Tuesday, September 29, 2009

Obamacare is Dead - Long Live Romneycare?

The dirty little secret of the Democrats' latest plan for advancing socialized medicine this year (under the guise of "reform") is that it has morphed into a copy of a Republican scheme. McClatchy-Tribune's Chen May Yee writes::

"Massachusetts is the only state that has adopted the core elements of the plan outlined by President Barack Obama and congressional Democrats: an individual mandate; an employer mandate; subsidies for the poor; insurance market reforms; and an 'exchange,' under which consumers can shop for coverage."

Although she doesn't mention it, the Dems' current scheme is the Baucus bill. And the Massachusetts plan (enacted in 2006) is the state universal healthcare bill enacted by then-Republican governor Mitt Romney.

The plan recently released by Senate Finance Chairman Max Baucus is, according to the Wall Street Journal, Public Option Lite. Just like in Massachusetts, the government will set the terms across the board:

“The headline is that Mr. Baucus has dropped the unpopular "public option," but this is a political offering without much policy difference. His plan remains a public option by other means, imposing vast new national insurance regulation, huge new subsidies to pay for the higher insurance costs this regulation will require and all financed by new taxes and penalties on businesses, individuals and health-care providers.

“The centerpiece of the Obama-Baucus plan is a decree that everyone purchase heavily regulated insurance policies or else pay a penalty. This government mandate would require huge subsidies as well as brute force to get anywhere near the goal of universal coverage. The inevitable result would be a vast increase in the government's share of U.S. health spending, forcing doctors, hospitals, insurance companies and other health providers to serve politics as well as or even over and above patients.

“The plan essentially rewrites all insurance contracts, including those offered by businesses to their workers. Benefits and premiums must be tailored to federal specifications.

“Everyone would be forced to buy these government-approved policies, whether or not they suit their needs or budget. Families would face tax penalties as high as $3,800 a year for not complying, singles $950. As one resident of Massachusetts where Mitt Romney imposed an individual mandate in 2006 put it in a Journal story yesterday, this is like taxing the homeless for not buying a mansion."

(Before I go any further, I want to say that at the time of enactment, I expressed reserved support for Romneycare. I have long since changed my mind, for various reasons, but based in large part upon the realization that Romney’s plan for “free market healthcare solutions” was no such thing.)

What we have here is another lesson in the destructive ramifications of a Republican attempt to play Democrat Lite; or, to put it another way, to act without principles. Romney teamed up with Senator Ted Kennedy to craft his “bipartisan” scheme. The result has been 432,000 newly insured individuals, most of them subsidized (including “healthy”, “carefree 20-something” Rebeccah Pearson, who received a policy for $34.60 per month, courtesy of the taxpayers). Ms. Yee writes that:

“Success in expanding coverage has brought its own problems: rising costs and longer waiting times… State costs shot up too. State spending on health care grew $707 million [including $354 million in Federal money].

"It took on average 63 days to see a family doctor [in Boston] for a routine physical exam, compared with 10 days in Minneapolis and seven in Miami, according to Merritt Hawkins, a Texas physician recruitment firm. It said that wait times had lengthened in Boston, while falling in other markets.

“Next, officials want to tackle costs. They want to stop paying doctors for each procedure, which can spur overuse, and pay for outcomes — that is, for keeping patients well. [rationing, in other words]

“As a result, providers are trying different strategies. Mount Auburn Hospital in Cambridge sends nurses to visit recently discharged patients in their homes, a bid to prevent the next hospitalization. [again, rationing]

“Atrius Health, a large multi-specialty group, is trying out group visits: one doctor sees several patients at once.

“Atrius Chief Executive Dr. Gene Lindsey, a cardiologist, now meets with 10 patients at a time. It takes him an hour and a half, compared with three hours to see each individually.”

Some “success”. Rather than liberate the insurance market from the third-party-payer system, government mandates, and interstate barriers to competition to allow a competitive market to drive down prices and widen affordability, we will instead have to endure higher taxes to cover budget deficits, two month (or longer) waits for routine doctor’s visits, rationing, group (rather than private) consultations for our most personal health problems, etc. – so that the irresponsible “carefree 20-something” Rebeccah Pearsons can get $34.60 a month healthcare – subsidized by us while we wait, of course.

These predictable outcomes are written off as mere growing pains (“lots of kinks and issues", as it is described by Phillip Gonzalez, director of grant-making at the Blue Cross and Blue Shield of Massachusetts Foundation). But FIRM’s Dr. Paul Hsieh sees more than kinks. In The Objective Standard, Dr. Hsieh documents at length why the problems with Romneycare were inevitable and destined to grow worse. His article, Mandatory Health Insurance: Wrong for Massachusetts, Wrong for America, concludes with:

“The Massachusetts plan failed because it suffered from all the moral and practical flaws inherent in any system of socialized medicine.47 Mandatory insurance was not right for Massachusetts—and it is not right for America. It is a rights-violating road to disaster.”

Where is all of this leading? Again, from the Yee piece:

“What critics don’t understand, [Lindsey] said, is that reform doesn’t end with universal coverage. It’s like building a house.

‘We’ve just put a basement in, and now we’re walking around and we see there’s a problem with where we wanted to put a bathroom. So we’re having to change direction.’

“The work of health reform, he said, has just begun.”

Just begun! In classic fashion, a government plan is enacted to correct problems caused by prior government interference, leading to more problems and more government controls. Where will the work of health reform end? In total government control of medicine. And, as all to often happens, the incremental creep toward socialized medicine is led and/or sanctioned by the Republican Party. We are on the verge of Obamacare because of one of the 2012 Republican presidential frontrunners, Mitt Romney. To be fair, many republicans and conservatives never liked Romney’s plan. But where would the Obama Democrats be following the summer of the Tea Party/ townhall rebellion against their original “public option”-led healthcare “reform” scheme, without the Romney model? Obama can rightly trumpet the Baucus “compromise” as a bipartisan bill!

The tragedy is that the Massachusetts plan, having been enacted under a Republican administration, operates under the free market capitalist banner. So when national Romneycare fails, if and when it is enacted, the cry will rise that the free market has had it last chance and has failed. After all, didn’t many Republicans and conservatives hail the Massachusetts plan as a “marked-based” solution? We will then be ready for the single payer dream of the American Left.

No other end result is possible, unless we move in a totally different direction. Urges Paul Hsieh:

“The solution to disproportionately high health care costs and poor access is for Americans to recognize that health insurance and health care are commodities that can be produced only by means of the long-range thinking, planning, and risk-taking of businessmen acting in a free market, and that individuals and insurers have the moral right to contract with each other as they see fit. Mandatory insurance fails because it ignores these facts and violates these rights.

“If we Americans value our health and our lives, then we must reject mandatory health insurance. We must demand that the government stop violating individual rights and start protecting them. We must demand a genuine free market in health insurance and health care, because only a free market can provide us with the quality, affordable health care that we all need.”

