Health and Freedom Go Together
If we change our mindset, Americans can live longer and freer lives
Sometimes you can solve two problems at once. Illness and tyranny form a vicious cycle, as we saw in 2020. Health and freedom form a virtuous cycle. The two values work together.
In America, freedom is presented as half of an unavoidable tragedy, of some hard choice where one good thing must be sacrificed for the sake of another. An example we get all the time is freedom and security. Of course you want freedom, we all agree that freedom is good: but let me tell you about this threat to national security, and how it means that you must accept restrictions on liberty. That is how our public conversations proceed.
We hear this script so often that we accept it without reflection. And yet such thinking is foreign to the spirit of freedom. The point of being a free person is to weigh up the difficulties oneself and to try to find some kind of reconciliation. Sometimes freedom and security may turn out to be in conflict. But not always. Not even usually. Very often the thing that makes you free also makes you more secure.
Democracy, for example. In a democracy you enjoy the right to representation, an important freedom. At the same time, you are less likely than under other forms of government to be drawn into a pointless war. You are both more free and more secure. It is easy to think of more examples. Imagine that your government guarantees a free press, and creates favorable conditions for investigative reporting. Thanks to local reporters, you learn that your water supply is polluted. Access to the facts has made you more free and more secure.
When we are told that freedom is always in conflict with some other value, we end up losing both freedom and that other value. We also lose the habit of thinking for ourselves. Politics becomes a game in which we lose all the time in the arenas that matter most: how long we live, and how well.
Our tragic mindset about freedom is evident in our debates about health care. Of course you want health, we all agree that health is good: but unfortunately, we are told, you cannot have both universal health care and individual freedom. There is some purported conflict there, which is never quite specified — and that is because it is does not exist!
We take for granted that the Left will talk about health care, and that the Right will talk about freedom. We think that this political opposition somehow reflects real life, that there is some sort of hard choice to be made.
But this is nonsense. There is no conflict. There is no hard choice. There is an easy win-win. Health and freedom work together. Health is a human right, as I wrote last time; and access to health care makes us freer citizens and freer people.
Before I explain how this works in the next post, let us have a look at some democracies beyond the United States. After all, if there really were a tragic conflict between universal health care and individual freedom, we would expect some countries to have one, and some to have the other.
But the real world tells a completely different story. Lots of countries have both universal health care and individual freedom. Quite a few democracies are both healthier than we are and freer than we are. The very fact that there are such countries, and lots of them, tells us all we need to know. In democracies health care and freedom work together.
Freedom House, the American NGO, rates liberty around the world. The three countries with perfect scores in political liberties and civil liberties for the year 2020 were Norway, Sweden, and Finland. In different ways, but in each case with more government involvement than the United States, these three countries provide their citizens with universal access to health care.
If you think Scandinavia is too high a standard, consider the other English-speaking countries. Canada, Great Britain, Australia, and New Zealand all score higher than we do in civil and political liberties, and all find ways to get all of their citizens access to health care. In all of those countries, people live longer and freer lives than in the United States.
It is we who stand out. And we stand out because we alone make the mistake of believing that we have to choose between health and freedom. In case you were wondering: in the Freedom House rankings of civil and political liberties, the United States is about sixty countries behind the leaders, and dropping. In life expectancy we rank in the forties, and are also dropping. We could and should be a much freer country than we are, and a much healthier one.
No one likes making a mistake. So it is easy to get defensive at this point, to say nationalist things that feel good: “we are the freest country in the world, we have the best medical system in the world.” No, we are not; no, we don't. We could do much better in both domains, but we have to see our mistake first. We have to see that freedom and health go together! If we do that, we can make a better country for ourselves and our children. That is the right and patriotic thing course of action.
Health care is a human right. It does not challenge but bolsters freedom. We can expand freedom and improve health by offering all of our citizens and residents access to health care, as for example by the kind of single-payer system that is now under discussion.
This is not how we are used to thinking about the issue! But when our mental habits are oppressive and lethal, we should change them. Why suffer needless illness and tyranny for the sake of an error? Why not be freer and live longer? In the next post, I will list ten ways that universal access to health care would make us more free.