I spend a lot of time reading internet message boards. These places are bastions of irreverence and stupidity. But since I live overseas, in many ways message boards are the best way I can stay in touch with American political life. I can read Politico and watch "Morning Joe," but for an unfiltered view of the American political scene, I turn to message boards. And not just the stuff on "Daily Paul," where I find myself agreeing with most people. I like Yahoo and CNN and Fark. Places where people from all sides of the political arena lash out at each other anonymously, betraying great cruelty but ultimately, real sincerity. It helps me feel in touch with my home that I miss very much.
Obamacare has been the subject this week, and kicking around on the message boards is a pro-centralized medicine view point which I think is worth refuting. It's actually a refutation of a libertarian argument. The liberty contention is that we shouldn't regulate what fees are charged in healthcare. Doing so would cause a doctor to be forced to sell his services at a certain rate. This seems reasonable to me. If someone becomes skilled in a trade, plumbing for example, why shouldn't they charge whatever rate the market will support? By extension, if someone is a highly capable internist-- shouldn't they be able to bill patients whatever rate they can agree upon, not some number tossed down at them from a NYU grad working at the Department of Obamacare? To do anything else would be to force a service provider to work for less than their skills are actually worth. This would be essentially plundering by one person (the patient) of another (the doctor).
The argument thrown out by the statists though is that isn't this what we do with public servants? Would libertarians argue that police, for example, should be able to ply their trade anyplace at any rate? Would libertarians contend that police services should be entirely privatized?
I've seen too many examples of libertarians saying "yes, we must privatize the police, and judges, and legislators." This is preposterous and violates my notions of sensible libertarianism. Too many libertarians categorically reject government and fall into the trap of believing that anarchy is a solution.
Anarchy is a mess. I've spent too much time in failed states to believe that the wonders of a completely free society with absolutely zero government makes up for the fact that there is chaos in the streets. Sure it's great to have an unregulated cell phone market where innovation reigns (Somalia) or a place where DVDs cell for a penny because there's no licensing fees or enforcement (Central Asia). But what fun is it if you need to spend a month's salary on razor wire and ammunition to protect yourself?
What libertarians forget is that excessive government is the problem, not government in and of itself. We need government to competently carry out the functions we charge it with. And police services (as well as the judicial services and legislative functions of government) are critical.
The proper response to the suggestion that we have centralized policing and therefore should do the same with medicine is that policing is inherently a state function. The purpose of the state is to apply uniform laws in limited areas that the private sector cannot fulfill, like naturalization, diplomacy, and border controls. Police enforce those laws. This policing is a service which cannot be privatized-- it is always the exclusive domain of the state.
Medicine, however, is not a monopoly of government-- unless we make it one. And why would we? There is nothing governmental about medicine. We have laws to make order, not to craft society (at least, that should be the function of government). A person can go out and find healthcare on their own, if they have will and finances. But even the wealthiest person in the world couldn't go out and create their own system of justice, under our form of government. You can't privatize criminal law because by nature it's uniform and equal for everyone. We all need police and they should all be the same. Police are a collectivist, socialist initiative. The downside for them is that they can't negotiate for higher prices, because there's only one buyer. The upside is that employment as a police officer is almost recession proof.
If giving government control of industries were the secret to a sound society the Soviet Union would be running full speed right now, and we'd be reading Marx and Engels instead of Peter Schiff.
The fact is government can't do everything. There are a few, very limited places where it must carry out certain functions, roles unique to a collectivist ideal, but to go beyond that is ineffective.
Sensible libertarian views on nearly everything- except foreign affairs.