Sunday, February 2, 2014

A Libertarian's personal views on Medical services

All too often, we avoid saying what we really believe about a topic for fear of offending someone. At the risk of offending many, I believe that universal health care services provided by the monopoly government service delivery model has never been the best model to meet the needs of our citizens. Furthermore, if we avoid making the changes needed, it will bankrupt us all as the baby boom generation passes through old age.

One significant unintended consequence of universal health care is that it has lulled the average citizen into a false sense of security - one that has been fostered by the nanny state message that it will take care of us in times of sickness and infirmity. With our guards down, our wills are weakened to resist the ubiquitous marketing messages that fast food, sedentary leisure and conspicuous consumption are the hallmarks of a successful and desirable lifestyle. Sure, some businesses promote prescriptions and products for healthy living but their siren calls are all but drowned out by the foghorns of the less desirable messages.

What role should personal responsibility play in healthy living and fending off the health-threatening temptations that promise to swamp our fiscal boat and national health?

To my way of thinking, there are two possible scenarios that suggest the answer to this question.

Scenario 1: If a government-funded universal health services monopoly did not exist, then each citizen would be more highly incented to take action in order to minimize health-threatening incidents. This means that eating healthy foods, drinking responsibly, maintaining optimal weight, exercising, avoiding tobacco and illegal drugs, etcetera – all of these lifestyle choices would gain greater popularity. For those citizens that choose to eschew these, the consequences will be theirs to face on their own terms and with the help of family, friends and personal community members.

Scenario 2: In Ontario, we have already experienced a long history of universal health care services from our government-funded monopoly. While considered “free” by many citizens who avail themselves of it liberally and often irresponsibly, it is definitely not free. In fact, it is hugely expensive. Yet, many citizens blithely adopt unhealthy life-style choices without any consideration for who pays the bill when the consequences finally arrive from their irresponsible and costly choices.

This begs the question: “How will our citizens ever learn and adapt from the consequences of their poor lifestyle choices if they are sheltered from them?” Pain and suffering is generally nature’s way of telling us that we have make bad choices. A hangover is an excellent example.

Its strange to me that while responsible parents teach their children to consider the consequences of their actions, our political leaders insist upon undoing these sound parenting lessons and actively coddling our grownup children with messages of "free" health care - all for their own political gain! "Buying votes" is a standard strategy for most modern politicians and as long as they have access to truckloads of OPM (Other Peoples' Money), there is nothing to stop them from continuing this practice. 

One lesson that I learned early in life is that you can’t please everyone.

With this lesson in mind, it is time to reconsider our Medical Services Delivery model and adopt one that gives people choices that will reward people who made healthy lifestyle decisions and leave the less responsible citizens vulnerable to the consequences of their own poor decisions.

The current Medical Services Delivery Model is a monopoly run as a top down, centrally planned and impersonally funded scheme that is controlled by government bureaucrats who aspire to provide access to everyone equally and without bias. This approach, of course, eliminates exposure of our citizens to the risk/reward incentives to which we referred above concerning lifestyle choices.

A bottom up, free-market, pay-as-you-go entrepreneurial service delivery marketplace is a vastly superior alternative because it will provide a rich tapestry of health services that can never be matched by those provided via government monopoly. Healthy lifestyle choices will be rewarded by lower costs, more service options  and a better over-all quality of life; poor choices by higher costs and spiraling quality of life.

Yes naysayers, there will always be people who wish to save those who carelessly choose to live the “death wish” lifestyle, and those charitable souls are free to come to their aid. However, actively enabling and reinforcing poor choices does not always produce the best long-term results. The less attractive “tough love” approach may seem un-humanitarian to some, but it often works and can save lives.


Note that a bottom up, free-market, pay-as-you-go entrepreneurial marketplace can only be realized if the playing field is made level for all participants to engage in fairly. Government monopolies can only exist under the protection of laws and regulations that prevent competition– these must all be removed. Our citizens will never realize the full benefits of free-market medical services until all the scaffolding of this anti-competition legislation has been torn down and filed in the trash can of history.

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