those previous interventions, rather than introducing new ones that will create more problems.

Mikenshmirtz September 16, 2011 at 2:59 pm

Amen!

John Dewey September 16, 2011 at 6:09 pm

Seth,

I have a different version of what health insurance would have looked like absent government interference. Employment based insurance would still have been the norm for three reasons:

1. insurance companies can overcome the significant problem of adverse selection when a large pool of young and old workers are forced by an employer to participate in an insurance program;

2. large pools of workers have buying power which individuals do not possess;

3. keeping workers healthy and on the job is in the employer’s best interest;

4. tying insurance to employment reduces turnover, a fact more obvious to employers than to new hires.

Regardless of the tax treatment of employer-provided health insurance, such programs should be Win-WIn-Win ,,, for the insurance company, for the employer, and for the worker. And that’s why emplyer-based health insurance was growing rapidly in the late 1930s and early 1940s before the federal government began interfering in those markets.

Michael September 16, 2011 at 10:56 am

I agree it is mostly a choice, but there are actually people who cannot buy policies. This number is most certainly less than the 25M or 40M or 50M (or whatever inflated number) is thrown around, but the number is not zero. However, the number would be more manageable and the cost less objectionable if the people receiving other peoples money were actually unable to get healthcare and not the person in Wolfe’s question who decided to get a BWM instead of buying insurance.

vikingvista September 17, 2011 at 12:15 pm

You can’t literally insure against a preexisting condition (risk is 100%), and insurance companies often cannot offer products that exclude them. They are then forced by law to offer only policies that are a mixture of insurance and health care financing. Premiums can therefore be very expensive for someone with a non-excludable condition. But the actual insurance part is almost always quite affordable.

vidyohs September 16, 2011 at 1:01 pm

A question just as good is to ask Eugene R. why he thinks that the words “We the people of the United States” actually means that all of the people of the colonies gathered to gather in a field or hall in Philadelphia and unanimously approved the Constitution. A casual check of the state votes ratifying the Constitution reveals quickly that there were a lot of those “we the people” that didn’t want any part of it.

Methinks1776 September 16, 2011 at 8:17 am

I don’t get it. Why is Robinson’s call to force Smith to care for Jones an exhibition of compassion, while Paul’s endorsement of arrangements under which Smith voluntarily cares for Jones a display of heartless indifference to the plight of others?

To most of the ruling elite, it is impossible to imagine that “compassion” (redefined and mangled beyond recognition) flows from anything but the brute force of the state they control. It is utterly impossible for them to wrap their minds around the possibility that the peasants may be kind to each other since they haven’t an ounce of real kindness and compassion within themselves.

Michael September 16, 2011 at 8:21 am

Very easy to be compassionate with other people’s money. I often offer to share all of the cash in my liberal friends’ wallets with more needy people … never had one of them accept my offer.

Methinks1776 September 16, 2011 at 8:53 am

I’ve been called crazy for suggesting they make private donations to charity to help out these people they’re so concerned about. Of course, the liberals who really care give a lot more and flap their gums a lot less.

dsylexic September 16, 2011 at 8:57 am

actually,their preferred excuse is “social contract”. maybe my grandpa signed it and sold down all his progeny into eternal bondage and forgot to tell us

Greg Webb September 16, 2011 at 2:37 pm

Michael, I love the idea and have made similar offers myself. But, all my liberal/progressive friends get as upset as they do when I inform there is no law prohibiting them from paying more federal income tax. They never take me up on either option, which proves what I’ve said about liberals and progressives all along — they want control to force others to do as progressives/liberals say, but not as progressives/liberals do.

Frank33328 September 16, 2011 at 8:36 am

I think people project themselves and their personalities onto others. The evidence that progressives tend to be less charitable than non-progressives (I really don’t want to say conservatives here) causes progressives to see the population as less charitable than it really is. They think, “if everyone behaved like I would like to, then there would be no charity, better fix that…..” Same with Women’s issues, race issues, etc.

Fred September 16, 2011 at 10:04 am

I think that also explains why progressives are so hostile to gun rights.
They figure that if everyone was allowed to pack heat, and if they disrespectfully shoot their mouth off to someone who is both armed and as emotionally unstable as themselves, that they’d rightfully get their head blown off.
The solution is to ban guns.

morganovich September 16, 2011 at 9:26 am

they also have a worrying tendency to ignore the moral hazard issues here.

why act responsibly if acting irresponsibly gets you free stuff?

i also echo michael’s point: it’s always folks wanting to be generous with my money then voting themselves less skin in the game through purported defense of the “middle class” and its “unfair tax burden”.

