The first book that The Future of Freedom Foundation published was entitled The Dangers of Socialized Medicine. Published in 1994, it was a little book consisting of various essays that FFF had published since our inception in January 1990. It was coedited by Richard Ebeling and me.
At the time, Richard was the Ludwig von Mises Professor of Economics at Hillsdale College and was also serving as FFF’s vice-president of academic affairs. He later went on to become president of The Foundation for Economic Education (FEE) and is now serving as the BB&T Distinguished Professor of Ethics and Free Enterprise Leadership at the Citadel.
In the book, which is still available at Amazon, we made the principled libertarian case for separating healthcare and the state, just as our ancestors separated church and state. In other words, no governmental involvement in healthcare at all. No regulations, no controls, and no central planning. No FDA. No Center for Disease Control. No Medicare. No Medicaid. No medical licensure.
A total free market in healthcare — meaning that the entire healthcare arena would be free of governmental involvement, interference, control, mandatory charity, licensing, and coercive redistribution of wealth.
That libertarian free-market position is the position that we have continued advancing through today.
Radical? You bet, especially among some conservative-oriented libertarians who threw in the towel years ago and accepted the seeming permanence of heavy governmental involvement in healthcare, including central planning, control, and management; Medicare and Medicaid; medical licensure; and a multitude of healthcare restrictions and prohibitions. Such libertarians have devoted their efforts to simply coming up with public-policy prescriptions based on what they call “choice,” whose aim is simply to reform America’s government-controlled and government-managed healthcare system. One popular “choice” reform is “health savings accounts.”
Why a free-market healthcare system?
So, why has FFF continued to hew to the principled libertarian position on healthcare instead of throwing our lot in with conservatives, progressives, and conservative-oriented libertarians?
Two simple reasons: One, we want to be free and, two, we want to end America’s decades-old, ongoing, perpetual healthcare crisis.
There is no way that people can genuinely be considered free under a socialist healthcare system. Americans don’t like to admit that they live under a socialist healthcare system. They like to think of themselves as capitalists, free-enterprisers, and ardent supporters of the Chamber of Commerce. But the fact is that while America doesn’t yet have a healthcare system that is fully owned and operated by the federal government, the core features of America’s healthcare system are based on socialist principles.
The U.S. healthcare system is also based on a core feature of socialism: central planning, control, regulation, and management. That’s what the FDA and the Center for Disease Control are all about.
Medicare and Medicaid are based on the federal government’s forcibly taking money (through the IRS) from those to whom it belongs and use it to provide healthcare to seniors and the poor. That is the essence of the socialist principle of coercive redistribution of wealth. The concept of these two mandatory charity programs originated among socialists in Germany in the late 1800s, was later imported into the United States, and ultimately adopted into law during the 1960s.
Entry into the medical profession is strictly controlled by state governments, through licensing laws. That keeps the number of healthier providers artificially low, with the aim of causing the people with licenses to make more money.
Prior to America’s socialist healthcare system, our nation had the finest healthcare system in the world. Prices were so low, stable, and predictable that no one needed major medical insurance. Doctors and hospitals provided free medical care to the poor, on a purely voluntary basis. Doctors loved what they did in life. Medical innovations, inventions, treatments, and cures were soaring.
That’s what a free society is all about. That’s also what a charitable society is all about.
And then came central planning, regulation, and control, along with Medicare and Medicaid, two socialist programs that launched America’s decades-long, ongoing, never-ending healthcare crisis. Owing to the enormous government-imposed demand on the healthcare system, healthcare costs began soaring. People began buying insurance for protection. Doctors began forming contorted associations to adapt to the crisis. A never-ending series of reforms began being proposed, including from libertarians. Obamacare was designed to be the ultimate reform that was going to fix the system. When it didn’t, there were the predictable calls for a full and complete federal takeover of healthcare, just like in Cuba and North Korea.
Through it all, FFF continued to maintain: There is one — only one — way to end America’s healthcare crisis: Separate healthcare and the state. End central planning, direction, and control of healthcare. Repeal Medicare and Medicaid. End medical licensure. Establish a full, 100 percent free-market healthcare system.
Healthcare reform and death
“But Jacob, that is so radical! You’re hurting the libertarian movement because you’re making people think that libertarians are heartless and merciless and that they hate the elderly and the poor. Just accept our nation’s socialist healthcare system and join us in simply calling for ‘choice’ reforms.”
And now look at where we are. Who are the people who are experiencing the highest death rates from the coronavirus? Seniors! Is that ironic or what? It is seniors who are now paying the biggest price — death — for America’s healthcare socialism.
And no one can rationally doubt that America’s socialist healthcare system is a major cause of the high death toll from the coronavirus. Every day, one can read any number of articles in the mainstream press about the incompetence of the central planners — about the shortages of masks, supplies, ventilators, and other essential medical supplies — about the ludicrous restrictions imposed on healthcare providers from providing treatment — about the shortages of healthcare providers.
All that dysfunctionality is classic socialism. The economist Ludwig von Mises called a system of central planning “planned chaos.” Can you think of a better term for what is going on today?
Socialism and tyranny
Today, there are libertarians who are lamenting and complaining about the tyrannical measures that government officials are employing to deal with the crisis. But at the same time, some of them continue to hew to the standard, “respectable,” non-radical line — that we have to accept this dysfunctional, decrepit, Soviet Union-like healthcare system and settle for simply reforming it so that people don’t think that we hate seniors and the poor.
What such libertarians block out of their minds is that the healthcare tyranny and oppression they lament is part and parcel of the socialist healthcare system that they continue to support. That’s what politicians and bureaucrats inevitably resort to when their beloved socialist systems start breaking down. Supporting healthcare socialism and opposing healthcare tyranny is much like supporting lightning and opposing thunder.
Only one solution to the Coronavirus crisis
Prior to the coronavirus, FFF consistently maintained that there was only one solution to America’s ongoing, never-ending healthcare crisis. Let me repeat that for emphasis. Only one solution. Not two, not three, not four. Only one: a total free-market healthcare system.
A free-market system produces the best of everything. In contrast to a socialist system based on central planning, which is limited to the “expertise” of government planners and planning agencies, the free market takes advantage of the knowledge and expertise of countless individuals, including entrepreneurs, each of whom is coordinating his efforts with others that always reaches fantastic results that no central planner, in all his wisdom, could ever conceive. In a free market, people are free to make rapid adjustments without governmental permission or interference. Essential supplies and equipment and innovations flood the market.
If we had had the free-market healthcare system that FFF has been advancing for 30 years, today we would be looking to the healthcare industry, not politicians, bureaucrats, and mini-dictators for guidance and direction. Test kits would be cheap and plentiful, even delivered overnight to people’s homes. Those testing positive would be urged to self-isolate while everyone else would be going to work, keeping the economy going. Testing kits, ventilators, masks, and other essential supplies would be in abundant supply. Entrepreneurs would be rushing into the market with new and innovative tests, treatments, and even cures. The death toll would have been minuscule compared to what we have today, especially among seniors.
Today, in the midst of this crisis, FFF’s position is amplified: There is only one way to extricate our nation from this deadly morass, especially for seniors. Not two, not three. Only one: a total free-market healthcare system. It is the only way to dramatically reduce the death toll, especially if this thing returns next fall and winter.
There is nothing like the prospect of death to focus people’s attention on an issue such as this. People are now faced with a life-changing choice: Stick with America’s dysfunctional socialist healthcare system or chose the only way out of this deadly morass. Just keep in mind: it’s no longer an esoteric debate. It’s now a matter of life and death. Choose wisely.