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Why universal health care is a Libertarian ideal

Reality Master 101 (179095) writes | more than 7 years ago

User Journal 4

Disclaimer: I'm not a Libertarian, though I'm sympathetic to *some* of their ideas. A lot of them are crackpot, though.

Universal health care has been traditionally an idea that Libertarians despise, because it's directly against the Libertarian ideal of personal responsibility, and not "stealing" from others to support oneself. In this small essay, I'm going to argue that Universal Health Care *is* necessary to a free Libertarian-style society.

Disclaimer: I'm not a Libertarian, though I'm sympathetic to *some* of their ideas. A lot of them are crackpot, though.

Universal health care has been traditionally an idea that Libertarians despise, because it's directly against the Libertarian ideal of personal responsibility, and not "stealing" from others to support oneself. In this small essay, I'm going to argue that Universal Health Care *is* necessary to a free Libertarian-style society.

First, let me say that for most of my life, I've been adamantly against Universal Health Care, primarily because I don't trust the governmen not to screw it up. I still believe this, but I've come to believe that UHC is necessary anyway.

The reason is because modern UHC is not directly subject to market forces, hence the reason health care costs are completely out of control in the U.S. The underlying reason is health insurance. Once people stopped paying directly for health care, they stopped caring what it cost. In fact, they had an incentive to get the *most expensive* health care. Why not? "The insurance company is paying for it." And the Doctors certainly have no incentive to keep costs down. Might as well order a few extra tests. The result of this are costs spiralling ever upward.

Now, Libertarian think tanks are aware of this, and their solution was the idea of "medical savings accounts", where people (in essence) get a refund for not using health care. This is a really weak incentive. It helps a little, but it still doesn't address the fundamental corruption of market forces. That this is the best the Libertarians can come up with ought to tell you how impossible it is to fix.

So given that market forces can't work, and in fact people are getting bankrupted every day by health costs, the only solution is really for the government to step in, as inefficient as that can be.

So, even if that's the only solution, why do I say this should be a "Libertarian Ideal"? Let me first start with what most Libertarians think the government *should* do. One of the most fundamental functions of government is to provide a legally level playing field, for example, contract law. Most (hopefully all, but you never know) Libertarians wouldn't argue that contract judges should be privatized. There needs to be a relatively fair legal environment for business.

So how does UHC fit into this? One of the fundamental tenants of Libertarianism is the idea of personal responsibility, that in the end, one should take care of oneself through hard work.

And that's the crux: someone *can't* take care of oneself if they are not physically capable of it. It's unreasonable to say to someone, "I realize that your leg is broken, so work harder so you'll have the money to fix your leg." People cannot be productive without being physically healthy, just like people can't be productive without a reasonable legal environment.

Note that health care is different from other items, say, food. If I'm hungry, it's *is* reasonable to say, "go out and work, so you can afford to buy food." Physical health is a very different idea. It can actually *prevent* the Libertarian ideal of working to support oneself.

So, just like a stable legal system is necessary for a healthy capitalistic society, so is a healthy workforce capable of working to support themselves.

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err... (2, Insightful)

Zak3056 (69287) | more than 7 years ago | (#20401307)

The reason is because modern UHC is not directly subject to market forces, hence the reason health care costs are completely out of control in the U.S. The underlying reason is health insurance. Once people stopped paying directly for health care, they stopped caring what it cost. In fact, they had an incentive to get the *most expensive* health care. Why not? "The insurance company is paying for it." And the Doctors certainly have no incentive to keep costs down. Might as well order a few extra tests. The result of this are costs spiralling ever upward.

It seems to me that your proposed solution would actually make this problem worse (instead of "the insurance company" being the one who is "paying for it" it will become "the government" who we all know has unlimited money... hell, if they run out, they can just print more, right?) A result of this would be that we are still on the "health care costs spiraling out of control" treadmill, only this time instead of insurance premiums groin through the roof, it'll be taxes instead.

Re:err... (1)

Zak3056 (69287) | more than 7 years ago | (#20401389)

only this time instead of insurance premiums groin through the roof

Err, that was supposed to say "going" instead of groin... though when talking about health care costs, it seems sadly appropriate as written.

Re:err... (1)

Reality Master 101 (179095) | more than 7 years ago | (#20401555)

It seems to me that your proposed solution would actually make this problem worse (instead of "the insurance company" being the one who is "paying for it" it will become "the government" who we all know has unlimited money...

True, but the government has a great deal more power than insurance companies. An insurance company can negotiate better prices, etc, but the government can *order* better prices. They can drag providers before congress and make them justify increases, like the postal service has to.

