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Tuesday, March 30, 2010

Healthcare Humbug from Mathews

Chris Mathews slipped in a puzzling comment on Hard Ball last night, that he's in favor of "ObamaCare" because he thinks people should "take responsibility" for their health care. This is an odd invocation of the concept of responsibility. Why should being forced to purchase something be thought of as "taking responsibility"? I have a friend, for example, who's in his mid-twenties and hasn't been to the doctor in years. He's not happy about adding another line item for expenditures each month, because frankly put, he's not worried about getting sick. If he did get sick I suppose he'd pay out of pocket if it wasn't too serious, or go to the emergency room if it was (I didn't ask, but I suspect I'd receive these types of responses). In short, he doesn't want to purchase health care, because he's healthy. He wants to spend his money on other things (say, giving to the Red Cross for disaster relief, or, okay, buying nice stuff). He wants to take responsibility for his own purchasing decisions, you might say.

So this is the point: Mathews' line about purchasers of mandatory insurance "taking responsibility" is humbug, because the concepts of "responsibility" and of "coercion" are naturally at odds with each other. When we tell our children to "take responsibility" say, for cleaning their rooms, we typically mean that we are tired of reminding them, and that we want them to internalize the value of it without us threatening them with punishment. Likewise, when my friend resists spending money on a health plan for himself, on grounds that he's healthy and wishes his money to be put to other uses, he is taking responsibility for his health care; he's saying "I'm not interested in making the purchase at this time", which is making a decision based on his circumstances and his judgement about his needs. It's therefore silly to claim that he'll be "taking responsibility" for his healthcare, just as soon as it's made compulsory. Downright humbug.

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