Don’t expand Medicaid in Iowa

Health insurance should not be considered a “human right” as the Register advocated on 1/31/2013 (Health insurance for poor is a human right).  When the term “human right” is used in conjunction with a product or service, such as health insurance, (or food, or shelter, or clothing), it implies that government should use its force to take property from some people to make sure that everyone is provided with that product or service regardless of cost.  Rights that require the use of force by government to take  from some to give to others are called “positive rights.”  Positive rights are only possible if some of the people work, create, and save their property – so that it may be taken and distributed to others.
The kind of rights that are guaranteed by the Bill of Rights of our U.S. Constitution, are called “negative rights.”  Negative rights do not require any action by anyone else and do not infringe on the rights or the property of anyone else.  For example, I have a right to speak , but you don’t have to listen.  I can practice my religion but you don’t have to believe.  I can form a union but you don’t have to join.  I can open a business but you don’t have to patronize it or work for me.  Negative rights are are based on the idea that we are each free individuals who own whatever property we create or acquire honestly and peacefully through voluntary social interaction and cooperation with other people.
The current question is whether or not to expand Medicaid in Iowa.  The fact that most, if not all, of the funding comes from the federal government does not make it free for Iowans.  Money from the federal government is not “free money.”  The more fundamental question is how far do we expand Medicaid.  The number of people in Iowa on Medicaid increased by 23% from 2006 to 2010.  Today, more than one out of five Iowans are on Medicaid.  Of course, many more people would like to be covered by Medicaid.  Who wouldn’t like to have someone else pay for their health care?  Governor Branstad is correct to not expand Medicaid.  Instead, we should make sure that we our current spending is being used as effectively as we can.
Register article:

4 thoughts on “Don’t expand Medicaid in Iowa

  1. As someone whom I respect is fond of saying, “Let me know where you sit before telling me where you stand.” The writer of this piece did an excellent job of explaining where he stands on the expansion of Medicaid, but for those not familiar with his background, I think it is important to understand that he approaches this issue (indeed, all issues) from a Libertarian perspective. What this means in practical terms is that he sees basically all government-imposed redistribution of wealth to be anathema, regardless of need.
    It is one thing to identify with Libertarian principles, i.e., doctrines to which adherence is worthy in a general sense. However, to view every economic scenerio through such an intractable prism is not only insensitive to those with legitimate needs, but betrays either ignorance or apathy about why so many are struggling.
    I’ve now indicated where I stand, but here’s where I sit: Over the past seven years, I’ve gone from being a “have” to a “have not.” This transformation has given me a perspective I probably would not have otherwise acquired. As a result, I’ve come to believe that dogmatism (libertarian or otherwise) is rarely a virtue.
    On a personal not, the writer to whom I’m responding is my oldest and dearest friend, a person who has been very generous to me throughout our friendship of over 40 years. That notwithstanding, I felt it incumbent on me to give him, and his readers, a different approach to consider.


  2. John, Thanks for your comment. It is emotionally not easy to advocate that government should not provide for those in need. Helping those who cannot help themselves is a good, moral, and honorable thing to do. I don’t question the intentions of those who want to use the force of government to make everyone contribute to good causes, But, I do believe they are morally wrong to use the force of government to require everyone to pay.. Charitable causes should be supported voluntarily.

    It is neither insensitive, ignorant, nor apathetic to advocate for voluntary, private solutions to our problems. We had voluntary mutual aid societies and charities long before government got into the business of using force to make everyone pay. Today, we have gone way too far in using government and taxes to try to solve our problems. Government solutions create dependency and reduce our ability and will to try voluntary social cooperation to solve our problems. I will continue to advocate for a civil society where government is limited to resolving disputes and protecting our lives, liberty and property against those who would use force or fraud to take those things from us.

    “Some may say that I’m a dreamer, but I’m not the only one.”


    • Kurt, you said in your most recent comments, “Government solutions create dependency and reduce our ability and will to try voluntary social cooperation to solve our problems.” Perhaps. But if that is the case, surely the same can be said of charitable solutions, for I doubt that the recipient of either type of aid cares much about where it comes from, but rather only that it comes when needed.
      You’ve determined that the proper role of government is to provide for the defense and safety of its citizenry, but not for their health and well-being. I accept that for what it is, i.e., a thoughtful opinion. It is, nonetheless, quite arbitrary. For example, regardless of how things were once done, the system we have today seems to be at least minimally acceptable to most people, despite its inefficiencies and fraud. Moreover, who’s to say that charitable organizations would be able to carry the weight of so many people and families in need? (And if not, then what would you propose?) Finally, if honest, you’d have to admit that, were we to carry your principles to their ultimate conclusion, there should be no need for government whatsoever. If the people want a national defense, let them pool their resources and provide for it themselves — why impose such a cost on those who are willing to take their chances? The same with police, roads, bridges, and anything else you can think of. The line you draw, my friend, is not only arbitrary, but drawn at just the location that suits your needs and desires. If you stop to think about it, you’re really not so different from anyone else — it’s all about where one chooses to draw the line, and in every case, that seems to be an arbitrary decision.


      • John,

        Your are mostly correct about the ultimate conclusion of my position.

        I start with the fundamental philosophical idea that each of us has an ownership right in our own bodies and other property that we justly create or obtain. (How we justly create or obtain property can be another lengthy conversation.) The idea of “ownership” or “property rights” means that an owner gets to have physical control over his property to the exclusion of others. It also means the owner has a fundamental right to defend himself against anyone who would use force or fraud to take his life, liberty or property. It also means that we have a right to restorative justice for any damages caused by people who use force or fraud against us. I also believe that punishment is morally justified in certain cases. (A person should not be allowed to use force or fraud again and again and only be subject to restorative justice if caught.)

        Next, I add the fundamental philosophical idea that each of us should be free to act without restriction as long as we don’t use force or fraud, and as long as we don’t infringe on the property rights of others. (Again, we could have a long conversation about property used in common – namely our environment – and the proper role that government does have in regulating and protecting our common environment.) We should be free to voluntarily interact socially with one another, including trading our labor and our property. To the extent that people act truly voluntarily with one another, there is mutual benefit and no one is harmed. We may get together and form “governments” to mutually protect our life, our liberty and our property. Anyone who does not want to join or participate in our voluntary “government” should be free to do so. But, just as I have a natural right to defend myself and my property, a group who creates a government has a right to defend themselves even against those who don’t voluntarily subject themselves to that government.

        To cut to the chase, if all that I advocate were put into practice, it would result in a voluntary government that would not be allowed to use its force to require anyone to pay or participate, and it would not be allowed to restrict the peaceful and voluntary actions of groups and individuals. Those who could not or choose not to pay might be able to “free ride” in some situations, but where possible and desired, users of government provided products or services would be required to pay, and those who did not pay would not get to use the service. There would be a government, but it would be much smaller and narrower in scope. It would be likely that we would not have many of the benefits that are provided by our current government system. (No bailouts, no too-big-to fail, no farm welfare, no grants or guaranteed loans for economic development, much less intervention in foreign affairs, and on and on.)

        As far as my position being arbitrary, I disagree. It follows logically from my fundamental philosophical ideas: ownership of self and private property, no use of force or fraud, voluntary and peaceful cooperation among people. I believe that what is immoral for an individual to do does not become moral because it is done by a majority through government.

        I understand that what I have described is a Utopian ideal that is not achievable in my lifetime, if ever. Nevertheless, I will continue to advocate for and support activities that move us in that direction.

        p.s. I’m nearly to the end of reading Anarchy, State and Utopia by Robert Nozick – which deals in detail about much of this subject.


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