The fairness problem with cost shifting in health care

One of the things that ObamaCare proponents keep saying (and please add a whining note in your mind as you read the following) is that “the current system isn’t fair.”  It’s not right, they say, that, in a rich country, some people have premium health care, while others are forced to go to a free clinic or an emergency room (or possibly back to their native Mexico).

What all these fairness proponents forget is that there is nothing fair about socialized medicine.  Unless you want costs to be stratospheric for everybody (as in ever higher taxes) or unless you want the system to break very quickly, you have to make sure that people don’t drain the system.  Morbidly obese people drain the system.  Drug users drain the system.  People with chronic diseases such as Crohn’s drain the system.  Diabetics drain the system.  Cigarette smokers drain the system.  Sexually promiscuous people drain the system.  You can make your own list, but it is apparent that some people are heavy health care users, and others aren’t.  All of them make more demands than your average middle class, healthy suburbanite, who goes in for well-baby checks, appendicitis, the occasional pneumonia, etc.

Now, we’re a compassionate people, and we’re probably willing to pay for those who suffer through no fault of their own.  We can find it in our hearts to shell out for the person who is crossing on the green light and gets hit by a car; or for someone who has appendicitis.  But what about the people who could have prevented their illnesses?  Do you really want higher taxes to pay for that big guy at the buffet who is loading up on fried stuff?  And how do you feel about replacing the liver on that recovered alcoholic?  And are you sure your neighbor isn’t going to tell you to forget having children in case one of them has your breast cancer gene? And since that’s not fair, and since the whole point of universal health care is a fair system in which everyone pays equally for and receives equally of the health care system, then someone or something (hint:  the government) had better step in and control or punish high risk people.

It’s not just me saying this.  Indeed, even though I had inchoate thoughts on precisely this topic, I didn’t put it together until Zombie sent me a link to a comprehensive article spelling out everything that’s wrong with the universality of universal health care.  Please read it.  Think about it.  Forward it to friends.  Use it as the basis for letters to your Congressman or woman, or as the talking point for a friendly discussion at work.

Life isn’t fair.  Equality of opportunity is a wonderful American tradition.  Equality of outcome is an impossible dream that eventually turns all nations that seek it into totalitarian dictatorships, intent on controlling every aspect of the citizen’s life.