Miéville takes a whack at the Libertarians


My least favorite political/economic group is the Libertarians, so it is a wonderfully pleasant experience to watch as China Miéville takes a sharp and dismissive rhetorical blade to a Libertarian pipe-dream. He’s specifically criticizing something called the Freedom Ship, a gigantic free-floating escapist fantasy for Libertarians, in which they cruise the seas with their own closed colony of warriors for greed.

Libertarianism is by no means a unified movement. As many of its advocates proudly stress, it comprises a taxonomy of bickering branches–minarchists, objectivists, paleo- and neolibertarians, agorists, et various al.–just like a real social theory. Claiming a lineage with post-Enlightenment classical liberalism, as well as in some cases with the resoundingly portentous blatherings of Ayn Rand, all of its variants are characterized, to differing degrees, by fervent, even cultish, faith in what is quaintly termed the “free” market, and extreme antipathy to that vaguely conceived bogeyman, “the state,” with its regulatory and fiscal powers.

Above all, they recast their most banal avarice–the disinclination to pay tax–as a principled blow for political freedom. Not content with existing offshore tax shelters, multimillionaires and property developers have aspired to build their own. For each such rare project that sees (usually brief) life, there are many unfettered by actual existence, such as Laissez-Faire City, a proposed offshore tax haven inspired by a particularly crass and gung-ho libertarianism, that generated press interest in the mid-’90s only to collapse in infighting and bad blood; or New Utopia, an intended sea-based libertarian micro-nation in the Caribbean that degenerated with breathtaking predictability into nonexistence and scandal.

The summary is particularly sweet.

It is a small schadenfreude to know that these dreams will never come true. There are dangerous enemies, and then there are jokes of history. The libertarian seasteaders are a joke. The pitiful, incoherent and cowardly utopia they pine for is a spoilt child’s autarky, an imperialism of outsourcing, a very petty fascism played as maritime farce: Pinochet of Penzance.

Well said — I think the institutionalized selfishness, petty small-mindedness, and bourgeois values run amuck of the libertarians represent the worst of America — and that finding common cause, supporting both social and economic equality, and striving for a real community of liberty (not that penny-pinching masquerading as freedom that libertarians espouse) represent the best.

(via Amardeep Singh)

Comments

  1. Ichthyic says

    I think the institutionalized selfishness, petty small-mindedness, and bourgeois values run amuck of the libertarians represent the worst of America —

    cue cale in 3..2..1…

  2. Robert says

    While I pretty much disagree with the entire economic libertarian ideal, I do find that some of their ideas concerning government have merit. I like the fact that they pretty much think that you should be free to do what you want as long as it doesn’t infringe on the rights of others ideal. I realize that many people profess such an ideal, but few really seem to mean it like they do.

    Of course its all kind of ruined by the fact that one of the things they have no problem with is the whole take as much as you can get regardless of whether you need it or not, and damn the rest of you ethic, which is then defended on some kind of moral principle of you deserve what you work for crap.

  3. says

    Still, I’ve got to admit that making a grab for Garifuna land in the name of property rights is a tour de force of compartmentalization.

  4. Michael X says

    Robert, I agree with you. I’ve never liked the party because of their horrid economic ideals. Although, I do tend to gravitate more towards civil libertarianism. My right to freedom is worth my paying for yours in the medical arena for example. I won’t legislate against red meat even if it causes heart cancer and I pull some of the medical care slack, because (in the most selfish sense) maybe I don’t want my enjoyment of bars and beer to get revoked because it infringes upon someone elses pocket book. We all have some joy that could be revoked through the cry of “it costs me money”. Our liberties should be worth what we pick up in extra costs from mistakes and human fallibility, ya know?

  5. Heterocronie says

    PZ, do you actually know any libertarians?
    Most of the ones I know (including myself) are:
    – themselves poor
    – contribute to charities
    – are pro-choice (on everything)
    – are non-interventionists
    – want to contribute to social and economic equality on their own terms, not on those of a Bush or a Clinton or some other Christian president.
    …and yet libertarians are your least favorite group. I guess that means that you don’t have much confidence in your ability to convince people through words rather than at the point of a gun. That’s unfortunate.

  6. darwinfinch says

    Saying “I’m a libertarian” is an even surer way to suspend any sense of respect than saying “the Bible is inerrant” in my (silly) little book, since it takes away the strong possibility that the utterer was brainwashed by his family or familiars.
    Self-anointed libertarians, the ones who aren’t openly and proudly LT (Looney-Toons), are sort of like the Christian Scientists of the political world here in the USA, but much more boorishly loud and unable to exhibit the faith needed to adhere to any of their own, generally faux-Alpha male, preachings, if there is some profit to be made.

    Next to Bushites, they are the trash a society like ours is doomed to generate, and which the clever among us must find a purpose for.

  7. darrell says

    Calling oneself “libertarian” or espousing any of the beliefs associted with said label is the height of political laziness. It’s “Can’t we all just get along?” meets “If I close my eyes maybe it will go away.” I especially like the “spoiled child” comparison. Every libertarian I’ve ever met is living in their own deluded fantasy world.

  8. Jasen says

    EVE Online is an awesome game, but only if you know lots of other people playing it and join/form a corporation.

    Speaking of games and libertarianism, the recent game Bioshock seems to be at least partially a critique of the idea of a libertarian utopia. You stumble upon an underwater city built by a rich visionary. His philosophy is basically this:

    “I am Andrew Ryan, and I’m here to ask you a question. Is a man not entitled to the sweat of his brow? ‘No!’ says the man in Washington, ‘It belongs to the poor.’ ‘No!’ says the man in the Vatican, ‘It belongs to God.’ ‘No!’ says the man in Moscow, ‘It belongs to everyone.’ I rejected those answers; instead, I chose something different. I chose the impossible. I chose… Rapture, a city where the artist would not fear the censor, where the scientist would not be bound by petty morality, Where the great would not be constrained by the small! And with the sweat of your brow, Rapture can become your city as well. ”

    Of course, by the time you get there the place is falling apart and its crazed, genetically modified inhabitants are killing each other over weapons and raw genetic material. I am not sure whether the fact that guns were being sold in vending machines was a symptom or cause of this degeneration…

    Like many, I sympathize with the amount of social freedom advocated by libertarians but find their economic policies to be ludicrous. Unfettered capitalism just can’t be trusted to produce a society that is livable for most people. Of course complete regulation doesn’t work so well either. The key is finding just the right balance to encourage hard work and entrepreneurship while avoiding exploitation, and that isn’t easy. Unfortunately, many people would rather blindly hold to a simple ideology than deal with a difficult truth.

  9. Heterocronie says

    Darwinfinch,
    The fact that you feel the need to “find a purpose” for another human being nicely illustrates your mentality. Thanks for showing us your true colors.

  10. Azkyroth says

    Aside from their unworkable economic policies (as my father observed at one point, they seem to mostly be people who took Economics 1A and then pronounced themselves experts), I’ve noticed that pretty much all the Libertarians I’ve met have been unclear on this point.

  11. andy says

    I’ve come to really really despise Libertarians.
    It’s almost like they live in some kind of a fantasy
    world where roads, bridges, sewer systems, etc just
    happen- somehow. If they thought about any of that for
    a second then all that self-made-man bootstrapping
    BS they constantly spew wouldn’t make a bit of sense.

    These jokers like to complain about free riders- but they
    are the worst offenders.

