How Much Insurance Are You Ethically Obligated to Buy?

In ’s entry I wrote about how I felt dishonest about not having health insurance, since I knew that if I were seriously injured I would try to get as much good health care as I needed even if I couldn’t guarantee that I could compensate the doctors and such for their care.

So a devil’s advocate asks me:

Hmmm… That does seem to make things stickier. In the legal case, I think I’ve got an argument. For starters, if I do actually incur a debt, either through negligence or deliberately, then I consider myself morally obligated to pay it to the extent of my ability (and while continuing to respect other moral obligations) — if I leave the debt unpaid then I’ve failed. So my intention is to live my life without incurring debts that I can’t pay. However, the best laid plans, etc., etc.

In any case, I don’t see advice from the legal system as a particularly good way of determining my actual obligations. In some cases, extensive legal precedent is a good way of navigating the ethics of contracts and such, but the actual practice of legal decision-making is so clouded by bullshit and politics that in any particular case in which those precedents are applied it’s very hard to tell whether an actual moral obligation is being enforced, or if it is just the result of lawyers and politicians fighting over money.

So in short, while I am concerned about inadvertently incurring an obligation that I might be unable to pay despite my best efforts, I am not as concerned as a moral matter about being unable to pay a debt that is imposed on me as the result of a legal decision.

But aside from all that, as a practical matter, where would I go to get “paying off any debts I accidentally incur but am unable to pay insurance?” In the real world, I have to rely on luck and good intentions.

Which begs the question of whether the same applies to health insurance*, but I think there is a difference between the two.

The question of whether I should insure my friends and family is more troublesome, because the logic is really very similar to what I used yesterday. Let’s say that my best friend is driving with me somewhere and we get in a wreck. I come out with a broken nose that my insurance can deal with, but my friend is comatose and in real trouble and is uninsured. The doctors ask me if he can pay for the life-saving medical treatment he needs. I say I’m not sure. They ask me if I will — I say I’m not sure if I’ll be able to. They ask if they should go ahead anyway. Of course, I say yes.

By yesterday’s logic, if I know I would do this, I should insure everyone I care about (or at least everyone who is insufficiently insured) so that I know now that I will be able to compensate those whom I may call upon to provide them life-saving care. Of course, I can’t afford to insure all of them — not on my tax-free low-income — which seems to be a possibly effective ethics attack on my strategy.

I’m suspicious, though, of any ethics attack that seems to say that I’m ethically obligated to try to earn enough money to buy enough health insurance to compensate everyone who may be called upon to deliver needed medical care to anyone I care about. That sounds pretty out-there. But I’m also reluctant to say it’s a reductio ad absurdum on ’s argument. Hmmm…

And so The Picket Line degenerates from “Tax Resistance Blog” to “Small Business 101” to “Thought Experiments in Ethics.”

* — Applying for health insurance is like something out of Kafka. You fill out a dozen forms detailing your personal life in uncomfortable detail and are almost inevitably told that you’re SOL. I’m a pretty healthy fellow, but was recently turned down because of a head injury I had about eight or nine years ago (and haven’t needed treatment for since). It could have been twenty years ago — the form just asked me if I’d “ever” been treated for such a thing.

And although insurance is supposed to pay for your care if the shit hits the fan, the insurance companies are keen to drop you or fight you if they’re ever put in the position of having to pay a serious claim. Which kind of upsets my ethical argument. If I couldn’t guarantee that I could pay my bills even with insurance, why bother?

Is health insurance just a costly scam — a suit of armor made out of the same fabric as the Emperor’s New Clothes?