The Health Plan's Devilish Principles

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Murray wrote
against Hillarycare in 1994; his article is also relevant to Obamacare
in 2010.

standard media clich about the Clinton health plan is that
God, or the Devil, depending on your point of view, "is
in the details." There is surprising agreement among
both the supporters and all too many of the critics of the
Clinton health "reform." The supporters say that
the general principles of the plan are wonderful, but that
there are a few problems in the details: e.g., how much will
it cost, how exactly will it be financed, will small business
get a sufficient subsidy to offset its higher costs, and on
into the night.

The alleged
critics of the Clinton Plan also hasten to assure us that they too
accept the general principles, but that there are lots of problems
in the details. Often the critics will present their own alternative
plans, only slightly less complex than the Clinton scheme, accompanied
by assertions that their plans are less coercive, less costly, and
less socialistic than the Clinton effort. And since health care
constitutes about one-seventh of the American output, there are
enough details and variants to keep a host of policy workers going
for the rest of their lives.

But the details
of the Clintonian plan, however diabolic, are merely petty demons
compared to the general principles, where Lucifer really lurks.
By accepting the principles, and fighting over the details, the
Loyal Opposition only succeeds in giving away the store, and doing
so before the debate over the details can even get under way. Lost
in an eye-glazing thicket of minutiae, the conservative critics
of Clintonian reform, by being "responsible" and working
within the paradigm set by The Enemy, are performing a vital service
for the Clintonians in snuffing out any clear-cut opposition to
Clinton’s Great Leap Forward into health collectivism.

Let us examine
some of the Mephistophelean general principles in the Clintonian
reform, seconded by the conservative critics.

  1. GUARANTEED UNIVERSAL ACCESS. There has been a lot of talk
    recently about "universal access" to this or
    that good or service. Many "libertarian" or
    "free-market" proponents of education "reform,"
    for example, advocate tax-supported voucher schemes to
    provide "access" to private schooling. But there
    is one simple entity, in any sort of free society, that
    provides "universal access" to every conceivable
    good or service, and not just to health or education or
    food. That entity is not a voucher or a Clintonian ID
    card; it’s called a "dollar." Dollars not only
    provide universal access to all goods and services, they
    provide it to each dollar-holder for each product only
    to the extent that the dollar-holder desires. Every other
    artificial accessor, be it voucher or health card or food
    stamp, is despotic and coercive, mulcts the taxpayer,
    is inefficient and egalitarian.

    "Guaranteed universal access" can only be provided
    by the robbery of taxation, and the essence of this extortion
    is not changed by calling these taxes "fees,"
    "premiums," or "contributions." A
    tax by any other name smells as rotten, and has similar
    consequences, even if only "employers" are forced
    to pay the higher "premiums."

    Furthermore, for anyone to be "guaranteed" access
    to anything, he has to be forced to participate, both
    in receiving its "benefits" and in paying for
    them. Hence, "guaranteed universal access" means
    coercing not only taxpayers, but everyone as participants
    and contributors. All the weeping and wailing about the
    37 million "uninsured" glosses over the fact
    that most of these uninsured have a made a rational decision
    that they don’t want to be "insured," that they
    are willing to take the chance of paying market prices
    should health care become necessary. But they will not
    be permitted to remain free of the "benefits"
    of insurance; their participation will become compulsory.
    We will all become health draftees.

  3. EGALITARIAN. Universal means egalitarian. For the dread
    egalitarian theme of "fairness" enters immediately
    into the equation. Once government becomes the boss of
    all health, under the Clinton plan or the Loyal Opposition,
    then it seems "unfair" for the rich to enjoy
    better medical care than the lowest bum. This "fairness"
    ploy is considered self-evident and never subject to criticism.
    Why is "the two-tier" health system (actually
    it has been multi-tier) any more "unfair" than
    the multi-tier system for clothing or food or transportation?
    So far at least, most people don’t consider it unfair
    that some people can afford to dine at The Four Seasons
    and vacation at Martha’s Vineyard, whereas others have
    to rest content with McDonald’s and staying home. Why
    is medical care any different?

    yet, one of the major thrusts of the Clinton Plan is to
    reduce us all to "one-tier," egalitarian health
    care status.

  4. COLLECTIVIST. To ensure equality for one and all, medical
    care will be collectivist, under close supervision of
    the federal Health Care Board, with health provision and
    insurance dragooned by government into regional collectives
    and alliances. The private practice of medicine will be
    essentially driven out, so that these collectives and
    HMOs will be the only option for the consumer. Even though
    the Clintonians try to assure Americans that they can
    still "choose their own doctor," in practice
    this will be increasingly impossible.

  5. PRICE
    CONTROLS. Since it is fairly well known that price controls
    have never worked, that they have always been a disaster,
    the Clinton Administration always keen on semantic trickery,
    have stoutly denied that any price controls are contemplated.
    But the network of severe price controls will be all too
    evident and painful, even if they wear the mask of "premium
    caps," "cost caps," or "spending control."
    They will have to be there, for it is the promise of "cost
    control" that permits the Clintonians to make the
    outrageous claim that taxes will hardly go up at all.
    (Except, of course, on employers.) Tight spending control
    will be enforced by the government, not merely on its
    own, but particularly on private spending.

