As I’ve confessed several times on the radio show, I make it a habit to stop and pick up litter every day in the neighborhood where we live. One of my big frustrations while walking to services on the Sabbath (Saturday morning, a two-and-a-half mile walk) is that Jewish law doesn’t allow me to pick up the trash and carry it to an appropriate receptacle. But I certainly notice it--- and today took special note of several cigarette packages tossed carelessly, thoughtlessly to the side of the road.

This particular form of litter gave rise to several thoughts: first, most obviously, that it shouldn’t be surprising that smokers who are careless about their own health should also behave carelessly by tossing their trash to the side of the street in a pleasant suburban neighborhood. I also recognized that my angry annoyance at this sloppiness and lack of consideration ought to be tempered with compassion, or at least pity—many smokers (I know, not all) would ultimately pay a price for their habit (smoking, not littering) in terms of health and longevity.

And this gave rise to another question: why should non-smokers pay for the health problems of people who choose to consume cigarettes? Obviously, the notion of subsidizing a dirty, self-destructive habit is absurd. But that kind of subsidy would be an almost inevitable consequence of the sort of sweeping governmental health care program liberals have long advocated. In fact, we already subsidize smokers to the tune of billions of dollars, no doubt, through the Medicare Program.

Think about it: life-long smokers who reach the age of 65 are likely to endure all sorts of health care problems and costs that non-smokers will avoid--- that’s why private medical insurance policies provide lower “non-smoker” rates. But since Medicare is a taxpayer supported program, smokers and non-smokers pay in their money at the same rate. It’s horribly unfair!

Expanding governmental financing of the health care system would only expand the unfairness. Isn’t it appropriate that the people with self-inflicted health problems or risks (smoking, alcoholism, obesity, irresponsible sex and the resulting diseases) should pay higher premiums for their insurance?
Of course, since everything is supposedly a “disease” today, and beyond any element of individual control – sex addiction, alcoholism, heroin, obesity, etc.—it’s politically incorrect to make people responsible for their own behavior. That’s why it’s so important to allow the market to work!

In fact, even with our private insurance system, there’s too much governmental interference. Why shouldn’t insurance companies be allowed to evaluate the health risks of their customers and price their policies accordingly? For instance, it’s well known that gay males have a much lower life expectancy than straight males – and single guys have a much lower life expectancy (and generally worse health) than those of us lucky enough to be married. Why should it be against the law (as it is in nearly all states) to set health insurance premiums based on marital status and sexual orientation?

With all Americans rightly complaining about the crushing cost of health insurance (a much bigger burden than the price of gas, by the way), we ought to help people save money by allowing more choices, not fewer. For instance, in Washington State the legislature just passed a bill requiring that every health insurance policy must include protection for psychiatric illness… and this particular requirement could raise the yearly cost of a typical policy as much as $300 a year—or much more, after a few years.

This is absurd. I would strongly prefer to avoid “mental health” insurance and if I lose my mind (some people believe I already have) we’ll just have to pay for treatment ourselves. In any event, I prefer to save my money and take my chances (after all, I have a wife in the business—as a psychologist). But my choice to avoid psychiatric protection – or to save money on my policy by declining any coverage for myself in the case of HIV/AIDS infection—isn’t allowed, by state law.

In other words, government already won’t let us benefit from good health decisions, nor will it require us to bear an extra burden from bad health decisions. Of course, an enlarged governmental role in health care will, inevitably, make it even harder to get people to pay for the consequences of their own decisions or lifestyles.

This suggests a new way to argue against socialized medicine – or “health care for all” as the new Democratic slogan would have it. We should ask the public – do you believe that non-smokers should subsidize the smoking related health problems of smokers? If you don’t think that’s fair (and since over 80% of Americans are now non-smokers, you can bet most people will think it’s wildly unfair) then we should rise up together to stop the insanity of turning over health care financing to the government.
It seems that this is a strong new way to make an argument that even enlightened smokers (yes, there are many such people) would support.