Imagine a country where the government regularly checks the waistlines of citizens over age 40. Anyone deemed too fat would be required to undergo diet counseling. Those who fail to lose sufficient weight could face further "reeducation" and their communities subject to stiff fines.I used to describe health care and health care financing as a trio of points:
Is this some nightmarish dystopia?
No, this is contemporary Japan.
The Japanese government argues that it must regulate citizens' lifestyles because it is paying their health costs. This highlights one of the greatly underappreciated dangers of "universal healthcare." Any government that attempts to guarantee healthcare must also control its costs. The inevitable next step will be to seek to control citizens' health and their behavior. Hence, Americans should beware that if we adopt universal healthcare, we also risk creating a "nanny state on steroids" antithetical to core American principles.
Other countries with universal healthcare are already restricting individual freedoms in the name of controlling health costs. For example, the British government has banned some television ads for eggs on the grounds that they were promoting an unhealthy lifestyle. This is a blatant infringement of egg sellers' rights to advertise their products.
In 2007, New Zealand banned Richie Trezise, a Welsh submarine cable specialist, from entering the country on the grounds that his obesity would "impose significant costs ... on New Zealand's health or special education services." Richie later lost weight and was allowed to immigrate, but his wife had trouble slimming and was kept home. Germany has mounted an aggressive anti-obesity campaign in workplaces and schools to promote dieting and exercise. Citizens who fail to cooperate are branded as "antisocial" for costing the government billions of euros in medical expenses.
Of course healthy diet and exercise are good. But these are issues of personal – not government – responsibility. So long as they don't harm others, adults should have the right to eat and drink what they wish – and the corresponding responsibility to enjoy (or suffer) the consequences of their choices. Anyone who makes poor lifestyle choices should pay the price himself or rely on voluntary charity, not demand that the government pay for his choices.
Government attempts to regulate individual lifestyles are based on the claim that they must limit medical costs that would otherwise be a burden on "society." But this issue can arise only in "universal healthcare" systems where taxpayers must pay for everyone's medical expenses.
1. It can be affordable
2. It can be universal--that is applies to everyone
3. It can be comprehensive
You get choose only two attributes in an absolute sense. The essence of all heath care financing decisions is the effort to strike the right balance between the points. But if you are looking at government run health care, they too, just like private health care and insurance, have to determine how to balance those three traits and deal with the issue of personal freedom.
In a market driven health care system, the issue of personal freedom is elminated to a certain extent. In a market system a person has the ability to shop for (i.e. exercise their freedom of choice) to find a product in which the balancing of affordability and comprehensiveness are appropriate while generally not having to worry about universality since they are buying for everyone, only themselves or their family.
But a government run health care system premised upon the notion of universality, i.e. that everyone, regardless of circumstances is covered, which is the case in many European nations, you are left with trying to find a balance between comprehensiveness and affordability. The result, long waiting lists for treatment that is routinely and usually immediately available in this country or come care not permitted because it costs too much to the government to provide. So what you get instead of a "heartless HMO" making a decision which can be obviated by going to a different plan is a "heartless government bureaucrat" making the same decision, and you can't easily rid yourself of the government.
So, if you value your personal freedom and your diet, perhaps government run, universal health care is not the right step for this country.