On the price tag: Itâ€™s often argued that, as a proportion of GDP, America spends more on health care than countries with government medical systems. But, as a point of fact, â€œAmericaâ€ doesnâ€™t spend anything on health care: Hundreds of millions of people make hundreds of millions of individual decisions about what theyâ€™re going to spend on health care. Whereas up north a handful of bureaucrats determine what Canada will spend on health care â€” and thatâ€™s that: Health care is a government budget item. If Joe Hoser in Moose Jaw wants to increase Canadaâ€™s health-care spending by $500 drawn from his savings account, he canâ€™t: The law prevents it. Unless, as many Canadians do, he drives south and spends it in a U.S. hospital for treatment he canâ€™t get in a timely manner in his own country.
You can make the â€œcontrolling costsâ€ argument about anything: After all, itâ€™s no surprise that millions of free people freely choosing how they spend their own money will spend it in different ways than government bureaucrats would be willing to license on their behalf. America spends more per capita on food than Zimbabwe. America spends more on vacations than North Korea. America spends more on lap-dancing than Saudi Arabia (well, officially). Canada spends more per capita on doughnuts than America â€” and, given comparative girths, Canucks are clearly not getting as much bang for the buck. Why doesnâ€™t Ottawa introduce a National Doughnut Licensing Agency? Youâ€™d still see your general dispenser for simple procedures like a lightly sugared cruller, but heâ€™d refer you to a specialist if you needed, say, a maple-frosted custard â€” and it would only be a six-month wait, at the end of which youâ€™d receive a stale cinnamon roll. Under government regulation, eventually every doughnut would be all hole and no doughnut, and the problem would be solved. Even if the hole costs $1.6 trillion.
How did the health-care debate decay to the point where we think it entirely natural for the central government to fix a collective figure for what 300 million freeborn citizens ought to be spending on something as basic to individual liberty as their own bodies?Thatâ€™s the argument that needs to be won. And, if you think Iâ€™m being frivolous in positing bureaucratic regulation of doughnuts and vacations, consider that under the all-purpose umbrellas of â€œhealthâ€ and â€œthe environment,â€ governments of supposedly free nations are increasingly comfortable straying into areas of diet and leisure. Last year, a British bill attempted to ban Tony the Tiger, longtime pitchman for Frosties, from childrenâ€™s TV because of his malign influence on young persons. Why not just ban Frosties? Or permit it by prescription only? Or make kids stand outside on the sidewalk to eat it? It was also proposed â€” by the Conservative party, alas â€” that, in the interests of saving the planet, each citizen should be permitted to fly a certain number of miles a year, after which he would be subject to punitive eco-surtaxes. Isnâ€™t restricting freedom of movement kind of, you know . . . totalitarian?
Freedom is messy. In free societies, people will fall through the cracks â€” drink too much, eat too much, buy unaffordable homes, fail to make prudent provision for health care, and much else. But the price of being relieved of all those tiresome choices by a benign paternal government is far too high.
Government health care would be wrong even if it â€œcontrolled costs.â€ Itâ€™s a liberty issue. Iâ€™d rather be free to choose, even if I make the wrong choices.
Steyn makes much the same point about liberty that I’ve been trying to make only he, you know, does it with more flair & humor.
This is a distinction I’ve made privately and tried to explain on the blog: There is a difference between what America pays and what Americans pay for health care (or anything else, for that matter).