• 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.

    The
    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.

    2. COERCIVE.
      "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?

      And
      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."

      In
      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.

    6. MEDICAL
      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
      egalitarianism.

      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
      jungle.

      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.

    The
    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.

    That
    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"
    plan
    laid out by Mises Institute Senior Fellow Hans-Hermann
    Hoppe (The Free Market April 1993) of dismantling existing
    government intervention into health.

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

    The
    Best of Murray Rothbard

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