Freedom to Freeload

Mary Brown, a small business owner, decided she didn’t want to carry health insurance, so she became the lead plaintiff in the anti-Obamacare lawsuit filed by the National Federation of Independent Businesses. Why should the federal government impose a penalty on her for her decision not to buy a financial product she doesn’t want?

Then she went broke, in the process stiffing a bunch of medical providers for more than $5000. That money goes into the “unpaid care” accounts, which means in effect that it winds up being paid by those who do have insurance, plus those who pay out of pocket but don’t go bust.

So the freedom she continues to ask for is the freedom to freeload: to take risks with other people’s money. That’s the reason why – as a former Governor of Massachusetts said, back when he was in touch with primary reality rather than the realities of the Republican primaries – we need financial incentives, whether positive or negative, to generate universal coverage: to “encourage ‘free riders’ to take responsibility for themselves rather than pass their medical costs on to others.”

This isn’t very complicated. Really.

[Cross-posted at The Reality-Based Community]

Mark Kleiman

Mark Kleiman is a professor of public policy at the New York University Marron Institute.