On Preventive Medicine

by Jared M. Rhoads

"With expectations for major healthcare reform on the rise, members
of Congress are pushing for comprehensive measures for increasing the
use and funding of preventive medicine. Senators Tom Harkin (D-Iowa)
and Chris Dodd (D-Conn), for example, want to put more prevention
programs in place because prevention is "smart economics in addition
to good public policy."1

Actually, this type of prevention has nothing to do with economics,
and it has no place in any proper discussion of public policy.

Practicing good prevention is a thoroughly personal responsibility.
Signing up for a mammogram, having a colonoscopy, or keeping on
schedule with dental exams are all part of what it means to be a
rational, self-interested adult. The same is true of exercising,
eating well, managing stress, and countless other measures. Sure,
scientific differences of opinion exist over which of these is most
important and why. But is this simple advice really so abstruse as to
require government officials to instruct us how to manage our own
bodies?

Whether in the domain of health, lawn care, or backgammon, the fact
that such-and-such an action is "smart" is not a sufficient reason
for it to be required, subsidized, paid for in full, or in any other
way made the business of the government. Dodd's claim that preventive
medicine is good economics and good policy makes, at best, a pseudo-
logical connection. If it is proper for government to oversee and
involve itself in the care of each man's health, then it is smart to
economize over the long term with preventive programs today. The form
of this argument holds, but where on earth did he get his premise
from?

What Dodd and his colleagues fail to grasp is that government is not
a plaything for do-gooders to improve society in whatever ways they
believe is good—regardless of whether such interventions make
economic sense. We all know what Dodd means: an ounce of prevention
is worth a pound of cure. But while that maxim is wise in the realm
of personal conduct, it is irrelevant to public policy.

Why? Because the sole purpose of government is to protect individual
rights. Whose rights are being violated if John Q. Smith does not
get, does not want, or cannot afford, a prostate cancer screening?
The answer is that nobody's rights are being violated—not Smith's
rights, not his neighbor's, and not anyone else's—so no government-
backed remedy is in order. There is, however, a violation of rights
if citizens are taxed to pay for each other's services; or if certain
preventive measures are made compulsory (or "highly incentivized");
or if insurance premiums are manipulated through selective tax
incentives; or if further licensing requirements are introduced to
mandate the teaching of preventive medicine in medical schools. Each
of these is a distinct possibility given the proposals currently
being discussed.

Legislators may have the power, but they do not have the right, to
intervene with healthcare or any other industry. Nothing they can do
can make such involvement right. Put another way, legislators do not
tell us what rights we have; rights tell us what legislators can (and
cannot) do.

If preventive healthcare is as economically advantageous as
proponents claim, then let people form free associations with like-
minded individuals and purchase—or forgo—healthcare services as they
choose. No programs, no personal fitness czar, no "public-private
partnerships", no "Universal HealthMart." Just individuals living as
they see fit, and managing the natural risks and rewards of their own
behavior. Now that would be smart public policy."

About the Author:

Jared M Rhoads is founder of the Lucidicus Project, which encourages
doctors and young people entering the medical profession to examine
the moral and economic foundations of ideas such as individual rights
and capitalism.

More info here:

http://lucidicus.org/about.php