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Change the Design

D__ isn’t the only person to write to me with this concern.

Hi D__:

Thanks for your e-mail about my new essay on what Christopher Snowdon calls “public health paternalists.

You’re correct that taxpayer-subsidized health care transforms many private choices into ‘public’ ones. And so, for example, when Jones’s penchant for eating poorly and not exercising lands him in the hospital, taxpayer Smith is understandably angry at having to help pay for the ill-consequences of Jones’s choices.

Yet I do not believe that this reality justifies public-health authorities proscribing and prescribing actions that would be private in the absence of government’s policy of collectivizing the provision of health care. With collectivized health care – as with collectivized anything – the problem is real of Jones and Smith free riding on each other and, hence, behaving in ways that are collectively harmful. Real too is the resulting pressure for government to reduce this harm by micromanaging personal choices.

But to ask a now-popular question: What’s the limiting principle? Where does the assault on individuals’ freedom to choose end? The problem exists only because government collectivized an activity – the provision of health care – that can and should remain privately supplied and demanded. With health care forcibly collectivized, rather than call for – or even to tolerate – government restrictions on personal behavior, the better course is to demand an end to the forced collective provision of health care. Otherwise, additional government intervention is summoned to ‘solve’ a problem that exists only because of earlier government intervention. And these additional interventions will themselves create spillover effects that are sure to fuel calls for yet further control by the state over private choices.

If you discover that your house is structurally unsound because its design is faulty, you don’t summon the same incompetent architect to use his same flawed design principles to patch up the evident problems. You change the design.


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