At a recent Rules Committee hearing on repeal of health care reform, a Republican House member extolled the importance of not forcing a business owner to offer his employees coverage “if he doesn’t want to.” Like a lot of recent-- especially conservative-- rhetoric, this idea went to something very basic in political thought. Modern debate is often criticized (rightly) for being too highly-charged, but it should also be praised for engaging more directly basic philosophical differences than do more polite exchanges.
The health care reform law enacted last year requires larger businesses (those with over 50 workers) to provide health care coverage for their employees and sets minimum benefits for that coverage. To liberals this seems like a necessary response not only to the fear and suffering of the uninsured (or underinsured) individual, but also to the societal phenomenon of cost shifting: of large, profitable companies allowing more conscientious businesses and taxpayers to pick up the cost of their employees’ health care. This happens whenever an uninsured patient shows up at the emergency room, can’t pay the bill, and the resulting cost is recovered through higher premiums and government transfers.
Personal liberty is not the only public virtue. As a Democrat on the same committee noted, if we lived in a society that accepted the idea of denying medical care to the uninsured-- of allowing people to bleed to death just outside the ER doors-- then the conservative position on employer health-care mandates would make more sense. But we have set higher standards for ourselves, and everyone (including that reluctant business owner) must help pay the bill for those standards.