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I consider myself a pragmatic libertarian, which off the top of my head basically means that: 1. I believe very strongly in the sovereignty of the individual.

I consider myself a pragmatic libertarian, which off the top of my head basically means that: 1. I believe very strongly in the sovereignty of the individual. 2. I prefer more open and incentive-driven markets. 3. I’m skeptical of governments, particularly large and powerful ones, because they’re inefficient, rely on coercion, and are too tempting as prizes to be captured for power, prestige, and wealth. However, these are all on a spectrum and I’m open to trying other points along that spectrum if they work better than our current system. I also recognize that the optimal system may be too distant from where we are today to even move towards it directly. So for healthcare for example, our system is dreadful, but I’m not sure that pure free markets would be better. But I’d strongly prefer a public option (and maybe even single payer), or a well-designed hybrid system like Singapore or Switzerland has to fully nationalized healthcare like UK. Similarly, I’m open to trying basic income, a land value or VAT instead of income tax, and other alternative systems. I’m particularly in favor of systems that are more stable and resistant to changing from the whims of the current government. I personally don’t understand how anyone who thinks the government is awesome can continue to believe that when they watch episode after episode of unchecked police brutality, or constant encroachments on civil liberties, or the entire Trump administration.

vidarh 9y ago
The UK doesn't have fully nationalized healthcare. * GP surgeries (doctors offices) are private businesses, and may provide NHS services or private services. * The NHS contracts out for a growing number of services, ranging from operating whole departments (e.g. Virgin operates the out-of-hours walk in centre for non-emergency care next door to the A&E/ER at my local hospital) to cleaning. * The NHS rents out facilities to private providers, and individual NHS trusts may derive income from carrying out private work (though the proportion of this income is limited, and the revenue goes back into their budgets). This is in addition to NHS staff often renting NHS facilities to carry out private surgeries outside their normal rotation. * Dentists are mostly private and generally dentists that do NHS work also do private work, and often mix and match with the same patient (e.g. the NHS does not reimburse more expensive types of fillings, so your dentist may recommend e.g. things like porcelain veneers on visible teeth and stick to NHS options for less visible work). * Pharmacies are mostly private - the NHS mostly operates pharmacies only in hospitals etc. but they too can be privately operated. * 10% of the population have private health insurance. This is mostly "top up" insurance offering additional services or faster turnaround for non-essential surgeries etc. than the NHS. * Many types of healthcare services are mostly private. E.g. while you can get some types of cosmetic surgery on the NHS As it stands, the NHS is the most cost-effective hybrid or private system in any developed country. Too cost-effective some would say; to the point where it comes at the cost of making things more miserable for patients. But that's what you get when we pay far less than any other countries at a comparable income level.
- ryanwaggoner 9y ago
  OK, you're sort of shining a spotlight on my ignorance here, but a few thoughts: 1. Maybe "fully nationalized" isn't technically true, but my understanding was that the UK was widely regarded to have a nationalized healthcare system. Not really interested in whether that's technically true at the margins unless there's some major policy impact. 2. "Cost-effective" is an interesting term, because it assumes we agree on what "effective" means. I want choice, innovation, better health outcomes, more convenience, shorter wait times, etc., and I'm willing to pay some premium (but not 4x or something) for them. For these reasons, I don't want want the NHS system here (nor do I think it'd work here), despite it being better for some values of "cost-effectiveness". 3. If by "cost-effectiveness", you just mean per-capita spending on healthcare, are you sure the NHS is the most cost-effective of any developed country? Doesn't seem to be the case here: https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... -- maybe you're using some more complicated measure of spending per health outcomes?
  - deleted 9y ago
    [deleted]
  - vidarh 9y ago
    > 1. Maybe "fully nationalized" isn't technically true, but my understanding was that the UK was widely regarded to have a nationalized healthcare system. Not really interested in whether that's technically true at the margins unless there's some major policy impact. Which countries do you consider not to have a nationalized healthcare system, then we can make a comparison? Note that even in the US, the government covers roughly half of all healthcare expenditure. The UK government covers about 79%. > 2. "Cost-effective" is an interesting term, because it assumes we agree on what "effective" means. I want choice, innovation, better health outcomes, more convenience, shorter wait times, etc., and I'm willing to pay some premium (but not 4x or something) for them. For these reasons, I don't want want the NHS system here (nor do I think it'd work here), despite it being better for some values of "cost-effectiveness". Even if you for some reason believe you don't get this