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Freedom and Healthcare: Is the Libertarian Party In Danger of Becoming Relevant?

You don't have to be a economist to understand why American healthcare has been such a disaster for so long -- and why Obamacare has spectacularly failed to do the one thing that would have solved most of its problems.

Because of a near-evil system in which employers are subsidized to pay health insurance premiums that the consumers of healthcare never pay, the health consumer has no incentive to shop for value. Price competition -- which is the most important mechanism by which the free market makes goods and services affordable -- is therefore eliminated. Care becomes hugely expensive as hospitals charge made-up prices that they know will be paid for by insurance companies. Not only does this system support the practicing of hugely wasteful defensive medicine, but also hospitals take every opportunity to recover from the insurance companies the cost of non-emergency care that government forces them to give for free to others who neither pay for what they use nor have their own insurance.

For the better part of a year, a pro-free-market, pro-liberty, grand-bargain solution to American healthcare has been kicking around my head, but I never wrote it down because it does not reject all government involvement in healthcare, and I rather expected that many of my libertarian readership would be disgusted by what many of them would deem a compromise of principle.

But for a reason that shall become clear, it's now time to share it. It goes something like this.

If you took the American Constitution to the UK and asked the British, "Which major government programs are consistent with the American notion that the purpose of government is to protect life, liberty and the pursuit of happiness", I'd be prepared to bet that the most common answer would be "The National Health Service", which is Britain's system of socialized healthcare.

To most American conservatives, libertarians and Constitutionalists, this would be anathema. But it wouldn't surprise Liberals.

The Brit, unschooled in the finer points of the Constitution and the Federalist papers, would no doubt point out that the NHS directly saves lives and directly promotes liberty and pursuit of happiness by completely eliminating the possibility of -- and therefore any reason to worry about -- medical bankruptcy. And so, he would say, the NHS is an example of government protection of life, liberty and pursuit of happiness.

One of the most effective principles for marketing libertarianism is used often by Penn Jillette. His standard for the use of government force is as follows. "If I as an individual cannot use force to achieve some ends, then government should not be able to do so either." This is a great way into the politics of liberty because even those who regard themselves as Liberals and Conservatives see it as a good non-ideological starting point to productive discussions about big issues.

So our Brit might also propose the following to an American Libertarian, armed with Jillette's principle. Imagine someone has just been hit by a bus. A bystander screams for a doctor to help save the wounded man's life. One is nearby. But he refuses to help unless is he is paid for his services. So the bystander breaks into a nearby house, steals an expensive-looking ornament and gives it to the doctor by way of payment.

Most people would say that although the doctor may have done nothing wrong in theory, he's not a very decent guy -- and they don't want to live in a world populated by people like him. Most would also say that the violation of property rights of the homeowner was a moral act, justified by (and only by) the saving of the man's life in the street. In other words, they would say that the liberty gained by the act exceeded the liberty lost. Accordingly, by Jillette's libertarian yardstick, government action in such an example of medical catastrophe is not only moral but also consistent with freedom.

If the liberty movement is to be able to make its case in the hugely important area of healthcare, it must be able to think like the average American about life and liberty. It is a shame, then, that conservatives and libertarians have any made any government involvement in healthcare a kind of proxy for Progressivism's worst excesses -- and something to be fought against without giving any quarter. As someone who writes extensively about Progressivism's excesses, I am quite clear that having government step in to repair limbs that are hanging off bodies is not one of the worst.

But what could possibly be the principled basis for a libertarian or conservative consideration of government involvement in catastrophic healthcare? The obvious answer is that unlike all non-catastrophic care, and unlike all welfare, there is no moral hazard here: it doesn't incentivize people to get run over by buses just so they can get some of that free surgery.

Once you add in the fact that when government pays the doctor not by surprising a nearby homeowner and grabbing an ornament, but as part of the normal progressive tax system, government in catastrophic healthcare is to most people as palatable as government-funded fire brigades and law enforcement.

This brings me to the essence of my grand Libertarian healthcare bargain -- which is simply to concede socialized catastrophic healthcare only, in return for a complete free market in every other area of healthcare. This would massively drive down costs; we'd eliminate employer-paid premiums; prices would be posted by doctors; patients would have the incentive and ability to shop around for value, and no one would pay for anyone else' non-catastrophic health needs. But if you get hit by a bus or get terminal cancer, you get some guaranteed level of treatment. We could argue about how to do it, but it probably amount to the government's acting as insurer at the high end of the risk curve. Whether they do so directly, or through insurance corporations could be determined. In this system, no one dies for lack of catastrophic care; there is no more medical bankruptcy, and 90% of the healthcare becomes a pure free market. Libertarians and conservatives get 90% of what they rightly stand for. And if you don't like the government's catastrophic coverage, you can still keep your own private policy.

