Wednesday, August 22, 2007

Okay, so Megan McArdle's got a new blog over at the Atlantic. And I added it to the blogroll because I don't often agree with her, but she's no demagogue. She is, however, a libertarian, which is where I usually end up disagreeing with her. Her post on the morality of health care finance is a really good example. Basically, she's catching grief because of a post on her old blog where she argued that, "as a class, the old and sick have some culpability in their ill health."

You see that sort of thing from time to time. This is the basic reasoning:

1. A single-payer health care system takes money from the healthy to pay the sick (in the form of health care).

2. Many forms of illness are the result of the sufferers choices in life. Therefore, the healthy are healthy and the sick are sick as a result of their choices (taken on average).

3. It is immoral to take money from people who make good choices and give it to people who make bad ones.

Conclusion: A single-payer health care system is immoral.

There are so many problems with this. Regarding the first premise: the "healthy" and the "sick" are not discreet groups. With early intervention, it's often not difficult to take someone who was sick and make them healthy again. It happens all the time, and it's easier to do the earlier you can catch the problem. That's one argument in favor of single-payer, which is proven to be better at early intervention.

Second premise: Many forms of illness are not the result of bad choices. Most, in fact, are the result of bad luck, and many more are environmentally based. Of course, as a libertarian, Megan sees taxes as a form of punishment, so she'd really only accept this as a refutation of a single-payer system if I could demonstrate that health stems from wickedness, making it a moral imperative to take money from the healthy.

My big problem, though is with the third premise and the conclusion, and this is where I really give up on libertarians. See, I could care less whether a government program is moral or not. All I care about is whether it solves the problem without creating worse ones.

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