with the NHS (meanwhile most people here considers the US system to be terrifying), you have all of that by combining the NHS with private top-up insurance. The average cost of combining NHS and private insurance in the UK is far lower than the average cost of healthcare in the US. So you can get the benefits that socializing services have in ensuring universal coverage and ensuring nobody drives up overall costs by waiting until things get more expensive to treat, with the ability to pay for whatever extra services you want. Fewer people go without coverage, and you get cheaper coverage and more choice since you can still pick and choose from private providers but also get a public option if you prefer that. In fact, because of the ability of the NHS to rent out resources, even privately paying for operations etc. tends to be so much cheaper even at top end London specialists that if you're in the US and need elective care it is worth checking the cost of flying to London, having it done, and staying in a nice hotel while recovering. For a lot of conditions that'll be cheaper. Personally I find it telling that it is almost impossible to find people holding your positions in places where people have experienced these socialized systems unless they have the money to pay far more for care that is out of reach of most people. For 3., note that you're referring to PPP adjusted numbers. The UK costs have also increased more the last few years than I realized. Even so, while the PPP adjusted data does not have the UK stand out as much as it used to, the gap between the UK and e.g. the US still illustrates the most important point.
njarboe 9y ago
It would be awesome if people with my values (my tribe) were in charge. Similar to the view that communism is a great political system; all those failures you point to are not true communism.
Nursie 9y ago
>> I personally don’t understand how anyone who thinks the government is awesome This is where I think some libertarians wander off from what those largely in favour of state actually think. I think a lot of people would agree there's a lot wrong with government, but most would also rather have one. They just want one that's run better. Your libertarianism seems quite pragmatic and I personally sympathise with the ideas behind libertarianism - lack of coercion, lack of people making arbitrary moral decisions (like drug laws) and imposing them on society. However I also like public services, welfare safety nets (BI is indeed interesting) and various other things that only come with state-level cooperation.
- ryanwaggoner 9y ago
  I think a lot of people would agree there's a lot wrong with government, but most would also rather have one. I would argue that most libertarians aren't anarchists, but it's a popular strawman tactic from those arguing against it (particularly on the left). It's almost a cliche: "You know where is a libertarian paradise with no government? Somalia! Hurr durr!" I think we all agree that government has problems. Libertarians just think that the problems of government are inherent and fundamental, so the solution is usually in less government (but not no government), while "liberals" (huge spectrum here, I know) seem to think that the answer is more government. And we all agree that we need better government, but libertarians think that public accountability works better the closer the citizenry is to the decisions being made, and liberals seem to favor more centralized decision-making, I guess for efficiency? I'm not entirely clear on why :)
  - Nursie 9y ago
    I don't much care for that, but like I said, I do like a welfare safety net, public health service and other public services. I'm not saying it's all libertarians, but I have interacted with quite a number on the net, over the years, who would scrap those things entirely. I, personally, think inefficient government is a price worth paying for such things, but that we must seek to do better.
  - _Tev 9y ago
    The more / less government is false dichotomy. That's why leftists make jokes about you, even smart-sounding libertarians like you always make these stupid black / white statements. Universal healthcare being one example (at least our system seems simpler than your deductible / premium / medicare / medicaid / etc. chaos), UBI being another.
socialist_coder 9y ago
You strongly prefer a public option, or single payer. You are open to trying basic income. Do you think we should have laws and regulations to protect the environment? If so, then I think you have graduated from Libertarian to Liberal. Ha ha! I did the same thing after I realized that a true free market libertarian ideal is easily abused by corporations and the wealthy, and the common man has no chance.
- ryanwaggoner 9y ago
  Classical liberal, yes.
scotty79 9y ago
> I believe very strongly in the sovereignty of the individual. You should be very interested then where your sovereignty comes from. At the moment it comes from having above yourself an entity so powerful that you and others around you (that are 10 times, 100, 1000 times as powerful as you) are equally insignificant and uninteresting as long as you pay your dues and don't make a fuss, ie don't try to overtake one another in violent way (even in some non-violent ways that in the past proved bothersome for the overlord so they were forbidden). The world is full of military technology that just invites anyone with a goal to put the finger on the trigger. So far best invention to control this state of affairs is to have the most dangerous weaponary in hands of just few actors preferably with non-overlapping geographical zones of interest.

