The Main Issue of Ayn Rand Accepting Medicare isn't Hypocrisy

With the elevation of Paul Ryan, various Rand stories are getting some more play and I'm fully supportive of efforts to highlight his profound links to the noxious author, particularly since he has made recent efforts to distance himself at least from portions of her image (in particular her atheism, and I'm sure her being pro-choice doesn't help either).  One story in particular wasn't understood properly when it first broke.  Hopefully I can help it along to its proper place in historical context. - D. 

In 2011, news broke that notorious libertarian ("objectivism" was what her school of thought was called to be precise) Ayn Rand had accepted Social Security and Medicare in the 1970s after she was diagnosed with lung cancer (unsurprisingly she was a cigarette-cancer connection denier).  Among liberal circles, a lot of attention was paid to the hypocrisy angle of all this.  A person who spent her life railing against collectivism and dependency accepting the benefits of the very programs her beliefs called "evil."

To the defenders of Rand, the common defence is that Rand had paid into these programs through her involuntarily seized taxes, and if she was going to be forced ("at gunpoint" as libertarians always say) to pay for these programs, why shouldn't she at least get something back from them?  Actually, I don't really disagree with that.  Liberals didn't support the Bush tax cuts, but I doubt many liberals gave back the government the extra taxes they would have had to pay under the Clinton rates after the tax cuts passed.  You're not typically morally obligated to martyr yourself for your beliefs. 

A Failure of Ideas, Not the Individual

No, the really important fact that this episode reveals is not Rand's hypocrisy, but the utter failure of her ideas.  Even she couldn't live without the social safety net.  Here's how the woman who persuaded her to take part in socialism explained it to a fellow objectivist in 1998 (emphasis added):

“The initial argument was on greed,” Pryor continued. “She had to see that there was such a thing as greed in this world. Doctors could cost an awful lot more money than books earn, and she could be totally wiped out by medical bills if she didn’t watch it. Since she had worked her entire life, and had paid into Social Security, she had a right to it. She didn’t feel that an individual should take help.”

McConnell asked: “And did she agree with you about Medicare and Social Security?”

Pryor replied: “After several meetings and arguments, she gave me her power of attorney to deal with all matters having to do with health and Social Security. Whether she agreed or not is not the issue, she saw the necessity for both her and Frank. She was never involved other than to sign the power of attorney; I did the rest.”

Ayn Rand was at that point a very successful author with several best sellers that continued to sell well.  No, she wasn't a billionaire or anything, but she was certainly not hurting for cash in ordinary people terms.  This site claims* that the NY Times reported her estate as being worth $500,000 at her death in 1982.  An online inflation calculator says that's worth $1.2M today.  Most people would be thrilled if they were told they'd be worth that much in retirement. Yet even so, Rand looked into the giant gulping maw of the for-profit medical industry and blinked, fearing her cancer would bankrupt her.

That's the failure here;  Rand needed society's help.  Rand ran headlong into the very premise of why Medicare was created in the first place:  The for-profit insurance market is very very bad to the elderly and particularly to those already stricken with serious diseases like cancer. 

Naturally, Rand showed no signs of rethinking anything in the face of her own personal failure to survive in the world she would see created.  If prominent intellectuals sitting on piles of royalties for perpetually successful books can't survive unaided by Big Government in Randland, who can? 

* - that author actually uses that figure of $500,000 to claim Rand didn't need to take Medicare but I think the quoted part above shows the person closest to her deciding to take part clearly thought fear of medical bankruptcy was a primary motivating factor.  Also, while it's possible $500,000 would have been enough to cover her medical bills to death in 1982, her estate would have been worth a lot less had she remained off Medicare.  Further, 1974 Rand would have no way to know how long she would live.  Finally, a big part of the safety net is not just the literal fact of avoiding medical bankruptcy, but having the sense of security that you won't.  I would bet heavily that Ayn Rand slept a little more soundly after going on Medicare knowing she wouldn't die a pauper under any circumstances.