These days it sometimes seems like a foregone conclusion that we’re going to have socialized healthcare in this country. This is quite a tragedy to contemplate.
America, for all its militarism and prisons, has had one sector where there has remained more room for freedom and less for bureaucratic power than can be seen in other Western nations: the healthcare industry. Some of these nations are much less cruel to foreigners and much less draconian with prisoners and outcasts, including those guilty only of victimless crimes. But there are some ways in which America still scores some major libertarian points over Canada and Sweden, and one of the most significant is that the US has not nationalized its healthcare sector. So for years after young Americans stopped fleeing to Canada to escape military slavery, Canadians have fled to America to avoid socialist medicine and rationing and pay cash to get operations they needed.
The conservatives have for decades rightly warned about socialized healthcare in America. It was a big goal of the communists, then the socialists, then the social democrats. Now it seems like a centrist policy goal.
National healthcare along with global warming was the progressive left’s biggest issue, perhaps, before 9/11 forced them into their more libertarian stands on war and civil liberties. But they still want socialized medicine bad, as is apparent whenever you hear them defend practically any foreign government, no matter how dictatorial, so long as it finances clinics and penicillin for its subjects. The left still seems to oppose capitalism in healthcare more vociferously than in nearly any other area.
Not that America currently has a free market in medicine. First off, there is licensing, a horrible injustice by which the medical establishment protects itself by forbidding free competition. Then there’re Medicare and Medicaid, which constantly deplete supply and inflate demand. And we must never forget the Food and Drug Administration, a corporatist agency that distorts the market, imposes huge costs on drug production and tramples the fundamental individual right to consume whatever one wishes to. In so doing, it has kept live-saving drugs off the market at the cost of many, many thousands of Americans dead.
America’s healthcare system has long been a twisted hybrid between free enterprise and fascism. The fascist part — the part that destroys individual choice and empowers Big Pharma and the medical establishment — should be the part that leftists decry, but instead they have for the most part focused on our remaining medical freedom as the supposed ill. They are correct when they say America spends more than some other countries on healthcare, sometimes for less actual benefit to the consumer than people get under more egalitarian socialist systems. But this isn’t America’s free market at work; it’s America’s government. The only solution is freedom.
In any event, despite the many problems, there are pockets of medical liberty we still have that others don’t, such as with the aforementioned operations that attract Canadian refugees. We would lose most of these remaining spheres of freedom if the left were to get its way.
The Republicans, for their part, have not mounted an organized resistance to nationalizing healthcare since gaining federal power. Far from it. With Bush’s prescription drug program, Republicans saddled us with the largest expansion of medical socialism at the national level since the introduction of Medicare. In his last State of the Union, Bush did say some free-market-sounding stuff about tax deductions and health savings accounts — but he also alluded to something quite frightening: He wants the feds to dole out money to states that come up with programs to give free health insurance to the poor. This comes, perhaps not coincidentally, within weeks of Republican Governor Arnold Schwarzenegger’s proposal for socialized health insurance for the poor in California, and to make it illegal not to have health insurance in the state. This medical despotism is a grave, horrific assault on the fundamental rights over one’s personal life.
Unfortunately, the masses, generally more favorable to the market on other issues, have been duped by nonsensical arguments that healthcare prices are bound to rise steadily in a market economy, and only the government can fix the problem. Supposedly, technology and new innovations make rising costs inevitable — and yet in every other sector not so strangled by regulation, we see real prices drop and ever-increasing quality. Troublingly, the masses don’t see how much of a role government has played in ruining healthcare.
Somehow, the left’s healthcare agenda, which was seen as subversively collectivist and pinko fifteen years ago, has now become a popular priority and something top Republicans can talk openly about implementing over time. Indeed, the Republicans have already been giving us all the worst of Hillary-care, one piece at a time, and are poised to do more through "market-reform" gimmicks and with the state governments as proxies, along with some extra gigantic programs to protect the profits of their friends in the medical industry.
When you think about it, we shouldn’t have expected medical freedom from the Republicans. How could conservative drug warriors, for example, really be enemies of the FDA? Take away the FDA’s power to nationalize choices of what medicines and drugs one can consume, and the drug war disappears. Give the feds this kind of awesome power, and fascist or socialist medicine can’t be too far away.
Leftists, on the other hand, have long been either clueless or disingenuous on these issues. They have called for more regulation of herbal supplements and alternative medicine, navely thinking that anything worth promoting is worth getting the federal government interested in. They defend the FDA not realizing it is the twin of the DEA, as well as the great ally of the established pharmaceutical companies. Most hypocritically and unrealistically, the left claims to want freedom over their bodies even as they don’t want the responsibility of taking care of them.
So the mainstream Republicans, almost all Democrats, and the ideological left are horrible on healthcare issues. Most moderates support moving toward more centralized control. We appear to be doomed for the short term on this issue.
It is a supreme tragedy that America might lose what’s left of its medical freedom. It would be one of our greatest domestic losses in some time.
What’s more, if the US government becomes adamant enough, it could even use imperialism to spread its version of "healthcare freedom and democracy" around the world. Just as it has tried to push US labor regulations, US disability regulations, and, indeed, pharmaceutical regulations on the rest of the world, perhaps the US will become even more internationally belligerent in regard to the global democratic revolution of socialized medicine. A right to healthcare already made it into the US-approved Iraqi Constitution. The US already pressures virtually every other major country to accept its policy on drugs and pharmaceuticals — "regulatory harmonization" is the imperialist euphemism. And what if the US begins forbidding Americans from going abroad, such as to Thailand, as many of them already do, to get medical services less encumbered by paperwork and thus cheaper? What if the US tries to impose its hospital and licensing regulations on these other countries? What if socialized medicine is indeed a goal of world government, as the 1990s rightwing feared, and yet it will be implemented not by the men in blue helmets, but by soldiers donning Old Glory?
There are a million reasons we should have medical freedom, and they must be articulated if we are to avoid a disaster in the next several years. Libertarians must go beyond what we often hear from free-market wonks: the usual denial that there’s anything wrong at all with the system, as if it’s already a free market, and the usual defenses of the largest pharmaceutical companies as the most persecuted minority, what with its inflated, FDA-protected, federal-patent-ensured mega-profits under attack. We must mount a principled, radical and informed intellectual assault on the fascist and socialist threats to medical liberty if we are to restore it or even defend what’s left of it.
The economics should speak for itself, but the right to control one’s own life and body is the core, moral argument for medical freedom. Life and death are intimately involved with the healthcare issue as with few others. Unfortunately, for the time being, it appears that creeping healthcare totalitarianism is on the agenda of both parties. They only disagree on how fast to run us off the cliff, and who should navigate us there.
Anthony Gregory [send him mail] is a writer and musician who lives in Berkeley, California. He is a research analyst at the Independent Institute. See his webpage for more articles and personal information.