Friday, September 25, 2009

Objectivist Round Up #115

Objectivist Round Up is a weekly compilation of blog posts focusing on a wide diversity of subjects presented from an Objectivist perspective. I've submitted several posts in recent weeks. This week's is hosted by The Little Things.

Healthcare and the Role of Money

Among the arguments used to promote socialized medicine, perhaps the most insidious is to denigrate money. Money, the basic argument goes, should not come between any person and the healthcare he needs. After all, no one should be “denied” treatment because of some provider’s selfish pursuit of profit.

What does this reveal about those who promulgate this line? I’ve had several opportunities to dissect various manifestations of it.

In response to an article by Amit Ghate, Misconstruing the Cause of Waste, Anonymous wrote:

Without government intervention in the health care market, most Americans would see no benefit from the advances in medical technology over the past fifty years. There is plenty of waste in a private market, but not all of this waste is in the form of money. Human potential is also wasted in the private system, that does not value human beings, but instead protects merely their money.

I want an option for medical coverage that doesn’t line the pockets of these folks, thanks.


Here is my brief response:

Anonymous condemns the money earned by the people who produce the valuable products and services without which there would be no healthcare debate. He demands “government intervention in the health care market” to grab by force for himself the “benefit from the advances in medical technology” so he doesn’t have to “line the pockets of these folks”… the very folks in the “private system that does not value human beings” who produce the goods that can keep Anonymous and his ilk healthy and alive.

“Peace”, he believes, will be the result of a [government-run public] “option” that uses its power of legalized physical force to provide for his healthcare needs.

Kathleen O'Neil of Toronto praises Canada’s healthcare system in a letter to the NJ Star Ledger, then says:

With a publicly organized health care insurance plan, you can concentrate on your health, instead of your bank balance.

So I put her words into proper perspective:

But your bank balance represents something profoundly moral...the money earned through your own productive work. Your money represents your means of purchasing the goods and services you need but that are produced by others. Your bank balance stands for your ability to earn your own keep.

By disconnecting "your bank balance" from your responsibility to "concentrate on your own health", Ms. O'Neil is in essence demanding that someone else be forced to pay for her health care.

The real soul of the advocates of a "Canadian-style", "publicly organized health care insurance plan" is the moocher.

Perry Leandro of Cranbury, New Jersey, leaves no doubt about his disdain for money in this Star-Ledger LTE:

As a species, we seem to believe we are highly evolved. But when I take a closer look, it becomes quite obvious we are really still very primitive because we labor under layers of illusions that allow us to severely mistreat each other.

A dollar bill is a piece of paper, nothing more and nothing less. We allow ourselves to believe a piece of paper with "one hundred" printed on it is more valuable than a piece of paper with "one."

We are smart enough to realize that money is only paper, yet we are willing to allow millions of our fellow humans to live without access to a primary care doctor simply because they lack the proper number of pieces of paper.

Pain and disease is true reality, the need to have constant access to a caring doctor is true reality. Holding back health care from people because they don't have enough paper is an illusion that only a primitive group would allow. We must strive to evolve to the point that everyone has access to care regardless of how much paper they possess.

Incredibly, Mr. Leandro seems to long for some form of primitive tribal society, in order to escape our “primitive”, advanced money economy! Here is my response to his ignorance:

Perry Leandro of Cranbury writes:

"A dollar bill is a piece of paper, nothing more and nothing less."

Then why do you receive those pieces of paper in exchange for the real products and services your productive work provides for others? And why can you then exchange those pieces of paper for real products and services you need and want, but that are produced by still others?

A civilized man sees money as a noble medium that stands for something - wealth that has been produced by human beings and made available to other human beings through the voluntary mutually advantageous transaction called trade. By making it possible to work for one person and purchase the work of another, the discovery of money led to the division-of-labor market economy that in turn made possible the huge advance from the primitive witch doctor to modern medicine.

A savage sees only that "A dollar bill is a piece of paper, nothing more and nothing less."

Perry Leandro says:

"Holding back health care from people because they don't have enough paper is an illusion that only a primitive group would allow."

There is nothing illusory about earning your own keep. As every civilized man knows, if you can't afford the price of another man's labor, you basically have only three moral choices - increase your earnings so you can afford it, rely on voluntary private charity, or do without. No one else is obligated to provide you with the necessities of life. As every civilized man knows, all wealth is produced and belongs to the individual human beings that earned it, not the primitive tribe. As every civilized man knows, you cannot consume that which you have not produced, nor consume more than you have produced (earned). And above all, you cannot acquire what others have produced except by voluntary, uncoerced means.

A savage sees providing for his own needs by his own efforts ... earning "enough paper" ... as an "illusion". A savage sees human evolution as returning to the brute force rule of the jungle or the cave dweller, where need is a license to steal rather than a spur to productive work - where "everyone has access to care regardless of how much paper they possess."

A savage sees an ant colony, not a human civilization that has discovered the capitalist market economy governed by the justice of voluntary production and trade, the principle of individual rights, and the nobility and vital necessity of money (which should be gold or gold-backed). A savage sees a primitive tribe that can confiscate and redistribute the property of its members at will, rather than a benevolent, non-coercive association of free individuals whose property is protected by a government of laws and not of looters.

The current healthcare debate reveals that we still have a lot of mental savages among us who long for the primitive world of witch doctors and the rule of the jungle. I'm sure that Perry Leandro is not one of them, just an uninformed soul who needs to grasp the primordial implications of what he is saying.

There is a common denominator linking Anonymous, Kathleen O'Neil, and Perry Leandro … the magic wand of the seekers of the unearned … attack money. Whether held consciously or subconsciously, the motivating factor of these three is the conviction that money is the root of evil. What is it about money that makes it evil? It is the tool of exchange among producers of the wealth that sustains us, and the symbol of the self-supporting man.

"To trade by means of money is the code of the men of good will. Money rests on the axiom that every man is the owner of his mind and his effort. Money allows no power to prescribe the value of your effort except the voluntary choice of the man who is willing to trade you his effort in return. Money permits you to obtain for your goods and your labor that which they are worth to the men who buy them, but no more. Money permits no deals except those to mutual benefit by the unforced judgment of the traders. Money demands of you the recognition that men must work for their own benefit, not for their own injury, for their gain, not their loss--the recognition that they are not beasts of burden, born to carry the weight of your misery--that you must offer them values, not wounds--that the common bond among men is not the exchange of suffering, but the exchange of goods.” (AS, page 411)

In other words, the “evil” of money is actually the justice it represents. Acquire the work product of others through voluntary trade and contract by means of the medium of money, or take it by force … that is the basic choice. The honorable man chooses the first method. The dishonest can rarely openly admit his true intentions and motivations … not even to himself. So he falls back on that age-old formula the parasite has hurled at the producer. He declares the evil of money even as he employs the method of force to acquire from the provider the valuable products and services that give meaning to money.

