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LUCKY DUCKIES! In addition to what Roy says, I'd like to highlight this odd part of Megan McArdle's counter to Ezra's attack on Giuliani's health plan:
Moreover, as a class, the old and sick have some culpability in their ill health. They didn't eat right or excercise; they smoked; they didn't go to the doctor as often as they ought; they drank to much, or took drugs, or sped, or engaged in dangerous sports. Again, in individual cases this will not be true; but as a class, the old and sick bear some of the responsibility for their own ill health, while younger, healthier people have almost no causal role in the ill-health of others.Virtually any health care thread will eventually produce someone making this kind of argument: We shouldn't pay for health care for sick adults because it's their fault for smoking, drinking, being fat, or some other lack of virtue. What these arguments leave out, however, is that 1) everybody dies regardless of their personal habits, and 2) people who die tend to get sick and rack up lots of health care costs at the end of their lives. For this reason, for example, it's far from clear that smokers are more expensive consumers of health care; smokers consume more health care when they're alive but also die earlier, which saves expenses later on. And then when you consider that as a class smokers are also much less expensive in terms of Social Security ... this argument is pretty clearly specious.What's really going on here, in most cases, is what John Holbo in his classic review of Dead Right called "dark satanic millian liberalism": To some libertarians, the fact that letting poor people die of preventable illnesses will compel them to be ascetic, conformist, risk-averse drones is a feature, not a bug. This puritan wing of the libertarian movement is especially easy to reject, and I don't know about you, but for me it's not much of an argument against providing universal health coverage.--Scott Lemieux
