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One major oversight that you fail to address in you hypothetical free market scenario is that supply is still constrained. In a truly free market, anyone can se

• bhauer 13y ago
  > That is why we have the FDA etc, and that is why doctors are rigorously vetted and trained through the med school/residency process, and I think most people would agree that that is a good thing. With the amount of error we have (see malpractice suits) as it is, I'm not convinced that what we have right now is actually yielding better overall results than a free market would with actual price signals. Reason being that medical care quality is usually not a binary matter—with outcomes of either total success or total failure. Usually it's a broad continuum, and yet mediocre doctors are presently extremely difficult to differentiate from superb doctors because of the lack of price signals. Malpractice suits would still exist in a free market, of course. And if care lead to death, there would be lawsuits. But in a majority of cases, bad care would lead to non-death but non-ideal resolution. That's where price signals will flourish. Ironically, I see the current situation as an all-or-nothing where I want more nuance. We currently treat all doctors as essentially similar because they have all completed the same rigorous training and certification process, and we few other measures to use. (Some above-market review systems notwithstanding.) Finally, don't be certain that doing away with regulation would lead to certifications evaporating. It more likely would mean variation in certification. A less politically-entrenched alternative to the AMA perhaps. (Of course, I'm also not necessarily bowled over by certification. I put no stock in computer programming certifications.) > And of course the typical libertarian response is "tough luck" or "work harder". While true, this shouldn't be dismissed cavalierly. We tend to speak without as much political thought as the right and left—saying apparently heartless things like "work harder." But what we mean in practice is that there would be more emphatic pressure on individuals to work to solve their own life situations first and only in extreme cases leverage safety nets. We have a situation today where half of the country uses some form of government assistance. That's not what safety nets should be for. But outside of "character" or other intangibles, there's no incentive to avoid the safety nets—in fact there's every incentive to use them, lest you be a sucker. Only suckers pay for things. When I had an electric car, I momentarily reeled at the $5,000 federal government incentive because it goes against my every belief. But, come on. Who is going to pass on such a sweet kick-back? I took the money. We all do. Yes, it's utterly impossible for a libertarian paradise to provide a 50% safety net. But we feel we have such a large safety net because it's a venus fly trap, not because it is necessary to have a 50% safety net as a first principle. Furthermore, many libertarians are amenable to a basic income, and with a basic income and a free market for health care and health insurance, it's almost a foregone conclusion that a great deal of competition would angle for that demand. > Compromise shouldn't be such a dirty word in today's political discussions, it's a sad state of affairs The trouble with compromise is what I said earlier. We're willing to allow central planners to build within a free market, to create a voluntary consortium of participants supporting one another through centrally-planned distribution of resources. But reverse the tables and we're absolutely never permitted the same freedom. Central-planning is not voluntary; it a piece of totalitarianism. So compromising with central planners means totally conceding. Either they plan for you or you plan for you. I prefer planning for me, difficulties and all.
  • pyoung 13y ago
    I am strongly in favor of basic income, primarily because I think technology is going to make it increasingly difficult for many individuals to find meaningful, high paying work. But even with sufficient basic income, people are going to forgo insurance and health care until it's too late, and as I mentioned in the previous post, this will have societal level effects. I would agree that in a more ideal world, we could have free market health care. With enough technological progress, it might be possible to get accurate diagnoses of illnesses just by using an iphone app and then go to a pharmacy (or get drone delivery) to get a prescription for a cheap nano surgery pillbot. But we are way too far away from that, and there are way too many human lives on the line. I think it's okay to be militantly idealistic, but when human lives are at stake, I think it is necessary to cede to practicality.
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  • warfangle 13y ago
    >But in a majority of cases, bad care would lead to non-death but non-ideal resolution. That's where price signals will flourish. Conjecture. Got proof? (let's say, a statistical analysis between the recent spate of doctors who no longer accept insurance -- only cold hard cash or credit -- and their Swedish counterparts in both patient care and malpractice suite rate) That's the thing about this entire argument. We're point at those other folks that seem to be a doing a lot better job at this whole keeping people healthy thing than we are. And you're pointing at this conjecture that maybe people make rational decisions in a market. And we know that's not true. Just look at homeopathic medicine to see how well the free market does, without FDA intervention, at keeping people healthy - and getting them healthy if they aren't.
  • vasilipupkin 13y ago
    Libretarians tend to conveniently forget that the reason we have FDA, EPA and all that good stuff is that when it was all pure market, it wasn't working very well - that's why we set FDA up in the first place. That is not to say that the current system is perfect.
• steamer25 13y ago
  > That is why we have the FDA etc, and that is why doctors are rigorously vetted and trained through the med school/residency process, and I think most people would agree that that is a good thing. I can imagine a world where it's sufficient to see that physician X is certified by Harvard and works for a clinic that's recommended by Consumer Reports without any involvement from the state. In this scenario the FDA would still exist as a competing organization but no one would be compelled to buy their product via taxation. > Of course we all know that charity will never come close to providing for the entirety of society Ostensibly, we've all voted for compulsory charity. If we can be trusted to vote so nobly, why not put down the guns and self-elect to be charitable? > I want to be able to go to a restaurant without being terrified of catching TB from the waiter or getting salmonella poisoning from the food I agree and I don't think I'd lose any libertarian cred to say that the government does have a role here because the restaurant has defrauded you and breached the implicit contract to provide you with safe food. > I don't want industrial companies polluting the ocean and rivers that I surf and fish in. I think property rights solve a lot of these things--"Oh, they polluted some river..." vs. "They polluted MY river?!" . I can concede that things like oceans and larger rivers should not be privately held but in these cases I'd prefer local government jurisdiction to federal/global governments. Essentially, the more aggregate the government, the more deliberate/unintrusive/restrained/super-majoritized I think it should be. In my mind, health-care is not one such federal issue.
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