Single Payer Sucks

Proponents of universal healthcare hold one of the most morally attractive political positions of present day.  That healthcare is a natural human right, and should be readily available to all regardless of socioeconomic standing.  On top of their moral high ground they pile on supposed proof of single payer’s merits by pointing to Canada, Scandinavia, and various other countries.  It’s their belief that if only such a system were implemented in the US, the problems associated with healthcare would largely be alleviated.

It’s a very emotionally pleasing opinion to hold.  Single payer advocates pat themselves on the back for being so benevolent to the poor and insurance-less, and claim that if it weren’t for their efforts, countless people would unnecessarily die.  Unfortunately, positive emotions for its proponents is about the only good thing that comes from single payer healthcare.

When subjected to reason, the only way for a single payer system to look attractive is to analyze it solely with emotion.  Logical and economic reasoning, along with an honest moral assessment, serve to show such a system to be the epitome of ugliness.

Economically, when the cost of a good or service is artificially dropped to $0, the demand for it will skyrocket.  When demand skyrockets, supply will fail to keep up.  When the supply of healthcare cannot meet the demand, the only way to solve the problem is through rationing.  Rationing inevitably leads to wait times, extended pain and suffering, and death.

It’s widely accepted that rationing is the natural consequence of government managed healthcare.  In an article that is supportive of single payer, the author says,

“Canadians have made a conscious decision to hold down costs. One of the ways they do that is by limiting supply, mostly for elective things, which can create wait times.”

It’s tough to identify the most concerning aspect of that statement, but the limitation of supply “mostly for elective things” is certainly at the top of the list.  In a single payer (or otherwise government controlled) system, who defines “elective”?  Whether or not a particular method of treatment is elective is a decision that can only be made by doctor and patient.  When this decision is placed in the hands of distant politicians and bureaucrats, the relationship between doctor and patient, and their ability to use free will to make healthcare decisions is irreparably harmed.

The word “mostly” in the above quotation is perhaps even more concerning.  Is one to conclude that even when central planners determine a treatment to be necessary – it can still be subject to rationing?  Supporters of universal healthcare cannot truly say that necessary procedures would NOT be subject to rationing.  If the demand for that procedure exceeded supply, logic and basic economics indicates that rationing would be unavoidable.

The Canadian single payer system is notorious for wait times.  A particularly troubling anecdote involves a man who needed both knees replaced.  The arthritis in his knees became so bad that he had bone grinding on bone.  It took him 4 months to get an appointment with a specialist, and then he was put 290th on a waiting list for the procedure.  While waiting, he became so desperate that he offered to purchase someone’s place in line ahead of him.  Needless to say, the provincial health care minister forbid that, calling it “unethical.”

Wait times and perversion of the patient-doctor relationship are just two of the major problems with a single payer system.  Patients’ ability to seek second opinions is another.  Imagine having waited several months to see a doctor.  You’ve never met the doctor before, and went to them only because it was the available appointment when your number was called.  The doctor makes a recommendation that you’re unsure of.  You’d like to get a second opinion.  But are you really going to wait in line another several months for that?  Likely not.  Patient options is one more victim of single payer systems.

Yet another major single payer problem is that healthcare decisions and policies are based on political rather than economic considerations.  It is a dangerous game to place this level of trust in the hands of corrupt politicians and inept bureaucrats.

Single payer proponents won’t readily admit that Canada’s healthcare system is a mess.  If they do, they’ll only go so far as to say that there are various reforms necessary to improve the situation.  Within Canada, they’ll point to Saskatchewan (which holds the lowest wait times among Canada’s provinces).  Internationally, they’ll point to Switzerland, The Netherlands, Germany, Japan, and Australia.

Virtually all of the proposed reforms involve moving healthcare in the direction of the market.  Saskatchewan chose to “partner with private medical providers”.  The international countries encourage “competition between regulated private insurers,” and require “patient cost-sharing through copayments and deductibles.”  Since shifting toward the market leads to better healthcare, the logical conclusion is to continue in that direction.

The alternative to single payer healthcare is not a “mixed” system.  It is not the system that currently exists in the US.  Principled opponents of universal healthcare argue that the only proper alternative is a completely free market.  No government intervention of any kind.  Elimination of all healthcare associated taxes.  Allowance for the exercise of free will and placing all decision making responsibilities back in the hands of patients.

