Problem Number One: My car is making a grinding noise when I apply the brakes. Diagnosis: I need new brakes. Solution: Buy new brakes and put them on the car. Options: (1) Buy the brakes and install them myself; (2) buy the brakes and have my buddy, an amateur mechanic, install them; (3) buy the brakes and pay a professional mechanic to install them. Furthermore, I have multiple places at which I can purchase the brakes, from the car dealer to the auto parts store.
Problem Number Two: I am in excruciating pain for hours at a time, necessitating a visit to the emergency room. Diagnosis: I have kidney stones. Solution: Wait for them to pass, and to alleviate the pain, take Percocet. Options: None. The only legal way to get the pills is to obtain a permission slip from a state-licensed physician and take it to a pharmacy where a state-licensed pharmacist will dispense it to me.
Problem Number Three: Having taken the Percocet last night, I wake up this morning to find that I have a sore throat and cough. Diagnosis: The Percocet contains acetaminophen, to which my body reacts with the sore throat and cough. Solution: Get a replacement painkiller. Options: None. The only legal solution is to get yet another permission slip from yet another state-licensed physician (my family doctor, since the E/R won’t write me a new prescription at this point).
Problem Number Four: The family doctor won’t call in a prescription for a narcotic to a pharmacy. Diagnosis: Fear of the War on Drugs and what might happen if I were to abuse or resell a one-time prescription for, say, Vicodin. Solution: I must drive to the doctor’s office and pick up a written prescription, which I cannot do today because I am working. Thus, I now have to hope I can get through a night without needing painkillers. Options: None. I cannot legally obtain the drug without the approval of a state-licensed physician, and my doctor — and probably most others — won’t give it to me unless I personally appear at his office.
Problem number one is hypothetical. Problems two through four actually happened to me today. The difference should be immediately apparent. In the first instance, I have at least three options for resolving the problem. In the other instances, I have essentially no options unless I want to risk jail time and forfeiture of my assets.
The cause of this difference, of course, is that there is no state-licensed monopoly on the sales and installation of auto parts, while there is a strictly enforced state-licensed monopoly on the provision of medical services and the dispensing of certain pharmaceuticals. In the former case, I have numerous choices about how to get my brakes replaced, and some of the garages will even go out of their way to make it easy for me by taking me to work and picking me up again when my car is fixed. Meanwhile, I have basically one choice for getting the painkiller I need, and I have to go out of my way to get it.
The question for those who support this status quo is: If you believe that drugs and medical services ought to be regulated by the government, why don’t you believe that auto parts and service should be regulated as well? If some bureaucrat in Washington gets to decide which drugs will be available and, of those that he deems fit for sale to a supposedly free people, which ones will require a permission slip from a state-licensed doctor for those same supposedly free people to obtain them, why shouldn’t there be a government agency micromanaging the auto parts and service industries, determining which parts should be sold over the counter, which will be sold only with a prescription, and which will require professional installation? (Yes, I know there is plenty of auto parts regulation to go around, but it’s a far cry from the regulation of the pharmaceutical industry.)
The primary rejoinder will almost certainly be that there are some drugs that are just too dangerous to allow people to have them at all; and then there are others that, while not quite as dangerous as those in the first category (although marijuana, for example, is certainly less dangerous than many of the psychoactive drugs approved by the FDA), are still too fraught with danger to be sold over the counter, even to willing, mentally capable adults. Only a professional can decide whether, when, and how much of these dangerous drugs an individual should have. Furthermore, we can’t take the chance that the "wrong" person might decide to become a physician, so we have to put the government in charge of determining who may and may not call himself "Dr." So-and-so. Otherwise people would start buying and using these dangerous drugs willy-nilly, and they’d start dropping like flies from drug abuse. Yes, this all creates a government-protected monopoly for medical services and pharmaceutical sales, which inevitably leads to higher prices and poorer, less customer-oriented service, but it’s the price we have to pay to be protected from ourselves and from others who might be less capable of making good medical decisions than we.
However, what if I choose to buy inferior brakes from a fly-by-night manufacturer? What if I choose to install them myself even though I’m so car-illiterate that I can’t even change my own wiper blades? What if I hire a mechanic who, unbeknown to me, drinks on the job and ends up putting the brakes on backward? Any of these situations could lead to disaster, endangering my own life as well as the lives of my family and anyone in the vicinity of my car when I try to stop. Having a market for auto parts and service definitely helps to keep prices low and service high; but why not subject them to the same kinds of regulation to which we subject the medical and pharmaceutical industries, thus protecting us from ourselves and from others who might be less capable of making good automotive decisions than we? Is it really worth the risk?
The fact of the matter is that most regulations are instituted at the behest of those already established in the regulated industries for the purpose of stifling competition from less well-heeled start-ups. Once the politicians, upon whom the established businesses lavish campaign contributions and other non-cash goodies, have agreed to institute the desired regulations, they then invent ways to convince the public that the regulations are being put in place for their own good, to protect them from charlatans and from themselves — or, more precisely, to protect their neighbors from themselves since, while John Q. Republican may consider himself perfectly capable of choosing which drugs to ingest, he’s not so sure his next-door neighbor, Jane Q. Democrat, can be trusted to do the same. That these regulations invariably drive up prices and drive down service is actually a side benefit for the politicians and their contributors because they can then blame the high prices and poor service on the evils of profiteering and thus pile on more regulations ostensibly to rectify the problems caused by the previous regulations (but seldom recognized as such), in an endless cycle.
This is where the American health care system finds itself today, to the point that a competent adult in need of a remedy for excruciating pain must hope and pray that the pain doesn’t strike again until after he’s able to get to the doctor’s office and then the pharmacy in the morning. He cannot simply go to the drug store, tell the pharmacist what he wants, pay for it, and walk out of the store. He must get permission from one state-licensed monopoly to obtain the drug from another state-licensed monopoly, with the result that he has few options in terms of price or service. He must go to the monopolists, at their appointed times and on their terms; they will not come to him.
Meanwhile, he can get his brakes fixed quickly and from a variety of parts and service providers. He need get no one’s permission; he simply buys the brakes and, if desired, the mechanic’s services. He can shop around for the best prices on parts and labor. Possessing no state-enforced monopoly, the parts retailers and service providers will do everything they can to make his experience as pleasant as possible, offering price incentives, extended hours, refreshments, comfortable waiting rooms, and even shuttle service.
Freedom implies that humans are willing to accept risks in exchange for the ability to make decisions for themselves — and then suffer the consequences if they end up on the wrong end of those risks. Too many people, it seems, prefer the illusion of safety via government regulation to the "dangers" of freedom, even when the regulations make their lives more difficult or even dangerous. Think about it: All those extra, unnecessary trips to the doctor’s office surely result in car accidents that need not have occurred if people were free to go directly to the drug store and buy what they want.
If you don’t believe that people prefer slavery with a false sense of security to freedom with its inherent risks, ask yourself this: How many people, having read this, now think that we need even more regulation of the auto parts and service industries?
Michael Tennant [send him mail] is a software developer in Pittsburgh, Pennsylvania.