The Libertarian Alternative to Universal Health Care
Ok, so this is my promised response to Greenstate’s question. That full question will appear below in bolded block quotes (non-bolded block quotes are from other sources). As I said before, I typically prefer to reblog for agreement instead of disagreement, so my intention here isn’t to start a massive reblogging argument, but rather to just answer a question with a presentation of a libertarian alternative to universal health care. There may be other alternatives which libertarians would also support; it seems unlikely that the case I make here will be amenable to all libertarians everywhere. Greenstate also addressed the original question to conservatives, for whom I don’t claim to speak at all. Anyway, here we go…
do libertarians/conservatives believe that it is ok for private insurance companies to deny people based on preexisting conditions, drop people when they get sick, or refuse to pay for life-saving treatment? and if so, why is that their belief? why is this kind of treatment ok? government aside, why would we say that the only healthcare available is entitled to not actually deliver on the promises that they make?
There are a whole lot of questions in the segment, so hopefully I can be clear. Let’s resort to bullet points:
- Is it ok for insurance companies to deny people insurance because they have preexisting conditions? I think most libertarians would be with me when I answer with a personally qualified “yes.” Insurance companies are a business, and, like other businesses, they exist primarily to make a profit. So it’s understandable if, from a business perspective, they would not wish to work with unprofitable clients. That isn’t to say that libertarians don’t value people, want them to go without health care if they can’t afford it, or would run their own insurance companies that way if they owned them. It’s simply recognizing that it is not in the insurance company’s interest to accept clients with preexisting conditions — or at least not to accept them at the same rates they’d give everyone else. Perhaps unfortunately, most people don’t get into the insurance business to be humanitarians; they do it to make a profit. If they were there to help people, they’d probably start a nonprofit or charitable organization.
I’m going to take a quick break from the bullets to include a quote that theonlyplfmat used in his response to Greenstate’s question, which I think is applicable here [emphasis added is mine]:
All of the actors in health care—from doctors to insurers to pharmaceutical companies—work in a heavily regulated, massively subsidized industry full of structural distortions. They all want to serve patients well. But they also all behave rationally in response to the economic incentives those distortions create. Accidentally, but relentlessly, America has built a health-care system with incentives that inexorably generate terrible and perverse results. Incentives that emphasize health care over any other aspect of health and well-being. That emphasize treatment over prevention. That disguise true costs. That favor complexity, and discourage transparent competition based on price or quality. That result in a generational pyramid scheme rather than sustainable financing.
Also, for a more detailed treatment of the preexisting conditions question, check out this reply to Greenstate’s question from coeus.
I’ll come back to this later — a key part of my post, you’ll no doubt notice, is its intent to shed light on just how much government already is involved in health care and how much it has contributed to its current failure. Now, moving on…
- Is it ok for insurance companies to drop people when they get sick? Is it ok for insurance companies to refuse to pay for treatment? This depends on the contract between the insurer and client. It doesn’t seem likely that someone would take out an insurance policy which wouldn’t pay for treatment or would drop them when they got sick (after all, that would be kind of counter-intuitive), which seems to indicate that this would break the contract. If that’s the case, then it’s definitely not ok, and this would be a criminal situation in which the government would be right to get involved. The article coeus posted is also applicable here.
- Why would we say that the only health care available is entitled to not actually deliver on the promises that they make? I’m going to say that libertarians are totally with you here: We think one of the main roles of government is to prosecute people and businesses which commit fraud or break contracts. So yeah, insurance companies which don’t deliver what they’ve contracted to deliver should be prosecuted.
Ok, next section:
it seems like everyone can agree that the current system is not working. this much we know. but what is the libertarian alternative to our present system?
Very true. The difference, of course, is where we place the blame for the current failure. For instance, I was honestly amazed to learn a couple years ago that HMOs are government-mandated — here be monsters, indeed, but they are not free market monsters:
We should remember that HMOs did not arise because of free-market demand, but rather because of government mandates. The HMO Act of 1973 requires all but the smallest employers to offer their employees HMO coverage, and the tax code allows businesses — but not individuals — to deduct the cost of health insurance premiums. The result is the illogical coupling of employment and health insurance, which often leaves the unemployed without needed catastrophic coverage.