"Run for your life from any man who tells you that money is evil. That sentence is the leper's bell of an approaching looter. So long as men live together on earth and need means to deal with one another--their only substitute, if they abandon money, is the muzzle of a gun.” (AS)

And it is exactly that – the muzzle of a gun, via governmental action – that is expected to provide the healthcare of the people who refuse to “line the pockets” of the providers; who would avoid personal responsibility by severing their healthcare needs from their “bank balance”; who see money as “pieces of paper” unrelated to “true reality”.

Saturday, September 19, 2009

Obama's Impossible "Balance"

The Associated Press reported on 9/18/09 that “President Barack Obama said Friday that angry criticisms about his health care agenda are driven by an intense debate over the proper role of government — and not by racism.”

This is very true, and I think that Obama is being sincere here. But a message of much more significance was buried in the article. Reported AP:

"There's been a long-standing debate in this country that is usually that much more fierce during times of transition, or when presidents are trying to bring about big changes," Obama told CNN.

To NBC News, Obama put it this way: "It's an argument that's gone on for the history of this republic, and that is, What's the right role of government? How do we balance freedom with our need to look out for one another? ... This is not a new argument, and it always evokes passions."
(Emphasis added.)

When Obama talks about "our need to look out for one another", he is not referring to the act of helping a person who is a value to us, which is motivated by self-interest. He means it in the sense of someone’s need … anyone’s need … being a moral claim on the lives and property of anyone who has achieved the satisfaction of their own needs (We are all our brothers’, and our sisters’, keepers). He speaks of altruism.

When he speaks of a “balance” between freedom and altruism, he speaks of government social programs that trample our rights in order to enforce that moral dictate.

I don’t know whether this was an unintended slip-up in a fit of honesty on the President’s part, or a simple statement that he feels comfortable making because he is secure in the conviction that its meaning will go unchallenged. But, either way, when he speaks of a balance between freedom and socialism, it is an explicit acknowledgement by the highest political figure of the collectivist American Left that socialism is destructive of freedom, and that altruism is incompatible with individual rights.

I have said often that President Obama is philosophically astute, and these comments are more proof of that. A key issue in the healthcare debate is the question of the proper role of government. More deeply, it is fundamentally a moral debate.

And in classic Obama fashion, he has snuck in an insidious idea … that there is a proper balance to be identified between our freedom and freedom-killing socialist government programs, and that our history has merely been one long argument over where the balance between the two should lie.

But he is utterly wrong that “It's an argument that's gone on for the history of this republic”. While it is true that America never achieved in practice a society fully consistent with its ideals, our Founding Documents are nevertheless crystal clear:

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness. That to secure these rights, governments are instituted among men, deriving their just powers from the consent of the governed.

A government that confiscates the wealth of some, for the unearned benefit of others, is a tyranny to some degree. The extent to which forced wealth redistribution takes place is the measure of the distance a nation has traveled on the road from freedom to dictatorship. Our rights are unalienable, declared the Founders. When, in the 20th century, our government commenced with the practice of wealth redistribution, our rights … which includes our vital property rights … ceased to be unalienable. They became, instead, a grant of privilege from “society” (i.e., the government).

Freedom means freedom from the initiation of physical force by any person, group, or the government. Once that principle is abandoned, no matter on how small a scale, the journey towards tyranny begins. The “balance” between tyranny and freedom thus becomes an unstable, ever-shifting demarcation line along that road of growing government control and ever-shrinking freedom. There can never be a “balance” between tyranny and freedom, between a gun and voluntary association among people. Once force is accepted as a proper means for men to deal with one another, there is simply no objective way to determine when it is proper, by whom, and for what. When Obama talks about a “balance”, he means to give that balance a huge shove in the totalitarian direction it has been moving for the past century or so.

The president has given us another clear demonstration of the moral nature of the healthcare debate now raging. The view that the individual is a sacrificial animal whose primary moral purpose is the satisfaction of the needs of the “less fortunate”, and who simultaneously may lay moral claim to the lives and wealth of those above him on the economic ladder, is a view that leads to Obamacare socialism. The view of man as an individual being for whom his own life and happiness is his proper moral purpose leads to capitalistic freedom.

There is not and can never be any balance between those two moral views, or between their respective logical political implications.

Tuesday, September 15, 2009

Obama - Bearing False Witness

“We’ve got to admit that the free market has not worked perfectly when it comes to health care.”President Barack Obama, The New York Times, 6/11/09

“I know there’s been a lot of misinformation in this debate, and there are some folks out there who are frankly bearing false witness”President Barack Obama, The New York times, 8/19/09

There are many fallacious arguments (click here and here) being used by the Left to advance their dream of socialized medicine, but perhaps the most egregious and dishonest is their description of our current healthcare system as a “free market”. One is tempted to say that they are perpetuating a myth. But, in fact, it is the Left’s’ version of The Big Lie. The reason is simple: to obliterate any consideration of the only real alternative to socialized medicine.

“One of the methods used by statists to destroy capitalism consists in establishing controls that tie a given industry hand and foot, making it unable to solve its problems, then declaring that freedom has failed and stronger controls are necessary.”

Ayn Rand, 1975

Medicare, Medicaid, SCHIP, and a whole host of state-level carbon copies are outright socialist. Nearly 50% of healthcare spending in America is government spending. Another 40% represents spending by private insurance companies under contract to third parties, not the actual healthcare consumers. It is this 40% that the president refers to as a “free market”. It is this allegedly free market sector that we will analyze, in order to determine exactly who is “bearing false witness”. Though administered by superficially private companies, this sector does not even remotely resemble a free market, for three primary reasons.

 The third-party-payer, or “employer-based”, system of health insurance is government-created.

The health insurance tax exclusion given to group purchasers such as businesses, non-profits like school boards, and labor unions … but forbidden to individuals … has made this system possible. It places a barrier between the consumer and the insurer. The insurer is beholden to the third party, via contractual arrangement, even though the employee is actually paying the premiums (Health insurance is a “fringe” benefit, which makes it part of the employee’s compensation package.) Big insurers are thus insulated from the rough and tumble, highly competitive consumer market that most industries deal with…while at the same time incentivized by third party bean counters seeking to keep costs down.

Further, the tax exclusion encourages the shifting of excessive employee wages and salaries from the direct payment, after-tax cash market into insurance products. This amounts to a huge government subsidy for the insurance industry, since it’s highly unlikely that in a free market many individuals would shovel wads of money to insurers, year after year, to pay for routine expenditures such as doctor’s visits, vision and dental procedures, standard pharmaceutical products such as blood pressure or cholesterol pills, or even somewhat pricier but still standard diagnostic procedures like mammograms, colonoscopies, or blood work-ups.

