I am a classical liberal. Adam Smith’s proposition that individuals pursuing their own self-interest serve the common good is right. Violence is behind every act of government, therefore: 1) government should be minimized, and, 2) suspicion of government is both necessary and healthy.
So why am I writing in support of state involvement in healthcare? A New York Times opinion piece passed through my Twitter stream over the past week that reminded me of how it is logically consistent to be a classical liberal and support state involvement in the health insurance market.
Nick Kristof, in his opinion piece advocating against the repeal of Obamacare, shares a story about his freshman roommate from Harvard, Scott Androes. A financial adviser and pension consultant, Scott decided playing poker was more important than buying health insurance. He didn’t get early medical treatment for symptoms that turned out to be prostate cancer and the result was a probably treatable condition was allowed to development into a probably fatal death sentence.
In typical Kristof fashion, the opinion piece is heavy on emotional appeal, and light on logic. Most of the article is spent arguing that society should feel bad for Scott because he made a bad decision which combined with some bad luck and so we should give him a second chance. While a touching argument, the result is a world where people that make good decisions pay for the bad decisions of others incentivizing bad decision making. Sounds like the financial industry. Heads I use my health insurance premium to play poker, tails society pays for my cancer treatment. That’s fair. Not.
Kristof’s strongest argument, the one that will convince those who typically disagree with Kristof’s politics, only makes a brief cameo: Scott’s choice to play poker instead of buying healthcare has already cost society over $500,000. This is a failure of government to fulfill one of the three roles Adam Smith enumerated as the sole roles of government: to protect its citizens from wrongs committed against them by other citizens.
The moment society required hospitals to provide emergency care without regard to ability pay, health insurance stopped being an individual issue and became everyone’s business. Your lack of health insurance is my problem. Obamacare, while far from a perfect solution, begins to redirect the costs of a bad choice made by an individual to the individual instead of imposing them on society. Individuals bearing the costs of their own decisions and personal accountability? That’s something Republicans, classical liberals and Libertarians should be lining up to support. Adam Smith is pro Obamacare. Why aren’t you?