The title of this article is not my own view, but the statement of many of its advocates. In fact, a lot of people say the same thing: the proposed health care reform is a u201Cgood idea.u201D But this makes me wonder.
As a proponent of the market I fail to see how there can be very good ideas that no entrepreneurs eager to find and exploit a profit opportunity are interested in. If it was really a good idea, then people would pay for someone to provide them with it and there would be potential profits to be earned. So the solution would hardly be political u201Creformu201D but to simply let market actors sort things out.
But this is not often the case if you ask people such as the ones advocating public health care. Not only has the market failed to provide u201Caffordableu201D health care to people who cannot afford much, but the market in general does not always (if ever) work and this is, they claim, especially true in cases such as this. u201CJust look at the mess in health care!u201D
Profit is expensive. So it is better that government monopolizes such necessary services and makes sure everybody gets it. Health care, after all, should not be exclusive and expensive; it should be inclusive and inexpensive and available for everybody always.
To answer all the critics looking mainly at the costs of such government programs, advocates claim that there is no real cost. Actually, there are only savings: a coordinated system based on cooperation rather than competition should be cheaper since no money is spent on advertising or cut-throat tactics to subdue competitors, and no profit is paid but everything is reinvested into real care; healthy people work more, provide for society, and pay taxes; and, by the way, health and happiness cannot be measured in monetary terms anyway. It is simply a good idea.
I sometimes play with the thought of being completely ignorant of economics (you know, the science of understanding people’s choices and actions that, in aggregate, explain how society functions) and simply accept the arguments as they are presented. But even when doing so, I fail to understand how advocates of such u201Creformsu201D think. The reason is this: if the market is a poor way of supplying people with goods and services that they want and need, wouldn’t it then be a good idea to prove once and for all that the market is a bad idea?
So how would one, as e.g. a proponent of public health care, prove the market is a bad idea? The obvious solution would be to let both systems co-exist, i.e. live side by side, and then let people see for themselves that the market simply doesn’t work. This is why I don’t understand advocates of health care u201Creformu201D: they demand u201Cuniversalu201D health care while claiming it is not restrictive or expensive (some claim it is even u201Ccheaperu201D) but refuse to show anyone this is the case and they will not allow any alternative solutions. If government provision is truly a better system, then wouldn’t we all be better off to stop our ideological fighting and settle the matter?
It is easy to figure out how to do this. This is how to settle it: start a government program with free and voluntary entry/exit that is fully financed by its users (as any public health care system would be), and let it run for some years to show it is stable too. That would show me and everybody else that it is indeed better. I understand arguments and tend to believe what I see. I would be willing to reconsider my views if provided with some kind of proof that I am wrong; so you would have won the fight without even having to go to war.
Also, this is a chance for all u201Creformu201D advocates to make things better while letting the ideological capitalists suffer a bit for their ancient beliefs. If the government program is better, then those not choosing to enter it would suffer until they choose to accept the relief government is offering. So nobody would have to suffer; anyone could choose whatever system they like and with time we will see for ourselves that one system is better than the other. How does that sound? Anyone truly interested in giving people what they want and need would take this opportunity.
Any advocate should easily foresee how everybody but the wealthy capitalists would flock to the government-run system. Since it is better, and perhaps even cheaper, they would all be better off, and capitalists would eventually give up on their old-fashioned world-view and join the rest of society. There would be no wasteful fight, only peaceful choice and we would end up with the best solution for everybody.
But my guess is this is an unacceptable solution to anyone advocating public health care. Why?
The reason is that this has nothing to do with quality or cost or accessibility concerns in health care. It has everything to do with envy of those who, at least so we imagine, could afford better health care for themselves and their families. Government u201Creformu201D is not a way to really make things better, but to make things worse for those we perceive are a little better off than we are. It is better if we all get equally bad health care than if someone gets better health care than I.
But do not forget the profit motive! Envy is surely part of the underlying rationale for reform advocates, but so is profit. Politicians have everything to gain from seizing another industry and putting it under their full control. But non-politicians also believe they will profit: if the rich are tied down and forced to pay for a system not requiring payment for use, then the non-rich may profit through using while the rich pay the bill.
My thoughts on the reasons for not showing the superiority of public health care set aside, my point should be clear. It should not be much of a challenge to all you advocates of public health care: all you need to do is establish your own system side by side with the existing system and prove it is better. And while you are at it, allow me and others to set up a market system to see if it is truly as bad as you believe. You choose your system, I choose mine and when we have had enough experience we can decide together on what system is superior. Fair enough?
Is there anybody out there who dares accept this challenge?
Per Bylund [send him mail] is a Ph.D. student in economics at the University of Missouri and the founder of Anarchism.net. Visit his website www.PerBylund.com or his blog where he comments on this article and more.