Tibor R. Machan

TANSTAAFL is an acronym for "There Ain’t No Such Thing As A Free Lunch," popularized, according to Wikipedia, "by science fiction writer Robert A. Heinlein." But the saying caught on mostly with classical liberals and libertarians who have a philosophical commitment to tell the truth about public policy matters. The current version should, however, be changed to TANSTAAFHC, meaning "There Ain’t no Such Thing As Free Health Care" despite what Obama Care champions pretend. 

Consider Sarah Lyall, who wrote–in her essay pushing to something like the UK’s National Health Service here in the USA, titled "An Expat Goes for a checkup, Here and Abroad," published in The New York Times on August 16th–that "Certainly, as someone who in the 1980s paid $333 to have an emergency room doctor at Georgetown University Hospital remove a piece of toilet paper from my ear after I had unsuccessfully tried to use it as an earplug, I applaud a system that is free." 

Never mind about the stupidity of stuffing one’s ear with toilet paper–whatever turns you on, I say. But why should anyone other than Ms. Lyall be paying for the removal of it? Because, let’s face it, there really is no such thing as free health care. Doctors want to be paid, as do nurses, medical labs, the clerk in the various facilities, the drug manufacturers, as do all others working in the health care industry. (I am also pretty sure that Ms. Lyall wants to be paid for her work that produced the essay about the wonderful free system in the UK which, of course, is anything but free.) Someone must pay for it all. 

But of course Ms. Lyall isn’t alone in advocating the "free" system–moreover, to her credit, when I contacted her by e-mail she answered that "You’re absolutely right that the NHS isn’t free, but is paid for by the taxpayer, and I should have explicitly said that in my article. But by that measure, I do indeed help pay for it: I pay British (and US, too, alas) taxes." In its coverage of the debate, which has featured some people on both sides of the Atlantic, UK produced magazine, THE WEEK, in a short piece published August 22, 2009, and titled "Knocking the NHS," also referred to the NHS as providing "free health care," which it clearly is not. It’s no more free than are freeways in the USA. But because many people do share the primitive magical belief that the name one gives to something influences its nature, politicians who favor socialized medicine–meaning medical care that is provided at the expense of taxpayers many of whom would rather take part one that involves no government and involuntary wealth redistribution at all–as well as all their academic and journalistic cheerleaders keep calling government mandated and taxpayer funded health care "free." 

But saying something is "free" will not make it so. Among the few free goods and provisions in the world health care is certainly not one. Perhaps the heat from the sun, when the clouds are hiding, is free. Maybe so is motherly love, at least to a baby. But because life requires support from hard-to-come-by materials, the work needed to discover and deliver those materials must be paid for by someone. And the case recounted by Ms. Lyall indicates pretty directly why collectivizing the provision of health care services is unjust–after all, all those folks who take better care of themselves than to stick toilet paper into their ear should not have to foot the bill for those who do and then must be provided with medical services to rectify their imprudence. 

It is interesting, by the way, that just at this time it has stopped being politically incorrect, even illegal, to discriminate against people who neglect their health. It is beginning to be OK to refuse to hire smokers and obese people because their condition, often brought on by themselves, imposes costs on employers. (It used to be considered unjust discrimination to refuse to hire the obese among us, not so long ago, actually.) That there are inconsistencies lurking here seems to have escaped many public commentators, including ones who were avid supporters of certain provisions of the Americans with Disabilities Act that made it illegal to discriminate against, well, obese people, at least in enough cases to have a chilling effect on those who would refuse to hire them. (

The most important flaw in both the UK’s NHS and similar systems around the globe, as well as the comparable proposals coming from the Obama administration, is that they treat all of us as if we were members of a voluntary group the membership of which has accepted the obligation to care for all. But the USA or UK is not such a club. They are countries where people are supposed to have the liberty to either sign up or refuse to sign up for systems of wealth redistribution, including health insurance. 

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