Reality Master 101's Journal: Why universal health care is a Libertarian ideal

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.

err...

[Zak3056]

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:

[Zak3056]

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:

[Reality Master 101]

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

It's not libertarian at all...

[wynler]

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 i