Fellow students, maybe you did not know it, but here at the Claremont Colleges we are at the climax of a centuries-long struggle. Depending on the outcome, the Magna Carta, Declaration of Independence, Women’s Suffrage Movement, defeat of Nazi Germany, Civil Rights Movement, and our Cold War victory may all be in vain. Yes, it has all built up to this moment, on our tiny little campus across the street from San Bernardino County. At least, that’s what the title of the new libertarian publication, Liberty’s Last Stand, implies.
As the title indicates, Liberty’s Last Stand is full of over-the-top simplifications. For instance, Karthik Reddy’s article on healthcare reform claims that rising costs are acceptable because they are (1) inevitable and (2) offset by a rising average GDP. For the inevitable claim, he compares the growth in United States expenditures on healthcare to a few countries that have universal healthcare and points out that their growth rates are similar to ours. However, he glosses over the fact that other countries’ cost growth is starting at a significantly lower baseline that is directly linked to their governments’ policies on controlling healthcare costs. He also claims that the only way to increase efficiencies in the healthcare market would be to mechanize doctors. Although it might be cool if Dr. Robotnik were real, other options for reducing costs exist. Doctors frequently recommend conflicting procedures and medications because there is no centralized record for patient history, and an integrated system of electronic records would solve this problem.[1] Additionally, doctors waste valuable time dealing with paper and bureaucracy from a wide range of insurance companies. Standardizing basic coverage would free up doctors to focus on what they should be concerned with – the health of their patients. Finally, the fee-for-service payment system combined with the natural asymmetry of information between doctors and patients encourages overtreatment for people who can afford coverage (e.g. spinal fusion surgery).[2] Reddy’s last claim, that rising costs are acceptable because average income is rising, is the most absurd, since median income (more important for the typical American), adjusted for inflation, actually fell in the last decade.[3]
Matt Filippo’s argument for “progressive libertarianism” tries to fuse liberalism and libertarianism and ends up with something as philosophically consistent as Mitt Romney or Harold Ford, Jr. His basic tenets are that people should have civil liberties and markets are generally a good way to organize things, but that sometimes the government needs to make up for market failures. At first glance, these basically sound like mainstream liberal thought. Actually, almost any Democrat or Republican politician would accept these generalities. The problem comes from Filippo’s explanations. He rationalizes the bank bailout as necessary to avoid greater evil, but then goes on to advocate the elimination of Medicare, as if eliminating funding for healthcare for 40 million people were not a great evil (Note that Medicare recipients are older and therefore generally in greater need of coverage than other individuals without coverage. Medicare and Medicaid combined cover over 87 million).[4] He frames the decision as the only choice if we wish to remain a competitive economy, but the facts show that every other industrialized country has been able to afford an entitlement program that ensures universal coverage for its citizens.
Ashley Baugh’s article attempts to address complaints about libertarian efforts to remove the social safety net. She does so by pointing out that she does not believe that there should be no social safety net – just that it is not the government’s responsibility. She claims private citizens will act out of their own ethical obligations to fill the gap left from removal of government services, and that they will perform those services more effectively. The problem, however, is the complete lack of evidence for her thesis. What she proposes would necessitate the development of an ethical theory so convincing that everyone not only agreed with it, but also acted upon that belief. Baugh needs to achieve what every religion and philosophy has yet to achieve. Such an argument is also misleading, because libertarians are philosophically opposed to government programs whether or not they are effective. Even if nothing in the private sector filled in for UNICEF, they are still opposed to its existence. I know going for the “think of the children” line might seem cliché, but (1) it is true and (2) their publication implies that every person who is not a libertarian is secretly leading us down the path to a feudal society (I understand it is a reference to Hayek, but that is also their implication). They are taking inflammatory, unsubstantiated claims to the extreme.
Every year I’ve been at CMC, I see a few more people jump on the libertarian bandwagon. Lots of people try to convince me on the efficacy of a generally market-based system. I don’t need convincing. I know markets are generally an efficient way to distribute things. I welcome their use for the vast majority of cases. However, what the above arguments fail to admit is that libertarianism is an ideology that is fundamentally opposed to government entitlement programs, which provide over 87 million Americans with healthcare.[5] Let’s have some intellectual honesty about that.