    Lots of guns, a weak central government, and the freedom
    to do what you want- Libertarian Heaven, right? There is,
    in fact, just such a place where they can all go. Certainly-
    it’s Iraq I’m talking about.

    Yup, and when they get there, they have their big chance to shoot
    their way to the top- literally.

  12. rrt says

    I assume Freedom Ship was one of the things Bioshock’s creators had in mind with Rapture, though their main target is Rand (“Andrew Ryan?”) Phenomenal game, though I don’t know Rand and/or libertarians well enough to say how effective its criticism was. No doubt others will have strong opinions. They clearly weren’t blaming the genetic maguffin for the fall of Rapture, despite the role it played. And yeah, of course the science was horribly wrong, but they knew that. How else could they mix tweaked steampunk with symbiotic deep-sea slugs and “magical” powers?

  13. says

    My least favorite political/economic group is the Libertarians

    You dislike libertarians more than the religious right? Man, that’s harsh.

    (But I don’t like libertarian economics much either)

  14. uncle frogy says

    libertarianism is what everyman for himself?
    that the government should stay out of our personal lives given some boundaries is OK.
    If there are no taxes and no government then what do we have?
    the dark ages? where the local strong man was the face of order we have done that.
    libertarianism could only develop in a prosperous stable society and only exist as an idea having some influence it could never be the founding principle of anything stable by itself.
    it is blind and ignorant to think that any where in the modern world you “earn you bread” by your self and are not dependent on the rest of society. the wealth depends on a stable market, On what does a stable market depend?

    In the real world who would protect this “magic island” from the rest of the world.

  15. uncle frogy says

    libertarianism is what everyman for himself?
    that the government should stay out of our personal lives given some boundaries is OK.
    If there are no taxes and no government then what do we have?
    the dark ages? where the local strong man was the face of order we have done that.
    libertarianism could only develop in a prosperous stable society and only exist as an idea having some influence it could never be the founding principle of anything stable by itself.
    it is blind and ignorant to think that any where in the modern world you “earn you bread” by your self and are not dependent on the rest of society. the wealth depends on a stable market, On what does a stable market depend?

    In the real world who would protect this “magic island” from the rest of the world.

  16. Shawn S. says

    After getting a B.S. in microbiology I realized that politics was too messy for clear thought. I’ve been on nearly every political side at one time and thought I was right each time and could cherry pick my data with the best of ’em.

    If only there was a way to test political theories more easily… then I might actually pick one. I am fond of the libertarians for their social views, rather than their economic ones. I like the idea of the free market, but I see the abuses of power and know that people are generally pretty nasty when they have material gain to protect. So I’m less inclined to favor Republicans and libertarians on that angle. At the same time I see how fucked up government run institutions are (my mother has had nothing but nightmare scenarios with the VA hospital system). So what’s the solution? Government vouchers for private systems??? I’ve heard that notion supported and attacked.

    Libertarians have a big disadvantage over their Donkey and Elephant counterparts: We don’t actually KNOW if their way of doing things would work or not. We’ve never tried it. PZ will admit that with Dem/Rep it’s a lesser of two evils. No libertarian experiment has been conducted, to my knowledge.

    But to criticize everyone here in their arguments: Where’s the data? It’s all rhetoric right now. Political discussions are nearly worthless. Let’s get back to octopus sex. Less messy, more interesting.

  17. Heterocronie says

    “Yup, and when they get there, they have their big chance to shoot their way to the top- literally.”

    Yes sir, that’s what libertarians are all about – shooting our way to the top.

    Libertarians are almost universally opposed to the initiation of force. Do you people even know what a libertarian is?

  18. Heterocronie says

    “libertarianism could only develop in a prosperous stable society and only exist as an idea having some influence”

    You mean sort of like the Constitution of the United States?
    Yeah those Founding Fathers, what a bunch of clueless, selfish pricks.

  19. Dan says

    Libertarian ideals are merely impossible. What you’re describing, PZ, is corporate greed pretending to be libertarian, which is far worse and actually happens. It’s based upon lobbying for deregulation, tax breaks, and so on … but instead of for everyone, as in the impossible libertarian ideal, it’s only given to the absolute richest people, who then become a hideous outgrowth of government, de facto subsidies since everyone poorer than them is paying the taxes to keep the society they profit off of running.

    It is, in effect, the exact opposite of what libertarianism is “theoretically” about. The fact that the “theoretical” libertarian types have no solutions for this, and often refuse to acknowledge it, is really the most damning part of the impossible idealism.

    Except for those little quirks, and the fact that actual libertarianism would create a power vacuum akin to a sucking chest wound, it remains a pretty neat ideal.

  20. Ian Gould says

    I know some very intelligent and nice people who are libertarians.

    Then too I know some very intelligent and nice people who subscribe to such nonsense as neopaganism and Mormonism.

    On the other hand, I’ve met a disproportionate number of really unpleasant, crass arrogant, rude people online who call themselves libertarians.

    In a way, it’s really a shame there’s virtually no chance of libertarians ever actually succeeding in establishing one of the various hare-brained Utopian schemes – it’d be interested ot see whether the inevitable collapse would be followed by Somali style anarchy; a military dictatorship or a corporate dictatorship run by the bigger businesses.

  21. Heterocronie says

    “as my father observed at one point, they seem to mostly be people who took Economics 1A and then pronounced themselves experts”

    You mean amateurs like Mises, Hayek, and Alan Greenspan? Greenspan is still a libertarian/objectivist at heart, he just understood that the country wasn’t ready for it, and that if he did the regulating himself, then the damage could be minimized. In case you didn’t know, Greenspan was Ayn Rand’s buddy, a fact that he’s still quite proud of.

  22. says

    Ouch. That hurt. Have been an avid reader of this excellent blog (though biology is not exactly my favourite subject). The criticism of libertarian ideology is surprisingly devoid of data and filled with spite. It sounds more like a post prayer rant against the Kaffirs (infidels) than anything else. While I think Ayn Rand is a pretty ordinary storyteller, some of the things she said make a lot of sense. Empowering the smallest minority of all- the individual – is a tremendous idea, especially when propagated at a time of overarching communism, where the individual loses her individuality. While markets are imperfect, they cater to human needs much better than Governments. I can cite the example of my country, India, which spent close to four decades under ‘socialism’. It might sound funny, but we had to wait for up to 8 years to get a ‘land line’ (telephone)from the Government controlled telephone supplier (the phone instrument and the connection both took 8 years). Today, thanks to the entry of private players, it takes much, much less.
    As for libertarianism, it allows the individual to pursue something close to her heart. It allows the individual the incentive to do things. To say that libertarians are selfish and small minded is a lot like saying atheists are, well, selfish and arrogant. Surprising stuff from you, PZ.

  23. darwinfinch says

    Oh, dear! My TRUE COLORS are showing! Red? Back? Tartan? A soft, warm pinkins brown?

    And my new slip as well!

    Heterocronie, whoever you are, I need feel no regret in offending the likes of you. (Somebody drop the 16 Tons on that one!)

    As for people like Nanden, who claim we are painting libertarians with too broad a brush, well, I can only speak from personal experience (perhaps thirty 100% smug, very white, greedy wackos), my interactions with libertarians on the netZ (urgh! I don’t like to even THINK about them!), and the platform of the Libertarian Party, which if implemented would have the nation both bankrupt and in civil war within a decade.

    I repeat: no respect for libertarians, even when their concerns happens to be in phase with my own, without prior demonstrations of sanity.

  24. Loren Petrich says

    These floating-city schemes remind me of George Orwell’s Animal Farm — a would-be utopia that turns out much like the old system that its inhabitants had rebelled against.

