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.
a lot about what attracts people to different political opinions is their inner instinctual moral feelings. It seems to be a mark of the left-libertarian instinctively to "side" with the vulnerable who are made weaker and less free by our current "unfree markets" while it seems an instinct of the right-libertarian to side with the strong, who thrive in this system. Their common ground of core principles gets lost because their deepest unquestioned compass causes them to interpret their experiences of reality differently. How to get around this? Hmmm...
ReplyDeleteSciabarra's 'Dialectics and Liberty' trilogy ('Marx, Hayek & Utopia', 'Ayn Rand: The Russian Radical', and 'Total Freedom: Toward a Dialectical Libertarianism') are among the most mind opening books I've ever read. Every libertarian should read them.
ReplyDeleteCarrying dialectical thinking beyond a certain point ensnares anyone attempting real-world changes in a kind of gridlock. Sheldon expanded our considerations (and implicitly, our goals) to the "whole" of government intervention in medical marketplaces.
ReplyDeleteBut there IS no "whole" of governmental intervention in ANY particular marketplace. As long as government is intervening in ANY markets, be they for labor, for materials, or for money, ANY goal set out "within a market" such as medical care suffers from incompleteness the same as a bare abolition of medicare/aid would.
I'm afraid that, if there is to be any progress ever, we shall have to suffer from the gravely deficient outcomes of partial measures, and hope that the "edges" we have to settle for in their scopes will allow us at least SOME net, perceptible progress from their implication.
It's a serious, potentially fatal, problem with the implementation of the libertarian agenda.
I fought this very battle on another site a few months back. There was a pretty good article explaining why health care was not a right, so far so good. But there was no mention in the article that there IS a right to see whatever type of "doctor" you want, to use whatever healing substances/modality you wish, to contract for insurance as you and the insurer see fit, etc. So the article ends up sending the wrong message.
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