Map of life expectancy at birth from Global Education Project.

Tuesday, January 12, 2010

Libertarian pretzel logic

Before I get to my boffo conclusion, I do want to take a moment to focus on the problem of liberty in the context of health care reform. It seems to me untenable for people who claim to put individual liberty before other values to condemn efforts to rationally allocate medical interventions. Remember that the idea is not to forbid anyone from going out and spending whatever of their own money they happen to have on whatever foolishness they may wish to waste it on; rather it is to restrict their claim on other people's money, whether as part of a private or a public insurance pool.

If you happen to be wealthy and you can find a surgeon to do a vertebroplasty on you, go for it. But why do libertarians insist that I should be required to help pay for it if all the evidence shows that it doesn't do any good? Perhaps even more bizarre is the right wing freak out over end of life care. How does it crush my liberty for Medicare to offer to pay for counseling so that I can make my own, informed decisions about how I want to check out when the time comes? And think back to Terry Schiavo -- remember that it was the taxpayers of Florida and the United States who were paying to keep her corpse breathing, despite the wishes of her next of kin.

As for universality, it is evident to me that it does not compromise liberty, but enhances it. True, it requires the younger and more fortunate to subsidize, to some extent, the older and the less fortunate. But remember that we are all going to trade positions at some point. And when the young and fortunate become older and/or less fortunate, they are going to assert a claim on the rest of us regardless of whether they paid their share previously. That diminishes the liberty of the rest of us by taking from us unfairly; at the same time, when people suffer pain and disability that could be avoided or ameliorated, obviously their liberty is reduced.

Universal, progressively financed health care hits the sweet spot in political philosophy because it simultaneously enhances both justice and liberty. The contradiction that libertarians are determined to see between these principles just isn't there. You get two for the price of one.

Which brings me to the contemporary grassroots conservative movement known as the Teabaggers. It is difficult to figure out exactly what they want. They are against health care reform, but it is unclear why. They talk about death panels and rationing but as I say, that's complete bullshit and if they were truly libertarians they ought to be for rationing, because we're talking about other people's money here. Other than that they didn't like the Wall Street bailout, which is fair enough, although most of their heroes were for it and the main opposition consisted of liberals; and they seem not to like president Obama for largely unstated reasons although we can guess.

We have a guest here who defends the movement essentially on the basis of nostalgia for a romantic vision of the pre-industrial past. When we had to get around on horseback and there was no telecommunication, it was a major project to get a message from Raleigh to Philadelphia, and life was pretty much organized around the plantation and the Town Meeting. Evidently people feel they would prefer to live in what they perceive as simpler times, but it's hard to say what public policy prescription that implies. We can shut down international and interstate commerce beyond what can be carried by horse-drawn wagons, but you won't like it when you don't have fresh vegetables in the winter and you have to weave your own textiles. Electricity and telephones are kind of handy. A complex, large scale society that can produce these things needs a government. That's the world we live in. Wishing you could live in a historical novel is not a policy.


C. Corax said...

Poor loser would have to stand on a box at a street corner in order to proclaim his politics to passers-by. Might even get pelted by some rotten fruit into the bargain. Bet he doesn't know how to saddle a horse, either.

Did you catch the reports on how the Teabaggers' protest at the Detroit Auto Show went down?

Cervantes said...

Yes indeed, it turns out the teabaggers from Michigan are all for the auto bailout and squashed the planned protest. That about says it all, doesn't it?

Daniel said...

I wonder how many of us have a brother in law that is a tea bagger? I do. In our last discussion(?) he informed me that he wouldn't work anymore. He is pushing 60 and his unemployment can probably keep him going until he collects Social Security. And why work he says, Obama is destroying the economy with his inflationary policies anyway. In the same conversation he expresses his enormous regret that this country has betrayed our Founding Fathers vision of limited government.

I don't even try to understand how this is all logically related.balic

Cervantes said...

Yup, that doesn't make any sense. The whole thing is just about vague feelings that the world is changing in ways you don't like.