John Stuart Mill on the harm principle, “The only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others.”
Michael Tomasky argued some time ago that Mills’ harm principle should be the one liberals use to justify the healthcare mandate:
I can think of no situation that fits this better than the individual mandate, and what is called in the health-care biz the “free-rider” problem. This is the problem that arises from people who don’t have insurance getting into a situation in which they need (and consume) health care, can’t or don’t pay for it, and the rest of us (insured people) picking up the tab. Remember, since the 1980s, hospitals can’t turn people away. That means everyone has access to care, so everyone is in the system—yes, simply by virtue of living and breathing, as the Tea Partiers like to say in griping about alleged federal overreach.
But here’s the problem. Millions of people in this system don’t pay insurance premiums. They are bringing direct and obvious harm to the many more millions who do pay premiums. They make our premiums higher. When they get in a car wreck or have a stroke, they’re amassing medical bills that they can’t possibly pay. The rest of us pay for them.
And that is why the harm principle applies here. The government, under Mill’s definition, has the right and duty to step in to prevent harm to others—by making the free-riders pay. It’s exactly a Millian case of harm to others. And just as it explains why the mandate is valid in this case, it also explains why this kind of government action is limited to health care and can’t be extended to the purchase of broccoli or Chevy Volts or funeral plans or whatever else the conservative justices came up with Tuesday. If you don’t eat broccoli, you cause me no harm. …
It would also have been a more powerful pushback against this silly freedom argument, because it would have said: no, you are not free to make other people pay higher premiums because you’re cheap or you’re young and think you’re invincible. Doing that is no different than walking out on a group check at a restaurant, leaving the others to pick up your part of the tab. That’s a strange kind of freedom
That makes good sense to me.