Tuesday, September 13, 2011

Turns out even Ron Paul supports universal health care

The video above contains a pretty fascinating exchange from the debate tonight. It starts off with Wolf Blitzer posing a hypothetical to Ron Paul: Imagine a healthy young man who chooses not to buy health insurance, for reasons other than cost. Imagine that man falls into a coma. Who should pay for the life support?

As you'd expect, Ron Paul doesn't think it ought to be the government. That's the problem with socialism and "welfarism," he says. "He should do whatever he wants to do. My advice to him is to have a major medical policy, but... That's what freedom is all about, taking your own risks."

Then Blitzer pushes back: "Should we just let him die?"

Some of the audience cheers, creepily enough. But Paul can't find it in himself to say yes. "No, no no," he says instead. "I practiced medicine before we had Medicaid... the churches took care of them. We never turned anybody away."

"We've given up on this whole concept that we might take care of ourselves, true responsibility for ourselves... our neighbors, our friends, our churches will do it."

Let me take that a step further for Dr. Paul. Let's imagine that, in order to make the process of taking responsibility easier and more efficient, we, our neighbors, and our friends all pay into a fund. That fund then goes towards paying for the medical care of uninsured members of the community. You know, this is starting to sound sort of familiar.

If I'm not mistaken, Ron Paul just described the ideological basis of a system of universal health care. We don't just take care of ourselves, but also our communities. We take responsibility for us and them. And there's no "freedom to choose" about it. If you never turn anyone who needs health care away -- as he claims he never did -- nobody has taken any risks. They've just made a decision about who pays for any health care they eventually need: they themselves, or their neighbors.

Philosophically, here's no real daylight between between this and the PPACA, except the latter is large enough to utilize economies of scale.

And this exchange is precisely why, over a long enough time horizon, universal health care is a virtual inevitability in developed states. When push comes to shove, even dyed-in-the-wool libertarians like Ron Paul are unwilling to let platitudes about personal responsibility lead to pointless loss of life. And once you've agreed that failure to pay insurance premiums shouldn't amount to a randomly administered death sentence, the realities of risk pooling and cost control push inexorably towards a state-run system.


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