Saturday, January 24, 2004

Rights & Reason: Treating Cancer by Killing the Market

My colleague Daryl Cobranchi points out this particularly irrational proposal from Delaware Governor Ruth Ann Minner's state of the state address:
Let me turn now to the opportunity we have to combat one of the most serious health issues facing Delawareans: cancer...We now know, thanks to research completed this year, that cancer victims without health insurance receive less than 60 percent of the health care that cancer patients with health insurance get. This means that health insurance for cancer victims can be the difference between life and death...I am asking the General Assembly to make Delaware the first state in the country to guarantee health insurance for every person in the state diagnosed with cancer. Some will say, “no other state has done it.” To them I say, it’s about time that someone did, and Delaware will lead the way.
Daryl points out that "singling out a single class of diseases is the obvious first step to universal health coverage." But there's another danger: If a state government makes insuring cancer patients a government policy, than the state will also seek to reduce its insurance costs—i.e. risks—by targeting any behavior that may cause cancer. We've already seen this happen with tobacco. State governments justified their extortion of cigarette makers by pointing to the large "public health" expenditures treating illnesses with some connection to smoking. This same strategy is now being pursued by trial lawyers against food companies—fattening foods increase the risk of heart disease and diabetes.

Of course, advocates of state power never stop to consider the idea that ending state subsidies for risky behaviors (such as overeating and smoking) via health insurance would cause individuals to take more responsibility for their own behaviors. Personal responsibility, however, is an anathema to the regulatory crowd, since it implies people can act to affect their own lives without state intervention.

And yes, I realize that many cancer patients do not engage in an identifiable risk behavior that causes their cancer. But the personal responsibility principle still applies. A man's need does not create a right to demand others help him. But when a disease affects a wide section of the population, a market will arise for financing research and treatment. Indeed, one of the consequences of government-directed healthcare research is that diseases are prioritized according to political pull rather than objective need. Rarely will you hear a politician propose a cut in AIDS research to fund research on prostate cancer, even though the former is fully preventable in most cases.

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