Against healthcare theater

13-Aug-09

Megan McArdle has a long post on her reasons to oppose nationalized health care, most of which I agree with:

I know, most of you have already figured out why I oppose national health care. In a nutshell, I hate the poor and want them to die so that all my rich friends can use their bodies as mulch for their diamond ranches. But y’all keep asking, so here goes the longer explanation.

Along similar lines, John Mackey, CEO of Whole Foods, posted the The Whole Foods Alternative to ObamaCare

While we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead, we should be trying to achieve reforms by moving in the opposite direction—toward less government control and more individual empowerment. Here are eight reforms that would greatly lower the cost of health care for everyone:

Arnold Kling posted an eloquent defense of the superiority of exit, rather than voice as a defender of freedom:

Neither my local supermarket nor any of its suppliers has a way for me to exercise voice. They don’t hold elections. They don’t have town-hall meetings where they explain their plans for what will be in the store. By democratic standards, I am powerless in the supermarket.

And yet, I feel much freer in the supermarket than I do with respect to my county, state, or federal government. For each item in the supermarket, I can choose whether to put it into my cart and pay for it or leave it on the shelf. I can walk out of the supermarket at any time and go to a competing grocery.

The exercise of voice, including the right to vote, is not the ultimate expression of freedom. Rather, it is the last refuge of those who suffer under a monopoly.
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In fact, if we had real competitive government, then we would be no more interested in elections and speaking out to government officials than we are in holding elections and town-hall meetings at the supermarket.

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Why isn’t medical care a right?

26-Sep-08

Azalynn asks:

As in, making people fear for their lives if they don’t do a particular thing is always bad — unless it’s a corporation wanting you to do that thing.

Here’s my take on it. Please take it in the same spirit of your original post. If any of it comes across as an attack please attribute it to my lack of grace, and not to any ill will on my part.

Your fundamental objection appears to be: “I will die unless I get adequate food, shelter, and medical care. Therefore, unless I want to die, I’m forced to work (most likely for a corporation) to earn money to pay for these necessities. Therefore, someone else should provide me with sufficient food, shelter, and medical care such that I’m free to work on whatever on choose.”

1. What ethical rule gives you the right to the forced labor of someone else? I will die in 30-40 years unless aging research advances dramatically. Does that give me the right to point a gun to your head, and force you to pay more for this research? After all, you have enough disposable income to afford a computer, and probably many other luxuries (cars, books, movies). If I don’t have the right, what gives you the right to demand the same of me?

2. If you do force someone to pay for your healthcare, suddenly they have an incentive to dictate what you do with you life. Want to smoke? Eat Big Macs? Ride a motorcycle? Engage in anal sex? Too bad. Now that I’m paying for the risks you take, I’m going to pass so many nanny state regulations that living in a nunnery will seem like Vegas.

3. When the government controls the market for medicine, how open do you think they will be to paying for new medical technologies? If you were contemplating starting a biotech startup, how much would you invest knowing that you’d have to persuade the U.S. government to buy your product before it would be economically viable?

4. We already have universal coverage for people 65 and older. How well is the government doing managing that? According to this 2004 New York Times article (Entitlement Costs Are Expected to Soar)

“The annual reports on Social Security and Medicare will include new estimates showing that the total gap between the cost of promised benefits and the revenues to pay for them is close to $50 trillion, the experts said. By contrast, the Bush administration estimated last year that the long-term gap was $18 trillion over the next 75 years.”

If we’re already $50 trillion in debt just from seniors alone (albeit the group with the highest medical needs), what do you think will happen when everyone is covered?

I emphasized healthcare above, but the same applies to food, and shelter. (Fannie Mae and Freddie Mac, the two quasi-governmental organizations at the heart of the current mortgage meltdown, were started by New Deal Democrats who wanted to help more low income people own their own homes.)

Rather than more subsidies, how about we try a little increased freedom? Abolish the FDA and/or the patent monopolies, and we’ll see an explosion of new medical devices and drugs. Abolish medical licensure and immigration restrictions on foreign doctors, and the cost of medical care will fall dramatically as many more people (both foreign and domestic) enter the profession.

If we passed such reforms, we could have both increased freedom and much lower healthcare costs.

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