10 years ago 24% of americans paid no net federal income tax.

that number is now 51%.

that’s a terrifying number as they are now the majority, so every time a new “compassion” issue comes up, a majority knows it’s not their money. it does not take a brilliant game theorist to see where that leads.

it also means that the median taxpayer pays no federal income tax.

am i the only one to whom that sounds absurd?

Seth September 16, 2011 at 1:04 pm

well said

Tom September 16, 2011 at 10:43 am

Elementary.

If a government takes money from Smith to provide for Jones then the amount that is taken from Smith will and must be greater than the amount that is used to provide for Jones. If Smith voluntarily provides for Jones then the amount that Smith provides and the amount that Jones receives will be the same amount. Regardless, cost is a negative real, or natural, amount. lt is a cost that Smith must be able to pass on and get rid of and dollars of cost can only go to places from which dollars of money can come in exchange for the dollars of cost.

If a government takes money from Smith to provide for Jones then Smith will embed the additional cost of the money that was taken into the prices of the goods and/or services that he is producing and selling in order to get the money that the government is taking to provide for Jones. It then becomes tax-cost–or cost-of-government–driven price inflation that shows up in the goods and services market places.

Smith needs to be able to either increase the prices of his goods by an offsetting amount or, if he is prevented from doing so by market competition, Smith needs to move some part of his business to some place where the cost of providing for Jones will not be dumped into the operating costs of Smith Enterprises. Else Smith eventually goes to bankruptcy court and then Jones is without again. But Jones now has company: Any employees who worked for Smith are now without also.

Greg Webb September 16, 2011 at 11:24 pm

Methinks1776, my experience has been that people assume that other people are exactly like themselves. This explains why liberals/progressives want to use government to force people to give to help others because liberals/progressives know that liberals/progressives won’t give a dime more than they are forced to and they assume that everyone else is just like greedy, selfish liberal/progressives.

Duncan Earley September 16, 2011 at 8:33 am

Thanks you Professor Boudreaux. For the first time in a while I doubted capitalism and thought government was they only way for health care. I was reading krugmans column:

http://www.nytimes.com/2011/09/16/opinion/krugman-free-to-die.html?_r=1&partner=rssnyt&emc=rss

But your have again reminded me that the key is voluntary vs the force of taking from others.

Michael September 16, 2011 at 8:51 am

Didn’t Hayek leave the door open to government involvement in Healthcare IF the involvement created competition and therefore a better product?

What people like Ron Paul misrepresent is the difference between theory and reality. In reality those of us with insurance and who can afford to pay get fleeced and end up paying for those without anyway. Would it be better to have that fact out in the open and transparent instead of masked?

Progressives, of course, never argue for government involvement in healthcare from the more efficient, better care, lower (overall) cost perspective. They just think that those who can should pay for those who cannot or will not because they can, and that idea should be rejected.

dsylexic September 16, 2011 at 8:59 am

ron paul misrepresnts nothing.he is for the ending of licensure and the end of FDA.regulatory bodies captured by special interests are not there for the good of the consumer.ron paul has been saying the same think for 30 years.he has had a lot of time to think thru all of it.perhaps you havent spent even 30 minutes on his policies

Michael September 16, 2011 at 9:36 am

dsylexic, I have spent the last 6 years following Ron Paul, I have donated to both of his campaigns. (one of two politicians to whom I have ever forked over money) That being said, I don’t agree with 100% of every single one his positions.

Yes, regulations controlled by special interests are bad for consumers. I would prefer healthcare more tailored to my needs, and I would prefer that people pay for their own care through which ever mechanism works best for them. If charity and goodwill actually provided adequate care to most people, we would never have had medicare, medicaid, SCHIP, etc.

Personally, I like knowing that my doctor went to an accredited medical school. I am not a Doctor; I do not have access to expensive technology; I do not always know what level of care I may need. I am paying for the delivery of healthcare and the results. Do I like the current delivery system, and it’s lack of transparency, and rules which sometimes prevent me from getting better care, No.

Healthcare is not a good or service like your TV, Dishwasher, or lawn care service. Under-consumption of it DOES have negative consequences. Whether I like it or not, and whether it’s fair, other people’s decisions affect my care and the cost of it.

Perhaps, you should spend 30 minutes thinking about his policies and not just accept them as absolute truth?

Martin Brock September 16, 2011 at 9:57 am

Paul would not prevent you from choosing a doctor that attended an accredited medical school for specific treatment, but he would leave this choice to you.

Paul doesn’t assume that charity is a health care solution for most people either. Insurance is the solution for most people.

dsylexic September 16, 2011 at 10:09 am

well, i live in a 3rd world country.while i may be privileged by my country’s standards,i am open to alternative and traditional therapies and treatments.not out of blind faith,but because i know modern medicine doesnt have the best answer always. these systems have been whittled away in the west.lets not blame the free market for it.lots of americans oppressed by its medical systems come to seek relief in indian ayurveda for example. just saying: medicine is a service -just like others.

