On September 12, 2011, during CNN’s GOP Tea Party express debates, Wolf Blitzer posed a hypothetical question to Republican candidate Ron Paul, asking who should foot the bill for a healthy 30-year-old man who chooses not to buy health insurance and then suddenly ends up in a coma with expensive medical bills? Paul responded that freedom is about taking risks and personal responsibility, and it is not about the government taking care of everybody. Paul is a libertarian and, as such, believes that government should be as small as absolutely possible and only interfere in people’s lives for basic protection from hostile enemies and criminals.
Blitzer then asked, should we just let him die? Some in the audience cheered, “Yes, let him die!” Many left leaning groups and individuals used this as a glaring example of the hypocrisy of the right. Republicans are a party that claims higher moral ground, conservative family values, and pro-life agendas, and yet at a party debate some verbalized support for a person dying because he couldn’t cover medical bills.
Paul himself said that we shouldn’t let him die, but he offered only altruistic church groups and charities as the solution. In 2012, medical expenses account for 60% of American bankruptcies. So, leaving this incredible financial burden for church groups and charities to shoulder means that, in reality, many people would die.
The day after the debate, news broke that Paul’s close friend and 2008 campaign manager, Kent Snyder, died of pneumonia at age 49 after accruing more than $400,000 in medical bills. Paul and his staff raised $50,000 towards the bills, but the hospital bill was never paid off. Apparently, libertarians think it is acceptable for the hospital to eat that bill. So they overlook an important point about our medical system: we pay these bills by a back-door financial policy. Hospitals make up for this kind of unpaid bill by the raising the cost of everyone else’s medical care.
This issue is a defining moment for the US because one could easily blame the high costs of healthcare on the Emergency Medical and Treatment and Active Labor Act (EMTALA), which says hospitals that receive taxpayer money cannot refuse care to people. Would libertarians propose getting rid of the EMTALA? Is this the kind of society we want to live in?
One other reason why healthcare costs are high is that the US political system allows corporations to get so powerful that they can steer government policy towards their own interests. Using their monetary influence, they can break down regulation and fix the game in their favor. If, as libertarians believe, government should be small and only used in defense and the like, who will be there to regulate these big corporations when they are in total control? Their default answer is the invisible hand of the market. But even Adam Smith, the great hero of capitalism, extolled the benefits of the invisible hand only when there is a general well being among all citizens.
I agree that when it comes to government intrusion on lives of its citizens, I think we should look at policies with a libertarian eye and not make a policy without a good reason. However, there is very good reason to provide health care, both for moral reasons, like those above, but also economic ones. The libertarian stance claims that when government gets involved, costs go up. Ron Paul frequently makes this argument in his speeches. I am not sure where their evidence comes from. Data shows instead that healthcare costs are lower in single-payer health systems.
When the ethical and practical reasons for a libertarian position on healthcare crumble, why continue to cling to the hard line?