Do obese people deserve medical treatment?

Faced with an “obesity epidemic“, that has dramatic consequences for medical costs, pundits have proposed different solutions, ranging from excluding obesity from health insurance, government-run prevention campaigns, higher taxes on junk food, or higher premiums for fat people.

The possibility of greater government involvement in medicine with the passing of ObamaCare puts this debate in a new light. If the government decides who gets money for medical treatment, the question of whether fat people deserve medical treatment will become a political issue.

The question of who "deserves" treatment is only conceivable in a welfare state. In a free, capitalist society, people are able to allocate their wealth according to their judgment of the merit of their own and other’s health, including the degree to which they are culpable for their condition. However, there is no rational way to allocate property taken by force.

Does Jake, who became paralyzed because he liked extreme sports, or Kate, who has lung cancer because she is a smoker, or Mary, who has problems because has a tendency towards obesity which she does not try to control with diet or exercise, or Sue, who is dying from old age, and whose life might be slightly extended at tremendous cost deserve my money?

Once the idea that theft is justified because others need something is accepted, there is no objective way to decide which group is more "deserving" or which values are most "needed." There is no way to make moral evaluations when "need" trumps justice and morality.