[ExI] Call To Libertarians

spike spike66 at att.net
Wed Feb 23 05:13:14 UTC 2011

>... On Behalf Of Samantha Atkins
>> Do trim responses please.
>> There are many different kinds of libertarians, which explains why we 
> seldom or never win elections.  A lot of times, we don't even vote for 
> our own candidates.
>> I am a libertarian who would argue that you can do a whole bunch of 
> things in a publicly funded way, but do it in such a way that private 
> entities can compete, and usually win against it.

>Spike.  How is a public healthcare system, that is government run system
paid for with money forcefully taken from individuals, remotely in keeping
with the NAP which is the cornerstone of libertarianism?

This proposed system is kinda what is evolving anyways.  Our emergency rooms
routinely take patients they know cannot or will not pay.  Currently in the
US we are telling people that health care is a right.  So how do we expect
them to pay?

Here's my scheme.  The emergency room will be open to all, and the medics
who work there will be on salary, not a particularly good one.  They will
hire pretty much any doctor who is willing to work there, and allow nurses
to do plenty of what doctors usually do.  These doctors and the hospital
will be immune from lawsuit.  There will be plenty of inexperienced doctors
working there, not so different from my favorite old TV show, that I miss
still.  No charge, and mostly worth it.  Yes it is risky as hell to go there
for treatment, but it's free to all.  Yes it might be crammed full of
illegals, but treatment goes to whoever is sickest.  I'm not actually
claiming this is a good solution.

>Do you really think that the government can be involved in healthcare 
without grossly inflating costs?  

Sure do.  The government-run ERs wouldn't do any of the high techy stuff.
With this system you can still have private emergency rooms which would have
CAT scan machines and all the stuff we are accustomed to seeing in the

> With the government health programs we have now we have tens of trillions
of unfunded liabilities...

Ja, because we try to make our government-run ERs state-of-the-art high tech
envy of the world hospitals.  I am saying we can have government run ERs
where anyone can get treatment, but I am not saying they will be good
hospitals.  With that arrangement, for-profit hospitals will do fine in
competition with the free clinics.  Now we are telling everyone that they
are entitled to high end medical treatment, when most people can solve many
of their own most serious health problems just by throwing away the
cigarettes and losing weight.

>>...  If the patient wants to buy insurance against the medics' slaying
her, then that is 
>> between her and the insurance company, with private arbitration being the

>What?  That isn't libertarian particularly either unless you are removing
all government created law and enforcement...

I am proposing removing all legal infrastructure from this one area,
medicine, since by involving the legal system we have created a system which
we cannot afford.  I am proposing we acknowledge that going to the free
hospital is dangerous, and they might screw up and we might suffer.  We
accept risk when we ride motorcycles, when we live unhealthful life styles,
when we go into bad neighborhoods.  I am proposing that we give away our
legal protections, not because we don't need them or that the doctor will
not mess up, but rather that we cannot afford all the current protection we
demand.  It causes doctors to perform defensive medicine, which not only
runs up the bill but makes for lousy care.  

My old favorite example: The doctors can't afford to risk not checking men
over 50 for prostate cancer, so when we older lads go to the doctor *for any
reason* including an ingrown toenail or the UPS guy delivering a package, he
gets the jelly finger.  Result: men over 50 avoid the doctor, even when they
are sick.  The risk of prostate cancer isn't high, but the doctor doesn't
want to get sued, so... we get treatments that are not necessary, while
losing some that are necessary.

>  Doing it only for medical stuff doesn't seem very reasonable or at all
sound.  If a doctor harms you through negligence then you do have a
legitimate legal grievance.

This I am acknowledging, and proposing that we remove the lawyers from this
one specific field, and yes I know it introduces risks of bad doctors (as
often shown on ER) but I am saying that it is a good tradeoff.  Bad doctors
usually are not criminals, rather just bad doctors, and for the most part
are likely good people trying to do right.

> Hmm.  I may be falling for the famous spike tongue-in-cheek remarks again.
:) - s

Well not really.  I do goof around far too much, but this isn't one of those
times.  I do want us to think of all the alternatives and realize none of
them are particularly good.  The system the US government is proposing, and
has actually passed into law (until the Supreme Court knocks it down) will
not work, even if it were legal.  It requires everyone to buy medical
insurance, but the penalty for not having it is a small fraction of the cost
of even basic insurance.  So you know most people will drop their insurance,
then buy the insurance only when they get sick, go to the doctors to get
everything taken care of, then drop the policy as soon as the last doctor is
consulted.  Even with the non-insurance penalty, there is no reasonable way
to extract money for insurance from those who don't have an income.  Hell a
child could see that system will collapse.

Some like to say single payer is the answer, but what happens if that payer
can't pay?

Answer: you don't get much.  So, all I am proposing is a formalized system
where it is single payer, but it isn't a particularly competent medical
system.  It is cheap enough that the government can pay for it.  In
parallel, you have a pay system, which ends up with all the high-techy
medical gear and all the real doctors, and is really the place to be if one
can afford it.

When you think about it, that is pretty much what's evolving anyway.


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