Writes Timothy P. Carney in The Examiner:

“Big government is why almost all of us get our health insurance through our employer, and not on an individual market. [Government] Wage controls from World War II forced employers to compete on benefits--such as health care. Then the tax exclusion and other laws--laws like the Employee Retirement Income Security Act of 1974 pitched, of course, as regulating insurers and protecting consumers--have favored employer-based health insurance over an individual market.

“The result: even if you feel you're getting a raw deal from your health insurer, there's not much you can do, short of leaving your job. This protects the insurers from real competition--which is why the insurers like it. ‘The last thing the health insurance industry wants," says Shadegg, "is to have to compete for every customer.’ Uncle Sam protects them from that horror.”

The insurer, in other words, doesn’t work for the patient. In a free market, an insurer is bound by the contractual agreement signed with the patient/consumer, who knows exactly what he has purchased, and who can bolt to another company at any time. Our current system strips the buyer of this all-important power that exists only in a free market. Posturing politicians like to champion the poor consumer who is alleged to be at the mercy of the insurance companies; except that it is they who put the consumer in this situation. In addition, this system establishes the insurer as an artificial middleman, resulting in huge, unnecessary administrative expenses that get blamed on a free market that doesn’t exist.

 Government mandates, nearly 2000 of them nationwide, dictate the content of health insurance policies.

Community Rating mandates force insurers to charge everyone in a given geographical area the same premiums regardless of individual risk factors such as lifestyle, age, or health history. This forces lower-risk individuals to unfairly pay higher rates to subsidize higher risk individuals, because it makes insurers ignore relevant facts of reality, up-ending a key discipline of the free market.

Guaranteed Issue mandates force insurers to issue policies to all comers, even to those with a “pre-existing” condition, high-risk lifestyles, etc. This is akin to an uninsured homeowner buying homeowner’s insurance after his house burned to the ground, then expecting the new company to pay for rebuilding. Again, insurers must ignore relevant facts and force higher premiums on other innocent customers.

Benefit mandates force coverages for specific ailments into policies regardless of whether the customer wants it, can afford it, or whether the insurer deems there to be enough of a market to justify it.

It is said that these mandates are necessary to forbid companies from “unfairly discriminating” against higher-risk customers or potential customers by charging higher rates or making policies unavailable or conditional. But once again, they are a rebellion against reality, and they force up premiums. Further, they violate the rights of insurers, who are human beings with the same unalienable rights to their own lives, independent judgements, and pursuit of their own goals as everyone else under American principles of equality before the law. Insurers have every moral right to exclude pre-existing conditions, to adjust prices according to specific risk factors (the facts of reality), or to refuse to sell their product (to discriminate). No one has an inherent right to any particular insurance product, on any particular terms, at any particular price, if no one chooses to produce or offer it…regardless of “need” or personal circumstances. Likewise, the insurer has no inherent right to sell policies that no one chooses to buy. There is only a right to seek a voluntary contractual agreement to mutual benefit…a trade…and a right to a government that enforces that contract. Just as Rowe v. Wade recognized that abortion is a private matter between a woman and her doctor, so the same logic applies to all of medicine. In this case, health insurance is a private matter between the individual (or his group representative) and his insurance company. The state has no right to interfere, except in matters of fraud, breech of contract, or to mediate honest disputes through the courts or some other objective venue.

By assuming the power to dictate private contractual arrangements, legislatures have become the targets of special interests seeking to gain control of the mandate mechanism to force the costs of their clients’ specific ailments on everyone else, just as their clients are victims of previous mandates. Mandates are nothing more than wealth redistribution masquerading as “insurance”.

 State-imposed restraint-of-trade laws forbid a national health insurance from developing.

Big insurers love this one. Just as the third-party-payer system protects them from having to compete in the individual market, so state trade barriers shield in-state companies from out-of-state competition. At the same time, consumers are “protected” from increased choices. Further, the coercive, controlling power of the politicians and their pressure groups are also protected.

The Big Lie being put over on Americans to force full socialized medicine on us is that our current system constitutes a “free market”. Sadly, a large contingent of the alleged pro-capitalist Right helps to foster this lie. In fact, the allegedly “free” part is a quasi-private, government created and protected cartel of health insurance companies controlled by government. It’s an unholy alliance between big government and big insurance. Writes Carney:

“Insurance companies lobby for big-government regulations, subsidies, [additional] mandates, and tax-code distortions that funnel them money, keep out competition, and stultify innovation. These policies preserve the employer-based health-care system that mocks the idea of free-market competition. Then they cry "unfair competition" when government threatens to encroach on their government-protected monopolies.

“But they're not just lobbying against a government option. Today, health insurers are lobbying to force you and me to buy their product or face a tax hike (the individual mandate).

“They are lobbying to force entrepreneurs to buy insurance for employees (the employer mandate). They are lobbying for more subsidies paid for by us taxpayers. In short, they are lobbying against regular people and against the free market.”

A free market leaves patients, providers, consumers, and insurers free to contract voluntarily with each other to mutual advantage, based upon the principle of individual rights, without the kind of massive government coercion noted above. The absence of physical force is the hallmark of a free market. That is what the “free” in free market means. An insurer is bound by the contractual agreement signed with the patient, who knows exactly what he has purchased. The government’s only job, but an important one, is to protect against fraud and breech of contract, and to mediate legitimate contractual disputes…i.e., to protect the individual rights of all participants.

Fighting for a free market does not mean defending the status quo or the current insurance industry. Although most Americans are still relatively happy with their coverage, the system, with its soaring costs and increasing number of horror stories concerning denial for expected coverage, is steadily breaking down. The status quo is clearly unsustainable. But today’s problems in medicine represent a failure, not of freedom, but of statist government intervention. And like the proverbial fireman who starts fires so he can be the first one on the scene to “save” persons and property, our politicians are now proposing to complete the government takeover of American healthcare in order to “rescue” us from the deteriorating system they themselves created!

The free market that Obama pretends to see is a mirage, like the Wizard in the land of Oz. Peel back the curtain and you will see the controlling hand of government. The socialists want you to “pay no attention to that man behind the curtain”, lest we discover the real source of the seeming “power” of the “private” insurance companies. By demonizing the Big Insurance that they themselves created, while declaring that some non-existent freedom has failed, they hope to push a confused and reluctant people into direct government control.

Our government-crippled insurance market has turned private insurers into conduits for government coercion. This is not indicative of a free market, but is in the nature of fascism … i.e., socialism through the back door. “Why need we trouble to socialize banks and factories? We socialize human beings,” said Adolf Hitler. And socialize human beings is just what the quasi-private insurance market does. Through the myriad of government controls and regulations such as those cited above, our “free market” sector is a covert carbon copy of the overtly socialized public sector: it, too, forces everyone to pay for everyone else’s healthcare.