I call this a "grand bargain" because for libertarians, the upfront concession of socializing any part of healthcare is extraordinary to contemplate. And I never wrote it down because I thought I knew what response I would get from my own side: I would be reminded that all tax is theft because violence against property rights is the moral equivalent to other forms of aggression; that any government involvement in our lives is a compromise of liberty per se; that if you concede the principle anywhere, you concede it everywhere.

All of those things can indeed be argued. But the proposal has four critical benefits. First, it is really easy to understand; second, it would get massive popular support and so could actually be implemented; third, it would massively increase liberty in healthcare relative to the current situation, and fourth, it would make the liberty movement that proposed it seem not at all like those callous Libertarians who everyone knows are happy to let the poor and weak die on the street ...

One might even suspect that were a party that were to propose it officially might be simultaneously trying to win elections and make realistic policy proposals that could actually get adopted.

You will imagine my surprise, therefore, when I was followed last weekend as a speaker at the Annual Convention of the Libertarian Party of Washington State, by the Libertarian Party's Vice Presidential candidate for 2012, Judge Jim Gray, articulating an approach to healthcare that was entirely consistent with this pragmatic, politic and entirely unorthodox compromise.

After all, said the Judge, "We are the classic liberals".

Judge Gray's speech was one of the most exciting speeches I'd heard from a Libertarian in a long time -- not because I learned anything new about their philosophy -- but because, if the Libertarian Party is now thinking this way about policy, it could be in grave danger of being taken seriously, at last.




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Robin Koerner ROCKED the Republican Liberty Caucus

Convention here in Washington State this weekend, and rocked the Libertarian Party convention the weekend before - I can't wait to get the video - Robin inspires sustained standing ovations to break out!

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Right way to go forward

While I disagree with some of Robin's remedy for our nation's health care problems, he makes an effort to move the ball forward. Some of the purintanical reactions to his effort are discouraging. Seems that some libertarians (and progressives) would rather things continue as is rather than be changed for the better, if only incrementally. As long as such puritans have their way, the liberty movement goes nowhere. When will we all stop making the perfect the enemy of the good? The corporate duopoly loves those all or nothing progressives and libertarians who keep it in power. Thanks for trying, Robin.

"Seems that some libertarians

"Seems that some libertarians (and progressives) would rather things continue as is rather than be changed for the better, if only incrementally."

I don't think these people you allude to actually exist. I've never met a even marginally sane person that would deny wanting to go from their current situation to a better situation. That stated there are tons of differing view of what a "better situation" actually is (such as those that feel a serious depression is unavoidable and would rather start it today instead of starting it after 5 more years of FED powered American Empire building).

Lots of libertarians would agree that establishing emergent medical care as a big "R" right that gov't 100% provides would have huge negative implications for both emergency medicine itself, and additionally would damage other areas of health care that such a president would leech its way into. Agreeing to grant a right to this care might open floodgates of associated or tangential rights once lawyers & judges started using liberal interpretations of the bill.

I think there are many lovers of freedom that look at history and note that freedom is usually lost bit by bit by bit over generations, but won back in watershed moments. These returns of freedom might be somewhat peaceful (think India leaving British rule) violent (American revolution and other colonies rebelling, French revolution ), or the result of gov't unsustainability (collapse of certain ancient empires).

What I've not seen in history was legislating the control away from the government - I mean lets me honest that just sounds insane to even suggest right? We'll have our politicians go to DC and make laws that limit their ability to make laws that control our lives? It won't ever happen.

Thus yes, there are libertarians that want that watershed moment to come (truly massive protest, military generals/soldiers refusing to invade some 3rd world nation, a collapse of federal/state governments, a massive sinkhole swallowing DC into the bowels of the earth, whatever) and they aren't very interested in tinkering with the arrangement of deck chairs in the mean time because the whole system is so corrupt that even bills with the best intentions will either be ignored or perverted to somehow grant more taxes or power.