vidarh 9y ago

The UK doesn't have fully nationalized healthcare. * GP surgeries (doctors offices) are private businesses, and may provide NHS services or private services. * The NHS contracts out for a growing number of services, ranging from operating whole departments (e.g. Virgin operates the out-of-hours walk in centre for non-emergency care next door to the A&E/ER at my local hospital) to cleaning. * The NHS rents out facilities to private providers, and individual NHS trusts may derive income from carrying out private work (though the proportion of this income is limited, and the revenue goes back into their budgets). This is in addition to NHS staff often renting NHS facilities to carry out private surgeries outside their normal rotation. * Dentists are mostly private and generally dentists that do NHS work also do private work, and often mix and match with the same patient (e.g. the NHS does not reimburse more expensive types of fillings, so your dentist may recommend e.g. things like porcelain veneers on visible teeth and stick to NHS options for less visible work). * Pharmacies are mostly private - the NHS mostly operates pharmacies only in hospitals etc. but they too can be privately operated. * 10% of the population have private health insurance. This is mostly "top up" insurance offering additional services or faster turnaround for non-essential surgeries etc. than the NHS. * Many types of healthcare services are mostly private. E.g. while you can get some types of cosmetic surgery on the NHS As it stands, the NHS is the most cost-effective hybrid or private system in any developed country. Too cost-effective some would say; to the point where it comes at the cost of making things more miserable for patients. But that's what you get when we pay far less than any other countries at a comparable income level.

ryanwaggoner 9y ago
OK, you're sort of shining a spotlight on my ignorance here, but a few thoughts: 1. Maybe "fully nationalized" isn't technically true, but my understanding was that the UK was widely regarded to have a nationalized healthcare system. Not really interested in whether that's technically true at the margins unless there's some major policy impact. 2. "Cost-effective" is an interesting term, because it assumes we agree on what "effective" means. I want choice, innovation, better health outcomes, more convenience, shorter wait times, etc., and I'm willing to pay some premium (but not 4x or something) for them. For these reasons, I don't want want the NHS system here (nor do I think it'd work here), despite it being better for some values of "cost-effectiveness". 3. If by "cost-effectiveness", you just mean per-capita spending on healthcare, are you sure the NHS is the most cost-effective of any developed country? Doesn't seem to be the case here: https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... -- maybe you're using some more complicated measure of spending per health outcomes?
- deleted 9y ago
  [deleted]
- vidarh 9y ago
  > 1. Maybe "fully nationalized" isn't technically true, but my understanding was that the UK was widely regarded to have a nationalized healthcare system. Not really interested in whether that's technically true at the margins unless there's some major policy impact. Which countries do you consider not to have a nationalized healthcare system, then we can make a comparison? Note that even in the US, the government covers roughly half of all healthcare expenditure. The UK government covers about 79%. > 2. "Cost-effective" is an interesting term, because it assumes we agree on what "effective" means. I want choice, innovation, better health outcomes, more convenience, shorter wait times, etc., and I'm willing to pay some premium (but not 4x or something) for them. For these reasons, I don't want want the NHS system here (nor do I think it'd work here), despite it being better for some values of "cost-effectiveness". Even if you for some reason believe you don't get this with the NHS (meanwhile most people here considers the US system to be terrifying), you have all of that by combining the NHS with private top-up insurance. The average cost of combining NHS and private insurance in the UK is far lower than the average cost of healthcare in the US. So you can get the benefits that socializing services have in ensuring universal coverage and ensuring nobody drives up overall costs by waiting until things get more expensive to treat, with the ability to pay for whatever extra services you want. Fewer people go without coverage, and you get cheaper coverage and more choice since you can still pick and choose from private providers but also get a public option if you prefer that. In fact, because of the ability of the NHS to rent out resources, even privately paying for operations etc. tends to be so much cheaper even at top end London specialists that if you're in the US and need elective care it is worth checking the cost of flying to London, having it done, and staying in a nice hotel while recovering. For a lot of conditions that'll be cheaper. Personally I find it telling that it is almost impossible to find people holding your positions in places where people have experienced these socialized systems unless they have the money to pay far more for care that is out of reach of most people. For 3., note that you're referring to PPP adjusted numbers. The UK costs have also increased more the last few years than I realized. Even so, while the PPP adjusted data does not have the UK stand out as much as it used to, the gap between the UK and e.g. the US still illustrates the most important point.