Economiser September 16, 2011 at 10:13 am

@ dyslexic:

Yes! Medicine is a service, like all others. Like the provision of food and clothing and shelter and iPods. When the government starts to treat medicine as a special service that’s too important for the market, that’s when we’ll stop progressing and start regressing.

dsylexic September 16, 2011 at 10:14 am

and yes,while i cant and dont donate to paul,i have been tracking him since 6 years too :-) quelle coincidence.if i could import him or his principles back here,i’d gladly buy some of the US govt debt.haha

rjs September 16, 2011 at 8:39 am
dsylexic September 16, 2011 at 9:01 am

his death was not because he lacked insurance.that is nonsense.he was going to die anyway.the issue in this case is who should foot the bill.and it is his mother who was sent the bill. a lot of of his friends and ron paul’s staff contributed too and i guess they paid down a lot of it

ChrisN September 16, 2011 at 9:02 am

Mr. Robinson should read Sumner’s “Forgotten Man”

If we lift one man up, we push another down.

Speedmaster September 16, 2011 at 9:25 am

Indeed! I expanded on this exact issue a couple of days ago: ( http://www.pretenseofknowledge.com/?p=9173 )

It’s apparently assumed that society and govt. are one in the same.

Trapper_John September 16, 2011 at 9:30 am

I think it boils down to a lack of trust that non-government individuals and organizations (churches, communities, etc.) will pick up the slack. I liken it to union dues–if they’re taken automatically from everyone’s check, it works, but if it’s voluntary, it doesn’t work. They see it as a prisoner’s dilemma where collusion (laws for reallocation of wealth) prevents free riders (people who are not generous). Furthermore, I would imagine they see free riderism as an incredible problem that generates bitternes (it’s not fair that I pay and you don’t).

Society is viewed as an entity that can be moral or immoral just like an individual. Society is judged based on its collective action (government programs) and this judgement is then transcribed to the individuals in that society, even though as many as 49% of them may disagree with its actions. How many times have you heard, “I don’t wan to live in a society where we __________” (fill in the blank with, “provide universal healthcare”, or “feed the poor”, etc.).

My $0.02

dsylexic September 16, 2011 at 10:34 am

this is not true at all. human kindness cant be quantified and game theory is a poor tool to evaluate kindness. compassion is not explainable by econometrics.

in fact,if govt takes up such activities,the charities will slowly get fewer patrons since everyone thinks that the govt will take care of his helpless neighbor.society probably turns more heartless. such a system is a decivilizing force.

vikingvista September 17, 2011 at 12:34 pm

And because people have less disposable income to do so themselves.

Martin Brock September 16, 2011 at 9:42 am

Paul couldn’t quite go all the way and agree with the unseemly sentiments of the guy in the audience shouting “Yeah, let him die!” He had to fall back on private charity, because he basically accepted the premise of the question, that “society” has an obligation to treat the uninsured man.

I’m an enthusiastic Pauli, and this issue doesn’t deter me at all, because Paul is not running for health care czar; however, it is a point of disagreement. I advocate some sort of mandatory health insurance, just as liability insurance for drivers is mandatory; otherwise, we have a genuine free rider problem.

Compulsory insurance is not compulsory charity. This uninsured man should bear the cost of his own risks, insofar as the risk can be shared with others willing to share it through genuine insurance, and he must bear these costs before suffering unpredictable illness or injury. That’s the nature of insurance fundamentally.

And maybe some compulsory charity is also defensible, when suffering is predictable (congenital illness for example), but it’s a separate issue. Relying exclusively on private charity arguably creates a different sort of free rider problem, but the utilitarian balance between costs and benefits seems less clear.

Jeff S. September 16, 2011 at 11:20 am

“compulsory charity”???

Martin Brock September 16, 2011 at 1:02 pm

Yes. It’s a reasonable label for what we’re discussing, but if you prefer some label, like “fascistic cripple care”, that’s OK with me. A rose by any other name …

James N September 16, 2011 at 12:39 pm

” I advocate some sort of mandatory health insurance, just as liability insurance for drivers is mandatory; otherwise, we have a genuine free rider problem.”

I don’t understand. Why do you assume that liability insurance, for automobiles, needs to be mandatory? Or health insurance, for that matter. The “free rider problem” is a red herring.

Martin Brock September 16, 2011 at 1:00 pm

If an uninsured driver hits you with his car and paralyzes you from the neck down, you can sue the guy for all he’s worth, but you likely won’t get the cost of your own care, because few individuals can afford this care, and the uninsured drive is very unlikely to be one of the individuals who can.