[1] http://jamia.bmj.com/content/16/6/816.abstract
[2] http://www.medscape.com/viewarticle/586950_5
[3]http://economix.blogs.nytimes.com/2009/09/10/a-decade-with-no-income-gain/
[4] http://www.kff.org/medicaid/upload/Key%20Medicare%20and%20Medicaid%20Statistics.pdf
[5] Ibid.
Here here!!!
It appears that “Sam” is up to his typically insecure and puerile tricks, signing in under my name and attempting a dollop of cheap, childish humour at my expense. As usual, however, he only manages to embarrass himself by putting his glittering ignorance on display for all to see.
“Hear, hear” is the proper expression, doofus. It’s the short form of “Hear him, hear him” and indicates the listener’s agreement with the speaker. If you understood that, you would never have suggested that I would be in agreement with the core message of this well written, but ultimately unconvincing commentary.
Actually, my apologies to “Sam” and “Max if they do, in fact, exist somewhere in cyberspace.
Since I just noticed that the time of “Sam’s” last post was synchronous with that of a post on another article herein by a certain Port Side National Editor, my long held suspicions that North Carolina boasts its own version of Cyrano de Bergerac have been confirmed.
Man up, Jeremy, and come out to wrestle honestly and openly in the open arena of ideas. If you must resort to petty insult on occasion, do it to my face. I’m a big boy, and you’re far too clever to have to resort to flinging rancid mud pies from behind a cyberbush.
Your baseless accusations are really rather tiring, alan. I did not post that comment.
Hey Tom,
“..libertarianism is an ideology that is fundamentally opposed to government entitlement programs, which provide over 87 million Americans with healthcare…”
Ever thought that maybe the reason healthcare[sic] costs so much is because of those programs or the tons of mandates that your side favors?
Hi Tom. Just to clarify, when I wrote (I’m including the majority of the paragraph here for context)
“In an age in which global competition is reshaping the economic landscape of the developed world, and in which entitlement programs such as Medicare and Social Security threaten to render this country insolvent, how can we afford to abandon the market and adopt the taxation and spending policies forwarded by the liberal government?”
I meant that the current system as is, threatens to rend the country insolvent, and sometime in 2017 no less.
http://online.wsj.com/article/SB124212734686110365.html
The progressive libertarian does not inherently think that every possible entitlement, or for purposes of the healthcare debate, socialized healthcare program is evil. Indeed I believe there is a cognitive bias or an “invincibility” mentality specific to younger adults and children where they will not, left to their own volition, invest as much in their healthcare as they should if fully rational. And so I can extend the healthcare argument to all aspects of society and not just attribute it to the cognitive biases of the young, pooling risk across society should at least theoretically provide a lower cost per person socialized healthcare plan. I think we’d both to be hard pressed to find a staunch libertarian opposed to employer sponsored health plans which do just this.
The issue with the current system is that it is not fluid. Since the 1930’s, life expectancy for those who lived to age 65 has increased by about 4 years while the percentage of people who make it to age 65 has risen by about 1/3 (http://www.ssa.gov/history/lifeexpect.html). Yet the system must stay true to its original ideal of 65 as the retirement age. With the above numbers, anyone can see why the current system is bound to be insolvent sooner or later, unless of course, the cost of per person medical care decreases or the gov’t gets a better return on their money. But what politician in his or her right mind would try to raise the retirement age or restrict benefits? A politician who is on his last term, thats who!
If instead, we had insisted on a system with at least basic free markets behind it, perhaps one centered around privately bought insurance, then it’d be much more likely that either the retirement age would be raised, that benefits would be controlled, and that the system as a whole was forever solvent. Instead we are left of a mess of a system which needs to increase taxation on the current generation to pay for the promises it made to the older generation. But even this system will never be solvent as you can’t just keep upping the taxes on every subsequent generation.
