Tuesday, July 10, 2012

Lifeguards and the Logic of the Shared Responsibility Payment

In a widely reported incident last week, a Florida lifeguard was fired for rescuing a man who had been swimming in an "unprotected" part of a beach. The Right has been quick to portray the incident as an example of the nefariousness of regulation and intrusive laws. Corey Robin notes, "Jonah Goldberg uses it as an opportunity to rail against liability law and union regulations. Even though no unions were involved and the major culprit here, it seems, is the privatization of public services." One could even argue Mr. Lopez's firing has to do with the nature of contracts and restrictions on conduct in the workplace (for more on this issue check out this post at Crooked Timber). 

Contrary to Goldberg's laments about the "the legal regime in this country that's creating a headwind against basic human decency," the sorry case of a lifeguard fired for saving someone's life illustrates the logic of the shared responsibility payment.

A person who chooses to go without insurance is like a person who chooses to swim in the "unprotected" part of the beach. In theory, both do so at their own risk. The swimmer makes a choice to disregard the signs alerting beachgoers to swim at their own risk just as someone makes a choice to disregard the risk of getting sick while uninsured. And yet, if something happens to either person, someone must perform a rescue. For some, like members of the crowd at a GOP debate who yelled "let him die" in response to a question about healthcare for the uninsured, letting someone needlessly die isn't a problem. But for those who care about others, and even, I suspect, for Mr. Goldberg, there is a moral obligation to save the drowning swimmer and the sick uninsured. 

Saving the drowning swimmer in the "unprotected" area requires that the lifeguard leave his post and at the same time put the beachgoers in the formerly protected area at risk, unattended. Likewise, providing care to the sick uninsured requires that resources and personnel be allocated from somewhere else to care for the uninsured patient. In both instances, the people who ignore the risks associated with their behaviors expect and require society to foot the bill for their rescue. The shared responsibility payment acknowledges the societal cost incurred by the uninsured's risky behavior, and requires that the uninsured pay for the care he will receive, should he fall ill. Extending this logic to the case of the lifeguard, a shared responsibility payment made by the risky swimmer to the lifeguarding company would have provide the necessary resources (e.g. another lifeguard, an extra buoy) to eliminate an instance when a lifeguard would have to leave his post to rescue a risk-taking swimmer. 

The shared responsibility payment is a natural outgrowth of a market-oriented society. Places that were once public, like beaches, are privatized and under corporate control. Goods and services that would otherwise be guaranteed to any member of a polity, like healthcare, are now sold with little regard for basic human need. In a capitalist economy, the value of which the Right and people like Mr. Goldberg incessantly praise, everything can be commoditized. The shared responsibility payment represents a full embrace of the idea that healthcare is a commodity; to a receive a service, even one that is lifesaving, absolutely necessary and entirely non-volitional, costs money. The Right's discomfort with this idea suggests either that they are less comfortable with the increasing commodification of all aspects of daily life than they pretend to be, or that they really would prefer to let the sick uninsured die and the risk-taking swimmer drown.

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