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Hornberger's Blog is a daily libertarian blog written by Jacob G. Hornberger, founder and president of FFF.
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Let’s Admit It: Enacting Medicare Was a Mistake


The ongoing fiasco in healthcare shows why it was so wrong to have enacted Medicare in the first place.

For one thing, Medicare reflects perfectly the mindset of dependency that the welfare state has inculcated in the American people, who have been born and raised under a culture of welfare-statism. All too many Americans are absolutely convinced that they could not survive without Medicare. The thought of repealing, not reforming, Medicare is so terrifying to them that they cannot even rationally discuss the subject. In their minds, if Medicare were repealed, elderly parents and grandparents would soon be dying in the streets of untreated infections and illnesses.

As they grow up in a culture of Medicare and welfare-statism, Americans are trained to look upon the federal government as a great benefactor, as a parent, as a friend, even as a god to some people. In the statist mind, Medicare is people’s lifeline to longevity and health. Given that the government can terminate this lifeline at any time, it is not surprising then that all too many seniors are reluctant to challenge the government at a fundamental level, such as its warfare-state functions. The underlying subconscious fear is that since their lives purportedly depend on the continuation of the government’s Medicare program, people cannot afford to risk sudden termination of the program by challenging what the government’s military empire is doing overseas.

Secondly, Medicare reflects the extent to which Americans have lost faith in freedom and the free market. This is precisely why virtually all attempts to resolve the healthcare crisis, even by many free-market advocates, involve some sort of reform proposal that will keep the basic Medicare program intact. The reformers, whether free-market or statist, simply cannot bring themselves to believe that healthcare can be entrusted to the free market.

What would a truly free market in healthcare mean? It would mean a total separation of healthcare and the state. What does that mean? It means a total repeal, not a reform, of Medicare and Medicaid. It also means a repeal of occupational licensure laws — that is laws that require official government permission to provide healthcare. (See “Medical Licensure” by Milton Friedman.) It also means a repeal of all healthcare regulations, especially those that prevent or inhibit interstate providing of healthcare insurance. It would also entail the abolition of all taxes that are needed to pay for the ever-burgeoning Medicare and Medicaid expenses.

The free market provides the best of everything. Deep down, everyone knows that, but call for a total separation of healthcare and the state (as our ancestors did with religion and the state) and all too many Americans start quaking. That’s what the welfare state has done to the American people. It has severely damaged their self-confidence, self-reliance, and faith in freedom, free markets, themselves, others, and God.

How would the truly poor get their healthcare in a totally free market? The same way they got it from 1787 to 1964, when this immoral and destructive socialistic program was imported to our land — by purchasing it themselves individually or through voluntary membership in associations or through voluntary charity, especially from healthcare providers themselves.

I grew up in what the federal government termed the poorest city in the United States, Laredo, Texas. Before Medicare, doctors’ offices in Laredo would be filled every day with patients, most of whom were desperately poor. I never heard of one doctor turning away even one single patient for inability to pay. Yet, doctors in Laredo were among the wealthiest people in town. The money they received from people who could pay subsidized those who couldn’t. And it was all voluntary.

My dentist here in Virginia belongs to a private group of dentists who provide free dental care for poor people. They take turns each week providing free dental care to the poor. There is no Medicare or Medicaid for dental care. No one forces my dentist and his friends to help the poor and needy. They do it because they want to do it and because they think it’s right.

That’s what genuine charity is all about. It’s not about coercion and compulsion, which is what Medicare and Medicaid are based on. It’s about purely voluntary actions, which is what freedom is based on.

Thirdly, consider the silent war that accompanies Medicare and every other welfare-state program. It is a war between those who want free healthcare and those who are being forced to pay for it. With Medicare, elderly people are demanding that their healthcare needs be provided for free.

But everyone knows that free isn’t really free. Hospitals, pharmaceuticals, and doctors, along with all the medical personnel, have to be paid. The money to pay for all this has to come from somewhere. With Medicare, the money is coming from people who are working for living, especially young people.

Thus, Medicare involves an intergenerational war, one in which seniors are demanding the right to take money out of the bank accounts of other people, namely the working class, including young people who are have a very difficult time starting out in life.

Perhaps the most revealing part of the healthcare debate is the extent to which Americans are wedded to this socialistic program. Even though everyone acknowledges that Medicare is playing a large role in leading our nation into the abyss of bankruptcy, all too many people are still unwilling to let it go. Combine that mindset of fear and dependency with the willingness to wage a financial war against people’s children, grandchildren, and their friends, and you start to get a sense of what a horrible mistake it was for Americans to have embraced this insidious program almost 50 years ago.

This post was written by:

Jacob G. Hornberger is founder and president of The Future of Freedom Foundation. He was born and raised in Laredo, Texas, and received his B.A. in economics from Virginia Military Institute and his law degree from the University of Texas. He was a trial attorney for twelve years in Texas. He also was an adjunct professor at the University of Dallas, where he taught law and economics. In 1987, Mr. Hornberger left the practice of law to become director of programs at the Foundation for Economic Education. He has advanced freedom and free markets on talk-radio stations all across the country as well as on Fox News’ Neil Cavuto and Greta van Susteren shows and he appeared as a regular commentator on Judge Andrew Napolitano’s show Freedom Watch. View these interviews at LewRockwell.com and from Full Context. Send him email.