In the US, useful steps forward would be the repeal of ACA, reduction of income taxes, elimination of healthcare regulations, and allowing individuals to “opt out” of Medicare, Medicaid, and Social Security.  Eventually (and ideally sooner rather than later) the US Federal government needs to abolish the Department of Health and Human Services, and get itself out of the healthcare industry altogether.  Decisions related to healthcare policy should be moved down to the state and local levels – closer to the individual.  When this happens, there will be competition among systems, and individuals will be free to “vote with their feet.”

Is there anyone who would oppose the goal of seeing all people have easy access to high quality healthcare?  Of course not.  Unfortunately, that goal has not yet been realized – anywhere in the world.  The debate comes when speculating about the best way to achieve this.  There are only two sides to this debate.  One being the use of force, coercion, and central planning; the other being freedom.  Allowing individuals to exercise free will is always the economically, logically, and morally correct path to take.

The Secret to Success

The phone on my desk at work rang.  Looking at the caller ID, a rush of adrenaline hit when my company’s owner’s name appeared.  He really only ever spoke to me in passing, and had never called me directly like this.  Him and I did, however; have a lengthy conversation at our most recent annual Christmas Party during which we discussed free market economic principles, the negative incentives and effects of welfare programs, and governmental hindrances put upon businesses and upon commerce in general.  Afterwards, he remarked to me, “you and I, we’re on the same page.”  It was a proud moment.

When I answered, he asked me to come to his office saying that he had something he wanted my help with.  Sitting down in his office, he began to explain what he was looking for.  The company had recently acquired a new property, and he wanted me to create a spreadsheet that could easily capture costs and predict revenues.

As we were discussing the concept of real estate investment in general, we quickly got off topic.  He mentioned how the company had lost a property they had purchased in Jersey City to eminent domain.  Shaking my head in disgust, he continued, “They stole that property from me.”

“That’s the exact right way to describe what happened – they stole it from you,” I said.  He shrugged, looked a little irritated and said, “Well, they gave me a little money for it, but it was nowhere near what I would have been able to get for the property on the open market.”

I continued his thought saying, “And you would have never voluntarily chosen to sell it in the first place.”

“No, I wouldn’t have.  Certainly not for the amount of money they gave me,” he replied.

Continuing our conversation, something must have triggered a memory in him, because he delved into telling me a story about a time he had been asked for advice.

He was attending a relative’s wedding in Ireland.  While mingling at the reception a younger male relative approached him and asked if he could ask a question.  The two of them walked off to the side where it was less noisy so they could talk.  According to the re-telling of the story that my company’s owner regaled me with, he had no idea what to expect.

“What’s the secret to becoming successful?” the relative asked.  

“He was clearly hoping for some kind of trick, some magical strategy,” he said to me, laughing.  “So I said to him, ‘I’ll tell you exactly where success comes from’,” he continued, “first you wake up everyday at 5 or 6am, and you go to work.  And you work until 6 or 7pm.  And you do this 6 or 7 days a week for 10-15 years.  Then, once you’ve done that, and you’ve built up a little bit of money, and if you’ve been smart with your money – only then will you be able to take a bit of a step back and maybe start having your money work for you.”

Still laughing, he continued, “I’ll never forget the look on his face after I answered his question.  His eyes lowered, he got this dejected look on his face, and he just walked away shaking his head.”

“I guess I didn’t give him the answer he was looking for,” he said to me.  We both laughed and then continued on with the business purposes of our meeting.

As I was driving home later that day, reflecting on the meeting we had had, I couldn’t shake the thought of what good, profound advice this truly was.  Yes, becoming wealthy and successful is extremely difficult.  Yes, it takes a lot of hard work, long hours, persistence, perseverance, smarts, and discipline.

There is no trick or magical strategy to making oneself successful.  No state intervention into the economy can produce prosperity.  No “basic minimum income” or other mystical proposal can produce the advertised results that so many of their proponents push.

If you want success for yourself, or if you want to improve your standing in the world, you’re going to have to work for it.

My Journey to the Philosophy of Anarcho-Capitalism

Bill Clinton vs Bob Dole in 1996 was the first presidential election that I remember. It was during this campaign season that I first learned the phrase “the lesser of two evils.” My parents were typical conservative republicans and though they weren’t overly enthusiastic about Dole, they thought that his brand of evil was more tolerable than Clinton’s brand of evil.

