In commenting on a libertarian take on health care, Ezra Klein notes,
Health-care services are somewhat unique in that they’re a rare form of consumption that you often get and get charged for, even if you haven’t asked for them. If you collapse on a street, an ambulance will rush you to a hospital. If you get into a car accident, you’ll wake up in intensive care. If you start suffering from dementia, your family will ask the doctors to help you.
The (or a) libertarian view may be that I ought to be able to live as I wish, purchase insurance or not, and be free of impositions of the choices of others, even if one of those choices is to save my life.
Ezra is right that our society doesn’t quite work that way. A simple reason for that is that my life is not entirely my own to the extent (some) libertarians may think it is or ought to be. I am not the only one who cares about the consequences of my decisions. I am not the only one who suffers or enjoys what comes of them. I am not the only one who cares about whether I live or die. I am not the only one who matters.
It’s not just some vague “society” that cares about my life. It’s much more concrete than that. It’s the people I see every day, that I live with, for whom I’m, in part, responsible and on whom I rely. It’s my family, friends, and co-workers. They all care about my life. I care about theirs. My life is not entirely my own.
Some may say that’s all by choice. I could have been a hermit. That’s quite a presumption of the extent of my feasible set of lifestyles. I am human and therefore social. All or most of you are too. Consequently, your life is not entirely your own either. You are not a hermit. I will send the ambulance for you. Welcome to a society that does at least that. Yes, somebody has to pay for it. If you (we) reject a socialized payment mechanism in favor of a private or libertarian one, it may be you who gets the bill. Consider it the price of being human, social, and surrounded by people who care. You can’t have it both ways.