At our regularly scheduled pub night recently, a libertarian friend posed this question to me: "Why are you a libertarian?" I had to think for a moment then I blurted out something about having choices. Deep thoughts aren't generated at pub nights, so I was not prepared for the question and my answer was poor. My friend followed with something like this:
"So, if libertarians are all about choice but want to get rid of government health care, and allow people to seek private insurers or have no insurance at all, then libertarians are restricting choice by eliminating the government option and effectively forcing people to have private health care or none at all. What kind of choice is that?" Again I did not immediately grasp the fallacy in that thinking, not until afterward, and that's why I writing about it here. So here is a more thoughtful answer to both of the above questions.
Suppose the government was in the food production industry. Food is essential to life, often health care is too, but overall it can be argued that food is more important, most of the time to most people, I hope you agree.
Governments in this part of the world are not involved with food production (not directly) nor should they be. Food is produced by efficient producers, for profit, and marketed all over the world. Food moves rapidly and efficiently across borders without much government fuss (except for the "marketing boards" in Canada, but that is another story). Food scarcity is controlled by price and so is food abundance, supply and demand rule most of the time. I have lived here in the Greater Toronto area virtually my entire life, and I have never known there to be a shortage of food. If you can't find red apples there are green ones, there are always choices that generally fit everyones budget. It's amazing, never a shortage, always more than enough in stores, and yet profits are to be made, and wealth is produced. So much wealth, and so much food in fact, that even the poor are able find enough through private charity and food banks.
In Canada, and much of the Western world, governments are involved in health care. A true libertarian thinker would say that they should not be. A hypothetical libertarian government by eliminating the option for government regulated health care, is not removing a choice, rather, that libertarian government is righting a wrong. The government should not be doing that, should not be involved in health care. Unlike food production, where shortages are controlled by price and choice, supply and demand,
ALL Canadians in all provinces know too well that there are shortages in health care, because scarcity is not controlled by price, it is controlled by government edict. All Canadians are familiar with the term "
wait-time" when it is used to reference health care. But did you ever have to wait to buy bananas? Maybe one store had sold out, but in the larger centres there are always bananas nearby! Rarely a shortage, even in the depths of a Canadian winter.
But health care?
Now you're talking shortages. Can't find a family doctor? Have you ever waited in a hospital emergency room for yourself or a loved one and been "triaged" almost to death? Have you ever been in a doctor's overbooked waiting room,
waiting and waiting and waiting? Have you or a loved one ever had to endure a long wait to get much needed treatment for any sort of ailment, surgery or otherwise? I'm certain most Canadians would answer in the affirmative to one or more of those questions. It's the Canadian way of life and death. Yet for some reason Canadians are proud to say that: "free health care" is what separates us from our less caring American cousins to the South. This is a fallacy that needs to be examined on several levels, but not here.
The point of course is that food production and distribution is relatively unregulated, driven by the profit motive and yet it fulfills the needs of most Canadians most of the time. Health care on the other hand, is almost totally regulated, removed from the profit motive because it is somehow unseemly, yet it rarely ever fulfils the needs of its customers at any time. The chart in the corner may be dated, but the message is the same today.
What about the poor, what about catastrophic situations? These are issues that can be accommodated, even in a competitive system. While I don't have all the answers, I do know that what we have now can be made much better with choice. A libertarian government would strive for choice, but there are some choices that are just plain wrong.