  25. Sam says

    Libertarianism is the economic ideology of choice for a particular sub-group of religionists – Flying Spaghetti Monster’s Witnesses who believe that eventually the FSM will return and institute a libertarian government, which will lead to Beer Volcanoes and Stripper Factories here on this very Earth, with none of that tedious shit like hospitals and roads.

  26. Julius says

    Nandan: Your idealism is very sweet, but in a truly libertarian society – i.e. pretty much no state intervention in anything – saying that “it allows the individual to pursue something close to her heart” is a bit optimistic, don’t you think? It allows the individual to pursue this *if she’s already rich enough*. If you put all your savings/resources into some personal project (business idea) and it fails – well, too bad. Good luck eating now, without money, a job, or the qualifications to get a job quickly. Or how about healthcare? Fairly simple argument – do you think it’s fair for the poorer part of the population to die of severe but curable cancer because they can’t afford the treatment?

    Or, to phrase it positively: I would argue that a functioning welfare state, including free healthcare for all and some sort of benefits that allow you to live in dignity, are an *absolute* necessity to allow true individual freedom – the freedom to pursue things dear to your heart, without fear of starving if it goes wrong. Not to mention a working police force/law enforcement/justice system…

    I think that’s related corporate element of libertarianism that PZ criticizes, as well: in a completely libertarian/anarchic system, corporations (i.e. ultimately, groups of people that gang up to pool their resources) will have unlimited freedom and hence power. But for individual freedom, it seems obvious to me that you need a welfare state and strong regulation of corporate activity.

  27. says

    Meh. There’s libertarians and there’s libertarians. (NB: I am not one.)

    I’ve met the braying, deluded Ayn-Randian rabid nutjobs, and I’ve met quiet, thoughtful, tempered-with-hefty-doses-of-realism children-of-the-Enlightenment libertarians, opposed to excesses of bad government and bad markets equally. My experience of the second group is admittedly small, but I’d hate to tar them all with the same brush. I have noticed that the second group tend to be substantially older and appear to be better educated than the first.

    Of course, the groups Miéville refers to seem to be firmly in the first group, and I have no problem with a bit of schadenfreude directed their way.

  28. Jen says

    Thank you, efrique, for making the distinction between two types of libertarians. Most who identify with libertarian values understand the need for some government regulation in order to keep freedoms intact. Maybe they’re just the quieter, more sensible ones, so they don’t get considered.

  29. says

    Julius: Nobody has called me an idealist before, so thanks for that :). Let me clarify: I am not saying that we have anarchy: we are not ready (enlightened enough?) for it. We need the State and no realistic/practical person would say that we do not need Government. A minarchist position is closer to what I think will help society (Democratic society). I am in favour of a limited government that looks after basic things: protection of civil liberties and rights (including property rights), looking after defence and enforcement of contracts.
    “If you put all your savings/resources into some personal project (business idea) and it fails – well, too bad”
    Well, the underlying assumption is that one is smart enough to understand the risks of putting all savings into a personal project. It assumes an individual has the sense to take rational and mature decisions. And even if we assume that somebody messes up big-time, given human nature and labour demand and supply, the person would, in a ‘libertarian economy’ have an opportunity to work and rebuild her life once again.

    To answer the other question: Yes, many poor people die due to cancer. I have seen enough state run hospitals in India and have heard enough about the controversy in US regarding treatment to US soldiers (please correct me here in case i have still missed anything) to know that State run Hospitals are not exactly paragons of efficiency. However, if there are correct incentives (provided by the state) and if philanthropy is properly channelized, it should not be an issue.(there are hospitals in rural India that have worked well using a mixture of philanthropy, free markets and technological/process innovation..e.g. Aravind Eye Hospital) Generally, private enterprise is more efficient and perhaps, therefore, more caring, than a State run enterprise, is my observation.
    PZ is probably talking about tooth and claw capitalism, which is abhorrent- as abhorrent as violent communism. Is it a coincidence that countries that have freer markets/open economies have generally not gone to war with each other? (the Golden Arches Theory/Dell Theory of conflict Prevention?)Transpose this to individuals, and we have a workable model of peace and prosperity. We would be too interdependent to fight.

  30. tacitus says

    Shawn: Libertarians have a big disadvantage over their Donkey and Elephant counterparts: We don’t actually KNOW if their way of doing things would work or not. We’ve never tried it. PZ will admit that with Dem/Rep it’s a lesser of two evils. No libertarian experiment has been conducted, to my knowledge.

    We already know what happens when governments emasculate their own agencies, like the EPA and FDA, charged with protecting people from the excesses of industrial greed. Just look at the last few years of Republican one-party rule. The environment is ravaged, food and toys are poisoned, home owners are bankrupted, and shareholders swindled. People died.

    All that with just a relaxation of government oversight. Now imagine what happens if someone like Ron Paul abolishes these agencies altogether. I can, but I can’t for the life of me understand why libertarians never seem to. I’ve yet to find anyone who yearns for the return to the days of the robber barons.

  31. Fernando Magyar says

    “It might sound funny, but we had to wait for up to 8 years to get a ‘land line’ (telephone)from the Government controlled telephone supplier (the phone instrument and the connection both took 8 years).” I had the same experience in Brazil, however the availability of ubiquitous cell phone technology made Government control of dispensing telephone lines pretty much moot.

  32. Gordon S says

    The people saying that a “true Libertarianism” experiment has never been tried sure are short on their history.

    Milton Friedman can pretty safely be called a Libertarian. He wanted the state to have no role in anything except controlling the federal reserve bank and matters of war.

    You can see the effect of these crackpot economic theories on the people of Chile, Bolivia, Argentina, and Brazil, among others. These ‘reforms’ did nothing more than make people poor, homeless, and dead. Most of these countries got their ‘reforms’ purely on the economic side, and in most cases under the thumb of brutal military junta’s, but this was something Friedman and his ilk were entirely comfortable with.

  33. says

    Randan, Fernando..
    Re Telephone lines …
    You are not talking about private versus public, just about monopolies. Now just imagine the monopolies are completely unaccountable (i.e. no politician could do a Ralph Nader on them) (bingo Robber Barron coming up). The market has its uses (for people with money) but it is not by itself a panacea. You a good functioning and well designed Democracy as well. Pretending that government is the problem and the whole problem (and in its essence – regardless of how the government is constituted) is the Libertarian conceit. In other words, I like what Libertarians say they want to acchieve (HEY FREEDOM, MAN) but I think they are disastrously mistaken in how they want to go about it. (Mostly because they get distracted by believing their own ideology.) Small incremental steps in a Libertarian direction are good, introducing the whole of their program, probably a disaster. I think Russia under Yeltzin is a good approximation for what a Libertarian state would look like in practice.

  34. MH says

    Just because public healthcare has failed to work in some countries, it doesn’t mean that it fails to work in all countries. It all depends on how it’s funded and managed, and there are plenty of examples of good public healthcare around the world.

    Libertarianism is not something that would work in any country, though.

  35. says

    And as for VA Hospitals see:

    http://www.washingtonmonthly.com/features/2005/0501.longman.html

    Public institutions can be well run or badly run as private ones. Most private enterprise supporters will agree to that – but just point out that the (COMPETITIVE)market tends to gives immediate feedback to badly run private ones. I don’t disagree, but of course a well functioning democracy should also give feedback to badly run public ones.

