Free healthcare may create sedentary and irresponsible lifestyle

The argument

The argument is about incentives rather than about cost. Free healthcare, on this view, alters the calculation individuals make about looking after themselves, and it alters it in the wrong direction. The starting premise is that healthcare should be a last resort. What actually produces health is upstream of treatment: a healthy diet, regular exercise and ongoing personal development are the things that keep people well, and medicine is what is called upon once those have failed. Any arrangement that makes the last resort cheaper and easier to reach changes how hard people work at the things which come before it. That is the mechanism proponents describe. Where treatment carries a personal cost, the prospect of needing it supplies a continuous reason to take preventative measures. Remove the cost and the reason weakens: people may become less motivated to make healthy decisions, worrying less about prevention because the consequences of neglecting it have been underwritten by someone else. The behaviour is not irrational — it is the predictable response to a change in what neglect costs the person doing the neglecting. The consequences follow at population scale. If enough people relax their attention to diet and activity, obesity becomes more common; where nutrition is neglected in other ways, malnourishment does too. Proponents argue that a broader slackening of personal responsibility tends to accompany these, as the habit of managing one's own wellbeing erodes across society rather than only in the individuals who first stop exercising it. The conclusion is that free healthcare buys short-term access at the price of long-term health. It treats more illness while producing more illness to treat, because it removes the pressure that kept people attending to their own bodies. On this reasoning healthcare should not be free — a system which asks something of its users is what keeps them from becoming its patients.

Context

Humans are risk takers and free healthcare might make them believe they can take more risk that might endanger their lives and livelihood.

Premises

Counter-arguments

Free healthcare has far too many benefits that outweigh the small portion of the population that might abuse this newfound medical freedom. The medical world, since the beginning, has been dealing with a fear of cost to maintaining a healthy life. Some people are so afraid of that cost that they would rather not seek medical help instead of taking on massive debt. Free healthcare would allow for everyone to be able to see doctors and receive care for all their medical needs. While there would be an increase in patients and doctors visits, there would not be a real increase in those with ailments. The only thing that would change is people coming in when they actually need help or advice.

Rejecting the premises

[Rejecting P1] The counter identifies the existing incentive as working the wrong way round: fear of cost has long deterred people from seeking care at all, with some preferring to go without rather than take on substantial debt, so removing the charge brings people to a doctor when they need one rather than removing a reason to stay well. [Rejecting P2] The predicted deterioration is not what the counter expects to follow: more appointments would not mean more illness, only that those already unwell present themselves, and it treats the portion of people who might misuse the arrangement as small against the benefit of universal access.