Ron Paul on helathcare

Ron Paul on health Care points to consider: No one has a right to medical care. If one assumes such a right, it endorses the notion that some individuals have a right to someone else’s life and property. This totally contradicts the principles of liberty.
If medical care is provided by government, this can only be achieved by an authoritarian government unconcerned about the rights of the individual.
Economic fallacies accepted for more than 100 years in the United States has deceived policy makers into believing that quality medical care can only be achieved by government force, taxation, regulations, and bowing to a system of special interests that creates a system of corporatism.
More dollars into any monopoly run by government never increases quality but it always results in higher costs and prices.
Government does have an important role to play in facilitating the delivery of all goods and services in an ethical and efficient manner.
First, government should do no harm. It should get out of the way and repeal all the laws that have contributed to the mess we have.
The costs are obviously too high but in solving this problem one cannot ignore the debasement of the currency as a major factor.
Bureaucrats and other third parties must never be allowed to interfere in the doctor/patient relationship.
The tax code, including the ERISA laws, must be changed to give everyone equal treatment by allowing a 100% tax credit for all medical expenses.
Laws dealing with bad outcomes and prohibiting doctors from entering into voluntary agreements with their patients must be repealed. Tort laws play a significant role in pushing costs higher, prompting unnecessary treatment and excessive testing. Patients deserve the compensation; the attorneys do not.
Insurance sales should be legalized nationally across state lines to increase competition among the insurance companies.
Long-term insurance policies should be available to young people similar to term-life insurances that offer fixed prices for long periods of time.
The principle of insurance should be remembered. Its purpose in a free market is to measure risk, not to be used synonymously with social welfare programs. Any program that provides for first-dollar payment is no longer insurance. This would be similar to giving coverage for gasoline and repair bills to those who buy car insurance or providing food insurance for people to go to the grocery store. Obviously, that could not work.
The cozy relationship between organized medicine and government must be reversed.
Early on medical insurance was promoted by the medical community in order to boost re-imbursements to doctors and hospitals. That partnership has morphed into the government/insurance industry still being promoted by the current administration.
Threatening individuals with huge fines by forcing them to buy insurance is a boon to the insurance companies.
There must be more competition for individuals entering into the medical field. Licensing strictly limits the number of individuals who can provide patient care. A lot of problems were created in 20th century as a consequence the Flexner Report (1910), which was financed by the Carnegie Foundation and strongly supported by the AMA. Many medical schools were closed and the number of doctors was drastically reduced. The motivation was to close down medical schools that catered to women, minorities and especially homeopathy. We continue to suffer from these changes which were designed to protect physician’s income and promote allopathic medicine over the more natural cures and prevention of homeopathic medicine.
We must remove any obstacles for people seeking holistic and nutritional alternatives to current medical care. We must remove the threat of further regulations pushed by the drug companies now working worldwide to limit these alternatives. True competition in the delivery of medical care is what is needed, not more government meddling.

jhon

the government is making us sick in the first place

... so maybe we could put a stop to govcorp eugenics slow-kill programs like atmospheric aerosol spraying, gmo's ....
.... we could instead gently encourage awesome nutrition especially iodine sufficiency and pure fluoride-free water and watch almost all the need for healthcare vanish

national healthcare sux : keep your mediocre government bureaucratic doctors away from me

ecorob's picture

To answer your question; No...

but labels are.

its 'cos I owe ya, my young friend...
Rockin' the FREE world in Tennessee since 1957!
9/11 Truth.

wolfe's picture

Interesting....

What is interesting is how easily a "libertarian" falls for the utopian government view of the world. It took me a minute to find the relevant paragraph.

"This brings me to the essence of my grand Libertarian healthcare bargain ... etc"

In which you lay out a system, effectively no different than what is currently mandated. What stops someone from going to their best friend's brother in law as a chiropractor at a $1000/hr to scam the system? Well, that's ok, we'll throw in some "common sense" rules. No non-government certified practitioner, oh, and let's fix some prices. What if that particular chiropractor REALLY was worth $1000/hr. Who decides that? Poof. Your magic utopia, dead.

The problem with ALL man-made systems, is that they are inherently flawed, and can be corrupted, abused, and controlled by those with power.

The problem is that reasonable and intelligent people may just simply disagree. So long as a consensus must be met between these two individuals because they are both having something taken from them, you end it with a political fight over who's opinion is correct. The -real- market knows no such failure because the only real solution is "to each his own" which is the core principle to any truly free market.

The flaw is in the theft, not the spending. Politics is merely the debate over how to spend the ill gotten gains.