    Most objective reports about problems for veterans of Iraq have to do with deliberate underresourcing (which would be problem whether it was private or public). Medicine is a problem in every country, simply because it contains within it a moral element that negates the normal moral assumptions underlying the market (that people are making free choices based on a rational and informed evaluation of optional alternatives).

  36. bernarda says

    WWLD? (what would libertarians do?) In this case about the California fires. Take San Diego for example.

    “At the same time, he said it was disheartening to know that four years after some of the costliest fires in state history tore through the area, little had been done to better the odds of fighting fires there.

    Bowman had told San Diego city officials it would cost at least $100 million to add needed new stations and equipment and $40 million a year more to increase staff. That investment, he said, is what it would take to bring San Diego into compliance with national standards. Those guidelines call for a city of San Diego’s size to have at least 22 more stations than the current 46, and 1,300 firefighters, up from the 980 now on staff.

    But his appeal had no effect. Four months after the Cedar fire, a ballot proposal to boost hotel-motel taxes to pay for better fire protection failed to win voter approval. The City Council, mindful of the anti-tax mood of residents, has opted not to try again.

    San Diego was recently denied full accreditation by the Commission on Fire Accreditation International, now called the Center for Public Safety Excellence, because many of its stations fail to meet the five-minute standard for arriving at major fires or calls for paramedic service.

    “This whole county is fire protection poor,” Bowman said, noting that the city has added only one fire station in the four years since more than 5,000 homes and businesses were destroyed in the Cedar fire. And that temporary station near Qualcomm Stadium is in an area where at least two permanent stations have been recommended by fire officials for the last 20 years.”

    http://www.latimes.com/news/local/la-me-prepare23oct23,0,6144290.story?page=2&coll=la-home-center

    Maybe just let it burn and then get compensation from their private insurance company? Maybe, just maybe, a little prevention and preparation is better than a whole lot of rebuilding.

  37. Gordon S says

    Nandan: You’re blathering on about state-run hospitals being inefficient and uncaring (and then citing examples from India and Bush-era America, rather than France, Canada, or Britain) is completely ridiculous. Rather than attack, however, the mere issue of private vs public health care, an issue that has been so completely covered and so obliterating to the argument for private hospitals, I will rather take on the big one: that private business is efficient, in anything, at all.

    It isn’t.

    The libertarian economic argument relies entirely on the premise that private business is efficient, and that competition magically lowers cost and increases quality of any service or product, or at least provides a reasonable cross-section of quality/price choices.

    It seems to me, looking at real world examples of this, that there is absolutely no factual basis for this. Let me provide a few examples, and I’d like to see your responses.

    1) The OECD ranks countries health care systems based on a number of metrics. The United States currently publicly outspends all but three other rich, Western nations on health care, per capita. Then, there is the private expenditures that, of course, dwarf every other country by an enormous margin. And, all the other countried use this money to insure all citizens, whereas the US provides no health care for more than 40 million of it’s citizens. So, it is safe to say that the US hugely outspends all other countries on health care, to cover less people. What is gained out of it? You should, obviously, have a hugely better health care system, right? Wrong. You have a health care system that is worse than even Canada, which has the worst of the public systems, in every single health metric the OECD measures except for, surprise surprise, elective surgery wait times.

    So my question is: If private business is more effective, why has it failed America so spectacularly?

    2) I live in BC, Canada. In BC, we have a publically owned corporation, ICBC, which offers car insurance, among other things. It has a monopoly. Many other provinces, such as Ontario and New Brunswick, have purely private systems, where different companies compete, freely. According to libertarians, the provinces with private companies that compete openly and freely, should offer cheaper services than a system which is run by a state-owned monopoly, which would, of course, be inefficient and uncaring, to use your own words. We find the opposite. The provinces with public systems, or even mixed public/private systems, have consistently and significantly lower rates for auto insurance.

    My question to you is: Why is this so? Why has the private system failed to lower costs?

    That’s all I really want to ask.

    My answer to both those questions is straightforward. Libertarians believe that the free market lowers costs by competing for customers, and that customers will move to the company which offers some balance between being cheap and being reliable. This is wrong. In reality, the competition between free market forces is not to attract customers by being the cheapest or best, but by charging as much as possible while still retaining clientele. This works especially well for essential services such as banking, health care, and insurance.

  38. says

    Uh…for the record…my name is Nandan. Nanden and Randan, though interesting, are not my names or variations thereof.

    @ Fernando: Exactly. The mobile revolution in India happened because Government got the hell out of the way.

    @ Reason:
    ” Now just imagine the monopolies are completely unaccountable”
    and many systems of Governments tend to become that. That is where the concern arises from. Western democracies have been successful, partly because the number of times the citizen has to interact with the Government is low and easy to seek redress in case of grievance. Also, it is pretty easy to set up a private enterprise. In other democracies, things are different. Libertarianism, as I understand, cannot function without democracy. It is a necessary condition. As for small incremental steps towards libertarianism, agree with that PoV. You cannot bring about large scale changes to a large system in one go…that is revolution, and not in a good sense most of the times.
    Here in India, some of us keep saying that we are held back by the ‘system’ and at least for India, most people believe that small incremental steps towards libertarianism would help us more than anything else.

  39. Torbjörn Larsson, OM says

    While we wait for Cal to descend on the (un)suspecting thread, I can offer my own analysis, because there is a lot about this post and the article that immediately jumps out to me.

    Much as I think areas of society can be outright condemned, religion being a prime example, I do think such a judgment should be based in factual claims. I don’t see much of that when it comes to politics in general or libertarianism here. It seems as in the post being kneejerk reactions, often based in earlier conflicts.

    And what is the article based in? It describes an utopian (and thus naive) project that involves tax invasion and a model of a ship based society in all probability ruled by international laws of the sea. Then it loosely ties the ever popular tax evasion phenomena, supported and realized by other political movements, onto a movement that has never been at power AFAIU.

    It also skips over laws at sea as rule by captain. I’m not familiar with if there are such laws and what they encompass. But I can’t believe it is a lawless sector.

    And the article is abridged reprint of a chapter of a book criticizing neo-liberalism. (Evil Paradises: Dreamworlds of Neoliberalism.) Isn’t there a whole lot of conflation going on here?

    Further expressions such as “institutionalized selfishness, petty small-mindedness, and bourgeois values” are moral values based on a different view. But how does the politic works for real, if it works at all? Hopefully someone will tell us. Right, Cal? :-P

  40. Torbjörn Larsson, OM says

    While we wait for Cal to descend on the (un)suspecting thread, I can offer my own analysis, because there is a lot about this post and the article that immediately jumps out to me.

    Much as I think areas of society can be outright condemned, religion being a prime example, I do think such a judgment should be based in factual claims. I don’t see much of that when it comes to politics in general or libertarianism here. It seems as in the post being kneejerk reactions, often based in earlier conflicts.

    And what is the article based in? It describes an utopian (and thus naive) project that involves tax invasion and a model of a ship based society in all probability ruled by international laws of the sea. Then it loosely ties the ever popular tax evasion phenomena, supported and realized by other political movements, onto a movement that has never been at power AFAIU.

    It also skips over laws at sea as rule by captain. I’m not familiar with if there are such laws and what they encompass. But I can’t believe it is a lawless sector.

    And the article is abridged reprint of a chapter of a book criticizing neo-liberalism. (Evil Paradises: Dreamworlds of Neoliberalism.) Isn’t there a whole lot of conflation going on here?

