Both Hillary Clinton and Barack Obama want everyone in this country to have health insurance. They differ in how to achieve it. Clinton wants to mandate that everyone purchase health insurance. Those who can’t afford it would presumably be given subsidies. Obama wants to make health insurance affordable for everyone. Those who don’t want it can go without it. During yesterday’s Ohio debate, Clinton and Obama went at each other for 17 minutes on this issue. Clinton kept saying that Obama’s plan would leave 15,000,000 people uninsured. Obama kept saying that Clinton hasn’t explained how her mandate will be enforced. Clinton’s argument is that, without a mandate, there will be free riders on the system. People who refuse to purchase health insurance will show up at emergency rooms for treatment, the cost of which will be passed on to everyone else. Obama, to my knowledge, hasn’t addressed the free-rider argument. Obama’s argument is that it’s acceptable for some individuals not to have health insurance provided it’s affordable for them. He thinks the reason people lack health insurance is not that they don’t want it, but that they can’t afford it. What he should say is that there are other values at stake besides individual welfare. Individual liberty is also important. Nobody should be coerced into purchasing health insurance. That’s how totalitarian societies operate. It’s an interesting debate, at least to those of us who have a background in economics.
Addendum: For what it’s worth, I’m with Clinton and Obama on free trade. It has been a disaster for many Americans and, I would argue, a bad thing for the country as a whole.
Addendum 2: Clinton said during the debate (with a triumphant air) that Obama’s health-care plan mandates that parents purchase health insurance for their children. She implied that this was an inconsistency in his plan. It’s not. There’s a morally relevant difference between coercing S into doing X for S’s good and coercing S into doing X for the good of S’s dependents. The former is paternalism, which is morally obnoxious. If Obama were as smart as people say he is, he would have pointed this out.
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