John Edwards says that his universal health care plan will be mandatory not just for taxpayers and doctors, but for patients: You will get preventive care, and you will like it:

“It requires that everybody be covered. It requires that everybody get preventive care,” he told a crowd sitting in lawn chairs in front of the Cedar County Courthouse. “If you are going to be in the system, you can’t choose not to go to the doctor for 20 years. You have to go in and be checked and make sure that you are OK.”


He noted, for example, that women would be required to have regular mammograms in an effort to find and treat “the first trace of problem.”

As Jon Henke notes, Edwards also proclaims that “the right to choose and the right to privacy are fundamental constitutional rights.” But apparently abortion is the only thing you have a constitutional right to choose. You have no fundamental right to choose not to get a mammogram. Or any other kind of preventive care. Shades of This Perfect Day and Brave New World.


This is, of course, a fundamental problem with socialism, or with socialization of the cost of anything. Edwards sincerely believes, with good reason, that preventive care helps to reduce costs by catching problems early and helping people stay healthy. (Though he may not be right about that.) But why is my health care budget his concern? Because he plans to socialize the costs of health care. So indeed, if I fail to take care of myself, I’m imposing costs on the collective. And as the collectivist-in-chief, Edwards wants to treat me as a national resource, not as a free adult individual.


This isn’t the first time such arguments have been made. What’s the argument for requiring adults to wear bicycle helmets and seat belts? That otherwise the taxpayers might have to pay for the costs of injury. Activists who want to restrict smoking, trans fats, and other unhealthy habits make the same argument: The collective is going to be paying for your health care, so you owe it to us to hold down our costs.


When we realize that socializing costs creates such unpleasant conflicts, we can respond in one of two ways: We can move away from socialization and allow people to make their own decisions and bear the consequences, or we can increasingly restrict freedom in order to hold down collective costs. Libertarians prefer the former approach, John Edwards the latter.


In One Flew over the Cuckoo’s Nest, Nurse Ratched was a tyrannical nurse who forced medical care on people who didn’t want it. She was known as “Big Nurse,” which might be a better metaphor for our increasingly therapeutic state than “Big Brother.” Democrats love Hollywood celebrities (and vice versa). Maybe Edwards can get Louise Fletcher to do a health care tour with him. She could wear her state nurse’s uniform and sing “You Belong to Me.”