    Further expressions such as “institutionalized selfishness, petty small-mindedness, and bourgeois values” are moral values based on a different view. But how does the politic works for real, if it works at all? Hopefully someone will tell us. Right, Cal? :-P

  41. truth machine says

    ..and yet libertarians are your least favorite group. I guess that means that you don’t have much confidence in your ability to convince people through words rather than at the point of a gun.

    Do you see any guns here?

    I’ve never met an intellectually honest libertarian.

  42. truth machine says

    At the same time I see how fucked up government run institutions are (my mother has had nothing but nightmare scenarios with the VA hospital system)

    Usually fucked up by people who don’t care about those institutions. It isn’t necessary for these institutions to be fucked up. This is the fundamental stupidity of libertarianism — they blather about problems with government programs, but they have no principled theory of why government programs must be bad. The fact is that there are many government programs that are excellent (often stuff we take for granted, like police, firefighters, roads, tree trimmers, water treatment, and on and on) that libertarians won’t talk about, and lots and lots of private “programs” like health insurance that are just horrid. Libertarianism is juvenile and can’t survive intellectually honest scrutiny.

  43. truth machine says

    Libertarians have a big disadvantage over their Donkey and Elephant counterparts: We don’t actually KNOW if their way of doing things would work or not. We’ve never tried it.

    Um, did you forget to read article? And we tried it before we invented culture and society.

  44. truth machine says

    Libertarians are almost universally opposed to the initiation of force.

    Whether true or not, libertarians turn a blind eye to coercion.

  45. Alverant says

    My brother, David, is a libertarian and I find his blog http://lawlegislationandlunacy.blogspot.com/ to be filled with garbage centered around the idea “anything Government does is Bad and anything Private Enterprise does is Good”. He’s also graduate student in economics and hasn’t spent much time in the real world. As much as I’ve seen libertarianism is a nice-sounding theory that degrades into abuses of power when it comes in contact with reality.

    PS He doesn’t get much traffic on his site so everyone please go there and comment on his blogs. At the least, they can be worth a laugh.

  46. truth machine says

    I’ve met the braying, deluded Ayn-Randian rabid nutjobs, and I’ve met quiet, thoughtful, tempered-with-hefty-doses-of-realism children-of-the-Enlightenment libertarians, opposed to excesses of bad government and bad markets equally.

    Eh? How would or could these libertarians control excesses of bad markets? Market interference isn’t allowed.

  47. truth machine says

    Most who identify with libertarian values understand the need for some government regulation in order to keep freedoms intact.

    Then they are confused about what libertarianism is.

  48. truth machine says

    Milton Friedman can pretty safely be called a Libertarian. He wanted the state to have no role in anything except controlling the federal reserve bank and matters of war.

    You can see the effect of these crackpot economic theories on the people of Chile, Bolivia, Argentina, and Brazil, among others.

    Indeed, and those who claim that the political philosophy is independent of the crimes are ignorant, lying, or in denial — read Naomi Klein’s “The Shock Doctrine” which documents the truth about it.

  49. Torbjörn Larsson, OM says

    Nandan:

    Here in India, some of us keep saying that we are held back by the ‘system’

    I believe I just realized that there could be a problem in India, but I haven’t had time to check it out. Yesterday I had the choice of watching a television documentary on market protections or Miller’s Crossing. The movie classic won out, but I glimpsed a segment comparing an India car manufacturer with a Japanese.

    For 50 years the India car kept to the same model and yearly output, while we all know what happened with the Japanese cars. It was blamed on market protections. (Well, considering the documentary focus, duh!) I would certainly want to know more about India’s specific situation, not least because so many individuals are affected.

    When you added the combination of democracy and free market, I can tentatively agree with you. I believe this combination of politics has raised living standards the most, including among the ~ 20 % or so that free markets leave in the lower or no income segment. (But I can never remember where I heard that – another documentary I believe. So its hearsay.)

    On the other hand, it doesn’t seem to be strictly necessary for a reasonable economy to work. According to Gapminder the earlier bimodal distribution of national economies are coalescing into a unimodal one. Also, IIRC Rosling in that TED speech notes that nations that pushed social medicine first and market economies later will still converge on the main trend.

    On a more petty level I wish the web would have a larger flat cost. That could reduce the amount of spam considerably. :-P

  50. Torbjörn Larsson, OM says

    Nandan:

    Here in India, some of us keep saying that we are held back by the ‘system’

    I believe I just realized that there could be a problem in India, but I haven’t had time to check it out. Yesterday I had the choice of watching a television documentary on market protections or Miller’s Crossing. The movie classic won out, but I glimpsed a segment comparing an India car manufacturer with a Japanese.

    For 50 years the India car kept to the same model and yearly output, while we all know what happened with the Japanese cars. It was blamed on market protections. (Well, considering the documentary focus, duh!) I would certainly want to know more about India’s specific situation, not least because so many individuals are affected.

    When you added the combination of democracy and free market, I can tentatively agree with you. I believe this combination of politics has raised living standards the most, including among the ~ 20 % or so that free markets leave in the lower or no income segment. (But I can never remember where I heard that – another documentary I believe. So its hearsay.)

    On the other hand, it doesn’t seem to be strictly necessary for a reasonable economy to work. According to Gapminder the earlier bimodal distribution of national economies are coalescing into a unimodal one. Also, IIRC Rosling in that TED speech notes that nations that pushed social medicine first and market economies later will still converge on the main trend.

    On a more petty level I wish the web would have a larger flat cost. That could reduce the amount of spam considerably. :-P

  51. atlas1882 says

    I find PZ’s vehement opposition to libertarianism hypocritical. On the one hand, he goes to great lengths to discredit those who profess an unjustified faith in the supernatural. At the same time he apparently holds the view that the government is a benign and enlightened actor whose interventions usually achieve the goal at which they aim. However, I find little evidence to support this belief, and abundant evidence to contradict it. Is this not also an instance of unjustified faith?

  52. Tulse says

    Interesting discussions here, but of topic: has anyone read the books of China Miéville? They are really good ;-)!

    I will second that enthusiastically. They are strange, weird, thoughtful, dark, and, relevant to this thread, very interested in politics (especially Iron Council). His work is like nothing else that I’ve read — I highly recommend him, and cannont say enough about Perdido Street Station.

  53. Zarquon says

    People interested in libertarianism should remember the rule TANSTAAFM

    (there ain’t no such thing as a free market)

  54. Torbjörn Larsson, OM says

    “its hearsay” – it’s hearsay.

    “the main trend” of health and capita income.

    Btw, IIRC it has with the recent unimodal economical distribution now become a fairly linear relationship with some oddities. I have a vague memory that US is as most always the bad kid in the class.

  55. Torbjörn Larsson, OM says

    “its hearsay” – it’s hearsay.

    “the main trend” of health and capita income.

    Btw, IIRC it has with the recent unimodal economical distribution now become a fairly linear relationship with some oddities. I have a vague memory that US is as most always the bad kid in the class.

  56. says

    atlas1882

    At the same time he apparently holds the view that the government is a benign and enlightened actor whose interventions usually achieve the goal at which they aim.

    No he doesn’t. (George Bush is in charge) He thinks it can be.

    However, I find little evidence to support this belief, and abundant evidence to contradict it. Is this not also an instance of unjustified faith?

    Really? Read a bit of history. How you vote DOES make a difference.

    But talking about unjustified faith – what about your faith in the unregulated market.

  57. Torbjörn Larsson, OM says

    People interested in libertarianism should remember the rule TANSTAAFM

    I think you may be conflating interest with positive interest. Personally, most of my interest comes from people reacting so strongly to it. It probably has cultural context, since I’m not sure I’ve ever met a libertarian here (Sweden).

