Let Him Die?

Please. Of all the herrings about what will happen if we don’t keep Obamacare, this one is the reddest. Jacob Weisberg of Slate has taken Ron Paul to task for his response to Wolf Blitzer in the recent Republican debate. At issue is what would happen under Ron Paul’s vision of America if someone, let’s name him “Jack” for convenience, refused to get insurance and then fell catastrophically ill.

First, the choice is not between Obamacare and a dead Jack. The choice is between individual rights and collectivism. Ron Paul, I, and any number of other perfectly sane people believe that no individual should be forced to pay for the care of another.

Likewise, Jack has every right to refuse insurance. Should he become ill, he is gambling that some kind (or perhaps foolish) soul will come to his aid. Fair enough. At issue is not whether Jack deserves help; it is who gets to decide whether he gets help.

Statists are aghast that any such choice should be left to individuals. Rather, they argue, the state must intervene to make sure everyone gets his/her due. When we start with the premise that the sick must be helped, we usually wind up with a coercive solution. What Paul argues, rightly, is not that the sick should not be helped, but that private, voluntary solutions are consistent with individual rights. They also have the virtue of working better.

The European and Canadian models of healthcare have all the appearance of being just and efficient, which they are–until someone gets really sick. Then, waiting lists and trips to other countries like the US are the norm. In other words, they succeed in bringing down the availability of care to the lowest common denominator. Like everything else with origins in socialist thought, scarcity is the inevitable result.

Aside from the practical problems associated with nationalized health care,* there is a nagging moral issue at its heart. Such a system can only work if doctors are prohibited from practicing privately. In other words, if I am sick and you are a doctor, we cannot contract with each other to our mutual benefit. If we try, a fine or jail is the result. This is morally monstrous.

Canada found this prohibition a law best ignored. Private clinics sprang up there in answer to the waiting lists and bureaucratic entanglements that characterized public clinics. Technically, they were illegal. Practically, they were necessitated by nationalized health care. In truth, I imagine the Canadian government secretly welcomed them.

Back to Jack. His decision not to get insurance does not obligate you or me to help him now that he is ill. If he could not afford it (unlikely if insurance companies and health care providers genuinely had to compete) you and I might be moved to subsidize his premiums or chip in to pay for his health care. In fact, we might be moved to start a clinic for folks such as Jack. Another set of people might be inclined to start a luxury clinic or an alternative medicine clinic or whatever. In the end, the choice and variety among health care providers would be astonishing, all courtesy of individual freedom.

“Let him die?” is the wrong question. It poses the false choice between a vivid picture of someone in need and a well-reasoned but less vivid alternative–a system that works and simultaneously preserves individual rights. Sentiment does not make for good policy. Happily, Jack will probably be fine if people are allowed to help in the ways they see fit. Given enough time and freedom, the private sector will soon drive down prices and drive up innovation, with plenty of people lining up to become doctors.

Jack and his fellow citizens will be far from fine, however, if statist thinking continues to dominate the health care debate. In Europe, nations are reeling from the barrage of punches economic reality has thrown at them over the last few decades. That is inevitable when people do not have to pay for something directly. It always devolves into a chump’s game wherein the winner is the guy who contributes the leastest while getting the mostest. In this case, the “winner” only wins as long as the chumps 1) have money, and 2) still agree to be chumps.

In the US, we still have a chance to avoid a complete meltdown, but not much time to do so. If Obamacare is repealed, either by the legislature or through a Supreme Court decision, we can start to free people and markets up to answer the needs of the sick. If not, the ensuing financial debacle will make health care in this country look like a Civil War hospital. Let’s make sure that does not happen.


*And please don’t try to tell me that Obamacare is not nationalized care. Its primary purpose is to destroy the private system so that a single-payer plan is the only alternative.

About Terry Noel

I am an Associate Professor of Management and Quantitative Methods at Illinois State University. My specialty is entrepreneurship.
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1 Response to Let Him Die?

  1. Tracy Doyle says:

    How about this for an option… assuming “Jack” is not destitute, he would have to consider treatments within his budget. No matter what the ailment, there are usually low(er) cost alternatives to what doctors initially propose. I know this from experience! What about folks who can actually pay for their own health care (and I don’t mean “insurance” – the two terms are NOT interchangeable)? Jack might be a “millionaire.” Why should he be forced to buy an insurance product? Why should he automatically be enrolled in Medicare at age 65? This whole system is insane.


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