This attitude is the one thing that keeps me from embracing universal government-provided health insurance. People are so quick to use it as a justification for legal restrictions on behavior.

I wouldn't let someone's knucklehead comment dissuade you from supporting something that would do a huge amount of good for people here in America.

My concern is that this is a popular enough sentiment that universal health care would lead to real reductions in freedom for Americans. I think it's reasonable to be concerned about anything that could contribute to current trends toward totalitarianism.

What freedoms does USA have that European countries with universal healthcare do not?

Bear in mind Portugal has healthcare and legalised all drugs.

I don't know the answer to your question. In the US we already have people trying to use welfare as an excuse to mandate drug testing and control what people are allowed to eat. Maybe this sort of thing never happens elsewhere, but the US is often an outlier in how shitty we can be to people.

It's also my understanding that healthcare was a big part of what convinced people in the UK to vote for Brexit.

Hey, local knucklehead here. I don't want to live in a place where folks don't get the healthcare they need just because they can't afford it. OTOH, the idea that our individual choices don't affect those around us is naive. Freedom and responsibility go hand in hand.

Freedom and responsibility going hand in hand doesn't mean that hobbies with negative health consequences should be illegal.

Never said illegal. If I willingly place myself in a high risk category I should pay for that myself. I may buy a wing suit someday, but I won't ask you to pay for my wheelchair.

Should coal miners get health insurance? What about first responders?

Yes. And their employers should bear much of the risk. The actuarial tables should dictate the cost.

What is this fear of paying for higher risk individuals based on? That more people will start bungee-jumping and skydiving or becoming firefighters and police officers? Part of the point of a nationalized system is that the costs offset- the healthier people use less services than they're paying for, but in exchange, you get to live in a society where everyone can get care regardless of employment, hobbies, or pre-existing condition. The young pay for the old. The idea of adding a bureaucracy on top of that to try to parcel out individual risk and surcharge people sounds like it'd be an amazingly complex waste of money in itself. It also sort of reminds me of China's social credit system, but with your healthcare-cost related activities instead. Would you have to start reporting that you play a game of touch football on Thanksgiving, or that you ride your bike instead of driving a car to get to work? Maybe I walk through a neighborhood where I could be mugged and end up in the ER. Now I have a "walks through bad neighborhoods" surcharge? Where does it end?

It is a matter of fairness. The way insurance traditionally worked is that your cost was proportional to your risk; This is what actuaries do for a living. Insurance companies live and die on actuarial tables. I was asked whether I smoked for my life insurance -- that was a fair question. Of course this will always be a crude estimate, but drug use voluntarily puts one in a higher risk category and actuaries can give you the numbers.

Now this should not be the end of the story. I understand there are folks who need medical treatment that can not afford it. There should always be a mechanism to make sure folks get the necessary help. I would hope the church or some other private entity would step up -- and often do. If not, then the final catch is the government.

The government taking over the whole health insurance industry is a naive solution that will result in crappy coverage for everyone. I don't claim to have a complete solution -- it is a difficult problem. I don't like extremes in either direction : completely privatized and completely government run are both bad solutions.

> The government taking over the whole health insurance industry is a naive solution that will result in crappy coverage for everyone.

This is demonstrably false when you consider the quality of coverage in places like France and Denmark.

I find the fairness argument understandable from a distance, but it falls apart when you look closer and realize the amount of overhead involved in managing such a system where we make sure everyone pays according to their risk profile, which itself, would be dependent on numerous subjective measures not to mention the potential for intentional or unintentional inaccurate reporting. As an example, our tax dollars go to pay for infrastructure whether we're driving on the roads and bridges they pay for or not, and we don't pay more or get refunds if we use more or less roads. Would it be fairer to only charge you for roads you use? Absolutely, but it'd also be a ton of overhead to administer.

What if their employers decline to pay for it? Or what if people with dangerous hobbies decide to take the risk and not pay for additional insurance? Are you OK with these people dying because they can't afford to pay for their health care?

Every now and then I hear of someone in a wing suit dying. I don't like hearing about anyone's death, but I realize they knew the risks. I am not sure where I stand on legalization of various drugs, but I do feel they should have a higher insurance rate. I'm am not OK with anyone dying, but my sympathy level does vary. In fact, I have a higher sympathy for folks who are hooked on various drugs and are trapped by their lifestyle. I am not above my own addictions.