Where survival, basic health, or dignity are at stake, persons should be entitled to society's support. In first approximation, a fair system of such support might be one that is funded out of revenues raised from those who might call on it. For example, tobacco users are entitled to any additional essential medical care they may need as a result of their habit, and the cost of such additional care is funded out of tobacco taxes.

Some may object to this system that it unduly restricts their liberty. They prefer not to fund the support and not to receive it should they need it. These objectors fall into two groups: Some want the support but pay for it as needed. The others want to forgo the support altogether.

In some cases it would make sense, ideally, to exempt people in the first group. Thus consider some of your recreational ocean-going sailors, for example, who do not want to contribute to marine rescues of people they consider irresponsible amateurs. Each of them gives society some financial guarantee that she will pay the full cost of any rescue she may need herself. Cumbersomeness aside, why not exempt such people from any rescue tax on ocean-going vessels?

Consider next those willing to forgo support or rescue in exchange for saving the tax. I think society should generally refuse this exchange. For one thing, it may be impractical -- to ensure that everyone on board an untaxed boat is a competent adult who has signed the waiver, for example, or to decide quickly whether a particular heart attack is due to smoking or not. More importantly, it is morally odious to ask our coast guard to stand by as people are drowning or to ask our emergency-room doctors to leave some serious tobacco-related health problems untreated.

These same moral reasons are decisive in cases where those needing support or rescue did not and cannot contribute. Our society should pay for its coast guard to rescue sailors and for its doctors to treat smokers even if those in trouble have not contributed to its tax revenues and cannot pay for the service. This is a duty of decency, not fairness, that any moderately affluent society should discharge, out of general tax revenues, toward indigent foreigners, for example, and toward its own citizens who are unable or unwilling to earn their own living. This includes all children, of course, and all mentally or physically disabled. And it even includes able-bodied and competent adults who refuse all employment. They too should nonetheless have access to basic food, water, clothing, medical care, shelter, and public toilets.