You know some people pay for sex. But did you know some people are having sex – and you’re paying? Government health insurance now includes trying to improve people’s sex lives. I’m all for improving folks’ sex lives, but with our tax money?

Government insurance is the first problem. Insurance was designed to protect us from the unexpected: floods, fire, severe illness, catastrophes that cost more than most of us can pay. But today, people expect insurance to cover everything, even routine things like eyeglasses and dental treatment. This is a terrible idea. Insurance is a lousy way to pay for anything.

Once some faceless stranger is paying for what you do, you don’t have an incentive to control costs. On the contrary, you have an incentive to get as much as you can and leave the other person with the bill. Doctors also have an incentive to run up the bills. Patients rarely complain, but they might complain if the doctor skips a test. Insurance companies know this, of course; hence the torturous bureaucracy: the paperwork, the phone calls where you beg them to pay, the times they refuse to pay for what you thought was covered.

I can’t blame them. They’re just trying to protect themselves from fraud and hoping to have enough money left over to stay in business. Government insurance is worse than private insurance. A private insurer has an incentive to cut costs; every dollar wasted comes out of profit or must be recovered by raising prices, which drives customers away. Government just raises taxes or increases debt. So when our bloated government picks up the tab for poor people’s health costs, guess what it buys: Viagra! In 2004, Medicaid spent $38 million on drugs for erectile dysfunction.

There was outrage recently when people learned the government health program was paying to give Viagra to sex offenders. When that hit the headlines, officials started cutting off subsidies for rapists’ erections. But why should taxpayers have to buy Viagra for anyone? Because the Clinton administration told states they have to. Current federal officials have kept the policy. They wouldn’t agree to a television interview about it, but they told us that the law requires that drugs approved by the FDA must be covered by Medicaid.

Many doctors defend the policy. “Erectile dysfunction is not fun, it’s a disease,” said Dr. Steven Lamb, who wrote a book about Viagra. “It needs to be treated. It needs to be paid for.”

I gave him a hard time about it: “Sex is a government entitlement now? … Do you ever think about budgeting? What the taxpayer pays?”

“What we’re trained in is to be your advocate,” he said. “I do not take costs into account.”

Of course not. Government medical insurance gives doctors a free pass on cost. They declare “needs” knowing someone else will bear the cost. If you had to pay for your own medical care out of your pocket, you might choose to forgo some expensive treatments in order to have money for a nicer home or for better education for your children. But when the government taxes you to pay for what other people “need,” you don’t get that choice. You are forced to buy Viagra for some man you’ve never met.

Does he really need Viagra? Do you really need the money for other things? If you are pursuing happiness, as our founding document says you have the right to do, your most important need is to be free to determine your own values, make your own choices, and live your own life. You need a government that will protect your contracts, so that you can make money, acquire property, and keep it once you have it.

You also need a government that understands it’s up to you to meet most of your needs. Otherwise, the money and freedom the government will take away will be limited only by the needs people can claim.

Mr. Stossel is co-anchor of ABC News’s “20/20.” ©2005 By JFS Productions Inc.