Anyone who can afford a car payment and gas can afford insurance against this sort of liability, because the accident is very unlikely; however, some people will economize by not carrying the coverage, so you must insure yourself against it. You pay for the risk that this uninsured driver takes, and he takes a free ride on your insurance. That’s the free rider problem.

The free rider problem is real. Labeling it a “red herring” with no further discussion is a denial, not a counter-argument. Why is it a red herring?

vikingvista September 17, 2011 at 12:45 pm

It is a red herring not because it isn’t real, but because it is merely another risk that an individual choses (ideally) to insure against. Private property and voluntary insurance are workable and acceptable solutions. Force is not.

House of Cards September 16, 2011 at 10:13 am

Mr. Paul gave a poor answer to the question about the person, who irresponsibly failed to buy health insurance, then needed immediate medical attention to save his live. The correct answer is that you call the paramedics and take him to the emergency room for proper treatment. Only a Nazi would let someone die, like a dog, for no good reason. But, of course, you send the person a bill for services rendered. Dr. Paul deserved to look like an unfeeling fiend for his cruel, terrible answer.

Richard W. Fulmer September 16, 2011 at 10:21 am

It seems to me that much of Liberal “compassion” is based on what I call the “economics of self-esteem.” In general, people want to feel good about themselves at the least cost to themselves, just as people want to maximize their material well-being at the least cost. I can feel generous by reaching into my own pocket and giving to the poor, or I can feel generous by forcing someone else to give to the poor – emotional “rent seeking,” if you will.

Forcing others to be generous is akin to Sharia law in which “virtue” is coerced. But am I really virtuous if I obey when someone holds a gun to my head and orders me to do X or not do Y? I believe that people exhibit virtue only when they have the option of doing bad and they choose to do good instead. Virtue cannot exist without freedom.

david nh September 16, 2011 at 1:42 pm

Nice formulation:

” people want to feel good about themselves at the least cost to themselves, just as people want to maximize their material well-being at the least cost. I can feel generous by reaching into my own pocket and giving to the poor, or I can feel generous by forcing someone else to give to the poor”

vidyohs September 16, 2011 at 10:23 am

Compelled or coerced giving, public or private, is extortion.

One can be compelled to give as private charity. The compulsion coming from the attitudes and reactions of one’s fellows which can generate fear in an individual that if he does not give his life in the community can be made to be less than enjoyable.

For myself, if I have not already taken responsibility for someone because of kinship or close friendship, I take the position as I did not cause another’s misfortune I have no obligation to repair that misfortune. If another person acts against his own best interest, health, and safety and suffers, that is on his head.

No good social lesson is taught by assuming a fool’s responsibility, even if the fool is near death. One who allows himself to be forced to assume the responsibility of a fool, proves himself a fool as well.

House of Cards September 16, 2011 at 10:33 am

Spoken like a true, babbling fool.

Anotherphil September 16, 2011 at 11:11 am

Radical individualism and self interest is the sign of immaturity and a lack of meaningful attachment in life.

You do have obligations to others-some are proscriptive (you cannot cause or risk other’s peril) and some are prescriptive. (you need to provide help, such as happening upon an accident.). If you take your position and leave the accident, victims unaided, you need to google the term “depraved indifference”.

That having been said government welfare isn’t charity, it isn’t help, its fostering dependency.

Scott Harrison September 17, 2011 at 4:30 pm

A quote from uslegal.com: “Depraved indifference focuses on the risk created by the defendant’s conduct, not the injuries actually resulting.”. This means that ignoring an accident victim is not depraved indifference unless you caused the accident. Just in case this is not clear, ignoring an accident victim does not create a risk; it just ignores an already present risk.

You might want to try googling terms that you tell other people to google before posting to keep from looking like a fool.

vidyohs September 16, 2011 at 11:26 am

I knew at least one of you loony would pop up and reveal true stupidity, you didn’t let me down, this time I drew a two-fer.

vidyohs September 16, 2011 at 11:27 am

Vidyohs, it is truthfully said that a looney lefty can not read, nor think. All you can get from them is true knee jerk to the socialist scripture.

Pom-Pom September 16, 2011 at 10:28 am

“Reasonable people can disagree over whether or not voluntary charity would be sufficient.”

Well I am not sure that it is reasonable. Decades of government intrusion into the charity market have likely destroyed the would-otherwise-have-been development of many private charities. So if the government merely “slammed on the brakes” and stopped, their may indeed be a void, but the void may have been the crowd out by the government in the first place.

dsylexic September 16, 2011 at 10:35 am

agree.200%

vikingvista September 17, 2011 at 12:54 pm

Like everything the government does, an orderly devolution may be necessary to allow voluntary institutions to organize in the vacuum of the previous monopoly.

Pom-Pom September 17, 2011 at 2:00 pm

I don’t know if the devolution will be orderly. That is what scares me is if the current gov is not reigned in. Does history show cause for optimism in reigning in a government?