A result of this would be that we are still on the "health care costs spiraling out of control" treadmill, only this time instead of insurance premiums groin through the roof, it'll be taxes instead.

Believe me, I'm not a fan of the government running things. But in this case where market forces *can't* work, it's better to have elected officials in direct control. At the moment, nothing is controlling the price increases.

I can't prove it (I've seen some studies, but I don't trust studies about this issue), but things are so out of control, I strongly suspect that if the government stepped in and brought things under control, it would actually cost less in taxes to cover everyone than the cost of the current situation.

And believe me, it pains me to admit, I generally hate the government. :) But having recently had some medical issues, I *could* *not* *believe* what they cost. It was highway robbery.

It's not libertarian at all... (1, Insightful)

wynler (678277) | more than 7 years ago | (#20417063)

First let's address your argument:

"The reason is because modern UHC is not directly subject to market forces, hence the reason health care costs are completely out of control in the U.S."

So the current health care system is not directly subject to market forces (due to government intervention), and your proposal is to completely eliminate the market instead of removing the restrictions?

"The underlying reason is health insurance. Once people stopped paying directly for health care, they stopped caring what it cost. In fact, they had an incentive to get the *most expensive* health care. Why not? "The insurance company is paying for it." And the Doctors certainly have no incentive to keep costs down. Might as well order a few extra tests. The result of this are costs spiralling ever upward."

This is not the reason.  No other industry that is overseen by insurance has this problem (cars, houses, business, life, etc.)  I don't suddenly quit caring about totalling my car because I have "the most expensive" insurance on it.  Why is that?  It's called denial of service.  If I continue to total my car (to get a shiney new one), my rates will skyrocket and eventually I will be denied coverage by all companies.

Due to government regulation, the health insurance industry is heavily restricted in what they can and can't deny.
If people knew that when they went in for a cold 6 times a year their rates would go up or they may be denied renewal, this would stop.

Combine that with those who don't pay (emergency rooms used as clinics), and that's where your high prices are coming from.

"Now, Libertarian think tanks are aware of this, and their solution was the idea of "medical savings accounts", where people (in essence) get a refund for not using health care. This is a really weak incentive. It helps a little, but it still doesn't address the fundamental corruption of market forces. That this is the best the Libertarians can come up with ought to tell you how impossible it is to fix."

Citations please. Because all of the studies I've seen from Libertarian groups basically say deregulate the industry.

"So given that market forces can't work"
You haven't shown this.  Your very first paragraph state: UHC is not directly subject to market forces.
How do we know market forces can't work, if we've never even tried?

"and in fact people are getting bankrupted every day by health costs, the only solution is really for the government to step in, as inefficient as that can be."

Why should the government step in because people are being bankrupted?  Bankruptcy happens from poor financial decisions, and in this case comes from people not preparing themselves for a medical disaster.

"Most (hopefully all, but you never know) Libertarians wouldn't argue that contract judges should be privatized. There needs to be a relatively fair legal environment for business."

Why not?  There's a term called Arbitration that handles the majority of business disputes.  These are basically private judges.  I'm not saying that it's a great idea for all areas and levels of contract space.  But I don't know of any Libertarians that are against the idea.

"and that's the crux: someone *can't* take care of oneself if they are not physically capable of it. It's unreasonable to say to someone, "I realize that your leg is broken, so work harder so you'll have the money to fix your leg." People cannot be productive without being physically healthy, just like people can't be productive without a reasonable legal environment."

Whether or not someone can take care of themselves does not abrogate them of the responsibilty.  It is irrelevant to the Libertarian stance.  The whole point is that noone else should be required to take care of them.

Everyone is required to take care of themselves.  If they cannot, as long as noone else is injuring them or defrauding them, it's their problem.

You're also making an assumption that everyone needs/wants/deserves healthcare and the ability to be seen by the medical industry.

The problem with the current medical industry is a combination of the following:
-Government regulation insurance carriers on what they are and aren't allowed to cover
-Hospitals being forced to treat people who can't cover their bills.
-Inability to get medication without first consulting someone in the industry.

I am not allowed to take care of myself.  I cannot write myself a perscription.  I cannot have blood work done.  I cannot diagnose, treat, or otherwise help myself because it is currently Illegal.  The market is not being allowed to work, because the government has eliminated all other options.

Universal health care is not a libertarian idea at all.  The only way it can be acheived is by forcefully taking resources from one group and giving to another.  Which is completely unacceptable.
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