Government’s Responsibility for the Health Care Crisis

December 11, 2008
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In the comments at the Reddit thread for my recent post about The Health Care “Crisis”, many people thought that I didn’t thoroughly make my case, that the government caused the crisis. My first thought was, “Why are these people reading Reddit | Libertarian? They must obviously be trolls.”

Perhaps it was not clear, so I will state it here: the purpose of my original post was not to defend the bureaucratic nightmare of American Health Care contra other (more) socialized forms of health care. Given the choice between what we have now, and something that is IMO objectively worse, I’ll keep the status quo, although I would prefer a completely free market.

Most of the complaints seemed to be saying that I didn’t prove my point. I’m convinced that they just didn’t read my post. Reddit user the6threplicant said

This is what I can gather from the article. Since the author can’t actually give good reasons for universal health care …

OK. I guess basic metaphysics, and fundamental, immutable laws of economics aren’t “good reasons.” You got me.

Reddit user daniels220 (who even went so far as to invoke the “from each according to his ability, to each according to his need” screed) said

I can see how the gov’t could have “caused” college tuition to rise, but healthcare costs? Of course you could argue that the cost of getting drugs approved is so high that it drives their prices up, but I’d rather not have stuff that’ll kill me out there, thanks.

I could argue that, but since you can see at least some merit in that, I’ll try not to belabor the point: the fact that R&D is so expensive is simply not because it costs a billion dollars to figure out how not to kill someone. But it’s not just the drugs – it’s the labor. The AMA is essentially a labor cartel that reduces the supply of available physicians, which serves to keep the wages they command and the costs we pay artificially high. Moreover, the lack of health plan portability means that those who are unemployed, or become unemployed, are often without care, and the fact that health insurance is so often tied to a place of employment is a consequence of government price-fixing of wages during WWII.

Topher who commented on my original post, said the following:

According to the Canadian fellow in the office next to mine, health care in fact does work quite adequately in Canada. There may be some delays for non-urgent care, but unlike in the U.S., nobody’s at risk of financial ruin because of health care costs. Exactly what is your basis for saying “inadequate care for everyone else”?

In a nutshell, whenever anyone is forced to wait for care that they could otherwise receive in the absence of government meddling, I deem that level of care to be “inadequate.” Whenever a a bureaucrat (and not the patient) is the arbiter of urgency, I deem that system to be “inadequate.” In short, any system of political rationing is inadequate.

Topher can say “Well, I have anecdotal evidence that it works,” but I have anecdotal evidence that it doesn’t. In talking to a young Canuck about my age, he said he couldn’t afford health care. However, he could afford to go to the Burning Man festival for a week or two, halfway across the continent. And he could afford to sit at the barstool next to me and put down $5 beers. Priorities, eh?

He noted, of course, that people could always go south (to the U.S.) and pay more if they really needed a procedure. This sort of health “tourism” is a fairly new phenomenon, whereby the wealthy are able to circumvent the limitations of their “universal” care, to pay out-of-pocket in another country.

In Canada, some people are finding that they’re being denied treatment (e.g., for cancer meds) that would be “routine” in the U.S.


[A] dramatic new trend in Canadian health-care advocacy: finding the treatment you need in another country, and then fighting Canadian bureaucrats (and often suing) to get them to pick up the tab.

David Gratzer

In terms of supporting free markets in Health Care, Gratzer is a convert. Growing up in Canada, he thought nothing of the universal program that’s been in place 40-odd years. It wasn’t until he witnessed an EPIC FAIL that he began to doubt the system:

My health-care prejudices crumbled not in the classroom but on the way to one. On a subzero Winnipeg morning in 1997 … the ER overflowed with elderly people on stretchers, waiting for admission. Some, it turned out, had waited five days. The air stank with sweat and urine.

Long waits or “queues”, typical for many procedures in countries with more socialized programs, are indicative of shortages (either of doctors, or of facilities, or both) and shortages are indicative of system failure. A system of universal health care is bound to fail because it attempts to circumvent the laws of economics, viz. scarcity.

To review: scarce resources can be rationed by the price mechanism of the market, or they can be rationed by the politics of pull, special interests, and class warfare. When goods and services are priced below market, they will be demanded in excessive quantities, and generally supplied in sub-optimum quantities. Shortages, and concomitant need for rationing, are an unavoidable consequence of price ceilings.

I do not have reams of empirical evidence to back up my claims, but Gratzer notes that the five-year cancer survival rates in America are significantly higher than they are in e.g., Europe. For instance, “The survival rate for prostate cancer is 81.2 percent here … and down to 44.3 percent in England.” I’ll take my chances with “financial ruin”, if it means I get to live another 5 years, TYVM.

Government is the problem: they cannot bend or break the laws of economics any more than they could invalidate gravity, or thermodynamics. I don’t have fancy charts and graphs or data tables or complex models. I have theory, and the theory is sound.

One Response to Government’s Responsibility for the Health Care Crisis

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