So you gave a very long winded sermon, on, well, nothing new or useful.

The Philosophy Of Liberty -
http://www.thephilosophyofliberty.com/

there is a differnce

he is talking about catastrophic coverage. A chiropractor doesn't generally practice catastrophic healthcare. So, you need to change your argument a little. Maybe a cardiac surgeon?

wolfe's picture

Why do I have to change my argument?

Because you believe "catastrophic" implies heart attack or similar? Because you believe a heart attack can't be resolved with a "witch doctor"?

Both of these are your personal opinions. Your personal opinions are yours, and may be valid to you, but when you steal my money to enforce your opinion, that is where you go off track.

It's the theft that is immoral, the rest is trying to put lipstick on a pig and fighting over how the stolen money is divided up.

Your response actually illustrates my point, possibly more clearly than I could in my initial words. Your opinion, your money, no problem. Your opinion, my money, and you can go .... Well, you see the point.

The Philosophy Of Liberty -
http://www.thephilosophyofliberty.com/

now you are making assumptions

Now you are making assumptions about where I stand. It doesn't matter if a heart attack can be resolved by a witch doctor or not. I certainly never said it couldn't be. But in his system catastrophic coverage would be available. So death being imminent. Sure you can fight over how imminent. What counts and what doesn't. But for the sake of your argument I think you need to address what the common person thinks. That is what he is trying to present...how the common person looks at it. So all I did was suggest changing your example, that is all.

You said his system is no different than the current one. I maintain that it is different. The current system pays for annual physicals. His system wouldn't for instance. There are many differences and I think you could improve your argument by addressing his system rather than the current one with your arguments.

Yes, I agree that in either system your money is being taken to help other people or you are being given money from other people to help you as the case may be....I won't assume one way or another which side the balance would come out in your case. In his system less money would be "stolen" than in the current system so that is another difference. More aspects of healthcare would be free of this regulation as well so that is another difference.

I personally think any system will be fought over no matter what. People in general chose to have more regulations because it wasn't working out. However people also forget to look back and say are we better off? They forget to reevaluate. They forget to look at the consequences of these regulations. blowback!!

wolfe's picture

You said two things.

to point out as interesting. And no, I made no assumptions about your beliefs. I merely point out whatever your beliefs are, belong to you as opinions. I was referencing the statements you made in reference to a cardiac surgeon being a requirement for a heart attack as a catastrophic problem.

"But for the sake of your argument I think you need to address what the common person thinks." Why? Do I need to somehow relate to my thief so that I might convince him to stop stealing?

"I personally think any system will be fought over no matter what."

Exactly. As long as you have someone stealing your money, someone will scream about how they use it.

The Philosophy Of Liberty -
http://www.thephilosophyofliberty.com/

at least we agree on something

:-)

I applaud your efforts here,

I applaud your efforts here, and I do think that exploring ideas that meet the current system halfway are not a bad idea. Especially as part of a plan to keep on rolling as the health care system gradually comes under free market forces.

I am wondering about the Constitutional, legal, and moral underpinnings, however. I'm a huge Penn fan, too. And I think the quote you chose is a good quick-draw yardstick to use.

In the example of the bystander who breaks into a house and steals to pay the doctor, I'm not at all sure you are justified in making the case that because the bystanders act is MORAL that is therefore LEGAL.

It seems to me that it is this linking of moral and legal that forms the basis of your case. And I don't think it's a link you'd be wise to assume. People steal for many reasons; some of them quite moral.

I'm betting you'd find my theft of my neighbor's car moral if I needed the car to rush my child to the hospital. Perhaps you'd even find it moral if I needed the car to rush my co-hort in a bungled armed robbery to the hospital. But what if I needed the car to rush to the store and get coffee because I knew my husband was likely to hit me if there was no coffee in the morning. What about if I needed the car because I'd forgotten to buy butter for the big dinner I was hosting for my husband's boss. (If the boss isn't impressed, my husband could lose his job; my children could be homeless, hungry.)

In all these cases, the morality of my theft is open for interpretation. For my neighbor, the theft of his car isn't; the harm done to him is the same regardless of the morality of my action. What is legal needs to be pretty. Firm. I should be arrested for stealing the car in any of these situations.

However, a jury and judge provide the mercy, the softer side. They look at a clearly illegal act and take into account my motivations, their understanding of the morality of my actions.

