“Your freedom is likely to be someone else’s harm”

smoking

The problem with collectivizing something like health care – which is to say turning health care into a “right” that we’re all obligated to provide for one another – is that when we do so we put our freedom to make individual life choices in jeopardy. Because that freedom can be attacked on the basis of the cost they represent to other people.

Case in point:

“Your freedom is likely to be someone else’s harm,” said Daniel Callahan, senior research scholar at a bioethics think-tank, the Hastings Center.

Smoking has the most obvious impact. Studies have increasingly shown harm to nonsmokers who are unlucky enough to work or live around heavy smokers. And several studies have shown heart attacks and asthma attack rates fell in counties or cities that adopted big smoking bans.

But it can be harder to make the same argument about soda-size restrictions or other legislative attempts to discourage excessive calorie consumption.

“When you eat yourself to death, you’re pretty much just harming yourself,” S. Jay Olshansky, a professor at the University of Illinois-Chicago’s School of Public Health, said.

But that viewpoint doesn’t factor in the burden to everyone else of paying for the diabetes care, heart surgeries and other medical expenses incurred by obese people, John Cawley, a health economist at Cornell University, noted.

“If I’m obese, the health care costs are not totally borne by me. They’re borne by other people in my health insurance plan and – when I’m older – by Medicare,” Cawley said.

From an economist’s perspective, there would be less reason to grouse about unhealthy behaviors by smokers, the obese, motorcycle riders who eschew helmets and other “health sinners” if they agreed to pay the financial price for their choices.

Before Obamacare, putting these “health sinners” out on their own to pay for their own health care was possible. Insurance companies could deny applicants based on pre-existing conditions, or charge them much higher premiums. But now health insurance is guaranteed issue, which not only means it isn’t really insurance any more but a de facto entitlement, but it also means that we’re all stuck paying for one another’s poor health choices.

If you don’t think that’s going to lead to some serious pressure for policies restricting our freedoms for the sake of keeping health care costs down, think again. Even before Obamacare the “cost to society” of things like smoking have been used, quite effectively, to argue for big restrictions on smoking. Now, with Obamacare, the connection is even more direct, and the pressure will be greater.

There are really only two ways to encourage people into living healthier lives. You can either let them make their choices and live with the consequences, or you can eliminate the consequences (guaranteed insurance/care) and start bullying them into living healthier with public policy.

Sadly, the trend in America has been toward the latter and not the former.

Rob Port is the editor of SayAnythingBlog.com. In 2011 he was a finalist for the Watch Dog of the Year from the Sam Adams Alliance and winner of the Americans For Prosperity Award for Online Excellence. In 2013 the Washington Post named SAB one of the nation's top state-based political blogs, and named Rob one of the state's best political reporters. He writes a weekly column for several North Dakota newspapers, and also serves as a policy fellow for the North Dakota Policy Council.

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  • headward

    And the anti-smoking crowd said it wouldn’t come to this…

    • two_amber_lamps

      Of course it will “never come to this”…. it’s the stick and carrot approach used by the left to get you to agree to THESE concessions because this will be the LAST new rule….

      Until next week.

      Sort of like 2nd Amendment curtailment and the AWB.

      • banjo kid

        X100,chipping away said the ram as he kept buttin that dam !

        • two_amber_lamps

          And if you question the ram you must obviously be a racist, misogynist, or a homophobe….

          • banjo kid

            actually I would be a dam inspector or a ram detector .

          • two_amber_lamps

            Correct…. I’m just postulating the label that would be applied to you if you were to say, to be invited as a guest on the Rachel Madcow show…

  • mickey_moussaoui

    I quit and I’m glad I did. But, there is nothing more irritating than a reformed smoker. I have to agree with you Rob, smoking is still a liberty that people should have a right to partake in. It doesn’t bother me to be around smokers but I do appreciate not having my clothing smelling like an ashtray.

  • banjo kid

    When I smoked I always tried my best to not smoke around people who would be affected by it but this new law across the nation today goes to far, not being able to smoke in your own home or in open air is not good . If someone wanted to really complain complain about some thing like nitrates or some other gas besides Co2 would be a good place to start . I don’t smoke and I am not around a lot of people that do but when I am it does not bother me . My advise to the younger people is to not smoke so when they enter into the so called golden years they will not be gasping for breath or lugging a bottle of air around with them every where they go. If you are a smoker stop now get on a program anything to quit you will pat your self on the back when you are 70. I have not smoked for the last 7 years . I am 69 today and feel like 80. It should be called the rusty years as nothing works and has to be oiled often . Have a good day all.

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