I believe there are examples of quite disorderly devolutions, replaced by something no better, and even worse.

vikingvista September 17, 2011 at 6:10 pm

Only to limited extent, like Thatcher’s partial rollback of socialism.

Scott Mayo September 16, 2011 at 10:36 am

Robinson posits as his justification:
“According to the Gospel of Matthew, Jesus told the Pharisees that God commands us to “love thy neighbor as thyself.” There is no asterisk making this obligation null and void if circumstances require its fulfillment via government.”
He’s just plain wrong on that. Theologians describe the biblical division of authority/responsibility as “sphere sovereignty.” Families have different parameters than churches, and churches than the state. I have a sneaking suspicion that Mr. Robinson wouldn’t be interested in altering his view of the 2nd Amendment by taking the same expansionist interpretation of the biblical instruction to the state to “wield the sword” and giving it to individuals. Again, it seems that the Commerce Clause way of looking at the world only flows towards an expansion of state influence! As Redleg Captain Terrell said “there ain’t no end to doing good.”

Richard Stands September 16, 2011 at 10:38 am

Mr. Blitzer’s question was, “But Congressman, are you saying that society should just let him die?”

“Society” (the hypothetical man’s family, friends, religious congregation, workmates, and complete strangers asked for voluntary charity) would not “just let him die.”

As Prof. Boudreaux summarizes in the four word title of this post, “The State” is not the same as “Society”.

A more useful question would have been something like, “Who, if anyone, should come to this man’s aid?” Some would effectively answer, “No one.” Some would effectively answer, “Anyone and everyone with the means who can be forced to contribute via the state.” Mr. Paul effectively answered, “He’s free not to think ahead, and others should be free to help or not, voluntarily.”

I agree with Paul.

Pom-Pom September 16, 2011 at 10:56 am

In addition, the sweeping use of the word “society” is usually animistic nonsense too.

House of Cards September 16, 2011 at 10:43 am

Michael Dukakis’s clinical answer to the infamous Kitty Dukakis rape question, during a debate, effectively ended his candidacy in 1988. This ought to be the death knell to Ron Paul’s futile campaign, as well.

Bernard Shaw (CNN):
“The first question goes to Gov. Dukakis. You have two minutes to respond …”

http://www.youtube.com/watch?v=aUXz4wFDAo0

SweetLiberty September 16, 2011 at 11:21 am

What are you smoking? Wrong topic. You want the Death Penalty debate blog, not this one.

House of Cards September 16, 2011 at 11:53 am

You are the Scarecrow and Tin Man rolled into one. You lack both a heart and a brain. Neither the Wizard of Oz, nor Obamacare can help you. You are on your own to troll the nether regions for eternity.

SweetLiberty September 16, 2011 at 12:16 pm

My mistake. You are clearly shooting your drugs intravenously, not smoking them.

Anotherphil September 16, 2011 at 10:57 am

“To the extent that government programs such as Medicare and Social Security were enacted, and survive, because the beneficiaries of these programs support them.”

Its worse than that. If you want to see how these programs were sold (file under fraud in the inducement), check out the Soc Sec Admin publicity films at archive.gov, or other places on the web.

They were sold as “insurance” and depicted Uncle Sam as a custodian taking you are your emplyer’s money to a vault. I think I recall one film adding this: “insurance, bought and paid for”.

Now, they have a sense of “investment” in the program, but are dependent on it. That dependence was fostered for decades by the 50% on wages for recipients.

When you get right down to it, its a form a feudalism. The feudal lord offers you protection (in this case from your own infirmities of superannuation, rather than marauders) in return (in this case for your vote and 1/6 of your earnings, its so much more civilized than absolute fealty, son’t you think-snark) .

Now, the more insidious aspect of it was that while the practical realities were vote buying, it was designed to do the very thing that would render it actuarilally unsound (see fraud in the execution) which was to lower the birth rate. All neatly designed by central planners who were slaves to that defunct economist, Malthus.

Somewhere in the “stacks” of the Pattee (or is it Paterno, now) library of the Pennsylvania State University was a dusty tome about the motivations of the German planners of the late ninetheenth century and the design of the first old age pension-designed to remove the inducement to fertility that came with the perception that one’s age age could only be secured by progency. As well read folks, they feebased the deceptive elegance of Malthus population. (Once again, its a bad thing when economists represent math as reality, rather than an attempt of limited ability to understand reality).

Today the left’s aggression against the family is more naked. It clearly understands the existence of any institution that mediates or buffers between the individual and circumstance is a threat to statist ambitions.

Think what a rich source of votes unwed mothers are/have been to politicians peddling state control of everything.

Anotherphil September 16, 2011 at 11:03 am

MINUS TYPOS:

To the extent that government programs such as Medicare and Social Security were enacted, and survive, because the beneficiaries of these programs support them.”

