Free needles, like free lunches, do not exist. Needles cost something - and there are some who believe taxpayers should foot the bill.

After all, the advocates of government-funded "needle exchange" programs say, the pennies each needle costs to distribute to drug users is small change relative to the costs of health care for those druggies who become infected with AIDS, hepatitis, or any other communicable disease.

As a physician, I can say with no uncertainty that it is far better for a person to use a sterile needle rather than a dirty one. Of course, it is also medically much better for someone to avoid putting harmful or addictive substances into their blood stream, or engage in risky sexual behavior.

I can also say, without a doubt, that the policy of distributing needles at taxpayer expense is both dangerous and immoral.

The argument for needle distribution is, of course, a very caring and pragmatic one. The proponents of needle distribution programs point - correctly - to the fact that using a clean needle will prevent the transfer of contagious disease and, therefore, the future health care costs to government will be reduced.

While factually this argument is true, it rests upon a huge but false premise.

Those making the relative cost argument in favor of these programs assume that the taxpayer has some obligation to pay one or both rather than neither. Unfortunately, this will be the focus of the debate. It is much easier politically to lambaste the "drug user" as opposed to the federal health care beneficiary, despite the fact that if one accepts the premise that the federal government has a duty to provide health care, the provision of needles is the fiscally logical choice.

Implicit in this assumption is the notion that the government should compel you, the non-user, to pay for the habit as well as the consequences of drug use. And while I would not stop you from using your own private funds to provide sterile needles to those in your community, it would be immoral for the government to use government force to compel someone to pay for this program.

Of course, this socialistic approach to sharing health care costs is completely at odds with a society which values freedom. There is a casual disregard for risks when an individual knows they will not have to bear the costs associated with the consequences of their actions. Therefore, they respond to this incentive and pursue activities - bad habits, sexual behavior, and on - with riskier consequences than they otherwise would.

This is the socialist's dream. As government assumes the responsibility of paying the costs associated with irresponsible behavior, the more legitimately government can justify its involvement in dictating the behavior. As economist Ludwig von Mises argued, intervention begets more intervention. The only choice is individualism or collectivism because some collectivism always leads to more collectivism, and eventually pure collectivism.

It is unrealistic to expect those who favor government (read "taxpayers") footing the bill for medical costs not to expect the government to then regulate everything a person does which might affect their health. Case in point, the tobacco settlement, and even the helmet and seat-belt laws.

There is a final argument against the distribution of needles at taxpayer expense, and it is an argument which goes more towards the consistency of the entire situation as it relates to the Constitution. Under our current laws, use and possession of particular substances is illegal. Yet needle exchanges would provide services to assist people in breaking the law. This is ridiculous. Our government has become so big, and has stepped so completely outside the limited, enumerated powers outlined in the Constitution, that contradictions such as these are the practical result.

When we allow the federal government to do things it is not constitutionally authorized to do, when we endorse the concept of federal intervention in what is constitutionally state and local matters, we are bound to see government tripping over itself to use its over-reaching powers in ways to satisfy everyone. Again, case in point, the subsidization of both tobacco interests and cancer research.

We must be extremely wary when people advocate the use of governmental force in the name of "free" provision for some. It always costs the taxpayers in the end. We should be even more cautious when the government proposes a way to "help" others, because, invariably, the help not only subsidizes negative behavior or results, but, at the same time, becomes the justification for more intervention.

Such is the nature of collectivism.