The Myth of Choice_ Personal Responsibility in a World of Limits - Kent Greenfield [66]
Notice where we are. A respect for choice, if taken seriously, does not translate into the simplistic libertarian prescriptions often trotted out on the heels of personal responsibility rhetoric. It is impossible to have accountability for choices with no legal or regulatory mechanism to enforce it. What’s more, an insistence on personal-responsibility-as-choice means that individuals can be required to buy insurance, to make sure the financial costs of their decisions are not borne by others.
This brings me to the nation’s recent debate over health care. Throughout the fight over national health care reform, its opponents consistently attacked President Obama’s plan as inconsistent with notions of personal responsibility and personal freedom.7 They argued that we do not need government to take care of us—people should exercise personal responsibility and take care of themselves. If they wanted to buy insurance, fine. But the government should not make them do so.
With the motorcycle illustration fresh in our minds, the flaws in the personal responsibility argument opposing health care reform become clear. If personal responsibility involves actually being responsible, then it is consistent with that notion to require people to make the mature judgment to purchase health care for their families. If personal responsibility means that people can choose and then pay for their choices, then insurance is the best way that payment can be assured. If people are allowed to make bad health choices and also refuse to purchase health insurance, it essentially forces the rest of us either to foot the bill financially or to live in a society where we are forced to watch our neighbors suffer.8
President Obama’s plan could have easily been called the Personal Responsibility in Health Care Act. To allow people to avoid paying for their own health care is inconsistent with both visions of personal responsibility. Purchasing health insurance is not only the responsible thing to do; it is also the best way to ensure that people actually pay for their choices. Instead of defending health care reform as an act of redistribution, cost saving, or altruism, the president should defend it on the grounds that it is the only way to make people take personal responsibility for their health care decisions.
3.
Respect for choice does not mean an absence of legal or governmental involvement, even for decisions as personal as whether to wear a motorcycle helmet. Most of our actions impose costs on others. Sometimes a respect for the autonomy and choice of others means that lawmakers or regulators need to step in, if only to make sure we pay the cost of our own decisions—either after the fact through judgments or fines, or before the fact through insurance. So the notion that personal responsibility means the law or government has nothing to say about our decisions is flat wrong.
And it’s wrong for another reason.
Let’s say there is a referendum on the ballot asking for a vote on whether to ban text messaging while driving. And let’s assume that I believe in personal-responsibility-as-choice. That is, I believe that wherever possible, the government should let me decide my own fate. Let’s also say—and this is true—that I text while driving sometimes, though I am embarrassed by the habit and avoid it when someone else is in the car (especially my wife, who won’t suffer it).
Is it obvious which way I should vote on the referendum? One might think that because I believe in personal-responsibility-as-choice, the last thing I want is for the government to tell me what to do, especially with my cell phone in my own car.
But the answer is not so easy. I may be convinced that texting while driving is almost always a poor decision. Like the decision to not wear a motorcycle helmet,