What I like about any Obama plan is that it has the potential to at least minimize the damage of Social Security and start us off anew. Indeed, I think the progressive libertarian would advocate a system where the government could coerce those in our 20’s who have these invincibility complexes to pay into a less than efficient system. What I don’t like is that there is no talk about an opt out plan and that too much is covered. A sane 40 year old who plans to die an early life shouldn’t be forced to pay a premium for coverage he believes he will never need. Indeed, maybe there should be a minimum he pays, as if he does live long enough and has no coverage, inevitably the state will subsidize his later years. Or maybe there should be a heavily tiered system, and I mean heavily, like Blue Cross has where one can choose which, if any, socialized healthcare plan to enroll in. But these little things aside, we need to focus on a system which allows flexibility. I almost feel we’d be better focused on lessening the barriers to entry to become an insurance company and to subsidize competition, as the insurance system at present isn’t exactly a free market. I’m not an expert in politics or economics but I do know that the current system, as is, will be insolvent sometime in 2017. Denying this does not help fix the problem, and claiming that empiricism shows that socialized healthcare can work is a weak argument as our culture and society is very different from the rest of the worlds. The simplest solution is probably to use free markets as much as we can, and to subsidize and incentivize what we feel is justified. But coercing a population into paying for an insolvent system seems absurd to me.
Sorry for the double post, I hit the wrong reply button:(Deleted erroneous comment ~admin).Reply to Matt on the invincibility mentality:
I wonder if there is any actual evidence for this. If you look to the time before Social Security, was there actually such a severe problem of older Americans being public charges? I think not. Even during the Great Depression, when this “indigent old age” problem was at its peak, the reality was that people across all ages were suffering and requiring public assistance. It had nothing to do with being old per se. Why do we insist on redistributing to older Americans based on age, whether they are rich or poor? It seems an arbitrary redistribution! (Note: Milton Friedman has a good spiel on this in his “Capitalism and Freedom.”)
Hi Ilan. I don’t think there have been many studies on an invincibility mentality per se but there are loads of studies on risk taking behavior in teens and young adults (the behavioral ones mostly focused on drugs and driving), and especially on brain development and how certain areas don’t fully develop until much later in life. In particular, a lot of research has dealt with executive function, planning, cognition, what decisions we make, and how we make them. Of particular interest are that large parts of our prefrontal cortex, specifically the dorsolateral cortex, don’t fully mature until we are in our mid to late 20’s. These areas have been linked with all of the above functions mentioned and really questions (at least on a psychological level) the idea that we as people are rational enough by our 20’s to make many long term decisions. Now I am not a fan of neuropsychology in isolation and I do believe personal responsibility comes into play at a point, but my point is that people in their 20’s on average are not as equipped to deal with complex long term decision making. Is this deficit enough to mandate coerced retirement/healthcare plans? Perhaps so and perhaps not, but it does open up a whole host of questions to the progressive libertarian as young adults are perhaps “less rational of an actor” than we assume. (easy to read abstract here . Structural magnetic resonance imaging of the adolescent brain. by Giedd JN.)
In regards to your public charges comment, I’m not quite sure how to respond but I will add that from a historical perspective it is amazing how the characteristics of social security have changed over the years. Back in 1940 only about half of men and about 60% of women even lived to receive it. Now almost 3/4 of men and over 83% of women do. And that’s all great news assuming we were in a flexible system which could become solvent. But we aren’t and need to find a way to reconcile our obligations of the past to the status quo. And I don’t think big government acting in isolation is efficient enough of an actor to dig us out of this hole. What may have worked well back in the 40’s may not be ideal today.
While a libertarian could be completely philosophically in line with employer-based healthcare, the system of employer-based healthcare weakens the power of the market on bringing down healthcare costs. First, employer-sponsored plans actually receive a huge subsidy by being exempt from federal taxes. This makes them much less responsive to market forces, because employees can value them at less than their actual cost and it is still reasonable for companies to pursue. Second, employer-based healthcare makes our job market uncompetitive, by limiting employees ability to seek out better jobs for fear of losing their coverage. This is especially problematic for people with pre-existing conditions.
I really fail to see how your position is at all libertarian. It’s just mainstream American liberalism, a little bit wonkier than most because it actually cares about the budget. Your quote about Medicare in the article implied that we, in general, can’t afford entitlement programs, and just appeared to be using Medicare as an example. I agree that we need major reform in Medicare and its funding, but we can’t afford to just drop the entitlement programs.
