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Governance, Continued

"The ultimate result of shielding men from their folly is to fill the world with fools." –Herbert Spencer (1820-1903)


A few more words about my post of Saturday. When restrictions of governmental payments are proposed based on age, contribution to society, personal habits or errors, there is commonly an outcry. Such efforts are considered mean-spirited, prejudicial, racist if they in any way fall more heavily on blacks. Complaints are made that the government is not taking care of all of its citizens, or its most needy, or its youngest, its most vulnerable.

None of this is true. The arguments being made are emotionally manipulative and inflammatory. They in no way contribute to a serious discussion of government's role, and are intended to manipulate the opinions of the uninformed and misinformed, who vote in large numbers.

We as a nation have given certain roles to government. Our societal premise is that the government has no intrinsic rights or privileges. WE give them to the government, not the other way around. This by conception gives credit for individual outcome to the individual, not the State. And it puts the burden of choices, effort and outcome on the individual as well. Government cannot, by conception and practical limitation, adjust the outcomes determined by individual effort.

Government, in the course of the Great Depression, was given the task of providing an ultimate safety net to prevent people from starving to death in tents and on the street. This concept has been extended to making government responsible for preventing individual failure. This distortion is in turn expressed as government being responsible for 'correcting' society's inequalities in outcomes. What started as the very last of preventive measures is now a belief in roles for government contrary to reality, let alone our Constitution.

Outcomes are not guaranteed. Effort and risk assumption have reward. To remove risk by preventing the consequences of failure takes away the rewards of risk and effort. There is no incentive to try if everyone gets a free pass at success in the end. We have reached a point where individual achievement is not applauded, only attacked as being the result of some unfair advantage, and then taxed to support everyone. Collective responsibility is assigned for individual failure. All this does is decrease individual effort, since there is no loss for failure, and no great reward for success.

I made specific examples of inappropriate governmental involvement in welfare support for pregnancy, and certain types of health care for the morbidly obese. I want to expand those comments.


In our society, the large majority of unintended pregnancies occur when no contraception was used. This is not societal failure, as we have free contraception readily available, and it is not method failure, as no method of contraception was used. This is individual failure. A substantial proportion of these pregnancies occur in single women, with fathers who do not stay involved. There is no family framework within which to raise a child, and the pregnant woman typically ends up poor and unmarried.

When we pay additional welfare money for such pregnancies, we are not 'helping the child', 'helping the most helpless' or 'helping people rise up in society'. We are subsidizing behavioral error. This subsidy allows men to walk away from children they father, and women to engage in sexual activity without real concern for contraception. All our additional societal payments do is to support and perpetuate individual errors of behavior. The State is not responsible for the choices of individuals. If there is no payment for children, people will think more carefully about how and with whom they have sex. What sounds mean-spirited is not simply good for the State; it is good for the individual as well.

Obesity is a national problem. 2/3 of adults are either overweight or obese. It is so bad that people, like myself, who meet the medical classification of morbidly obese (my BMI is 31.5) are considered attractive and in good condition. We do not even notice obesity socially until someone is quite remarkably fat- BMIs of 40+, even 50+. Individuals with BMIs less than this are called 'big and tall', 'fluffy' or 'thick'. They are not. They are obese, with significant associated medical risk. I have not done well in maintaining my own weight, but I was explicitly told I would have to lose weight to qualify for a transplant. that is a powerful inducement for exercise and weight loss, I assure you.

And yet, we have no such inducement for the obese. We will finally require the posting of nutrient values of fast foods in a prominent location in the store, but other restaurants do not have to do this, and their menus are just as bad. We encourage people to overeat. The enormous majority of my patients think a serving of meat is 8 ounces, when in fact it is 3. And when people become obese, we have free health care for the secondary problems- joint disease, diabetes, heart disease, peripheral edema. When these individuals become unable to walk, they are given motorized wheelchairs at governmental expense. There is no personal responsibility for the consequences of personal choices and actions.

Like, pregnancy, when people are responsible for the results of their own choices, they have a powerful incentive to choose differently. We currently have no such incentive for the obese, encouraging their food consumption while subsidizing their problems. This is unreasonable on both ends. we should be encouraging healthy eating by increasing licensing fees for restaurants with inappropriate portions, much like we charge a licensing fee to serve liquor. There are many more problems caused by obesity than alcohol. And we should stop subsidizing failure by limiting governmental payment for care of illness caused by obesity.

Organ donation involves a distillation of these ideas. There is a limited supply of organs for transplant, and the issue is one of life and death. Potential recipients are therefore carefully screened medically and psychologically. Many who desire organ transplant are not candidates. They smoke, use drugs, are morbidly obese. There is no issue of 'fairness' or a complaint that organs must be available for 'our poorest and most vulnerable citizens', or any other manipulative slogan. There are criteria applied equally to everyone. If you do not meet them, you are not a candidate for transplant. Your choices, your life, your organ, your death. Government does not have endless resources. Government involves choosing. We can not provide for everyone's needs, nor should society be asked to do so. Like transplant programs, government has not only reason, but responsibility to determine benefits based on suitability and behavior.

These ideas are not mean, they are not hostile. They are simply based on reality. Society cannot assume responsibility for individual outcomes, and especially cannot, in the name of kindness and fairness, pay for the consequences of individual failure. Like Jesus, besieged by those desiring healing, we must declare 'heal yourselves'. Government is not the answer.

"The ultimate result of shielding men from their folly is to fill the world with fools."

Ted






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