Its worse than that. If you want to see how these programs were sold (file under fraud in the inducement), check out the Soc Sec Admin publicity films at archive.gov, or other places on the web.

They were sold as “insurance” and depicted Uncle Sam as a custodian taking you and your employer’s money to a vault. I think I recall one film added this line: “insurance, bought and paid for”.

Now, they have a sense of “investment” in the program, but are really DEPENDENT on it. That dependence was fostered for decades by the 50% on wages for recipients which ensured ABSOLUTE depence on Soc sec.

When you get right down to it, it’s a form of feudalism. The feudal lord offers you protection (in this case from your own infirmities of superannuation, rather than marauders) in return for your “loyalty” (in this case for your vote and 1/6 of your earnings, its so much more civilized than absolute fealty, son’t you think-snark) .

Now, the more insidious aspect of it was that while the practical realities were vote buying, it was designed to do the very thing that would render it actuarially unsound (see fraud in the execution) -which was to lower the birth rate. All neatly designed by central planners who were slaves to that defunct economist, Malthus.

Somewhere in the “stacks” of the Pattee (or is it Paterno, now) library of the Pennsylvania State University was a dusty tome about the motivations of the German planners of the late ninetheenth century and the design of the first old age pension-designed to remove the inducement to fertility that came with the perception that one’s age age could only be secured by progency. As well read folks, they freebased the deceptive elegance of Malthus population. (Once again, its a bad thing when economists represent math as reality, rather than an attempt of limited ability to understand reality).

Today the left’s aggression against the family is more naked. It clearly understands the existence of any institution that mediates or buffers between the individual and circumstance is a threat to statist ambitions.

Think what a rich source of votes unwed mothers are/have been to politicians peddling state control of everything.

Reply

Ken M September 16, 2011 at 11:16 am

A couple of points.

First, this confusion is older than America. One has to wonder to what extent it is deliberately fostered by those who see themselves acting in the role of government. As Thomas Paine wrote,
Some writers have so confounded society with government, as to leave little or no distinction between them; whereas they are not only different, but have different origins. Society is produced by our wants, and government by wickedness; the former promotes our happiness positively by uniting our affections, the latter negatively by restraining our vices. The one encourages intercourse, the other creates distinctions. The first is a patron, the last a punisher.
Society in every state is a blessing, but government even in its best state is but a necessary evil; in its worst state an intolerable one; for when we suffer, or are exposed to the same miseries by a government, which we might expect in a country without government, our calamity is heightened by reflecting that we furnish the means by which we suffer. Government, like dress, is the badge of lost innocence; the palaces of kings are built on the ruins of the bowers of paradise.

Second, for some reason people seem unable to grasp the essential purpose of insurance when the subject is medical care. Insurance’ only real purpose is to protect against relatively rare events, not to provide for those that are routine. How much would automobile insurance cost if we were to insist that a basic police include coverage for tune-ups, oil changes, and filling the tank? That’s exactly what many people seem to believe that medical insurance should do, and government seems intent on forcing us all to choose between that sort of medical policy and none at all.

SweetLiberty September 16, 2011 at 11:24 am

*Like*!

Great quote, and I agree that the concept of insurance has been largely distorted regarding health insurance.

vidyohs September 16, 2011 at 12:56 pm

As one who has spent countless profitable hours recording legal depositions concerning medmal and personal injuries, I can affirm that your final paragraph is dead on.

People have been taught to think that medical insurance should cover every aspect of their health and life, and furthermore that every health practitioner be perfect and infallible in every way. Even when warned and indoctrinated on the risk of procedures, and sign off on, they still believe that only perfection should result.

Where did the American people get this distorted idea of life? Think about what social philosophy preaches total lack of personal responsibility and you have your answer. They were carefully and consistently taught by those of the socialist faith.

Pom-Pom September 16, 2011 at 5:05 pm

Health “insurance” coverage skyrocketed after the distortion of incentives in tax law during WWII. That was the big
entry of the third payer.

People found other ways to pay before. One may wonder what part charity and pro bono, informal sliding scale played a part before the tax law grossly distorted incentives.

The third party payer problem has developed as one might predict, the first being that “health insurance” has morphed into (largely prepaid) “health care.” Immediate incentives to control costs that would normally exist between the two primaries, minus the third party, have largely been destroyed. One would expect this has had an effect on prices over the years. The government, as a third party payer who doesn’t use its own money, has weak incentives too.

The health care patient now has diminished concern about costs. They just want it paid, not really feeling the reality of deductions from their paycheck, and lower pay rates, as it is not immediately connected to the receipt of care. If the cost is spread through government supply, then they *really* don’t care.