“The greatest trick that supporters of socialized medicine ever played was to convince the American people we don’t already have it”, writes Brian Schwartz. For the past 75 years, we have been moving toward full socialized medicine piece by imperceptible piece, just as Ronald Reagan predicted. Obama’s “change” is no such thing. His “reform” is no such thing. He is an empty suit, simply cashing in on failed collectivist ideas and the long-established trend in America of incremental socialism. He is just maintaining the status quo, seeking to take that final step … or at least another giant step … along the same road.

There has indeed “been a lot of misinformation in this debate”. Any honest and objective healthcare reform debate must begin with an examination of how we got to this point. The problems in American healthcare have grown in lock step with the growth of government intervention over the past 75 years. But honesty is not the Left’s modus operandi. It has been the president himself, his party, and his supporters that are the main culprits who are “bearing false witness”.

Sunday, September 13, 2009

Some Post - DC Observations

As reported, I, my wife Kathy, and daughter Susan attended the 9.12.09 DC Tea Party march on the Capitol. I wore a tee shirt with the words; The Smallest Minority: The Individual. Kathy wore a cap with a bold "I" superimposed on the words; The World’s Smallest Minority – along with a matching tote. These are a reference to Ayn Rand’s famous statement in her essay on Racism (see below). And Susan wore a tee shirt that read simply, SHRUG, an obvious reference to Atlas Shrugged.

“[T]he smallest minority in the world is the individual. Those who deny individual rights, cannot claim to be defenders of minorities." (The Virtue of Selfishness, page 154)

Ipresented a full discussion of our plans and my take on the Tea Party movement in my last post, but I just wanted to follow up with some observations.

It was quite an experience. As expected, there were a multitude of opinions and motivations expressed by the crowd and the speakers. But I think there was a common sentiment that united everyone, which can best be expressed by:

“Don’t push me around!!”

I think that that was the most important and encouraging and, potentially, the most significant aspect of the march. But there were other positive observations.

One was the utmost civility of the people. Everyone we encountered was pleasant and respectful. No one we encountered was rude.

I also was amazed by the sheer number of signs. This indicated a high level of motivation, a good sign (no pun intended) for the endurance of the movement.

Another good sign was that there was a lot of anger expressed against the Republican Party and not just to Obama and the Dems. The march, I believe, was primarily an anti-statism message. I did not see or hear President G. W. Bush’s name invoked a single time! As would be expected, Ronald Reagan was mentioned and quoted numerous times. This is good. It’s reflects the realization that Bush was a statist, not a “free market kind of guy”.

Finally, the size of the crowd was huge. It ranged well up Pennsylvania Ave. It was quite a sight looking back from the hill in front of the Capitol back over the masses of people. The lowest estimates were in the tens of thousands, and ranged up to two million. The actual tally likely measured in the mid-hundreds of thousands. The main thing is that the Tea Party movement’s growth trend seems to remain on track.

I also want to stress very strongly my belief that the Tea Party movement is much bigger than the mere physical appearance of so many people. I believe that the millions of Americans who are frustrated and fearful of the statist trend, and who speak out on any level, can rightly call themselves as much Tea Partyers as the attendees.

All in all, the 9.12.09 experience was one to remember, and the three of us are proud to have been direct participants in it.

Thursday, September 10, 2009

9.12.09 - Here We Go

My first voting experience was 1972. In 2008, for the first time, I abstained from voting in the presidential election. Just prior to the election, I stated my reasons for this:

Both Obama and McCain share the same fundamental philosophical premises…that the individual is second to some “higher” cause or power. For McCain it is the “nation”, for Obama, the “collective.” Neither is a champion of individual rights. The difference is that Obama is an unabashed socialist. He is a clear target. McCain, on the other hand, is a murky target. That is because as the Republican, rightly or wrongly, he carries the banner of free market capitalism.

The danger is that a President McCain will discredit, demoralize, and split the pro-free market forces between those who feel obligated to support the GOP guy they voted for, despite bad policies, and those who oppose him on principle.

With Obama in the White House and a Democratic congress, the Left’s agenda will take explicit center stage. This will open the door to a full exposure of the true authoritarian nature of their designs on America. Rather than sneaking their freedom-eroding agenda into law piecemeal under stealth cover of a Republican administration, the Dems will have nowhere to hide. The disparate elements of what today passes for the “Right” will present a solid wall of opposition. The key question is, will an effective, principled pro-capitalist, pro-individual rights opposition arise within the GOP? Or will the Left be able to move its destructive programs through an intellectual vacuum?

The true authoritarian nature of Obama’s agenda is now fully exposed on center stage. The threat to America is clear and unmistakable, just seven months into the presidency of Barack Obama. At the same time, as I expected, the disparate elements of what today passes for the “Right” [now] present a solid wall of opposition. This wall, manifested in the “Tea Party” movement and the townhall meetings this August, is obviously building on a grass roots foundation. More fundamentally, the collapse of both major political parties in so short a time frame has opened up a gaping political and intellectual vacuum … a veritable black hole. People are looking for answers, and this has manifested itself in an extraordinary cultural phenomenon. Richard E. Ralston, Executive Director of Americans for Free Choice in Medicine, writes:

“Tea parties and town hall meetings are not the only signs of public discontent. There are more substantial cultural indicators. One of the most remarkable is the rapidly rising sales of Ayn Rand's 1957 novel Atlas Shrugged.

“In 2008 more copies of that novel were sold than in any year in its 52-year history. And more copies were sold in the first half of 2009 than in all of 2008.

“Why are hundreds of thousands of people suddenly reading a serious, intellectual, eleven-hundred-page novel written half a century ago? Perhaps it is because events in Washington, D.C. are disconcertingly developing like the plot of Atlas Shrugged. Not least among these events is the push for government control over health care.” (Emphasis added.)

The surprising strength and powerful motivation of the “rebellion” has knocked the Dems back on their heels. Despite large majorities in both houses of congress, the president’s signature domestic policy initiative, health care reform, has been anything but the legislative cakewalk they expected. In fact, it is in serious trouble as infighting between their “moderate” and liberal wings breaks out over key provisions like the “public option” and Medicare.
This unity on the Right would not have been possible with a President McCain. We would be struggling with a compromise, watered down version of Obama statism.

But when you look below the surface of the Tea Party phenomenon, what you see are indeed the disparate elements of what today passes for the “Right”. People and organizations seem mostly motivated by a myriad of specific concrete issues. Many do refer to America’s founding principles, but without clearly or consistently delineating those principles. Many advocate for capitalism on utilitarian or practical grounds. There are religious rightists, libertarians, conservatives, "moderates", and even disgruntled Democrats. The movement is marked by a chaos of mixed premises, but all are united in opposition to the year-long burst of statism from two parties and two administrations.

Differences aside, there is a common thread woven through the movement, which reflects the growing unease of what is now a majority of the population – the sense that something is seriously wrong with the country’s direction, that the government is breaking free of all constitutional restraints, that “We the People” are losing our freedom and our American ideals.

