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Federal universal health insurance coverage is an invitation for government to further regulate our private choices.

Speaking of the so-called “Twinkie Tax,” Jonathan Cohn writes:

By contrast, calls to impose taxes on unhealthy foods have raised mostly hackles — or worse. When Dr. Kelly Brownell, director of the Yale Center for Eating and Weight Disorders, introduced the notion in a Times op-ed a decade ago, Rush Limbaugh called him part of a "high-fat Gestapo" trying "to force the American people to act in the 'proper' way."

When you put it that way, the idea of a "Twinkie tax," as it has come to be known, really does sound absurdly paternalistic. If you want to load up on french fries, health risks and all, why is that the government's business? Unfortunately, fat consumption really is the government's business in one, very literal, sense. As taxpayers, we all bear the burden of higher medical costs — either directly, by paying for Medicare and Medicaid, or indirectly, by subsidizing employer-based health insurance (which is tax deductible). So, when some people choose to eat poorly, we all end up bearing the financial burden for their decisions. A Twinkie tax would help rectify this, however modestly. Government wouldn't be scolding Americans about their choices. It would simply be asking them to confront the costs of those choices — namely, the future medical bills that fatty foods make more likely. 

Mr. Cohn isn’t some far-left liberal whacko, writing in The Nation or The Progressive; he is a senior editor at The New Republic, an opinion journal aligned with the Democrats, to be sure, but far more moderate than hard left.

He continued:

But the link between the Twinkie tax and health care funding must be explicit. Proponents like Brownell usually talk about using the revenue to finance health education campaigns or otherwise improve dietary habits — thus reinforcing the idea that they are, as one National Review writer put it, "busybodies pining to police your plate." Government could instead earmark the funds for programs like Medicaid (or, better yet, universal health insurance), which provide health benefits for the poor and uninsured. Among other things, this would help address a major flaw in the Twinkie tax: its inherently regressive nature, given that poor people spend a larger share of their income on food.

This is what happens when government becomes too intrusive.  Mr. Cohn likes federalized universal health insurance, as do many on the left.  Their arguments are that everyone incurs health care costs, though unevenly in both time and cost by individual, and that we would be much better off if we eliminated the catastrophic nature of health care costs on individuals by evening things out over the entire population.  It is, essentially, the argument that for an orderly society, everyone ought to be covered by health insurance, and there ought to be no choice to opt out.

But, perhaps unintentionally, Mr. Cohn points out what a government controlled national health insurance would require: increased federal control over our daily lives.  If saturated fats (commonly found in red meat and dairy products) and transfatty acids (used by the food industry in baking or frying) can lead to obesity or increased levels of low-density lipoproteins (LDL cholesterol, or “bad” cholesterol) in the bloodstream, which can lead to clogging of the arteries, and government becomes completely responsible for paying for health care costs, it becomes a compelling government interest to regulate what you eat. 

Now, the federal government did do some good here, as Mr. Cohn noted:

The government has already taken some steps to reduce consumption of unhealthy fats — with some success. In 2003, the Food and Drug Administration (FDA) announced it would require food manufacturers to include transfat (transfatty acids) content on their labels. The industry fought that requirement bitterly. But, with the regulations taking effect next year, manufacturers are busy removing transfat from their products, with companies like Frito-Lay leading the way. The FDA estimated that this change alone could save up to $3 billion a year, on average, in health care costs over the next two decades.

Private companies, seeking competitive advantages, reduced transfatty acid content because they believed that private individuals, making millions of private decisions about what they would and would not buy, would demonstrate a preference toward food with reduced or eliminated transfat contents. 

But there’s a huge difference between private companies offering consumers a choice and government mandating actions.  Will JT’s All-American Steak and Ale Restaurant in Jim Thorpe, Pennsylvania (where the Pico family dines with some frequency) no longer be allowed to serve really fatty foods like prime rib?  After all, if the government has a vested interest in reducing health care costs, the logic exhibited by Mr. Cohn above would certainly cover prohibiting prime rib!

There are plenty of people who seem to find themselves in the business of regulating private conduct.  We see it most obviously when it comes to tobacco: several major cities have major bans on smoking in public places and even private clubs.  One company, Weyco in Michigan, has not only banned smoking on its property, it has banned smoking among its employees .  .  . even at home.

Weyco doesn’t see any problem with banning all of its employees from smoking, even off the premises, even in the privacy of their own homes, and has enforced the policy through at least three terminations. "There's not a liberty right or any other right to have any particular employment, and I think it's time for people in our country to start taking personal responsibility for many aspects of their life, including health care," said David Houston, Weyco’s general counsel.

Well, if Weyco, a private company, can regulate its employees’ liberties to the extent that they cannot both smoke and remain employees, why couldn’t the federal government, if it were responsible for all health care costs, determine that Americans (all covered by the national health insurance Mr. Cohn and so many others advocate) simply couldn’t be allowed to smoke?

Or eat fatty foods?

Or make any of the other private choices Americans are wont to make that don’t necessarily have the best of consequences?

The real problem with Mr. Cohn’s logic is that it is unassailable: he’s actually right about this!

1.  If government is going to be obligated for health care costs, government has a reasonable right to take steps to lower those costs; then

2.  Government has a reasonable right to lower the costs for which it has assumed responsibility; and thus

3.  Government has a reasonable right to regulate private behavior which contributes to higher costs.

Smoking is the most obvious case, and there are plenty of people who advocate government stepping in and making the use of tobacco illegal, period.  The fat police (and the ambulance chasers who Mr. Cohn noted were now following pizza delivery boys) have declared war against fatty foods, and if lawsuits against McDonald’s haven’t been successful yet — nearly 90 percent of Americans say they oppose obesity lawsuits against the food industry — it wasn’t all that long ago that the notion that tobacco companies being responsible for smokers’ illnesses, being that smoking was a private decision, was considered ridiculous.  If the current lawsuit fails, which it probably will, there will be another, and another, until some idiot jury decides that someone is too fat not because of his hand-to-mouth disease, but because McDonald’s forced him to eat that food!

Count on it: federal government action against food producers and restaurants that serve fatty foods won’t be far behind, at least not if government has a huge vested interest in health care costs.

The arguments of the liberals for federal universal health insurance all sound just so good, so compassionate: nobody would be devastated by huge health care costs, people would be able to see doctors before they got really sick rather than having to go through emergency rooms, all of the things like that.  But such coverage is not only the invitation for government to further regulate our private choices, it is virtually the requirement for government to further regulate our private choices.