What your suggesting sounds a lot like systems set up in Switzerland and the Netherlands. They have higher costs than single-payer systems, but also have higher satisfaction rates. They don’t let the government use its massive purchasing power to bring down costs. No system is perfect, and yes, we do need to include more specific ways to pay for it. The Swiss also have many more small insurance companies than are available in the United States.
I don’t understand your complaint about not having an opt-out, since you accept having people pay a minimum instead of purchasing health insurance. That’s exactly equivalent to what the mandate does, since it just imposes a strictly monetary fine to those who do not have health insurance. They can choose not to purchase health insurance and just pay the fine, exactly equivalent to what you are proposing. But you are accepting the principle that the government should sometimes spend other taxpayers’ money to help those less well-off, which is contradictory with libertarianism. If I’m interpreting your elaboration correctly, I agree with you more or less, you’re just not a libertarian.
My apologies again for the lack of clarification on the employer based post. What I meant is that one would be hard pressed to find a libertarian opposed to the rights of individuals to collectively gather into a large group, pool their risk, and buy cheaper insurance. Nor would it be easy to find a libertarian opposed to allowing an individual employer from encouraging other individuals to opt in to a collective healthcare program which pools risk and reduces costs. A better term would be a collectivist healthcare program. One would NOT be hard pressed to find a libertarian who supports coercing the masses into purchasing coverage for things they don’t want covered. While the current system is a mess of governmental subsidies, I was speaking in terms of a more isolated system, not one from where big brother, without reason, transfers wealth from others to subsidize an individuals employer based health program. And while an employer based system does, as you point out, lead to less fluidity in the job market, I was not arguing that an employer based system is ideal, but merely a system libertarians would support assuming no unfair coercion was going on. But if we are going to weigh the pros and cons of a governmental versus an employer based program, which one leads to the greater evil? The credibility of the governmental program is already called into question as our current system has been corrupted enough to be insolvent due to inflexible mandates ,not due to the failure of market forces. But I myself am all for a collective program which pools risk, there just needs to be an ability to opt out or to only get coverage for what an individual desires, minus any correction due to cognitive biases and minimal coverage as brought up in my original Liberty’s Last Stand post and the previous response.
Which brings me back to the opting out argument you brought up. The current proposal wants to add a fine to opting out. A fine! We should not be fining people for wanting to maximize their own individual liberty. If we want to tax them in the amount that minimal coverage would cost, I am fine with that, as some risk taking individuals will lose it all and become a liability to the tax payer. And unlike some classic Libertarians, I don’t support throwing them out of the hospital and leaving them to rot. But there is a difference between a mandatory minimum tax and a fine and even if the costs were equivalent, the framing of the cost makes all the difference. As a progressive libertarian, I aim to minimize coercion. I hate debating semantics and the above argument I just made seems to be very semantic as we are calling two theoretically equivalent costs by different names. But one cost minimizes coercion while another spits in the face of liberty loving individuals and fines them for their freedom. But apart from this semantic issue, I feel we are largely in agreement that there may need to be a minimal cost to everyone in a socialized system. Mind you, I aim to minimize coercion as well.
And just to clarify the Libertarian aspect of progressive Libertarianism, yes, we are somewhat moderate Libertarians. But I’d argue that we map up with most other Libertarians on the Nolan Chart. We just have a slightly different view of what it means to be economically conservative. I’d say the biggest issue separating myself from classic Libertarians is that I don’t agree that people are all fully rational individuals in every case and that coercion is sometimes necessary. As a clarifying example to what I believe is progressive Libertarianism, I believe that all non addictive drugs should be legal to those of a certain age, yet I understand that addiction can compromise one’s ability to make rational choices, so I support limitations on liberty in banning highly addictive drugs. The Democrat or Republican might call me crazy as nowhere in my statement do I talk about the harm of the drug, and the Libertarian might call me misguided as I am actively supporting restrictions on liberty. What makes my theory almost excessively subjective is that it is up to us as individuals to determine where the threshold of addiction is too great that a restriction on liberty is necessary. Yet we are restricting liberty not because an action will “doom public morality” or because the action is “too harmful”, but because we as individuals are not able to rationally choose whether or not to undertake that action
But I think if psychology and economics has taught us anything in the last three or four decades, its that people are not always rational, and in very predictable ways. I think progressive Libertarianism is a great way to merge these findings with classic Libertarian and progressive theory. But this theory is not better off being called progressivism or Libertarian Liberalism as at its heart, I support the freedom of the individual to make choices. It is only in these plethora of scenarios where individual choice making is largely compromised that big government (or theoretically any effective regulatory agency) should come in and set things right.
