five by five: No More Tiers

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May 21, 2005

No More Tiers

I found this piece particularly depressing: an article in the New York Times about Jacques Chaoulli, a Canadian doctor and "gadfly" trying to argue that the Canadian health care system violates Canadians' constitutional rights. If you're unfamiliar with the intricacies of the Canadian system, it not only taxes the bejeezus out of all citizens to pay for crappy health care, it also includes (I would even say necessitates) outlawing any private contracts for almost all types of medical care. That means no matter how much money you've earned, saved and sold all your star wars action figures to scrape together, you get to wait in line with everyone else for that life-saving surgery you need...

In the case of Chaoulli, this meant that he was fined and harassed for creating a house call service with other Canadian doctors that filled a hole in the Canadian system. It seems no capitalist "monopoly" is as threatened by tiny upstarts as the Canadian health care monopoly. The mere thought that any doctors or patients should be allowed to trade outside of the system based on their own interests and ability to pay is regarded as antisocial. The reason is made clear in this editorial: that the best, the most rational doctors will pursue their own interest and seek out the best situations. They will break free of the shackles of "duty" to the public and be free to trade as individuals. Just as hundreds of the best and brightest doctors leave Canada every year for more choice and freedom in the US, so will they leave the state-run system when a private "tier" inevitably offers better choices. The opponents of a two-tier system know this and state openly that they are against this type of individual empowerment of doctors who are now safely squashed under the thumb of government.

But isn't health care a right? Shouldn't everyone receive care when they need it, regardless of their ability to pay? This sounds really nice, but arguing that this is a moral, fair way to address the need for health care ignores the true nature of this service. Health care is provided by individuals, specifically taxpayers and health care professionals. To argue that somehow this service- the product of individual effort- can be distributed on the basis of need, without regard to the basic rights and interests of the individuals who provide it, shows either extreme ignorance or complete disregard for justice.

There is no difference between health care and other goods and services that are traded in society, such as food and shelter. We all need these things at some point or another in order to live. But no sane person these days suggests that you shouldn't be able to have a better house, eat better food, or provide more safety for your family if you earn more money. Only in the most oppressive socialist and communist regimes is this kind of "equality" enforced. Like all industries, health care advances are made by individuals seeking profit, taking risks, thinking and acting as free individuals. The more we treat the providers and subsidizers of health care as serfs and slaves with no right to consider their own interests and negotiate as individuals in a free society, the less advancement we will see in the health care industry.

The fatal error that Dr. Chaoulli makes is in arguing that he should be able practice privately because health care is a right under the Canadian constitution. But it is precisely that guarantee that necessitates the curtailing of voluntary interactions in order to stop the "diversion of resources" from the state-run system.

If I had more time I would explode the myth that the US health care "system" is a free-market one. The US system is in fact highly overregulated in almost every aspect in some way or another. This article from Mises.org does a great job of laying that out.

And don't even get me started on the ban on selling organs.

Posted by exaltron at May 21, 2005 01:10 PM

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