    One of the most chilling aspects of the Clinton plan is
    that any attempt by us consumers to get around these price
    controls, e.g. to pay higher than controlled prices to
    doctors in private practice, will be criminalized. Thus,
    the Clinton Plan states that "A provider may not
    charge or collect from the patient a fee in excess of
    the fee schedule adopted by an alliance," and criminal
    penalties will be imposed for "payment of bribes
    or gratuities" (i.e. "black market prices")
    to "influence the delivery of health service."

    arguing for their plan, by the way, the Clintonians have
    added insult to injury by employing absurd nonsense in
    the form of argument. Their main argument for the plan
    is that health care is "too costly," and that
    thesis rests on the fact that health care spending, over
    recent years, has risen considerably as a percentage of
    the GDP. But a spending rise is scarcely the same as a
    cost increase; if it were, then I could easily argue that,
    since the percentage of GDP spent on computers has risen
    wildly in the past ten years, that "computer costs"
    are therefore excessive, and severe price controls, caps,
    and spending controls must be imposed promptly on consumer
    and business purchases of computers.

    RATIONING. Severe price and spending controls means, of
    course, that medical care will have to be strictly rationed,
    especially since these controls and caps come at the same
    time that universal and equal care is being "guaranteed."
    Socialists, indeed, always love rationing, since it gives
    the bureaucrats power over the people and makes for coercive

    And so this means that the government, and its medical
    bureaucrats and underlings, will decide who gets what
    service. Medical totalitarianism, if not the rest of us,
    will be alive and well in America.

  7. THE
    ANNOYING CONSUMER. We have to remember a crucial point
    about government as against business operations on the
    market. Businesses are always eager for consumers to buy
    their product or service. On the free market, the consumer
    is king or queen and the "providers" are always
    trying to make profits and gain customers by serving them
    well. But when government operates a service, the consumer
    is transmuted into a pain-in-the-neck, a "wasteful"
    user-up of scarce social resources. Whereas the free market
    is a peaceful cooperative place where everyone benefits
    and no one loses, when government supplies the product
    or service, every consumer is treated as using a resource
    only at the expense of his fellow men. The "public
    service" arena, and not the free market, is the dog-eat-dog

    So there we have the Clintonian health future: government
    as totalitarian rationer of health care, grudgingly doling
    out care on the lowest possible level equally to all,
    and treating each "client" as a wasteful
    pest. And if, God forbid, you have a serious health problem,
    or are elderly, or your treatment requires more scarce
    resources than the Health Care Board deems proper, well
    then Big Brother or Big Sister Rationer in Washington
    will decided, in the best interests of "society,"
    of course, to give you the Kevorkian treatment.

  8. THE
    GREAT LEAP FORWARD. There are many other ludicrous though
    almost universally accepted aspects of the Clinton Plan,
    from the gross perversion of the concept of "insurance"
    to the imbecilic view that an enormous expansion of government
    control will somehow eliminate the need for filling out
    health forms. But suffice it to stress the most vital
    point: the plan consists of one more Great Leap Forward
    into collectivism.


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    The point was put very well, albeit admiringly, by David
    Lauter in the Los Angeles Times (September 23).
    Every once in a while, said Lauter, "the government
    collectively braces itself, takes a deep breath and leaps
    into a largely unknown future." The first American
    leap was the New Deal in the 1930s, leaping into Social
    Security and extensive federal regulation of the economy.
    The second leap was the civil rights revolution of the
    1960s. And now, writes Lauter, "another new President
    has proposed a sweeping plan" and we have been hearing
    again "the noises of a political system warming up
    once again for the big jump."

    The only important point Mr. Lauter omits is leaping into
    what? Wittingly or unwittingly, his "leap" metaphor
    rings true, for it recalls the Great Leap Forward of Mao’s
    worst surge into extreme Communism.

Clinton health plan is not "reform" and it doesn’t
meet a "crisis." Cut through the fake semantics,
and what we have is another Great Leap Forward into socialism.
While Russia and the former Communist states are struggling
to get out of socialism and the disaster of their "guaranteed
universal health care" (check their vital statistics),
Clinton and his bizarre Brain Trust of aging leftist grad
students are proposing to wreck our economy, our freedom,
and what has been, for all of the ills imposed by previous
government intervention, the best medical system on earth.

is why the Clinton health plan must be fought against root
and branch, why Satan is in the general principles, and why
the Ludwig von Mises Institute, instead of offering its own
500-page health plan, sticks to its principled "four-step"
laid out by Mises Institute Senior Fellow Hans-Hermann
Hoppe (The Free Market April 1993) of dismantling existing
government intervention into health.

N. Rothbard
(1926–1995) was dean of the Austrian
School, founder of modern libertarianism, and academic
vice president of the Mises
. He was also editor — with Lew Rockwell
— of The
Rothbard-Rockwell Report
, and appointed Lew as
his literary executor.

Best of Murray Rothbard

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