Thursday, September 15, 2011

The Wrong Bad Idea

In the wake of members of the crowd appearing to enthusiastically cheering for a man to die if he became critically ill after refusing to purchase medical insurance came the news that a former Ron Paul campaign manager, Kent Snyder had died of complications from pneumonia not long after Representative Paul had suspended his 2008 bid for the presidency. The Paul campaign did not offer health insurance to it's staffers and because a pre-existing condition "made the premiums too expensive" for Snyder to afford, according to family. This has been picked up on as proof that Paul is a heartless bastard, who would rather allow even people close to him to die, rather than see them insured.

This is an unfair characterization. First off, Snyder did not die from lack of care. In fact, the total bill was $400,000. If anyone got the short end of the stick here, it was the hospital. Secondly, exactly what Paul advocates happened. Friends immediately started raising money to pay off the debt. I don't know if Ron Paul himself contributed. Personally, I suspect that he did, but I have no way at my fingertips to verify that.

But it does expose a flaw in the libertarian conception of how health care should work. Health insurers, being primarily for-profit entities who are trying to make money, are going to avoid insuring people who are more likely than not to end up taking more money out of the pool than they put in. Their options to voluntarily contract with others to reduce their risk of being bankrupted by medical expenses are limited, leaving them with nothing other than charity to fall back on. And it's worth stating that in a strictly Libertarian society, it would be considered inappropriate to mandate that hospitals care for all comers - they would have the freedom to pick and chose who they dealt with, just like any other business. And in a society where entering into good contracts is the responsibility of the individual, abuses could be rampant.

That said, it's worth pointing out that the Left's current rallying cry - the most Americans with the resources to ensure that others don't suffer premature death due to lack of care - is also problematic. If Americans are so unwilling to pay to keep one another healthy that the only way to ensure public health is by mandating that everyone pay into a pool and threatening consequences for non-participation, democracy starts working against you. You either need a situation in which an "enlightened minority" strips the majority of the right of refusal, or you start turning the electorate against itself, encouraging the less well-off to vote that the better off shoulder the burden and then hoping that you don't trigger a tragedy of the commons.

This highlights the central issue of most ideological positions - they tend to have views of human nature that are too rigid to adapt themselves to reality. And, when it comes down to it, all politics is about working with and/or controlling human nature to sustain societies. Just as the libertarian idea that charity can be relied upon is flawed because it doesn't scale well, the progressive idea that the tendency of coercive systems to corruption and authoritarianism can be controlled indefinitely by properly educated leadership is just as flawed because it presumes that the right people can always be elevated into positions of power.

There are valid criticisms of Representative Paul's position on how health care should be funded. The idea that he favors simply allowing people to die from lack of coverage is not one of them. Given this, the Left's rush to score points with this to energize their base and cast aspersions on the Republican candidates as a whole is unbecoming and should be abandoned.

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