Another concept I first learned during this election was the idea of a “single-issue voter.” Though the phrase wasn’t explicitly used, the reason Dole was thought to be a lesser evil than Clinton was his opposition to abortion. That alone was reason enough to support Dole regardless of his stance on other issues. In that time and up until the 2008 elections, I hadn’t thought about or formulated my own political opinions. I had more or less taken up the ideology that I was brought up with in my family. However, I do recall being less than satisfied with the idea of voting for the “lesser of two evils.”

Starting college in fall 2005, I slowly started leaning more liberal democrat with thoughts such as “everyone should get free healthcare” and that sort of thing. It was also during this time that I began to see the problems with the war on drugs. During primary season, a friend pointed out to me two candidates who were advocating for the complete legalization of marijuana – Ron Paul and Dennis Kucinich.

There was something about Ron Paul that drew me to him more so than Kucinich. He was candid and unafraid to voice unpopular opinions. As was true for so many others, his “Giuliani Moment,” was life changing for me, and opened my eyes to the immorality and criminality of US foreign policy. Those in power are constantly preaching that they are keeping us safe with their wars and foreign interventions. In reality with every bomb that is dropped, and every innocent person that is killed, the US is inciting hatred and provoking blowback.

Aside from the war issue, he was he only candidate who ever referred to the Federal Reserve. He was the sole voice speaking about monetary policy, and he explained how inflation and boom/bust cycles are not natural phenomena in an economy. Rather, they are a predictable result of central banking manipulation of the supply of money. His stances on war and on the Fed were the two greatest lessons I’ve ever learned, and started me down the path of fighting for liberty.

When Ron Paul eventually dropped out of the 2008 race, I was drawn to Barack Obama because he sounded a lot like Ron when it came to foreign policy. He was promising to end wars, bring troops home, rein in executive power to declare war, and close down Guantanamo. I let myself believe in the message of “Hope and Change,” and it was then a proud moment to pull the lever and cast my vote for Obama.

Midway through Obama’s first term, it was evident that he had made false promises. He either didn’t have the power to fulfill his promises, or he didn’t have the desire. Either way, it was during these years that I decided I wouldn’t get fooled again.

It was also during his first term that I began referring to myself as a libertarian. It was increasingly clear that government, especially big government, was the root cause of so many problems. My distrust of the state grew. Obama’s (and Hillary’s) Libyan War was another major turning point in my views on the US military. I read how Gaddafi’s regime was using weapons against the rebels that had been supplied by the US. I read how the rebels that the US was backing were comprised of jihadist fighters who were veterans of the US war in Iraq. How could the US be on the side of Al-Qaeda? Weren’t these the same people who flew planes into the WTC towers? Weren’t these the same people that the US had just lost 5,000 lives fighting against in Iraq and Afghanistan? Then after the US toppled Gaddafi, the Libyan government’s stockpile of weapons fell right into those jihadists’ hands. This played a direct role in the rise to power of Al-Nusra in Syria and in the creation of ISIS. Could the government really be this stupid? Or were they deliberate in their criminality? Regardless, it had become an institution that I feared more than cheered.

Aside from having my eyes opened to the ridiculous foreign policy of the US government, I was also coming to a more crystalline realization that domestic policy was equally farcical. In 2009, I began my first full time job after graduating college. I saw first-hand the problems associated with artificial government regulations, I was confronted with the concept of taxation as theft, and I began to see the problems associated with mandatory unionization of employees.

During the 2012 election, I became a part of the “Ron Paul or none at all” coalition. I was not going to be voting for the lesser of two evils. I donated to his campaign, passed out information on street corners, made the case for him on social media, and went to hear him speak when he come locally – dragging my parents along with me. During a Q&A session at a luncheon that I attended, a person asked him, “I find that I agree with you on virtually everything, what should I do to help bring about the changes that you speak about?” Ron’s answer was perfect. He said simply, “Do what you want to do. Do whatever makes you happy.”

As had become a staple of his speeches, it was not up to him to tell people what to do, nor was it the responsibility of government to make decisions in the lives of people. His advice was that if you’ve become a believer in the philosophy of freedom, the best thing you can do is to educate yourself. To read as much as possible. And, when confident in your knowledge and ability to refute those who would argue against freedom, to spread the ideas of liberty. I took that message to heart, and have been trying to follow that advice ever since.

