Who Should Pay for Health Care?

The Chronicle's editorial on Wednesday claims that health care costs for "illegal" aliens should be shared by all Americans, rather than imposing these costs upon the residents of the individual states:

The matter of who pays for health care for illegal immigrants has been partially settled in the reform debate continuing in the Senate: The federal government will not. That satisfies most conservatives and vexes many liberals, but it leaves a huge unanswered question for all: Who does pay?

With the nation's largest group of uninsured, and a burgeoning group of illegal residents, Texas has an obvious and enormous stake in the outcome of this fight.

We believe history and fairness argue persuasively that responsibility for caring for those here illegally must not be left only to the region most affected. The burden must be shared.

The editorial fails to tell us why this burden must be shared. Indeed, it fails to tell us why anyone should pay for the health care of others. Refusing to question its basic premise--that one man's need is a claim on the life and property of others--the paper is left to ponder which "others".

Acknowledging that the debate involves money and power, the paper ignores the nature of that power and whose money is involved. The power is political power--the power to coerce, mandate, and prohibit; the power for force individuals to act contrary to their own desires, interests, and judgment; the power to take money from some individuals for the alleged benefit of others. The editorial staff does not question this basic premise, accepting it as an indisputable given.

The fact that one individual wants or needs some value--whether it is purse, a car, or health care--is not justification to rob others. This does not change merely because government acts as a proxy. Indeed, it makes it worse because government holds a legal monopoly on the use of force. An individual can properly resist a mugger or carjacker; resisting the government is likely to result in a "vacation" in a jail cell.

To be clear, this isn't about "illegals". It is immoral to force anyone to pay for another's health care, whether they are in America legally or not. There is no "right" to health care.

So long as the American public accepts the premise that morality consists of service to others, that one man's needs must be paid for by others, that sacrifice is a moral ideal, "dilemmas" such as "Who does pay" are irresolvable. So long as the American public accepts the premise that life requires sacrifice, political debates will continue to center on whose lives will be victimized.

The truth is, life does not require sacrifice. Life does not require a constant debate over whose money will be stolen and who will allegedly benefit from the theft. A proper ethics--an ethics of rational self-interest--resolves these issues. Such an ethics recognizes the moral right of each individual to live according to his own judgment in the pursuit of his own values.

The editorial asks: "Who does pay?" The rational, practical, and moral answer is: Those who receive the health care.