There's been a lot of handwringing in certain media precincts over the fact that some audience members cheered during the Republican candidates debate over a hypothetical in which an employed 30 year-old man who could afford health insurance but who chose not to buy it becomes comatose. Moderator Wolf Blitzer who posed the scenario to Rep. Ron Paul, asked who should pay for his care; or should he just be allowed to die?
Paul asserted that the young man should take responsbility for himself—so far so good. But Paul basically whiffed the question when he harked back to the good old days when charity hospitals and churches would pay for the medical care of indigents. Well, yes. But as Paul pointed out we now live in "a society in which he expects the government to take care of him." Just so. Paul did note that government overregulation has helped the cost of medical care skyrocket, but in the end Paul said that he wouldn't let the improvident young man die. It's a bit ambiguous whether somehow Paul meant that as physician he would have taken care of the guy, or that the United States is so far gone down the path toward socialized medicine that we can't really disappointment people's expectations that the government will cover unpaid medical care. But never mind.
The more tough-minded members of the audience might well have been thinking along the lines of American Enterprise Institute health care analyst Tom Miller. In my 2004 article, Mandatory Health Insurance Now!, I asked:
Why not just tell Americans they are responsible for buying their own health insurance from now on? If people couldn't pay for medical care, either through insurance or out of pocket, they wouldn't get it. "After people begin to notice the growing pile of bodies by emergency room entrances," Tom Miller wryly suggests, "they will quickly get the message and go get medical coverage."
In that same article, in response to Miller's observation, University of Pennsylvania health care economist Mark Pauly asserted:
"Americans don't want to see their neighbor dying bleeding in the street," he says. "Therefore we already make sure that everyone gets some medical care when they need it. The alternative would be a world in which voluntarily uninsured people wore a bracelet that read: 'In case of an accident, do not take me to the nearest hospital. I've made my choice.'"
Given the reaction of some of the debate audience members, Pauly is wrong at least to the extent that some Americans do appear to be willing to let improvident 30 year-olds suffer the consequences of their actions.
And before y'all go all nuclear on me over the mandatory health insurance proposal; it was offered as a second best alternative to a full-on single payer plan run by the government. As I wrote:
I want to stress that mandatory health insurance is a second-best proposal. A totally free market system would be preferable; it's just not likely politically. Mandatory health insurance is a way to stop creeping socialization and preserve private medicine.
For more details on Baileycare, see my post, Center for American Progress and the New Republic Endorse Totally Private Baileycare Plan.