“One would NOT be hard pressed to find a libertarian who supports coercing the masses into purchasing coverage for things they don’t want covered.”
Really? It seems to me that this is exactly the libertarian’s (unfounded, IMO) fear. Coercion of the masses.
It is logically incorrect to generalize from the fact that the current healthcare system involves some government and is dysfunctional that all government programs are therefore discredited. That is simply evidence that the current healthcare system is ineffective. Evidence from other countries’ systems shows that government should not be unilaterally ruled out, but rather provide examples of systems that are cheaper and produce better outcomes.
There is no difference between the mandatory minimum tax and the fine in this situation if they cost the same. You are merely having a negative reaction based on your personal connotations with the words.
Ugh, sorry about that above quoted comment. Speaking in triple negatives is confusing. I meant that it would be hard to find a libertarian who wants to coerce the masses for something they don’t want covered.
On the minimum tax and “fine” arguments I think we just have to agree to disagree. I find calling a minimum tax a fine to be counterproductive and inherently liberty reducing even if the cost is the same as a mandatory minimum coverage tax. You don’t. To most people, this is simply a semantic argument, but to me, a fine brings up a natural defense mechanism and implies someone is doing wrong whereas a minimum tax is more of an accepted evil and implies no wrong doing on one’s part and minimizes reductions to liberty.
In regards to a government sponsored healthcare plan, I am not unilaterally ruling government out as an answer, but due to our government’s past ineptitude at handling largescale socialized healthcare, i.e medicare and medicaid, I think their credibility is thrown out the window. Sure, other government programs in foreign countries may do an okay job of handling healthcare, but the better comparison is to our own government, and not one representing people of completely different cultures, backgrounds, and economic success. If a plan was organized by the US government but run by market forces vis a vis insurance companies charging a premium where the government pays them by transferring wealth from its citizens, that theoretically is okay in my book as long as individuals have the option to opt out. Perhaps minimal coverage justifies a natural monopoly of sorts for insurance companies, though I do not know the stats behind this statement to support or discredit it. My point being, in my article I hoped to offer a different perspective on a twist on classic Libertarianism. I don’t think progressive Libertarianism aligns perfectly with either classic Libertarianism or with modern Democrat or Republican ideology. But I classify it as an offshoot of classic Libertarianism with a few kinks. If that makes me a wonky progressive in the eyes of one or many, so be it.
It is indeed inconsistent to applaud the too-big-to-fail argument as a proclaimed libertarian.
Furthermore it is also inconsistent to argue for acceptable costs of government-run programs, healthcare or not, as a libertarian.
This attempt of fusionism between libertarianism and liberalism is just one of the many abominations, born out of misunderstandings of what libertarianism is all about on one hand, and what it is working against on the other.
The core of libertarianism is the purely ethical conviction that
1) taking property from someone without their consent is fundamentally wrong, and
2) using or threatening force against someone who has not done the same to you, is the prototype of everything that is bad in this world.
Everything else libertarianism advocates has sprung from these two thoughts (which are at their core the same), and any new assertions must be compatible with them.
Taking money from one citizen to support another, without asking the first for their consent, and then threatening retribution for disobedience (e.g. every government program in existence) can certainly not be part of this.
Practical considerations, like cost and “doability” in this or other countries may be discussed, but have no implications for the foundation of libertarianism, which is of a purely moral nature.
Your formulation of libertarianism is deceptively simple. You don’t define your terms: what, precisely, is “property,” how does one acquire it and under what conditions does it remain yours?
Your propertarian libertarianism doesn’t work out so well: it’ll either be horribly unintuitive or logically inconsistent. [That's not to say that modern, "big government" liberalism follows; I think a more person-centered, rather than property-focused, libertarianism is quite salvageable.]