    OTOH we are free to explore a lot of political (and religious) views early on, so for example anarchists of different groupings you do meet. The article the post links to places anarchism under libertarianism, another conflation I’m not sure is valid as there are collectivist anarchists as well.

    Anyway, anarchist politics can be pretty offensive as well. And when I think about it it seems to me that people seem to react as strongly here. But some anarchists have done a lot of bad things for real, from French history over Soviet history to WWI instigation to outright terrorism, which invalidates the idea, at least as far as the collective versions go.

    I’m not sure that applies to libertarians. These circumstances evokes my interest.

    Another question you raise to is what characterizes a “free market”? As happens with populations in evolution, markets crash or get stuck in a bad situation. If regulations or active measures are constituted in such cases, is that still not a free market in economical terms?

    And finally, I thought most economical libertarianism was focusing on minimizing such measures, not removing them. As it seems they love markets. :-P

  58. Torbjörn Larsson, OM says

    People interested in libertarianism should remember the rule TANSTAAFM

    I think you may be conflating interest with positive interest. Personally, most of my interest comes from people reacting so strongly to it. It probably has cultural context, since I’m not sure I’ve ever met a libertarian here (Sweden).

    OTOH we are free to explore a lot of political (and religious) views early on, so for example anarchists of different groupings you do meet. The article the post links to places anarchism under libertarianism, another conflation I’m not sure is valid as there are collectivist anarchists as well.

    Anyway, anarchist politics can be pretty offensive as well. And when I think about it it seems to me that people seem to react as strongly here. But some anarchists have done a lot of bad things for real, from French history over Soviet history to WWI instigation to outright terrorism, which invalidates the idea, at least as far as the collective versions go.

    I’m not sure that applies to libertarians. These circumstances evokes my interest.

    Another question you raise to is what characterizes a “free market”? As happens with populations in evolution, markets crash or get stuck in a bad situation. If regulations or active measures are constituted in such cases, is that still not a free market in economical terms?

    And finally, I thought most economical libertarianism was focusing on minimizing such measures, not removing them. As it seems they love markets. :-P

  59. Bee says

    Every self identified Libertarian I’ve encountered on the internet (I have never met an actual real live one) has been blithely dismissive of any call to aid the people who for whatever reason are unable to help themselves. Every man for himself, in my estimation, means every child for himself as well, and if your parents are disfunctional or dead, well, that’s just too bad – starve in the gutter, kid.

    When this subject is brought up, (and my categorey includes the disabled, the addled senior, the mentally ill, etc.), the Libertarian tosses off a line about how ‘charities’ (usually he means ‘churches’) will take care of such human problems. At this point it is obvious the Libertarian is either a religious nut or is living in a total dreamworld.

  60. brent says

    At the same time he apparently holds the view that the government is a benign and enlightened actor whose interventions usually achieve the goal at which they aim.

    This is a completely unsupported assertion that gets right to the heart of libertarian illogic. Most rational people understand that government in the abstract is neither benign, nor malignant. Most people understand this because they have had plenty of experience with government being both and because they are able to think through the simple implications of fair government with regard to the project of both social cohesiveness and individual freedom. For some reason, libertarians have some trouble understanding these simple concepts. Its quite bizarre and it is precisely why libertarianism cannot be taken seriously.

  61. David Marjanović, OM says

    Unfettered capitalism just can’t be trusted to produce a society that is livable for most people.

    Unfettered capitalism is not even stable. Capitalism has to be protected from itself all the time. Look the other way for a few years, and corporations form cartels with monopolies.

    Like in biology, where competition is selected against, too, because it’s a waste of energy.

    I’ve come to really really despise Libertarians. It’s almost like they live in some kind of a fantasy world where roads, bridges, sewer systems, etc just happen- somehow.

    Oh, if someone gets the idea and finds a way to make money with it, they will happen.

    If not, they won’t.

    Case in point: the US health insurance system.

    Greenspan is still a libertarian/objectivist at heart, he just understood that the country wasn’t ready for it, and that if he did the regulating himself, then the damage could be minimized.

    And Lenin and Stalin truly believed that the state would “die off” over time, they just understood that it was necessary to have “socialism” before “communism”, and if they themselves led the “dictature of the proletariate”, the damage could be minimized”…

    I’m well aware that this is a comparison across plenty of orders of magnitude. But the principle sounds similar. Doesn’t it?

    Or, to phrase it positively: I would argue that a functioning welfare state, including free healthcare for all and some sort of benefits that allow you to live in dignity, are an *absolute* necessity to allow true individual freedom – the freedom to pursue things dear to your heart, without fear of starving if it goes wrong. Not to mention a working police force/law enforcement/justice system…

    Bingo.

  62. David Marjanović, OM says

    Unfettered capitalism just can’t be trusted to produce a society that is livable for most people.

    Unfettered capitalism is not even stable. Capitalism has to be protected from itself all the time. Look the other way for a few years, and corporations form cartels with monopolies.

    Like in biology, where competition is selected against, too, because it’s a waste of energy.

    I’ve come to really really despise Libertarians. It’s almost like they live in some kind of a fantasy world where roads, bridges, sewer systems, etc just happen- somehow.

    Oh, if someone gets the idea and finds a way to make money with it, they will happen.

    If not, they won’t.

    Case in point: the US health insurance system.

    Greenspan is still a libertarian/objectivist at heart, he just understood that the country wasn’t ready for it, and that if he did the regulating himself, then the damage could be minimized.

    And Lenin and Stalin truly believed that the state would “die off” over time, they just understood that it was necessary to have “socialism” before “communism”, and if they themselves led the “dictature of the proletariate”, the damage could be minimized”…

    I’m well aware that this is a comparison across plenty of orders of magnitude. But the principle sounds similar. Doesn’t it?

    Or, to phrase it positively: I would argue that a functioning welfare state, including free healthcare for all and some sort of benefits that allow you to live in dignity, are an *absolute* necessity to allow true individual freedom – the freedom to pursue things dear to your heart, without fear of starving if it goes wrong. Not to mention a working police force/law enforcement/justice system…

    Bingo.

  63. Jack says

    Or, to phrase it positively: I would argue that a functioning welfare state, including free healthcare for all and some sort of benefits that allow you to live in dignity, are an *absolute* necessity to allow true individual freedom – the freedom to pursue things dear to your heart, without fear of starving if it goes wrong.

    And libertarians are “utopian”?

  64. yoshi says

    A science professor that works in the public university against libertarianism. Wow – that’s original.

    Sorry PZ – unlike you most of us have to operate in the real world.

  65. Brian Macker says

    Wow, PZ apparently hates libertarians worse than Nazis and Communists. Is this because a small fraction hate their taxes supporting things like war so much they are willing to forgo certain advantages to live on a boat (or so they think)? Don’t be so sure you know motivation PZ till you’ve actually talked to one of the boaters.

    This is the same exact problem I saw with another post of PZs in which he overgeneralized to all “religions”. Libertarianism is very broad. There are even socialists who call themselves libertarians.

    Sloppy.