And it’s true. Yet the eruption of this spontaneous rebellion is only the beginning. The hard work is just beginning. The Tea Party Movement … and it is now a movement … has the potential to dramatically alter the political fabric of the nation. But the wall of opposition as it currently stands is too granulated to succeed in the longer run. Without the proper philosophical/moral cement to solidify it, the wall will disintegrate under a sea of compromise and equivocation, like a sandcastle on the beach.

With this in mind, my wife Kathy, daughter Susan, and myself will be in Washington DC on 9/12/09 for the march on the capital. In my 60 years, I’ve never participated in any kind of political demonstration before. But thanks to Susan’s prodding – “It’s time to put your ‘money’ where your mouth is, dad”, she told me – I’m going.

But we won’t be going as protesters, so much as advocates. Our focus will not be on narrow concrete issues like taxes, Tarp, or Cap & Trade. All of the issues of the day are important, of course. But the real battle … the outcome of which will determine the resolution of the major issues … is much more fundamental. I truly believe that we now have our first openly counter-revolutionary president – that is, counter- American Revolution. Therefor, we must take the fight to the battleground of fundamental philosophical ideas.

So we will focus on raising awareness of the twin pillars of America’s Founding Ideals. In keeping with our belief that the Right must congeal around a coherent set of philosophical principles if it is to succeed in defeating statism, our purpose will be two-fold (three-fold, really). We will focus on two almost-forgotten and virtually-ignored yet vital ideals. Our presence will feature a banner which reads “Save our Republic, Uphold Individual Rights”. We will be passing out a couple of flyers, as well.

The first flyer begins with this preamble:

The trend toward the end of freedom and capitalism in America is being fueled by the abandonment of two indispensable principles: that America is a Republic, and is based upon unalienable individual rights. It is absolutely imperative that we rediscover these two concepts, without which America cannot survive.

That introductory statement will be followed by “What is a Republic?” featuring selected excerpts by philosopher Leonard Peikoff which starts out with “The American system is not a democracy. It is a constitutional republic.”

The American system is not a democracy. It is a constitutional republic. A democracy, if you attach meaning to terms, is a system of unlimited majority rule; the classic example is ancient Athens. And the symbol of it is the fate of Socrates, who was put to death legally because the majority didn’t like what he was saying, although he had initiated no force and had violated no one’s rights.

Democracy, in short, is a form of collectivism, which denies individual rights: the majority can do whatever it wants with no restrictions. [Collectivism is the doctrine that holds that the standard of value is the group, to which the individual is subordinate and can be sacrificed on any group whim, as represented by the state.] In principle, the democratic government is all-powerful. Democracy is a totalitarian manifestation; it is not a form of freedom . . .

The American system is a constitutionally limited republic, restricted to the protection of individual rights. In such a system, majority rule is applicable only to lesser details, such as the selection of certain personnel [as with the election of mayors, congressmen or the president, who are bound by the constitutional limitations]. But the majority has no say over the basic principles governing the government. It has no power to ask for or gain the infringement of individual rights.

Then, the answer to “What are Individual Rights?” features selected excerpts and paraphrases from philosopher Ayn Rand’s important essay Man’s Rights.

The Declaration of Independence states that men “are endowed by their Creator with certain unalienable rights.” Whether one believes that man is the product of a Creator or of nature, the issue of man’s origin does not alter the fact that his means of survival is his reasoning mind. The mind is an attribute of the individual, and cannot function successfully under coercion. Individual rights are a necessary condition of man’s particular mode of survival, and are therefore unalienable based upon this fact of nature.

 A “right” is a moral principle defining and sanctioning a man’s freedom of action in a social context. The concept of a “right” pertains only to action—specifically, to freedom of action. It means freedom from physical compulsion, coercion or interference by any other person, group, or the government. Individual rights are the means of subordinating society to moral law; they are a legal sanction of the freedom to live and act upon one’s own moral principles.

 Individual rights guarantee the freedom of each person to think and act on his own judgement.

 Rights impose no obligation save one – to respect and refrain from violating the rights of others.

 The right to life is the source of all rights—and the right to property is their only implementation. Without property rights, no other rights are possible. Since man has to sustain his life by his own effort, the man who has no right to the product of his effort has no means to sustain his life and thus no right to life. The man who produces while others dispose of his product…his property…is a slave.

The right to life means that a man has the right to support his life by his own work (on any economic level, as high as his ability will carry him); it does not mean that others must provide him with the necessities of life. There is no “right”, for example, to a job, an education, a home, or healthcare that must be provided by others. There is only the right to produce them oneself or to acquire them by voluntary trade and contract from those who do produce them.

These two issues are related, of course. Individual rights is the core founding principle of America, and the republican governmental construct is the practical implementation of the need to protect those rights.

The second flyer will be “What the Tea Party Movement Must Stand For” from the Tea Party web page of the Ayn Rand Center for Individual Rights. It urges the Right to defend the morality of the American ideals, declaring:

"To uphold the individual’s political right to pursue his own happiness, we must uphold the individual’s moral right to pursue his own happiness [because] the pursuit of happiness is selfish. That’s why you need the individual freedom of a capitalist system – to pursue your own interests, to act on your own judgement, to make your own life the best it can be."

The first two pillars were lost primarily for the missing third pillar … a moral justification. That pillar has been forged by Ayn Rand, whom I consider to be America’s Last Founding Father. She has provided - through a rigorous process of scientific observation of the facts of reality and of man’s nature, and validated by the systematic application of logic and reason - a powerful ethical system that completes and philosophically justifies the American Revolution.

In it’s briefest essence, Rand rejected both the ethics of altruism (self-sacrifice for the good of others), and the ethics of greed (the sacrifice of others for one’s own ends, or the conventional definition of “selfishness”). In it’s place emerges “a new concept of egoism”, an ethics proper for man and man’s nature as a reasoning being of volitional consciousness and free will - rational self-interest, the practical application of which … in both the spiritual and material realms … is the non-sacrificial mutually beneficial trader principle. It is an ethics that was implicit in the Declaration of Independence, and which was responsible for the explosion of wealth creation and living standards unleashed by the millions of free individuals pursuing their own happiness under a government of laws and not of men. It is a morality that, from this country’s founding, had been the primary ethics that most Americans lived by … and still live by … despite the corruption of altruism. It is an ethics that, once and for all, banishes the primitive practice of human sacrifice. It is an ethics that, alas, was never acknowledged by a people that lived and thrived by it.

In the Declaration of Independence, the Founding Fathers made the most purely egoistic political statement ever as the foundation for a nation; “that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness.” Yet nobody rose to declare that the pursuit of one’s own happiness … the pursuit of goals, values, prosperity, the good life for oneself and one’s family … is the highest and noblest of moral ideals. Nobody rose to expose the altruist creed for the vicious doctrine that it is … one that masquerades under the banners of compassion and good will, even as it kills them off and turns people into predators or slaves. Nobody, that is, until Ayn Rand rose to declare:

Rationality is man's basic virtue, and his three fundamental values are: reason, purpose, self-esteem. Man—every man—is an end in himself, not a means to the ends of others; he must live for his own sake, neither sacrificing himself to others nor sacrificing others to himself; he must work for his rational self-interest, with the achievement of his own happiness as the highest moral purpose of his life." Thus [my philosophy] Objectivism rejects any form of altruism—the claim that morality consists in living for others or for society.