I don’t wish to hog this thread any moreso than I have already but what my article was getting at is that there are times when people are not able to freely give consent as we know it: where they are not well enough developed or where they are in a circumstance where humans repeatedly and predictably make cognitive errors.
In these types of situations, I advocate that a regulatory approach to behavior may be justified. I think of it more as a twist on class Libertarian philosophy substituting economics and the belief in free choice with behavioral psychology and the realization that one’s choices can be manipulated by predictable external influences.
“…libertarianism is an ideology that is fundamentally opposed to government entitlement programs, which provide over 87 million Americans with healthcare. Let’s have some intellectual honesty about that.”
Not to mention the millions of people dependent on the government for their housing, food, education, etc, etc. When will people learn that dependency on the productivty of others for their very lives is the perfect recipe for losing their liberty?
freeBatjko: I think Matt Filippo is what we might call a “moderate” libertarian, just like most people are “moderate” Democrats and “moderate” Republicans. If you say one is not a Republican or Democrat unless one embraces every policy view to which reductio ad absurdum will bring one, then you’re basically saying that every Democrat must be a communist, and every Republican must be a fascist. I think you need to back off your rabid quest for ideological consistency because nobody has it.
Democrats and Republicans can be moderate because their ideologies have nuances and spaces for disagreement. Their general goals are actually the same (although not always the goals of the elected politicians). Democrats and Republicans have some a few philosophical disagreements and in general more substantive policy disagreements over how to achieve their goals. Fascism and Communism do not allow nuances or disagreement. There a few bands of libertarianism, but all of them are radical. You can’t be a moderate libertarian.
Tom Clifford:
Are the general goals of Democrats and Republicans the same? One party advocates for increased state intervention into the economic lives of Americans in the form of regulation, consumer protection, high taxation, and government provided services among other forms of intervention. This party also embraces a degree of social liberalism and toleration. The other party is more concerned with minimizing government intervention in the economy, but instead supports government intervention into our personal lives in the form of surveillance and legislated morality. The former of these, the Democrats, are SOCIALLY LIBERAL and ECONOMICALLY LIBERAL. The latter, the Republicans, are SOCIALLY CONSERVATIVE and ECONOMICALLY CONSERVATIVE. The libertarians are merely SOCIALLY LIBERAL and ECONOMICALLY CONSERVATIVE. If there is room for moderation in the two main parties, there is room for moderation in a party that combines their views. You might think of libertarians as extremist because of your own biases. But do us all a favor and state your biases as opinion, not as fact.
Dear Tom:
I feel myself compelled to respond to your critique of the first issue of Liberty’s Last Stand. While in retrospect I agree with you that the title of our publication is perhaps more combative than Spencer and I originally intended, I take issue with nearly everything else you have written.
The central claim of my article on universal health care is that the health care cost curve cannot be “bent.” I assert that the rate at which health care costs grow cannot be meaningfully reduced because labor-intensive industries such as medicine are naturally more resistant to efficiency improvements. I do not attempt to hide that we currently pay more for health care than other developed nations on a per capita basis, or that there may be ways of effecting a one-time reduction in health care costs, such a electronic medical records. I simply say that the rate at which health care costs rise will not be reduced, and that this phenomenon is not unique to the United States. Doctors can obviously not be mechanized, and I do not suggest that they will be; I only mention this because mechanization is one of the only ways to improve efficiency at a rate that is rapid enough to bring the growth in medical costs in line with inflation. The remedies that you suggest have nothing to do with the rate at which health care costs rise, and, consequently, your article is no response to the principal assertion that I make. While you suggest that the government may be able to reduce health care costs (note: not the rate at which health care costs rise), the government generally does not have a very good track record at maintaining quality and reducing costs. The private sector, on the other hand, does. I suppose that you will, of course, indict the private sector’s performance in the health care industry because of the high cost of the status quo. Yet the current system is not a free market. The system is highly regulated, and the system of tax subsidies is connected to employment and given to employers, leaving no incentive for the recipients of health care to cut costs. For some free market solutions to health care, I will direct you to the Cato Institute (link below). Your final assertion that median income growth has been stagnant is similarly no threat to my central assertion that the rate at which health care costs rise will not be contained over the long term, though I would also question whether health costs are included in the inflationary number cited (their inclusion, and I do suspect that they are included, would, of course, render your criticism of this last point irrelevant).