  66. Thadd says

    Not all libertarians are 100% free market Ayn Rand nut jobs, some have the sense to realize that altruism is an evolutionary illusion of a largely social species, and that Ayn Rand’s philosophies and the free market both entail trespasses on the freedom of individuals and that they subsequently do need some control.
    I find the fact that some members of the skeptic/atheist/pro-science movements are so oppose to all libertarians on principle to be relatively distasteful, and hypachritical (as someone pointed out before) and more likely based on objects to the wacko libertarians than all libertarians.
    Many libertarians believe that government is necessary and that it can do good. Personally, I believe the most important aspects of the government are to serve people, ie put out the California fires or provide affordable (read free) education, and protect the freedom of the individual, which I believe means that the government does have a duty that runs contrary to having a free market.
    I also certainly have no problem paying taxes, as I am getting something in return, and see this as comparable to the idea that many libertarians have of paying charities or businesses for the same services.
    I guess for me it is an issue of ideals vs. reality. I have no illusion of altruism, and so see that a free market etc cannot work without ruining people’s lives and subsequently see the necessity for government, yet I self identify as a libertarian because I believe in the ideal of a government that allows as much freedom as possible to the people who live under it. It seems that most of those who vehemently hate libertarians do so because of vocal minority of loons, not because of the larger more moderate group of people that have similer ideas.

  67. Thadd says

    “Is this because a small fraction hate their taxes supporting things like war so much they are willing to forgo certain advantages to live on a boat (or so they think)? Don’t be so sure you know motivation PZ till you’ve actually talked to one of the boaters.”
    I find it strange that someone could hate someone who does not pay taxes in protest of something like this, growing up, I always saw Thoreau as a hero of peaceful protest. I am all for paying taxes, but I certainly understand using it as a form of free speech, which is what this is.

  68. CalGeorge says

    Libertarians have a few simplistic, reductionist ideas, which they have lathered up with lots of enthusiastic, patriotic lingo.

    They do nothing but spread stupidity.

    It’s the American way.

    They should stop bothering the rest of us, go find an island somewhere, and start up Libertopia.

    Everyone would be able to haul around a gun, which they will use to patrol their sacrosanct little properties as they spend their days finding ever new ways of being selfish and greedy.

  69. windy says

    Like in biology, where competition is selected against, too, because it’s a waste of energy.

    Say what?

  70. Caledonian says

    I repeat: no respect for libertarians, even when their concerns happens to be in phase with my own, without prior demonstrations of sanity.

    And by ‘sanity’, you mean “agreement with my own prejudices”.

    What’s remarkable is that so many people claim to reject the philosophy, yet utilize it so frequently – like the teaching professor of science.

    Shall we take a look at how the professor’s classes are graded? Or how the scientific community deals with research and ideas? Sink or swim. Publish or perish. You get what you earn, and no more than what you earn. Do the work or fail. It’s been said that liberals want to minimize the number of people who fail, and conservatives want to maximize the number of people who succeed. Somehow I don’t think PZ lowers the standards in his classes to make it easier for people not to fail.

  71. David Marjanović, OM says

    And libertarians are “utopian”?

    Excuse me? I live in a functioning welfare state with free healthcare for all EU citizens.

    Personally, I believe the most important aspects of the government are to serve people, ie put out the California fires or provide affordable (read free) education, and protect the freedom of the individual, which I believe means that the government does have a duty that runs contrary to having a free market.

    I also certainly have no problem paying taxes, as I am getting something in return, and see this as comparable to the idea that many libertarians have of paying charities or businesses for the same services.

    Then why do you call yourself a libertarian?

    Ah, there you say it:

    yet I self identify as a libertarian because I believe in the ideal of a government that allows as much freedom as possible to the people who live under it.

    Then I “fear” everyone is a libertarian — they “just” disagree on how much is “possible”.

  72. David Marjanović, OM says

    And libertarians are “utopian”?

    Excuse me? I live in a functioning welfare state with free healthcare for all EU citizens.

    Personally, I believe the most important aspects of the government are to serve people, ie put out the California fires or provide affordable (read free) education, and protect the freedom of the individual, which I believe means that the government does have a duty that runs contrary to having a free market.

    I also certainly have no problem paying taxes, as I am getting something in return, and see this as comparable to the idea that many libertarians have of paying charities or businesses for the same services.

    Then why do you call yourself a libertarian?

    Ah, there you say it:

    yet I self identify as a libertarian because I believe in the ideal of a government that allows as much freedom as possible to the people who live under it.

    Then I “fear” everyone is a libertarian — they “just” disagree on how much is “possible”.

  73. Tulse says

    Thadd:

    Many libertarians believe that government is necessary and that it can do good. Personally, I believe the most important aspects of the government are to serve people, ie put out the California fires or provide affordable (read free) education, and protect the freedom of the individual

    But the principle of “to serve people” can also be extended to universal health care, and pollution regulations, and professional licensing requirements, and product safety laws, etc. etc. etc. I for one don’t see why it is acceptably libertarian to have the State protect you from fire and violence, but not protect you from illness.

    And that is one of my problems with libertarianism — it claims to adhere to rock-solid, uncompromising principles, but when you get down to it, those principles largely seem to be “the government should protect me from the stuff that threatens me, like people stealing my property, but should stay out of my life for the stuff I’m not worried about (since I can afford health insurance).” It is vastly short-sighted, vastly impractical, and vastly lacking in compassion.

  74. Tulse says

    Shall we take a look at how the professor’s classes are graded? Or how the scientific community deals with research and ideas? Sink or swim. Publish or perish.

    Cal, you do understand that in that phrase “perish” is metaphorical? Unlike, say, those who lack food or shelter or adequate medical care? And that what works in one domain may not work in another?

    That’s the best our local libertarian curmudgeon can come up with? Man….

  75. says

    Libertarianism as a social philosophy – as the idea that we should be completely free to do whatever we like as long as we don’t infringe on the rights of others – is a far, far better thing than the current knee-jerk system of banning whatever the hell society feels is the current evil pariah.

    Financially, in some cases the market is a good tool to get things done without intervention; the areas where some small amount of government control is required, in my opinion, are essential services with little or no competition – where the consumer has little or no choice but to paid the gougy prices.

  76. David Marjanović, OM says

    Say what?

    Ever seen something evolve into an occupied niche?

    Often we see “the ghost of competition past”: niche partitioning — species having become very specialized and thus avoiding competition. We can even see it within species, where e. g. male and female birds of prey have different ecological niches, or most frogs and insects where larvae and adults have different ecological niches. If you can avoid it, you have nothing to gain from keeping competing, and something to lose. And that’s the same in economy: let them, and corporations make megamergers or MS Windows or whatever it takes to get a (complete or near-complete) monopoly.

    You get what you earn, and no more than what you earn.

    I simply think there are some things you deserve simply by virtue of being human.

  77. David Marjanović, OM says

    Say what?

    Ever seen something evolve into an occupied niche?

    Often we see “the ghost of competition past”: niche partitioning — species having become very specialized and thus avoiding competition. We can even see it within species, where e. g. male and female birds of prey have different ecological niches, or most frogs and insects where larvae and adults have different ecological niches. If you can avoid it, you have nothing to gain from keeping competing, and something to lose. And that’s the same in economy: let them, and corporations make megamergers or MS Windows or whatever it takes to get a (complete or near-complete) monopoly.

    You get what you earn, and no more than what you earn.

    I simply think there are some things you deserve simply by virtue of being human.

  78. Moses says

    Posted by: Robert | October 26, 2007 1:17 AM

    I like the fact that they pretty much think that you should be free to do what you want as long as it doesn’t infringe on the rights of others ideal. I realize that many people profess such an ideal, but few really seem to mean it like they do.

    First, they don’t mean it without the caveat that “your rights are what I say they are.” Thus living in a self-defined situation where they are free to violate the rights of others, only rationalize their putrid behavior away.

