What if we were just free?
What if my employer paid my entire compensation package in money, and I could do with it what I wish? I could buy cars or books or Chia Pets or travel to Idaho hunting for potatoes that resemble famous political leaders.
I could buy health insurance. Or not.
I could buy any kind of policy I wanted, were I just free. I could take out a plan that covered contraception and abortion, but not pregnancy, if we decide we want no more kids. I could take out a policy that covers pregnancy but not abortion or contraception, if we decide we want endless kids. I could take out a policy that covers addiction treatment, knowing that if I fall off the wagon it's going to take a lot of resources (and repeated whacks with a baseball bat) to get me sober again. But I could also purchase a policy that does not cover rehab, hoping that knowing I could not afford treatment would scare me straight.
If I were just free I could buy no health insurance, instead banking the money to pay medical bills as they came due.
But "just free" societies must have onerous consequences for the imprudent and the unlucky. If we want to be allowed to buy health insurance or not, we must be willing to let folks who choose wrong be bankrupted by medical bills. Worse, we must be willing to let them die for lack of care, and listen to them wail from the gutters.
It seems that over time we've become a society that's not willing to just turn up the TV to mask the cries of the dying. I can accept that. We've guaranteed health care for senior citizens via Medicare, and for the very poor via Medicaid. And we've passed the Affordable Care Act, with penalties to make everyone who can pay for health insurance do so and subsidies to let everyone who is not quite poor enough for Medicaid get coverage.
And because we passed a law that demands everyone have health insurance without having the courage to call it what it is and get all single-payer Canadian on the situation, we have a mess. The Supreme Court says some companies don't have to provide some stuff to employees to preserve some religious freedoms -- but that stuff still has to be provided for those employees somehow.
I'd argue that an atheist who opposes types of contraception he believes to be forms of abortion has as much right to not provide them to employees as someone who opposes them because he thinks God said so.
But maybe I missed the part of the Constitution that says religious people have rights which atheists do not enjoy.
Again, if all my compensation was money and I did with it what I wish, we could save Justices Antonin Scalia, Ruth Bader Ginsburg and the gang a lot of tooth-gnashing and robe dry-cleaning.
If I had my way, I'd pay taxes to make sure no poor person, disabled person or child went without care. I'd let able-minded and -bodied adults who can afford coverage buy it or not, and live or die as they choose.
But if we absolutely insist on universal coverage, we should put the whole nation on Medicare and tax to pay for it. Tax my employer, and the company can pay the bill with the money it now spends on my health insurance. Or tax me, and the company can pay me the money it spends on my coverage. Either way, we'll have to pay for those who can't afford insurance, but we already do.
If we insist on replacing freedom with paternalism and liberty with health care for all, it should at least be done in the most straightforward and efficient manner possible.
There are two ways to avoid the Constitutional contortions over who gets to be free: agree that everyone is, or accept that no one is.