A majority of British doctors polled call for denying medical care to smokers and the obese.
In the United States, we don’t have a British health care system. Yet. But the majority of private health care spending here occurs through a health insurance cartel. In a free market, there would be no such thing as health insurance. Since health outcomes are explained by individual choice, they are not random and are therefore not insurable. Nonetheless, in a system in which mandated health insurance companies are ostensibly in competition with each other, we would expect to see some companies competing for the business of customers who make unhealthy lifestyle choices alongside other companies that choose to reject such customers. In this latter case, incentives would then exist, via market forces, to encourage people to eschew unhealthy lifestyles—incentives that do not exist in the present, hyper-monopolized and corporatist health care system present in the United States today.
Along with price controls and inflation of the money supply, this is one of the key reasons why the health care costs in the U.S. are escalating. And yet, the officially acceptable solutions to problems resulting from years of interventionism in health markets are in the direction of more intervention. Thus we see a specific case of many in which intervention leads to unintended consequences leading to broader intervention, as explained by Ludwig von Mises in the 1920s in his classic Liberalism. I would add that the interventionists fully realize there will be unintended consequences but they ignore them since, in the long run, they play in their favor.
Mises understood this too. ”There is no other choice,” he wrote later. ”[G]overnment either abstains from limited interference with the market forces, or it assumes total control over production and distribution. Either capitalism or socialism; there is no middle of the road.” The World War II-era regulations that established the modern health insurance industry, Medicare and Medicaid in the 1960s, BushCare in the last decade, and ObamaCare today, all prove this point.
