Advocates of universal coverage seek to create a society in which, if you can’t afford health insurance, the government forces others to provide it for you. What is the moral defense for treating some people as slaves to the needs of others? At the American Medical Association’s JAMA Forum, Austin Frakt presents one argument (citing other scholars):

[T]here is a “social obligation to protect opportunity.”


From this, a lot follows. One’s opportunity is threatened by poor health. In sickness, one cannot learn or earn as efficiently, let alone enjoy the same length or quality of life. Therefore, protecting opportunity implies protection of access to health care services that promote and preserve health. And, it’s hard to argue with the notion that such access should be protected equally.

I have two comments:


First, “protecting opportunity” is a euphemism for destroying people’s opportunities. If the government forces Joe to spend a portion of his income footing Sandra’s medical coverage, Joe’s ability to pursue his own opportunities, such as the longest, highest-quality life for himself, is impeded. In practice, the “social obligation to protect opportunity” means the government sacrifices people who have earned opportunities to pursue better lives for themselves, for the sake of those who have not earned them.


Second, it’s true that life can be harder for Sandra when she’s sick compared to when she is healthy. But why does this impose an obligation on others to support her? In fact, it doesn’t. Other people’s medical needs, no matter what challenges they present these individuals, do not impose an obligation on you.


I’m reminded of a passage from Ayn Rand’s “Apollo 11,” in which Rand memorably summarizes her response to the notion that need is a first mortgage on the time, efforts and lives of others:

Poverty is not a mortgage on the labor of others — misfortune is not a mortgage on achievement — failure is not a mortgage on success — suffering is not a claim check, and its relief is not the goal of existence — man is not a sacrificial animal on anyone’s altar nor for anyone’s cause — life is not one huge hospital.

Nothing justifies treating people as if they are the servants of others. Universal coverage is immoral.