- Health policy should focus on making health care of ever-increasing quality available to an ever-increasing number of people.
- To achieve “universal coverage” would require either having the government provide health insurance to everyone or forcing everyone to buy it. Government provision is undesirable, because government does a poor job of improving quality or efficiency. Forcing people to get insurance would lead to a worse health-care system for everyone, because it would necessitate so much more government intervention.
- In a free country, people should have the right to refuse health insurance.
- If governments must subsidize those who cannot afford medical care, they should be free to experiment with different types of subsidies (cash, vouchers, insurance, public clinics & hospitals, uncompensated care payments, etc.) and tax exemptions, rather than be forced by a policy of “universal coverage” to subsidize people via “insurance.”
Like I told my new BFF Andrew Tobias, I don't want every trip to the doctor to be like a trip to the DMV--or the emergency room. Though I stick to my economic guns (principle number 2), an interesting and quintessentially libertarian take on this is principle number 3. (Also number 1, here, although many other good points as well). I hadn't quite considered that an actual personal liberty argument can be made. Nonetheless, the sad thing is others won't find it very compelling; I fear that the "Government has a DUTY to take care of me" mindset is alive and growing (damn you, FDR and LBJ, damn you!).
Update: Kip Esquire makes an exceptional point: why do we trust the government to be better at spending on healthcare than say, it is on antiterrorism grants? Excerpted:
So the question becomes: If the federal government can't get spending on domestic security "right" (I refuse to use the fascistic word "homeland" except as part of a proper noun), then why should the healthcare socialists expect the federal government to get spending on health care "right"?
All the same indignation would emerge under socialized medicine: "Why does cancer get more than heart disease?" "Why do New York City's research and teaching hospitals get so little?" "Why does white suburban geriatric nursing get more than black inner-city pediatric nursing?" "Why are 'homosexual diseases' covered at all?" "Why is Viagra covered but not Propecia?" "Why does my neighbor's kid get a motorized wheelchair while my kid gets crutches?" "Why is there a huge hospital at the other end of the Bridge to Nowhere?" And so on.
* * *
Socialized medicine would be a never-ending political haggle based, not on objective metrics, but on the Politics of Pull, balanced out by the Politics of the Warm Fuzzy Feeling, perhaps with some racial, gender and sexual orientation inequities tossed in for flavor.
And the worst part? People would suffer and die from it -- in needless, senseless ways that a terrorist could only dream of.
And Tim, I promise I'll add my own thoughts soon.