But we don’t have a free market healthcare system or anything like it. Most people intuitively believe that everyone should have access to healthcare, even if they deeply disagree on how best to provision it; at the very least, few people would countenance children dying of preventable illnesses simply because their parents are poor. And the crucial thing to understand is that once you extend any societal commitment to provide care, you’re making government intervention into the system inevitable. That’s why various arguments against regulation and entitlements are so wrongheaded, because they suggest a system untainted by government influence where no such system can exist. The default American system of employer-provided health insurance has always left millions uncovered, chained people to jobs they would like to leave behind, and done nothing to guarantee access after retirement. […]
I am well aware that I’m not going to change anyone’s mind here. What I’m trying to do today is to demonstrate that, first, as soon as we make the moral determination that everyone should have at least some access to medical care regardless of ability to pay, any “free market” issues go out the window and government involvement becomes necessary and inevitable. Second, the point is that getting to this point didn’t take any rabid socialist sentiments or anti-capitalist assumptions. You can get here purely through a pragmatic consideration of the underlying reality. Medicine just is not like other human goods; the basics of capitalism don’t work when people simply cannot choose to go without an expensive service, and if we agree that they shouldn’t have to, then we’re left to comprehend how much simpler, more efficient, and more humane our system could be, if we committed to providing care to everyone via the only organization in the country large and rich enough to accomplish that, the United States government.