Ron Paul’s GOP debate debate performances were nothing short of spectacular (see here, here, here, here, here, here, and here). When his campaign was finally over, it became the work of the millions he had inspired to assist him in carrying the torch for freedom. Reading was my priority. I consumed all the greats including Bastiat, Hazlitt, Hayek, Mises, Rothbard, Napolitano, and Woods. I read article after article on LewRockwell.com, Antiwar.com, Mises.org, and Fee.org. I simply could not get enough. It was like coming out of The Matrix.

In libertarian circles, there’s a joke that goes, “what’s the difference between a libertarian and an anarchist? About six months.” This became true for me. The more I read, the more I became convinced that the state is always a hindrance to human prosperity and an enemy of peace. It does not matter how the state is arranged or who is in power, everything that the state does is always a drain on wealth and on the productive capacities of free people.

Anarchy is a word that comes with negative connotations in the main stream. That anarchy has come to be synonymous with chaos is sad, and goes to show the ability of those in power to co-opt words and to skew language to their benefit. The true definition of anarchy is simply the lack of a ruling class. Anarcho-capitalism, the philosophy popularized by the great Murray Rothbard, is much wider in context. It is the philosophy of true and complete freedom in every aspect of life. Its guiding lessons include the non-aggression principle, property rights, and free market economics.

Every person has a right to their life, liberty, and justly acquired property. Aggression against another is never justified except in cases of self-defense, to achieve restitution, and in certain cases of retaliation. Economic resources are scarce, and as such, they should always be put toward their most efficient use as desired by the will of society.

That last point is often used as justification for central planning and state authority. How else would scarce resources be put to the best possible use? But this is a fallacy. The free market, comprised of the collective voluntary transactions and interactions between all individuals is the only way to effectively use Earth’s scarce resources. The collective knowledge of billions of free individuals will always be greater than the collective knowledge of a handful of central planners. The price and profit & loss systems that comprise free market economics show how resources will always be put toward the use that is valued most.

This newly acquired knowledge was liberating. Even so, as I began having discussions with people around me, I was still too frequently confronted with arguments that were difficult for me to refute. I knew the arguments I was being presented with were wrong, but I still lacked in ability to respond in a way that satisfied myself intellectually and in a way that could potentially change minds.

The “who would build the roads” argument was simple enough. Others, though; such as “we are the government” and “politicians represent us” were more difficult. The more I read, the more I was comfortable with responding to those arguments. Tom Woods’s podcast, The Tom Woods Show was another major contributing factor to my development, and I would be remiss were I not to give Dr. Woods his due.

Ron Paul ran as a strict constitutionalist, and that is a large part of what attracted me to him. In government schooling, I was taught how great and wise the founding fathers were in drafting the Constitution. That someone would be ridiculed and shunned in the way that Ron was for defending this supposedly revered document struck me.

I have become much more confident in responding to arguments against a stateless society that are presented to me. Politicians cannot truly be our representative, because what is representation? These people “represent” hundreds of thousands of individuals. If another individual and I hold opposing views, how can someone represent the both of us?

The entire premise of government authority is now like something from another planet. What right does 51% have to make laws that the 49% must follow? For that matter, even if every person in the world except one all agreed on a particular issue, what right do they have to tell the one how to live his life?

The questions that people will have when confronted with the ideas of a world without government will be many. While it will be increasingly difficult to answer every possible “what about this” scenario, it will always hold true that the market, the collective actions of millions of free-thinking and free-acting individuals, will be able to provide for any needs that arise.

The philosophy of anarcho-capitalism is so compelling because of its logical, economic, and moral consistency. It never requires one to follow up “I believe in freedom” with “but…” The point I always try to make when engaging people about these ideas is that I don’t want to force freedom and voluntarism on anyone. Ultimately, all I desire is to live with my family in a society free of coercion. I’d never try to force others into that society. If a group of people want to live in a community where they share everything collectively, and all wealth is evenly distributed, they should be free to do so. I only ask that these people do me the same courtesy and allow me to be free of state mandates and edicts.

While I will always be willing to accept smaller government, and a government more in line with the original desires of the Constitution, it has become clear that small, limited government cannot be the end game that is sought. It must be no government. No one should be given power to rule the lives of others. Lysander Spooner said this about the Constitution during the 19th century, “… it has either authorized such a government as we have had, or has been powerless to prevent it. In either case, it is unfit to exist.”