Thomas Jefferson is famously reported to have said, “A government big enough to supply you with everything you need, is big enough to take away everything you have.”  Although there is some dispute over whether Jefferson actually said this, there can be no dispute about the logical correctness of the sentiment.  The power to give resources necessarily includes the power withhold them.  The power to allocate necessarily includes the power to allocate unjustly. Once citizens cede an economic power to government, they forever risk that power being used to compel their behavior, affiliation, speech, or even beliefs.  This conclusion is not merely speculative or philosophical –it has been verified, time and time again, by history.

The coercive potential is the true danger of the “health care reform” proposals before the United States Congress.  The President, many in Congress, and a good number of citizens, seek to debate only the details of how to most effectively manage a fundamentally top-down, controlled health-care system.  This debate is, however, ornamental.  It misses entirely the most critical objections to the proposals, which sound in the premise that it is emphatically not the government’s role to have a hand in allocating substantial economic resources.  Whether or not the government can do so effectively (history resoundingly and conclusively suggests “not”) is a side-issue, not worthy of discussion in the central debate.  The question “should we” must be answered before we are qualified to ask “how should we.”

Assume for the sake of argument that all of President Obama’s claims on this issue are true.  Assume, for the sake of argument that for once in history a free lunch exists, and its main course is that the government can somehow provide to everyone in America equal or better health care than we enjoy now, at a substantially lower cost.  Even assuming the truth of that proposition, no sane person who values freedom would submit to a  government-run health-care system.

Government-run health proposals are designed to require citizens to depend on the government to allocate health resources, either directly by mandate, or indirectly by making private employer-based insurance economically unrealistic (in other words, by creating huge market distortions that discourage behavior the market would otherwise encourage, and visa-versa–the same way we ended up in the mortgage foreclosure mess).   Either directly or indirectly, the end result is the same–if you want to see a doctor, the government gets a say in who, when, for what, and even if.

In other words, under a government-run health care system, the government ultimately (again, directly or indirectly) allocates health resources.  Having the power to allocate, the government must then decide how and to whom to allocate, and it must make zero-sum choices between citizens in doing so.  Nothing stops the government from doing so expressly and for reasons unrelated to individual health needs.  If, for one not-unrealistic example, the government were to decide that high infant and adult mortality rates among blacks justifies disproportionately increased levels of care to remedy an artifact of discrimination, the increased allocation must come at the expense of non-blacks.  Non-blacks would receive a smaller allocation of health services because the government arbitrarily decided that others were more deserving.  To put in bluntly, some people would be statistically likely to die because the government decided they were less worthy of care.   Like all victims of tyranny, those who lose in the zero-sum game of top-down allocation have no recourse.

More nefariously, nothing would stop the government from using its power to allocate health resources to compel behavior.  For another not-unrealistic example, what would stop the government in such a system from denying or reducing care for those who engage in behaviors deemed “undesirable”–like smoking, or eating trans fats,  or having too many children?  It is no response to say that these are “private” behaviors.  If the government is responsible for health care costs, it logically has an interest in everything that creates a need for health care.  In other words, it has an interest in everything done by citizens that affects their health.  In other words, it has an interest in everything.  History shows that governments eventually succumb to the temptation of using the power inherent in the right to allocate.

Once the government has a say in everything, Jefferson’s warning becomes all too real, and the liberty the great men of his generation fought to achieve becomes all to tenuous.  No man who values his freedom can accept the government has his parent, priest, or, especially, as his doctor.