Cross-posted from MI Health Facts.

In the Sept. 1 Wall Street Journal center-left columnist Thomas Franks sets up some straw-man caricatures of “the right’s” arguments against a federal government takeover of the health care market. One of them is this:

Consider the assertion, repeated often in different forms, that health insurance is a form of property, a matter of pure personal responsibility. Those who have insurance, the argument goes, have it because they've played by the rules. Sure, insurance is expensive, but being prudent people, they recognized that they needed it, and so they worked hard, chose good employers, and got insurance privately, the way you're supposed to.

Those who don't have what they need, on the other hand, should have thought of that before they chose a toxic life of fast food and fast morals. Healthiness is, in this sense, how the market tests your compliance with its rules, and the idea of having to bail out those who failed the test—why, the suggestion itself is offensive.

I suppose some on the right have made that particular argument, but I’ve only seen it offered so explicitly in just one place - a piece by Detroit Free Press columnist Brian Dickerson, another center-left voice, who referred to the impositions on society of a "Cheetos-scarfing, beer-swilling coach potato":

Strolling along the route of the Woodward Dream Cruise this month, my friend Aaron noticed a trio of well-fed spectators wedged into identical lawn chairs on the public right of way. None of the middle-aged men in this comical triptych wore a shirt. Each held a beer in one hand and a cigarette in the other, and all three sported pendulous bellies that spilled over his beltline and glistened in the midday sun.

"There," Aaron observed ruefully, "are the guys whose health care we're about to be on the hook for."

If you've pegged my friend as a staunch opponent of President Barack Obama's health-care initiative, you're mistaken . . .

. . . My own conviction is that everyone ought to enjoy access to some minimum level of preventive and acute care, but that reimbursement for the cost of treating many chronic health problems should depend, at least to some extent, on what steps the patient has taken to avoid them. Just as people who commit felonies forfeit their right to vote, those who make no effort to limit their own risk factors diminish their moral claim on medical treatment.

Perhaps I can resolve the apparent contradiction: “Righties” (at least the fit ones) may not want to be forced by the government to subsidize the bad habits of others, but (perhaps grudgingly) do so when choosing to pay for their own insurance. For their part, some “lefties” wouldn’t mind giving the government new powers to force those "Cheetos-scarfing couch potatoes" to shape up.

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