Your bus accident bystander's theft is moral and illegal. The doctor's refusal is immoral and legal (although I think there's some kind of professional ethics about failing to provide aid). Moral and legal often don't go together. The complex web of our court system, in fact, developed in large part because moral and legal aren't synonymous and we recognized the need to account for that.

I don't think you've quite made the argument that because it is moral to provide assistance to the victim of an accident, it should by definition be legal.

Maybe you can. But it has to be addressed, I think, if you want to pitch this idea to libertarian types.

Burglary

I don't think breaking into a house to use the phone in an emergency, or take shelter in a storm is even considered a crime, and as long as the taker makes restitution, it may not be immoral. If the homeowner is home, they might even donate the item--it's our contention that most people would want to help--and if they didn't, they wouldn't bother to dial the government at 911 and you'd have a bigger problem.

I have no trouble making the argument to liberals that if the goal is to erase guns from the face of the earth, that we should first eliminate nuclear weapons, stop the wars, and disarm criminals. To disarm the law-abiding, peace-keeping people, before one disarms the war-making and criminal elements, doesn't make any sense.

And liberals, especially, should be concerned about the People being able to protect their civil rights against our government or someone else's, and for women and the disabled to be able to go toe to toe with a linebacker, if the need arises.

I want to cut government spending and gouging, and I want non-majority-dominated healthcare and healthcare freedom, and I think it's a great idea to reintroduce it in phases. Incrementalism is bad when it goes against one, but our ally when it works in the correct direction.

What do you think? http://consequeries.com/

Finally someone is

Finally someone is articulating a rational non-ideological policy that recognizes the reality of Heath care. My analogy is basic Heath care is the 21st century eqivilent to the ancient practice of the government maintainig graineries to protect againt famine at least in an alleged 1st world country. I would also point out that our current system actually limits liberty by enslaving people either to their employer or to the government through medicaid. If catastrophic care were freely available people would be free to start businesses and hire employees without fear. The poor could get jobs without placing themselves or their children at risk. BTW. Does the health insurance industry do *anything* to remotely justify their profits? This deserves more discussion. I'm glad Judge Grey is on it

Thetis

His suggestion is marginally

His suggestion is marginally better than the current system, but once implemented would slide back into a system we have now.

Far better to get the gov't entirely out, including a halt to the employer insurance mandate that you properly target. Allow people to purchase "catastrophic coverage insurance" which would have much lower cost than something that covers every minor drug and procedure under the sun and yet still be able to cover treatment for people who get cancer or need a kidney transplant.

For the other stuff (check ups and flu shots) you could pay the doctor or hospital cash. It would eliminate millions and millions of middle men (billers, coders, insurance company staff, etc...) who all get a cut of our medical payments but don't improve and often detract from the quality of our medical care. Those hundreds of billions of dollars saved would translate to much lower costs and more logical prices for procedures; as is demonstrated with the Oklahoma Surgery Center's operation -> http://www.youtube.com/watch?v=0uPdkhMVdMQ

Several faulty premises here

1. The Constitution does not, can not, make any guarantees about life. We are "endowed BY OUR CREATOR" with a right to life. The government has no role in that project. Does the government GIVE me liberty? Of course not. Their job is to PROTECT my efforts to be free. The Constitution is primarily a document to restrain the government. To think that it authorizes the government to "provide" me with any thing is a huge error.
2. "Health care freedom" means I can go see a witch doctor if I want. "Giving" me mandated insurance that will force me to either see a Pharmapimp or see no one is not something I want.
Eh, this guy is popular around here and my husband just got home.

This is the article that got my posting privileges revoked:
http://bklim.newsvine.com/_news/2013/05/12/18212165-dr-stan-...

Robin Koerner's picture

Neither of those are my premises

1) Of course govt does NOT give us our rights or our lives. The point was that, if you ask most people, directly saving someone's life when they are bleeding to death is prima facie consistent with "securing the right to life", as specified as the role of govt in the Declaration of Independence.

2) Under the system, as I said explicitly, you lose no healthcare choice. "...if you don't like the government's catastrophic coverage, you can still keep your own private policy."... You could also go to any doctor at any time. You could specify that in the case of an emergency you would not be helped by the govt. Also, since all non-emergency care would be free-market - unlike now - you can see any witch doctor whenever you want, and you'll have an incentive to shop for value and you'll pay a price that is set by the market. Indeed, one of the points of the proposal would be to give that choice affordably in a free market to people who don't have it now.

Thanks

Agree to disagree, then?

