Think Dialectically

The title of the post is the advice my old friend Chris Matthew Sciabarra would surely give about proposals to change or abolish Medicare and Medicaid. It means holding the full context at the front of one's mind. These programs certainly violate the rights of the people forced to finance them and make the recipients dependent on the political class while discouraging independence and mutual-aid solutions. But they are parts of a system that has other, interlocking components. Focusing only on abolishing Medicare and Medicaid commits the serious offense of overlooking all the ways government (at all levels) cartelizes and restricts the provision of medical care and insurance against medical expenses. Licensing is pervasive, and myriad other controls and privileges impede competition, innovation, and entrepreneurship. Libertarians must emphasize this during every discussion of Medicare and Medicaid or they will appear to be advocating that vulnerable people be thrown into the nightmare that the reigning medical and medical-insurance "markets" can be and often are. We must also teach the public about mutual-aid societies and "lodge practice," which enabled poor people to obtain quality medical care during an earlier period in American history. (Also see Roderick Long's article on lodge practice.)

Unfortunately, too many libertarians imply (without quite saying) that these rigged markets are already free and, moreover, that they are the best in the world. I can't imagine a worse position for libertarians to take these days.

If we don't insist on freed medical and insurance markets, we will have no chance to make headway in the public debate. Potential allies who care about the vulnerable will be alienated, and we will be looked on as ... conservatives.

P.S. It should go without saying that this principle applies across the board.