At the Bleeding Heart Libertarians blog, Roderick Long, a libertarian scholar in the Mises-Rothbard tradition, wrote a post on Ron Paul’s lackluster reply to a question from Wolf Blitzer about universal health insurance. First, the question:
Wolf Blitzer: You’re a physician, Ron Paul, so you’re a doctor. You know something about this subject. Let me ask you this hypothetical question.
A healthy 30-year-old young man has a good job, makes a good living, but decides: “You know what? I’m not going to spend $200 or $300 a month for health insurance because I’m healthy, I don’t need it.” But something terrible happens, all of a sudden he needs it. Who’s going to pay if he goes into a coma, for example? Who pays for that?
Long begins his post with the following observation:
This is the kind of question that libertarians usually give stupid answers to. Their first impulse is to stress that no one has the right to force other people to pay her medical bills – which is true enough, but a weird place to start. This answer in effect treats the free market as the present system minus welfare, and so takes for granted that the problem described is likely in a free market. It also casts the sick person as a threat to others’ liberty rather than as a person who can be better helped by libertarian methods than by statist ones. If someone is looking to smear libertarians as people who want to let sick people die, this hands them the opportunity on a platter. (Of course it doesn’t help if your alleged supporters are actually yelling in the background that the patient should die.)
Most libertarians’ second impulse is to mention charity. And their third impulse, if they ever get around to it, is to mention the point they should have led with – that the high cost of health care is a product of state regulation.
The author goes on to note that Ron Paul’s reply to Blitzer’s question adhered to this pattern very closely, at which point Long offered an alternative approach: turn your third impulse into your first impulse:
The right way to answer a question like Blitzer’s is to proceed in precisely the opposite order. Start by asking what causes people like the hypothetical patient to be in the plight they’re in. In other words, lead with stage three. Why didn’t the patient buy insurance? Because the price was too high. Why is it so high? Talk about the specific ways in which corporatist policies drive up medical costs (and disempower the poor in other ways too).
Then, if you still have time, proceed to stage two. If someone doesn’t have insurance and needs care, what’s the most efficient way to get it to them? Talk about how charity and mutual aid are more efficient than government welfare, and how we therefore need to shift the venue of assistance from the latter to the former.
And then you can finish by pointing out that peaceful, voluntary solutions are not only pragmatically but morally superior to coercive ones.
As Long’s discussion continues, he delves into a number of interesting questions, including what he characterizes as the flaws in the “right-libertarian paradigm.” I recommend taking a look.