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Does Mandated Insurance Mean More Paternalistic Public Health Policy?

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Does Mandated Insurance Mean More Paternalistic Public Health Policy?

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There are several questions I’ve been toiling over lately related to health care spending, public health, and paternalism. Here are three: • If the state requires everyone to have health care, does that mean the state should necessarily have a larger role in improving public health? • If my tax dollars or insurance contributions go to pay for a smoker’s lung transplant, is that unfair, and does it give me a right to snatch cigarettes from strangers’ mouths? • And at the extreme end, does federally mandated health insurance also justify more paternalistic policies to improve our individual health? My hunch is that the answer is “no” to all three, although they do raise difficult issues. These aren’t abstract questions, either. In fact, they’re questions that are often raised in Britain, where the National Health Service is funded from general taxation and whose public health policies are often more paternalistic than those in the United States. They are also the questions that are likel

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