njarboe 9y ago

It would be awesome if people with my values (my tribe) were in charge. Similar to the view that communism is a great political system; all those failures you point to are not true communism.

Nursie 9y ago

>> I personally don’t understand how anyone who thinks the government is awesome This is where I think some libertarians wander off from what those largely in favour of state actually think. I think a lot of people would agree there's a lot wrong with government, but most would also rather have one. They just want one that's run better. Your libertarianism seems quite pragmatic and I personally sympathise with the ideas behind libertarianism - lack of coercion, lack of people making arbitrary moral decisions (like drug laws) and imposing them on society. However I also like public services, welfare safety nets (BI is indeed interesting) and various other things that only come with state-level cooperation.

ryanwaggoner 9y ago
I think a lot of people would agree there's a lot wrong with government, but most would also rather have one. I would argue that most libertarians aren't anarchists, but it's a popular strawman tactic from those arguing against it (particularly on the left). It's almost a cliche: "You know where is a libertarian paradise with no government? Somalia! Hurr durr!" I think we all agree that government has problems. Libertarians just think that the problems of government are inherent and fundamental, so the solution is usually in less government (but not no government), while "liberals" (huge spectrum here, I know) seem to think that the answer is more government. And we all agree that we need better government, but libertarians think that public accountability works better the closer the citizenry is to the decisions being made, and liberals seem to favor more centralized decision-making, I guess for efficiency? I'm not entirely clear on why :)
- Nursie 9y ago
  I don't much care for that, but like I said, I do like a welfare safety net, public health service and other public services. I'm not saying it's all libertarians, but I have interacted with quite a number on the net, over the years, who would scrap those things entirely. I, personally, think inefficient government is a price worth paying for such things, but that we must seek to do better.
- _Tev 9y ago
  The more / less government is false dichotomy. That's why leftists make jokes about you, even smart-sounding libertarians like you always make these stupid black / white statements. Universal healthcare being one example (at least our system seems simpler than your deductible / premium / medicare / medicaid / etc. chaos), UBI being another.

socialist_coder 9y ago

You strongly prefer a public option, or single payer. You are open to trying basic income. Do you think we should have laws and regulations to protect the environment? If so, then I think you have graduated from Libertarian to Liberal. Ha ha! I did the same thing after I realized that a true free market libertarian ideal is easily abused by corporations and the wealthy, and the common man has no chance.

ryanwaggoner 9y ago
Classical liberal, yes.

scotty79 9y ago

> I believe very strongly in the sovereignty of the individual. You should be very interested then where your sovereignty comes from. At the moment it comes from having above yourself an entity so powerful that you and others around you (that are 10 times, 100, 1000 times as powerful as you) are equally insignificant and uninteresting as long as you pay your dues and don't make a fuss, ie don't try to overtake one another in violent way (even in some non-violent ways that in the past proved bothersome for the overlord so they were forbidden). The world is full of military technology that just invites anyone with a goal to put the finger on the trigger. So far best invention to control this state of affairs is to have the most dangerous weaponary in hands of just few actors preferably with non-overlapping geographical zones of interest.