Americans are likely overinsured now, and as you point out, it isn’t insurance in any ordinary sense of the word. They are not generally underinsured.

John Dewey September 16, 2011 at 6:29 pm

Ken M: “Second, for some reason people seem unable to grasp the essential purpose of insurance when the subject is medical care. Insurance’ only real purpose is to protect against relatively rare events, not to provide for those that are routine. “

Well, I disagree. In a free market, a consumer should be able to buy insurance to protect whatever he wishes to protect. You may not believe that the word “insurance” would cover so-called “routine” care, but I hope you can see that others might have a different opinion.

Insurance protects against uncertainty. What I think you refer to as routine care is not certain care. Consider a person who becomes afflicted with diabetes. Before that event, he had no need for semi-annual medical and vision exams, for expensive prescription drugs, and for diabetic monitoring supplies. But that person may have desired to protect against those very significant costs in the future. This is where health insurance provides a hedge against such risks.

A diabetic’s treatment costs are routine. But they are not certain, and they are not cheap.

Non-certain health care expenses make up the overwhelming bulk of benefits paid out by health insurance companies and Medicare. I suspect the portion is more than 90%. IMO, the argument that coverage of truly certain and routine health care expenses drives up health insurance costs is incorrect.

Ken September 17, 2011 at 5:07 pm

JD,

” In a free market, a consumer should be able to buy insurance to protect whatever he wishes to protect.”

While I agree with the above, your next statement is incorrect.

“You may not believe that the word “insurance” would cover so-called “routine” care, but I hope you can see that others might have a different opinion.”

We can see in other insurance markets that people will not buy insurance to cover routine maintenance. If you think that’s wrong, please point me to a car insurance policy that covers oil changes, break pad replacements, headlamp replacements, etc. The reason people don’t buy insurance to cover these things is because they are guaranteed to take place AND the insurance company needs to turn a profit. Since the average person will pay into an insurance plan MORE than they will get back (the insurance company goes broke if this is not true), routine maintenance will cost more to be covered by insurance rather than paid out of pocket.

“Non-certain health care expenses make up the overwhelming bulk of benefits paid out by health insurance companies and Medicare.”

Can you cite this?

Regards,
Ken

Bill September 16, 2011 at 11:25 am

I don’t understand Robinson’s reference, ““We the unconnected individuals … .” How is associating voluntarily “unconnected”? Perhaps Mr. Robinson could benefit from reading Leonard Read’s classic “I, Pencil.”

Sam Grove September 16, 2011 at 11:31 am

“The State Isn’t Us”

And the why is because of the different sets of incentives that operate on people in the circumstances of wielding personal or political power.

Seth September 16, 2011 at 1:07 pm

I’d love to watch a video of Don Boudreaux and Eugene Robinson having a coffee.

david nh September 16, 2011 at 1:39 pm

Also, the state didn’t invent charity. And states designed on the notion of “forced charity”, driven as they were by the relentless logic of coercion, i.e., that coercion always leads to more coercion in order to enforce the earlier coercion, ended up as the most vile, cruel, humanly destructive societies imaginable. But hey, they were “well-intentioned”, right?

Coercion is ultimately the most uncharitable thing possible.

Debra Myers September 16, 2011 at 3:41 pm

My daughter made a good point this morning. Why would someone choose to pay $600 to $900 a month on a truck payment & full coverage & not purchase health insurance? She worked in benefits administration & said that alot of people don’t have coverage simply because they fail to include new children or spouses on their plan within 30 days after birth/marriage – even though it doesn’t cost them a penny more! So I guess the moral of the story is – people prefer the World Series, new trucks, parties & refuse to take responsibility for themselves because they know someone will pick up the bill! ~Ron Paul 2012~

Debra Myers September 16, 2011 at 3:45 pm

Besides, I have seen more good will & open wallets from people that volunteer than from any other source! And social security…yeah, there are bottom feeders eating away at the almost half million I put into it during my lifetime. Damn straight – it’s not charity for many people in the system. Don’t confuse the issue. If you don’t put in – you shouldn’t take out – period! That would solve that & it should include the government spending of those funds also. It needs to be phased out or give me back what I put in – I can live with that.

Adam September 16, 2011 at 5:21 pm

This makes sense once you realize that most people view laws as extensions of themselves. A law is an expression about their beliefs in how the world should work and, by extrapolation, it is also in their eyes an expression about how you believe the world should work.

If something is not illegal, it follows that it is something you condone and vice versa. It’s simply not possible to think something is wrong or immoral and not make it illegal. Even if it was proved beyond all doubt that charity worked better than government welfare she would still find it highly immoral to not have a law.

She thinks that because Ron Paul doesn’t want to force someone to help another in need it can only be because he thinks that not helping is the most moral course of action. It’s the same thing with drug laws. If you don’t think drugs should be illegal it means that you think that everyone should be taking drugs all the time, no other viewpoint is possible (let alone desirable).

