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Opinion

Barrier to better health care: Republican definition of freedom

Republicans oppose the health-care law's insurance mandate because it curbs freedom. Do they oppose traffic lights, too?

By Anthony L. Schlaff / January 18, 2011



Boston

If traffic lights were invented today, the Republican Party would be against them.

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After all, aren't traffic lights a perfect symbol for government imposition on individual freedom? The government takes our money to build and maintain them, and then uses them to tell us when we can stop and when we can go.

But anyone who drives in a city knows how necessary traffic lights are. In fact, they increase our freedom of movement, making it possible for us to move at a reasonable pace through a crowded city. Try driving through cities in parts of the world where they don't have traffic lights or where the social norm is to ignore them. Who has greater freedom: Those unrestricted by traffic lights who sit for hours in a traffic jam, or those who obey the law, and get where they want to go?

This thought experiment about traffic lights points to how simplistic and wrong-headed current Republican rhetoric about freedom is. Freedom is about rights, choices, and opportunities. Government action, whether through laws or taxes, does not necessarily restrict freedom. As with traffic lights, it can enhance freedom, and we need to be thoughtful, not reflexive, in how we view what we ask of government.

Take a more complicated and politically contentious issue: the mandate to purchase health insurance. This is clearly an imperfect mechanism, as private insurance is an imperfect product. Nevertheless, does an insurance mandate really take away freedom, or does it enhance it?

What kind of freedom do we really want?

The answer becomes clear when we consider the kinds of "freedom" that the status quo – a lack of such government involvement – imparts. How many of us want the freedom to face medical bankruptcy, or the freedom to be denied coverage (and care) because of a preexisting condition? And how many of us see dying, due to lack of insurance, from a treatable or curable disease as an acceptable cost of individual liberty?

As with traffic lights, there is a trade-off; we cannot get something for nothing. The only way to have a system that guarantees necessary care for those in need – to give us the freedom to live our lives without that fear – is to make sure everyone is included in the system.

Broadly speaking, there are only two ways to do this: by requiring everyone to purchase insurance or by using a tax base to have government provide that coverage for all. There's an argument that the tax-based (single payer) solution might be even more liberating – but we need not make that argument here.

As for the notion that the new health-care law robs us of freedom because it is a mandate, let us not forget that we as a society created our government to make our choices and we used this mechanism to do so. This was an exercise of our freedom!

Freedom starts with the opportunity to make choices, including the choice of whether to act individually or collectively. A choice once made sets us on a more limited path – but are we not freer for making choices rather than remaining forever frozen in a prechoice world of possibility but no fulfillment?

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