Moreover, liberals do not appear to believe that markets are a good way of organizing things. Instead of allowing markets to function as they may, liberals have consistently been the architects of barriers to the free market, such as the minimum wage, excessive regulation, and the development of government sponsored enterprises such as Fannie Mae and Freddie Mac (which, though your liberal paper happily ignores it, both had a great deal to do with causing the financial crisis). You and your fellow liberals do not seem to be the ardent defenders of the free market you claim to be. Have you ever thought that free market solutions may exist to the health care “crisis?” Have you ever considered that perhaps private charity may be more responsive to those in need than government programs are? Your propensity to blindly defend government programs indicates that you have not. I suggest that you think twice before you again write: “I know markets are generally an efficient way to distribute things. I welcome their use for the vast majority of cases.”
The numbers you cite in your article merely prove that in the specific sample set of years that you gave, the UK’s government program failed to keep healthcare expense growth rate lower than that in the United States (in dollar terms, however, as Ezra Klein notes, is an annual growth of $206 per person in the UK and $422 per person in the http://voices.washingtonpost.com/ezra-klein/2009/09/health-care_spending_growth_ar.html). The lower growth rates in the other nations should actually indicate that there is some bend and greater resistance to cost growth (again, credit Klein for the observation).
Furthermore, my point was that if growth rates are about equal in a comparison, then they should not be the criteria by which cost of a healthcare system are judged. Growth rates are a poor point of cost comparison when the actual costs are often less than half.
My remedies would reduce healthcare costs and, therefore, reduce the rate of healthcare growth (although these may be one-time gains).
“the government generally does not have a very good track record at maintaining quality and reducing costs.”
Except in certain cases, such as healthcare, where other governments have reduced costs and increased quality. For increased quality, I would point you to the longer life expectancies and lower infant mortality rates.
My point about median income is that you seem to suggest that increased efficiencies have rendered healthcare more affordable, when, in fact, it has not.
Because liberals are in some cases in favor of market reform or regulation in some instances does not mean we are opposed to markets It does mean that occasionally we believe they function poorly.
I have considered whether free markets might offer solutions to healthcare. However, we have less healthcare coverage and worse health outcomes than other countries. Other countries have more government regulation and control of healthcare. Charities have not filled in the gap in government involvement in the United States. We have much less government regulation than any other industrialized country.
The fact that I defend government programs in the case of healthcare in no way contradicts my statement.
http://healthcare.cato.org/free-market-approach-health-care-reform
This is really well-written, and I hope most people realize that sometimes there are market failures that are solved best by the government. However, why must we attack this publication?
1. A broad aphorism, not an actual policy suggestion.
2. I agree completely.
3. HSAs do not make healthcare any more affordable, although they do help sever the link with employment. However, increased cost-sharing usually decreases necessary treatment as much as unnecessary treatment.
4. But what type of coverage would they get? A major problem with insurance coverage in many states is the practice of recision, whereby an insurance company will revoke coverage once someone begins incurring costs, on the basis that it was a pre-existing condition. They can do this for as little as misspelling a pre-existing condition, or by interpreting symptoms associated with a disease you did report as an indication of another disease. Often the company merely has to suspect it to have been a pre-existing condition to deny coverage. Appeals against the insurance bureaucracy can take so long that the patient is dead before a proceedure is approved. Some states (for example, Illinois) have fortunately solved this problem by requiring insurance companies to accept all conditions not previously explicitly excluded, a year after coverage begins.
5. I hope you’re comfortable with that sponge the mall surgeon left in your stomach.
6. Cato Institute in favor of a massive redistribution of wealth? In any case, this does not solve problems because a huge proportion of those with Medicare would not be able to get insurance coverage because they are old and very sick. The healthy would have money given to them while the sick are not given adequate coverage. Larger vouchers to the poor and sick? That will require a large increase in spending, rather than taking advantage of the money already allocated and not used by the healthy.
7. Insurance companies already charge individuals different amounts based on their health status. This is exactly what makes insurance coverage unattainable for those with pre-existing conditions.