William September 16, 2011 at 8:33 pm

While I agree with Dr. Boudreaux’s points about compassion and some of the points brought up in the previous comments about how actions must be voluntary and properly-intentioned to be truly virtuous, I would like to offer a devil’s advocate view about compassion and health care:

“It is compassionate to want to help people who need medical treatment; helping not only means actually providing said treatment, but helping to pay for people’s treatment when they cannot afford it themselves. The benefit of government-funded health insurance/care is that it will be able to help more people, since it can MAKE people give it money for this purpose, than voluntary methods, which only rely on the goodwill of others. It is not the case that people like Paul want people to die or are evil, its just that they are not as compassionate as supporters of public healthcare because their system will help fewer people and expose those in need to more risk.”

The responses that come to my mind are 1) We don’t know for sure that voluntary provision/aid, along with other practices (such as a sliding scale of payment) wouldn’t be able to provide for as many people, especially since the govt has taken over that function

2) The argument: “government can help more people b/c it has more resources” could be extended into areas many would find unacceptable (the government can provide food, clothing, etc to more people so it should) and could in theory justify complete govt ownership of all wealth. This also sidesteps the issue of whether it is moral in the first place for govt to take resources from people. You could argue that it is b/c everyone has some sort of obligation to help everyone else in need out of an obligation to show equal concern for everyone’s life, but this argument will end up justifying massive restrictions of freedom and ownership and seems untenuous: it suggests I must give something to someone I have never met or directly affected. Do I really have a moral obligation to help feed a poor person I’ve never met before? It is not clear that showing equal respect for persons requires this

William September 16, 2011 at 8:39 pm

Then, there is even the question about whether I have a duty to show “equal concern and respect” to persons. At some level–a very basic one–we do; everyone has the right to life, liberty, and a minimum of respect, for example. But many of us believe we have special moral obligations to specific people, namely, our family members (especially our children) that we don’t have to others. So, I have a duty to feed my children, but would I really be a immoral person if I didn’t spend some money to feed people I’ve never met?

Mr. Blather September 16, 2011 at 11:28 pm

Hmmm, when Robert Reich was explaining, two years ago, that an “honest” liberal president would tell sick senior citizens “we (government funded/controlled healthcare) are going let you die”, there wasn’t as much uproar. I don’t remember Eugene Robinson complaining then, but maybe I missed it.

http://online.wsj.com/article/SB10001424052748704107204574473331382043514.html

And here’s Grayson trying to pass the buck:
http://newsbusters.org/blogs/p-j-gladnick/2009/10/13/robert-reich-reveals-brutal-health-care-truths-msm-snores

Bill Koehler September 17, 2011 at 8:29 am

Mr. Robinson seems to thing that rewarding bad behavior will somehow produce good behavior. Good luck with that theory.

billyblog September 17, 2011 at 12:48 pm

“Reasonable people can disagree over whether or not voluntary charity would be sufficient. ”

No they can’t.

What errant/hypocritical/sophistical nonsense from Don Boudreaux. Sorry, manufacturing a conditional where we already have a categorical track record that tells us voluntary charity is not — nor ever has been — up to the task of constructing a robust social safety net, is not a rational response.

Mr. Boudreaux should do a little research, something which may be difficult for someone of his apparent ideological stripe, possibly because, as Stephen Colbert has reminded us, reality has a well know liberal bias.

Mr. Boudreaux, simply look at the budget of your local friendly voluntary charity hospital, perhaps a Catholic hospital or one run by another religious faith with very much the best of intentions. (I am in no way criticizing the operations or intentions of such institutions, which I admire greatly.) Their sources of financing are already overwhelmingly from the Federal government and State governments in the form of Medicare, Medicaid, and SCHIP payments. And it is UNreasonable fantasy to imply that it is an open question as to whether if those sources of funding were withdrawn from these and other similar “voluntary charities,” the kindly folk at the churches would just reach a bit deeper into their pockets on Sunday to put more money in the collection plate to make up the difference for withdrawn governmental funds.

And coming up with an anecdote or two about voluntary charities that don’t accept, indeed, aggressively solicit, government money, doesn’t change the overall picture. Government money reduces to practically a rounding error private sources of funding for safety net programs — across the board, and even when these funds are run through “voluntary” institutions.

Mr. Boudreaux and his ilk are living in a manufactured fantasy world of McGuffey readers or some such time that never existed in this country — or anywhere else — and never will.

Mark Tully September 19, 2011 at 4:09 pm

Seems like a fairly bold assumption to believe that our neighbors, friends, and churches would care enough to help. Has Ron Paul ever visited Wal Mart on a Friday night?

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