The rule of rescue is important here not only because of the way it affects our allocation of resources, but because it refutes the liberty claim against compulsory insurance. Someone who can afford insurance, but exercises a choice not to buy it, and then is hit by a bus or has a serious illness, will impose a claim on others – family, purchasers of insurance, taxpayers, somebody somehow will pay for their urgent care – and thereby others will be deprived of property and their liberty impaired. No-one can be said to have a right to do that.
The Rule of Rescue, operating not only at the extreme of life threatening contingencies, but even in more mundane circumstances where identifiable people are already less critically ill, fundamentally distorts the way we allocate resources. This is a famous poem in public health circles. It was written in the 1890s, long before the medical institution became the Blob that Ate the Economy.
‘Twas a dangerous cliff, as they freely confessed,
Though to walk near its crest was so pleasant,
But over its terrible edge there had slipped,
A duke and full many a peasant.
So the people said something would have to be done,
But their projects did not at all tally.
Some said, "Put a fence around the edge of the cliff,"
Some, "An ambulance down in the valley."
But the cry for the ambulance carried the day,
For it spread through the neighboring city,
A fence may be useful or not, it is true,
But each heart became moved with pity,
For those who slipped over that dangerous cliff;
And the dwellers on highway and alley
Gave pounds and gave pence not to put up a fence,
But an ambulance down in the valley.
Then an old sage remarked, "it’s a marvel to me
That people give far more attention
To repairing the results than to stopping the cause,
When they’d much better aim at prevention.
"Let us stop at its source all this hurt," cried he.
"Come, neighbors and friends, let us rally.
If the cliff we will fence, we might almost dispense
With the ambulance down in the valley.
(The Ambulance in the Valley by Joseph Malins)