Can you see President Obama reciting those words, as justification for his agenda? You can't? Now you know why our side needs a proper ethical base.

We are at a crossroads. The altruist-collectivist-socialist Left has won the 20th century, despite the demonstrable superiority of limited republican government and unalienable individual rights and the unprecedented capitalist prosperity it unleashed. We are in the late innings, and they are looking to close out the game. The twin political/philosophical pillars of America’s founding must be regained and united with the morality of rational self-interest – then adopted as the uniting bulwark of the Tea Party Movement.

We, all of us on the Right, must uphold the egoist-individualist-capitalist American ideal. We must declare that:

Capitalism is not a necessary evil that works. Capitalism works because it is right.

American ideals are not the remnants of an obsolete past, but the righteous moral path to recapture and complete the American Revolution.

It’s late in the game, and our time is running out. But the stunning collapse of the Obama “mandate” now underway - which I expected and, in fact, predicted in private conversation last November - has opened a yawning political and ideological vacuum in America. It’s a huge opportunity for the Tea Party Movement, which must now seize the ideological momentum or itself erode and collapse, paving the way for something really bad. We have reached the crossroads, I believe.

It’s time for our side - the pro-capitalist, pro-individual rights, pro-American side – to finally seize the moral high ground from the phonies on the Left, which is ours by logical right.

Monday, September 7, 2009

The President's School Speech

The flap over President Barack Obama’s 9/8/09 school speech centers around the fear of many parents that it will be a venue for advancing a political agenda. They needn’t fear that. There is nothing overtly political about his speech - at least not in the official text.

The president’s message is much more fundamental, important, and dangerous. Politics is a final consequence of the dominant basic beliefs held in a culture…particularly moral beliefs. True to his modus operandi, Obama aims his speech straight at the heart of America’s fundamental individualistic "sense of life”.

The president’s talk contains a lot of good, standard practical advice. “Being successful is hard”, he tells the students. “No one’s born being good at things, you become good at things through hard work.” “Don’t be afraid to ask questions.” “But at the end of the day, the circumstances of your life – what you look like, where you come from, how much money you have, what you’ve got going on at home – that’s no excuse for neglecting your homework or having a bad attitude … That’s no excuse for not trying.”

It’s good advice on what you, as a student, should do. But why should you do it? What should be your focus, your orientation? Buried in the platitudes is the real message:

“And this isn’t just important for your own life and your own future. What you make of your education will decide nothing less than the future of this country. What you’re learning in school today will determine whether we as a nation can meet our greatest challenges in the future.

“You’ll need the knowledge and problem-solving skills you learn in science and math to cure diseases like cancer and AIDS, and to develop new energy technologies and protect our environment. You’ll need the insights and critical thinking skills you gain in history and social studies to fight poverty and homelessness, crime and discrimination, and make our nation more fair and more free. You’ll need the creativity and ingenuity you develop in all your classes to build new companies that will create new jobs and boost our economy.

“We need every single one of you to develop your talents, skills and intellect so you can help solve our most difficult problems. If you don’t do that – if you quit on school – you’re not just quitting on yourself, you’re quitting on your country.”

There isn’t a dictator that ever walked the face of the earth that wouldn’t laud those words. The collectivist overtones are unmistakable. He speaks of “the country” and “the economy” as though they are mystical entities separate and distinct from the individual human beings that make it up. They are to be the purpose and the focus to which the president urges the young “to set your own goals for your education”. But what are the “country” or the “economy” except the sum of the individual interests and efforts of its individual members? When you focus on your own life as the purpose and end of your own actions – to make your own life the best and most fulfilling it can be by your own efforts – it is the betterment of the country and the economy that you accomplish. That is because you are the country. You are the economy, just as is every other individual that comprises it.

The president’s purpose is not to advance his political agenda. It is to establish the necessary prerequisite ideas for his (and any future socialist’s) agenda. It is not the good of the “country” or the “economy” that he seeks. When anyone speaks of the “country”, the “economy”, “society”, the “public”, the “proletariat”, the “race”, or what have you, apart from its individual members, the collective group term of choice always comes down to – the state.

So when the state makes a pitch for its next power grab; its next infringement on our rights; its next tax increase; its next social program to “fight poverty and homelessness, crime and discrimination … protect the environment, cure cancer and AIDS, and develop new energy technologies”, a compliant population trained at a young age to subordinate their lives to whatever the latest state purpose is will be ready to submit because “We need every single one of you to develop your talents, skills and intellect so you can help solve our most difficult problems.”

It is a grave mistake to believe that dictatorships spring on a nation at the drop of the whim of some violent “revolutionary gang”. Rather, the establishment of a dictatorship is the end result of a long evolutionary chain of legal, intellectual, and, especially, philosophical steps. To establish a socialist dictatorship in America, the ideal of individualism must be replaced with the principle of the subordination of the individual to the group – collectivism. The main battleground is the classroom, where the minds of the young are in the process of solidifying around the fundamental premises that will guide them throughout their lives, and where the future direction of the country will be determined. We are well along that transformational road, but there is still a ways to go … and time to change direction.

Obama’s message is fundamentally anti-American. It runs diametrically opposed to the idea of each individual as the master of his own life, with the achievement of his own happiness as the purpose of his own efforts. It runs completely contrary to the idea, implicit in our founding documents, that each person is an end in himself, not the means to the fulfillment of the wishes or whims of others or of the state. It runs contrary to the American “can-do” spirit that our individual problems are our own to overcome, rather than the automatic responsibility of others to solve. It runs completely contrary to the factual causes of this nation’s greatness.

It is the reason-driven, entrepreneurial, individualist energy unleashed by free people pursuing their own goals for the sake of their own happiness and their own lives as an end in themselves that leads to “cures for diseases like cancer and AIDS, and new energy technologies” … i.e., a general rise in the standard and quality of living – a better country and economy. A nation full of serfs living for the “nation” or “community” or the “state” or simply “others” is by definition a nation of people waiting to be taken care of … or taken over.

Individualism leads to the United States of America. Collectivism leads to Nazi Germany or Soviet Russia or any number of stagnant, poverty-ridden tribal societies –or to a socialist America.

Any leader attempting to inculcate in the young the sense of duty and service and a sense of smallness next to a cause larger than oneself is a leader who wants and intends to rule their lives.

