There are other children born with disease and disability, like cystic fibrosis or juvenile diabetes. Unlike our chronic smoker, who has brought about his own health problems, these children face severe disadvantages in life, through no fault of their own. These children—and the many adults who endure similar misfortune—are worthy of our attention, and our charity.
By the classical liberal understanding of negative rights, that mother who bears a child with Down Syndrome has no right to my financial support. But surely, in the wealthiest country in the history of the world, we can afford to pool our resources to care for those who truly need our help. I, for one, would be glad to pay a portion of my earnings to fund high-quality health care for the truly needy.
But that is not what we do in America. We massively subsidize health care for wealthy seniors, through Medicare, and for wealthy workers, through a provision of the tax code called the employer tax exclusion. Those two programs alone cost us over $1 trillion a year, and do much to make American health care absurdly expensive. They also make it much harder to fund health care for the poor and the uninsured, by starving the government of resources it could direct to that purpose.
Did you know that in America—this alleged bastion of the free-market—the government spends more per capita on health care than all but three countries in the world? In 2010, U.S. public entities spent $3,967 per person on health care. That’s far more than Germany, Canada, France, Britain, and all of the other countries we conservatives normally think of as socialist dystopias.
This point is so compelling that it has become a standard talking point on the left. “Not only would a single-payer system provide health care to everyone,” they say, “but it would also reduce the deficit.” And they’re right.