The basic rift between your goal and my goal is pretty simple: You still think we can use politics and government to gain liberty. I wish you the best in your efforts, I poured a great deal of energy into that effort myself. I try to stay alert for signs that something within the political sphere has changed deeply enough that I would be willing to put effort there again, so far I have not seen that.
I believe that true liberty is only to be had one one person at a time. One by one, if humans embraced their birthright to self govern, the power of those who seek to rule over others would fade away.
As for compromises about healthcare... as it stands, only "government certified" witchdoctors may practice. Massage therapists have to be licensed. Insurance companies will not cover most alternative practitioners, and only licensed ones. For a truly free health care market, I ought to be able to hang a shingle: "Witch Doctor" and as long as my voodoo worked, people would come to me. If I got caught scamming, people would stop coming to me. If I hurt people out of negligence, my neighbors would punish me.
It is sort of like the atheist thing... "I just believe in one less god than you." You talk a pretty good game about "smaller government" - I just want one a little smaller than you.
Interesting timing, though. That Taibbi article this morning has my eyebrows up...

This is the article that got my posting privileges revoked:
http://bklim.newsvine.com/_news/2013/05/12/18212165-dr-stan-...

Is he actually popular here?

Is he actually popular here? I wonder if it isn't that his posts come with a picture (which screams "used car salesman" to me) so we notice his posts more. The only other article of his I commented on was a flawed as this one.

Why ask us to concede emergency care for progressives? If libertarians and progressives somehow hammer out a unified approach to healthcare in America, would everyone in between suddenly agree to it? Of course not, so we should thus argue for what we understand to be the best policy for each individual issue.

Mr. Koerner apparently thinks that trauma medicine would be best served by a socialized approach, I strongly disagree. If his pie in the sky fantasy of all medicine in a truly free market but emergency medicine made socialized - yes, I'd vote for it b/c it's far better than what we have currently. But I won't sit and advocate for it as a goal b/c even if implemented I'm completely skeptical about it's effect. Surely the one socialized area would grow and grow as every thing was suddenly "emergent care". 1st car accidents and chest pain. Next year, dialysis and C-sections. Until eventually, anything and everything is "emergent" and thus all is socialized.

Give them and inch and they will take a yard. I seem to remember hearing the income tax was supposed to be for the very richest and only to pay down war debt before being taken back off the books. Worked exactly as they planned as we all know.

*Also, there absolutely is moral hazard in giving out free catastrophic care. It frees individuals or their families from the enormous financial detriment to reckless living and shifts that burden to society at large. It also encourages individuals to pretend they need ambulances and trauma surgeons (for free service) when in actuality they need a ride from grandma and the local nurse practitioner (who isn't free).

Robin headed up one of the official Ron Paul 2012

Coalition groups. It's cited on the Ron Paul 2012 wiki page. Yes, he's popular with a number of us here, in fact he's hands down my favorite political writer..not many have started a political movement with one article as he has...

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Robin Koerner's picture

Thanks for your thoughts.

Thanks for your thoughts.

"Mr. Koerner apparently thinks that trauma medicine would be best served by a socialized approach, I strongly disagree."

No. I didn't say that. I doubt that anything is really best served by socializing it. I am observing that such a system would be massively less socialized that it is now, and having lived in a socialized system, I know what people like about it, and why de-socializing the system, which is what this is a proposal to do, relative to our current situation, is so difficult.

This is not an article about the best kind of healthcare system (obviously). It is about what is the most that could be practically gained for liberty as a matter of political strategy. If there is a way to make more liberty a political reality by moving 90% (or 50% etc.) in the right direction, surely it makes sense to think about where the concession would have to be made to make that happen.

I never said that this was a panacea. I said it was an option that could get average Americans thinking in our terms about liberty principles and the free market in an important area where we (liberty movement) have made absolutely no influence on policy so far.

We can keep repeating our ideals. And we should have them. But I am more interested in making a material difference to liberty in this country. No point being right in theory if unable to make an impact in practice.

Maybe I don't have the best idea... But how about we have a discussion with the goal of policy that a) gets govt out of our lives in a big way and b) could win majority support?

I also agree that the biggest problem would be the creeping definition of "emergent". But our one defense against that would be to have the country see how effective the freemarket is in delivering non-emergent healthcare, so that people say "It's working well as it is"... just as they are happy not to have govt involved in food distribution, despite the existence of foodstamps...

Bravo!

GOP you are in danger of losing me!

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