Socialized Medicine Ain't Freedom

The emergence of a pro-Enlightenment, pro-reason, anti-woke left, with its eloquent declarations in favor of freedom, is welcome indeed. But this political force still has some way to go. It is disappointing to hear the same people who effectively and properly debunk the power elite in so many ways, including its Covid policies, nevertheless stop regularly to endorse Medicare for all, or single-payer health care, or better, socialized medicine. If you understand what's wrong with a system that enables a power elite to use the state to impose its will, how in the world can you also call for putting all medical care under that elite's control? Who do they think would ultimately run it? The people?

The only thing answer I can come up with is that the anti-woke left thinks socialized medicine is the only alternative to what we have now, which they call "the free market." In fact, what we have is fascized medicine. My reference to fascism is not an emotional outburst; it's technical Fascism as devised by Mussolini is a system of total government control of the production of goods and services with a facade of private ownership. A free market in health care couldn't be more different from what we have today.

If we can disabuse the anti-woke left of its screwy notion about America's health care and insurance system -- by pointing out the many ways the government prevents the market from working -- we might get them to abandon socialized medicine. One can only hope.

Market-Based Medical Care for All

My latest article for the American Institute for Economic Research is "Market-Based Medical Care for All."

It Makes One's Head Spin

President Obama’s jobs program calls for cuts in both sides of the payroll tax. That tax finances Social Security and Medicare. Social Security and Medicare are already taking in less money than they need to pay retirees. So they will have to cash in more of the Treasury IOUs left behind when previous surpluses were used to finance general expenditures. But the Treasury is also already running a trillion-dollar-plus deficit. So it will have to borrow more in the capital markets in order to pay back the Social Security and Medicare funds. Unless Obama makes up the lost revenue by changing the tax code. But then money will be withdrawn from the economy in the form of higher taxes so it can be put back into the economy through the payroll-tax cut. Somehow that’s supposed to stimulate the economy.

Got all that? There’ll be a quiz later.

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.

Alarmism or Realism?

A standard charge against opponents of the medical insurance overhaul is that the dire predictions are nothing but alarmism. The argument is something like this: “You said the same thing when Medicare passed in 1965.”

This is actually a very funny contention. One of the arguments against Medicare was that it would pave the way to greater government control of the medical system.

Does anyone now think that was a bad prediction?

Medicare has made $37 trillion in promises (over the next 75 years) for which there is no money. Even Barack Obama acknowledges that Medicare is responsible for a major part of the federal deficit, which is creating the huge national debt. To deal with the out-of-control budget, coverage for some services is being denied. The bureaucratic burden is prompting doctors to stop accepting new Medicare patients.

By paying for the medical care for retirees, the government program has stimulated the demand for products and services, pushing up prices for everyone. More expensive medical care means more expensive medical insurance. As the price of insurance goes up, many people are priced out of that market, adding to the number uninsured. (This is not the only factor in price inflation, but it is a big one.)

Higher prices and the growing number of uninsured — in large part a product of Medicare — fueled the effort to increase government power over the medical system.

So: Q.E.D. The predictions about Medicare were valid. It has led to deeper government control of medicine, which is to say, us.

Are we alarmists or realists?

Has Medicare Extended Life?

Here are some facts that champions of Medicare are either ignorant of or hope you remain ignorant of. They leave the impression that before Medicare (pre-1965), life for "seniors" (hate that term) was unenviable because of lack of access to medical care. Since then, thanks to a government program that really "works," things have turned around.

Leaving aside whether a program with a $37 trillion unfunded liability can be said to be working, look at this:

In 1930 average life expectancy for Americans at age 60 was 74.5 years. (Infant mortality pulls down average life expectancy, hence the measure "at age 60.") In 1960 -- five years before Medicare began -- the average jumped 2.6 years, to 77.1. By 1990 -- 25 years after Medicare began -- it had jumped to 79.7 -- again 2.6 years.

Medicare did not make the upward-sloping life-expectancy curve any steeper!

For historical context, from 1900 to 1960, overall life-expectancy increased 22.4 years, from 47. 3 to 69.7.

I hasten to add that the medical system may be the least important factor in life expectancy, and one must never judge a country's health care by that measure. (Too many other factors -- lifestyle, genetics, culture -- play more important roles.) Nevertheless, it is interesting to know that Medicare did not improve the rate of progress in life expectancy that was occurring before the program started.

(Source: Derived from data presented in Sue A. Blevins, Medicare's Midlife Crisis, Cato Institute, 2001.)

Rachel Maddow, Demagogue

I know, I know. Why am I wasting time on her? Good question. But I can't let this get by me.

The other night she and state-socialist congressmen Anthony Weiner had a good laugh because all the Republicans on a congressional committee voted against his trick amendment to end Medicare. What hypocrites, they sneered. Republicans say they are against socialized medicine, but when their political careers are at stake, they won't vote to end the socialized medicine we already have for retirees. (Clip here.)

I am the last person to want to defend the Republicans. The charge of hypocrisy is easy to make, and no doubt Maddow and Weiner are right about many or most of them in this case. But they were engaging in demagoguery, and they must have known it. The principle of charitable interpretation is worth applying not only because it's decent but also because it forces oneself argue against your opponent's strongest possible case. Going for the weakest case is a wimpy thing to do--a confession you lack confidence in your own.

Someone can nonhypocritically and coherently say, "I'd vote against creating Medicare today. But since after 44 years people on fixed incomes have come to rely on it, I would not just kill it in one shot now. I favor some kind of gradual transition to a private system."

Agree or disagree with that position, it shows that voting no on an up-or-down vote to kill Medicare is not necessarily hypocrisy for one who opposes government-controlled medical care.

Maddow's schlocky program is little more than a series of conversations with guests who agree with her so she can distort the positions of those she diagarees with. She might have brought on a someone to argue the point I make above, but she wouldn't know what to do with someone who intelligently disagrees with her. That speaks volumes about her intellectual heft or confidence, or something.

Obama, Medicare, and Socialized Medicine

At his AARP event yesterday, President Obama derided those who in the 1960s called Medicare "socialized medicine." Yet later in the event he conceded the point. See for yourself:

I got a letter the other day from a woman; she said, I don't want government-run health care, I don't want socialized medicine, and don't touch my Medicare. And I wanted to say, well, I mean, that's what Medicare is, is it's a government-run health care plan that people are very happy with.

As he read this, he and the audience laughed condescendingly as if to say, "What a dolt. She hates socialized medicine but she loves Medicare. Doesn't she realize they are the same thing?"

As for people being happy with Medicare, Obama might have pointed out that retirees receive far more in medical benefits than they ever paid into the system. At the moment they can basically have all they want for free or for low cost. Now they even have drug coverage. But that will change if Obama gets his way, because he's decided "we" spend too much on m medical care and he is determined to do something about that. Part of that "something" will be to scale back Medicare, which Obama himself says is, along with Medicaid, the biggest source of the budget deficit. Anyone who thinks that "reform" won't start denying options to retirees is dreaming. It's already happening. Wait until the government inserts itself in to end-of-life decisions. I guess the earlier critics of Medicare weren't wrong, they just had their timetable off.

If government were really interested in seeing a rational medical system, it would stop forcing the taxpayers to pick up the tab for other people's medical care. How could that do anything but send costs through the roof and then "justify" government control?