Should parents who disagree with Obama refuse to allow their children to listen to this speech? Based upon the text, I wouldn’t. I think that bad ideas must be confronted openly. I would use it as a “teaching moment” (assuming the appropriate intellectual level of the child). I would tell my child where the president is wrong. I would tell him that America was founded on the opposite premise that each individual’s life is his highest value, and that the pursuit of his own happiness is his unalienable moral and political right.

I would tell him that there is no conflict between the good of the individual and the good of the country or of the economy. I would tell him that to flourish, he must make his own life, not the lives of others, his standard of value. He must set and pursue goals based upon his own interests, values, and loves. He must learn to stand on his own judgement based upon his own observation of the facts of reality, not seek the approval of others as a guide to living. I would tell him that the answer to such problems as “poverty and homelessness, crime and discrimination” is embedded in the words of the Declaration of Independence, which leaves all of us as individuals free to make our own lives the best that it can be.

[It looks like some conservatives have been snookered by this philosophically astute president. To view a Time article and my comments, click here]

Tuesday, September 1, 2009

Rationing Vs. Freedom

In a 5/3/09 letter to the Denver Post, Beth Hohle wrote:

“I disagree with Charles Krauthammer’s idea that health care would be rationed under single-payer insurance system. It is already rationed by cost.”

Leaving aside Ms. Hohle’s “disagreement”, government-run single-payer healthcare is by definition rationing. When the government pays, the government sets the terms. It will, and necessarily must, decide who gets what healthcare when. The government obviously will not be blindly cutting checks according to the whim of any person, anywhere, at any time…whether patient or provider.

On this point, David Leonhardt is more honest. In advocating for socialized medicine, he readily admits that government will ration healthcare. But to make that reality more palatable, he simply obliterates the distinction between government force and voluntary private decision-making:

“The choice isn’t between rationing and not rationing. It’s between rationing well and rationing badly.”

The “rationing” angle is yet another of the fallacious arguments used to justify a complete government takeover of Medicine. The crucial questions to ask are: What is rationing, and does the allocation of goods and services by the price mechanism in a free market constitute rationing?

Rationing is variously defined as:

 Government-imposed restrictions on the allowance of people’s food, clothing and fuel in both World Wars…

 The allocation of product among customers during periods of short supply. When price is used to allocate product, it is allocated to those willing to pay the most.

 The controlled distribution of resources and scarce goods or services. Rationing controls the size of the ration, one's allotted portion of the resources being distributed on a particular day or at a particular time.

Rationing is defined by Webster’s (1979) as “a fixed portion; share; allowance…to distribute, in times of scarcity”. This implies a central authority with the power “to distribute”–for example, the government under single payer health care. In common usage, the term “rationing” is sometimes used to describe market forces such as the price mechanism and supply and demand. Nevertheless the fact remains, the term rationing stems from the war time government-imposed system of distributing specific goods…i.e., force is the essential ingredient that defines rationing. In the free market, force is necessarily absent, because all legal private associations are voluntary. The legal use of physical force is the exclusive domain of government.

It is force that is conveniently ignored by Ms. Hohle and Mr. Leonhardt. “Rationing” by cost (or price) in a free market is the absence of physical force and compulsion in human relationships. Rationing by government is physical force and compulsion. Don Watkins describes what real rationing amounts to:

Rationing means that the government decides how much of some good or service you are allotted.

This bears no relation to what happens under the price system of a free market. On a free market, goods and services are not rationed. They are produced by individuals and then voluntarily exchanged for the goods and services others have produced. A craftsman builds a chair, which he sells for money, which he uses to purchase a doctor’s services. A doctor trades his services for money, which he then exchanges for a lawnmower.

The difference between prices and rationing is the difference between you choosing what groceries to buy and the government telling you what food you’re allowed to eat.

Loose definitions aside, there is essentially no such thing as “rationing healthcare by cost” in a free market since there is no central authority to do the rationing. There are only producers of healthcare trading their work for the earnings of others willing and able to pay for it, by voluntary agreement to mutual advantage…i.e., by trade, just as in most other economic sectors.

It can be no other way. It is an inexorable fact that man’s needs and desires are not a free gift of nature, but must be produced by actual human beings through productive work…i.e., a process of reason applied to physical labor. As any honest man knows, one cannot consume what one has not produced. As any honest man knows, one can morally consume what another has produced only after acquiring it by voluntary means…by trade or private charity. As any honest man ultimately knows, one cannot consume in excess of what one earns.

What Ms. Hohle and Mr. Leonhardt object to is justice. Morally, being unable to pay for your healthcare…while unfortunate…gives you no right to seize it forcibly by theft or through political surrogates you elect. The fact that some cannot afford the healthcare they need does not constitute the rationing of healthcare, any more than a person’s inability to afford a Jaguar amounts to Jaguar rationing. You have only the same rights as others…to consume according to what you earn. Justice, not rationing, is the ruling principle in a free market.

To repeat, what Ms. Hohle, Mr. Leonhardt, and their ilk ignore is the issue of force. This equivocation of government-imposed rationing with market “rationing” is meant to obliterate the difference between political and economic power…between the dollar and the gun. They are tacitly admitting that government-run healthcare amounts to a dictatorship with the power to obliterate individual rights. But the truth won’t sell in America, so the crucial nature of the choice we face is camouflaged behind such rhetoric as the false choice between “rationing well and rationing badly”, with government control rather than free and voluntary choice being the lesser of the two evils. The socialists need to hide the fact of what Americans will be giving up, what government control actually means, as well as the only valid alternative to socialized medicine…capitalism. So they simply imply that freedom is a “bad” version of what government must do.

The real target of their attack on the “price” or “cost” rationing is the self-supporting human being who manages to find a way to pay for his healthcare by his own efforts. It is this productive person who will be denied his rightful treatment under “good” rationing, for the sake of the non-self-supporting...i.e., the moocher. It is for the sake of the moocher that government will be handed dictatorial power over all of medicine.

Disingenuousness is their only weapon. As Don Watkins says:

The real reason for our health-care woes is that we do not have a free market in medicine today. But those pushing the “everything is rationed” line are trying to wipe out the last vestiges of freedom by means of erasing the crucial distinction between voluntary trade and force. To the extent they are successful, they are able to deflate any moral opposition to socialized medicine. Instead of a fight between those who believe in freedom for doctors and patients and those who don’t, supporters of government health-care want to bicker over different means of achieving the same collectivist end. That’s the only kind of fight they can win.

Related Reading:

"Sanders' debate performance, meanwhile, was a reminder of some of the dangers of populist rhetoric on policy making. Sanders insisted healthcare ought to be a right for all Americans. When Cruz pointed to rationing, waiting times, and lower quality service in countries with such arrangement, Sanders claimed that healthcare pricing was a form of rationing of its own. Insofar as government intervention distorts pricing incentives, he's right. Decades of government regulation, intervention and favoritism in the insurance and healthcare industries have largely divorced prices from any market forces, which can 'control' prices better than any bureaucrat."