To continue the health care debate--first of all, let me get something off my chest. This is not a debate about health care reform. This is a debate about health care financing. There's nothing wrong with health care in the US; we have some of the finest in the world.
I'm totally opposed to socialized medicine like they have in Europe. The main problem with socialized medicine--and why all communist and socialist plans must fail--is that they diffuse personal responsibility. We learn maturity and responsible behavior when we are responsible for the consequences of our own actions. We learn irresponsibility when we make everyone pay for everyone else's mistakes. (This is the subject of Chapter 22 in my book, which can be ordered from my main website.)
To see a concrete example of this, let's consider two neighbors--the A's and the B's. Mr. A watches what he eats, because he tends towards being overweight and has high cholesterol. He runs a mile every morning, doesn't smoke, and doesn't drink except for the occasional single glass of red wine. Mrs. A is a diabetic but takes her insulin and avoids sugar, so she's fit enough to take yoga and kickboxing down at the local gym. The kids eat their vegetables, brush their teeth, and are limited to two hours of TV a day.
Right next door are the B's. Mr. and Mrs. B are chain smokers and couch potatoes. Their kids are overweight and sedentary. Mr. B drinks heavily every weekend. The kids don't take vitamins or eat anything green. Their dinner is usually macaroni and cheese, cheeseburgers and fries, or takeout buckets of fried chicken, with lots of ice cream for dessert.
Family A takes care of themselves and has low medical expenses, save the annual checkups and periodic sports injuries. Family B has no pre-existing health issues but the kids are constantly sick and the adults are both on heart medicine.
Under the current free-market system, the A's would have lower health care premiums on account of being non-smokers and being in good general health. As smokers and heavy drinkers, the B's would have higher premiums. While currently premiums are set to amortize risks and costs over the whole population, they make some differentiation so there's at least some element of personal responsibility.
Now...consider what would happen under socialized medicine, where (1) everyone theoretically has coverage, and (2) medical care is free (free meaning we all pay for it through taxes, because ultimately somebody has to pay). One family has low health care costs and the other has many prescriptions and doctor visits every month. Then Mr. B develops lung cancer. Who get to pay for this? Both households see their taxes rise to pay for the treatment of him and many others like him.
Is this fair? Under socialized medicine, we would all have to pay for the consequences of each other's poor choices. Clearly, the B's are not really getting away with anything--their human suffering is its own cost. But equally clear is the fact that individual consequences are not enough to dissuade people from harmful or self-destructive behavior. What will the government do to keep health care costs down under such a system? Will it mandate that we all quit smoking, set limits on the food we eat, or dictate how much exercise we get? What if we don't follow those guidelines--will we still get free health care?
The current system isn't perfect. But it's better than what they're contemplating right now.
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