What if Someone Can't Afford Healthcare In a Free Market?

In reply to my comment calling for free market healthcare, which related to the Purple Health Plan I covered on 10/11/13, a correspondent answered:

The free market is not the solution. You want people to spend their own money on healthcare. You assume that people have money to spend. How is a person living paycheck to paycheck making less than $30000 a year afford healthcare. For that matter, how do you pay for healthcare when you're too sick to work?

Here is my reply:

If people don't spend their own money for their own healthcare, then whose money do they have a moral right to spend? Money seized at gunpoint from their fellow citizens? There is a name for a social system in which everyone is forcibly made responsible for other people's needs, but not his own. Can you guess what that system is? And who is its architect?

You're attempting to frame the issue in collectivist terms. You assume as the given that if some people can't afford to cover their own healthcare expenses, there is a problem for "society" to solve. I reject that premise outright. We are individually responsible for taking care of ourselves, and it is up to each of us to figure out how to do that. Health care cost is not a national issue. It is an individual issue, which each individual and family must deal with and plan for in his own way, through voluntary, mutually beneficial contractual relationships with providers and/or insurers. We are not our brother's keepers, and neither is our need an automatic moral claim on the property or labor of others. If a person needs help with medical expenses, his only moral recourse is to ask for voluntary help from friends, relatives, or private charity. But no one has an inherent moral obligation to help him, and neither he nor the government has any right to force others to provide for him. Need is not a license to steal. 

Each of us has his own life to live, and must take responsibility for it. More importantly, each of us has a moral right to our own lives. We need free market healthcare not because freedom magically guarantees that everyone can afford healthcare, but precisely because freedom protects individuals and their property from predators who would forcibly take earnings from those according to their ability, to give to those who did not earn it according to their needs.

Having said that, I also reject the premise that your $30,000 guy would not be able to afford healthcare in a free market. As any good economics textbook and real-life examples will tell you, healthcare (and by extension health insurance) would be dramatically more affordable—and of better quality—in a free market than under government control. And as I've argued before, Americans collectively spend nearly 20% of GDP on healthcare, nearly $10,000 for every man, woman, and child. Nearly 90 % of that spending is by 3rd parties, rather than the productive Americans who earned it. If Americans couldn't afford to pay for their own healthcare, they wouldn't be able to foot that enormous bill collectively. The truth is, in a free market, very few people would be left without adequate healthcare if they were free to spend their own money; and for those few who truly could not afford it, ample private charity would be available. 

But in the end, there are no unchosen moral obligations. The choice is fundamentally a moral one: Take control of your own healthcare, which is your moral right and responsibility, or submit to state control for the sake of people who don't.

Related Reading:

The Answer to "Our Uncontrolled Healthcare Expenditures" is Free Market, Not Single Payer, Health Care