    Second, the minute someone applies that principle to them, they whine.

    Third, the second they need help from government, they abandon these principles faster than I’d drop a bad cheese.

    Fourth, it’s just an excuse for selfishness and self-centeredness. They talk the talk, but they don’t walk the walk.

  79. Caledonian says

    Often we see “the ghost of competition past”: niche partitioning — species having become very specialized and thus avoiding competition.

    1) Specialization is often very costly in the long-run, when the niche shifts beyond the capacity of the organism to adapt.

    2) Strategies to avoid competition are generated when the cost of competition becomes greater than the costs of avoidance and/or cooperation.

    3) There’s still competition.

  80. windy says

    Often we see “the ghost of competition past”: niche partitioning — species having become very specialized and thus avoiding competition.

    I wouldn’t say that’s avoiding competition, since the species can only get that way and stay that way by out-competing their less fortunate conspecifics.

  81. David Marjanović, OM says

    (Of course, I don’t mean “seen” in the literal cre_ti_nist sense. I’d accept good indirect evidence.)

  82. David Marjanović, OM says

    (Of course, I don’t mean “seen” in the literal cre_ti_nist sense. I’d accept good indirect evidence.)

  83. says

    You know you might temper your criticism of libertarians if you realized the fact that a large percentage of them are fellow unbelievers, PZ. You really should stick to science and godlessness because you are insufferable when it comes to politics.

  84. David Marjanović, OM says

    1) Specialization is often very costly in the long-run, when the niche shifts beyond the capacity of the organism to adapt.

    Too bad. Evolution lacks any trace of foresight.

    (Corporations don’t, which is why there are few hyperspecialized corporations.)

    2) Strategies to avoid competition are generated when the cost of competition becomes greater than the costs of avoidance and/or cooperation.

    Which is normally the case.

    3) There’s still competition.

    Yes, but a species outcompeting another happens only when species that have the same ecological niche suddenly find themselves in the same geographic place. The rest is just enough for stabilizing selection — we don’t normally see competition, we see the ghost of competition past.

    I wouldn’t say that’s avoiding competition, since the species can only get that way and stay that way by out-competing their less fortunate conspecifics.

    OK. I was more talking about interspecific competition.

  85. David Marjanović, OM says

    1) Specialization is often very costly in the long-run, when the niche shifts beyond the capacity of the organism to adapt.

    Too bad. Evolution lacks any trace of foresight.

    (Corporations don’t, which is why there are few hyperspecialized corporations.)

    2) Strategies to avoid competition are generated when the cost of competition becomes greater than the costs of avoidance and/or cooperation.

    Which is normally the case.

    3) There’s still competition.

    Yes, but a species outcompeting another happens only when species that have the same ecological niche suddenly find themselves in the same geographic place. The rest is just enough for stabilizing selection — we don’t normally see competition, we see the ghost of competition past.

    I wouldn’t say that’s avoiding competition, since the species can only get that way and stay that way by out-competing their less fortunate conspecifics.

    OK. I was more talking about interspecific competition.

  86. brent says

    A science professor that works in the public university against libertarianism. Wow – that’s original.

    Sorry PZ – unlike you most of us have to operate in the real world.

    The belief that the public sector is somehow isolated from the “real” world is rather strange but, in my experience, common among conservative libertarians in particular. It is especially strange when one considers that it is libertarian ideals which fail to survive contact with “reality.” Individual liberty is, of course, something to be desired but cannot exist unless collective society decides to protect the individual’s right to it. This is precisely where the dreaded public sector comes in.

  87. says

    At the same time he apparently holds the view that the government is a benign and enlightened actor whose interventions usually achieve the goal at which they aim.

    I do? I like government and think it is important, and believe we could use more of it; that doesn’t mean I trust it. I’m with Jefferson: checks and balances all over the place. Constant monitoring and criticism. An active and informed citizenry that works to build a better government, all the time.

    Shall we take a look at how the professor’s classes are graded?

    As ever, Caledonian makes the idiot’s argument. Look at how my classes are run: they are not Libertarian exercises where I the professor stand back and let the students strive, and I am merely the judge and executioner. The whole point of a class is to help students learn…and when I see students doing poorly, it isn’t an opportunity to hand out an F, it’s a responsibility to step in and try to help them learn.

    It’s a perfect example of the Libertarian failure to comprehend the purpose of something, whether it’s government or the classroom.

  88. Jim A. says

    (putting on my pedant hat)Gee, I find Ayn Rand’s writings pretentious rather than portentous. I wonder whether this is a typo?

  89. David Marjanović, OM says

    OK. I was more talking about interspecific competition.

    Actually, no. Being specialized enough usually takes one out of competition with more generalized conspecifics, which are bad at intra- and interspecific competition, often so bad that they keep dying out — stabilizing selection.

    It does happen that specialized species become generalists over time. Today’s alligators — generalist carnivores — come from a long line of durophages (specialists for hard food, like mollusks and turtles). As Caledonian said: change the environment, and the specialists tend to die out first.

  90. David Marjanović, OM says

    OK. I was more talking about interspecific competition.

    Actually, no. Being specialized enough usually takes one out of competition with more generalized conspecifics, which are bad at intra- and interspecific competition, often so bad that they keep dying out — stabilizing selection.

    It does happen that specialized species become generalists over time. Today’s alligators — generalist carnivores — come from a long line of durophages (specialists for hard food, like mollusks and turtles). As Caledonian said: change the environment, and the specialists tend to die out first.

  91. says

    Like David Marjanović I have a problem identifying Thadd as a libertarian in the sense that is meant here.

    I see liberty itself as a difficult concept (your freedom to smoke and my freedom to breath clean air might just come in conflict) this:

    I believe in the ideal of a government that allows as much freedom as possible to the people who live under it

    is not easy to actually interpret. There is no easy way to work out the moral issues involved in the possibility of increasing one persons freedom at the expense of another, since it is difficult to make interpersonal comparisons. (This is especially true if you consider not just negative freedom – i.e. freedom from constraint – but also positive freedom – the availability of choices.) Thinking that it is always obvious what is meant by increasing freedom is just naive.

  92. Ben Terry says

    Wow, it seems crazy to say Libertarians are your least favorite political/economic group. Personally I put all social conservatives, the well-meaning but misguided socialist, and the obvious fascist, national socialist, or dictatorial types below them.

    I’ve seen messed up Libertarians, of course. The strangely cold, greedy idealists. The slightly less intellectual “I want guns and a hacked free satellite box, because your radio waves are on my property” sort of Paladin Press/Loompanics Libertarian.

    On the other side, having control of your money seems preferable to having the government decide what to do with it. I would not “invest” my money in this war, and of course there would be no drug war. As it is, I am forced to support murder and torture unless I leave the country, or else the government will ultimately come and take my possessions, using whatever force they find necessary to do so.

    So, on that perspective I find some sympathy with elements of Libertarianism. It’s not that I am against money being used to make for a better society, but that I don’t trust other people to make those decisions with my money, when I could make them directly myself.

    Of course I’m not a libertarian, because capitalism leads to concentrations of wealth, leading to rich kids and concentrations of power, which destroys the idea of “everybody has a chance to make it, and deserve what they get”. That has left me as some sort of weakly committed voluntary anarcho-syndicalist or something I guess… While in the end I disagree with libertarianism, I have a soft spot for utopian visions, and if they want to get a boat, and try to make some artificial island libertarian utopia… I actually think that is kinda cool.

  93. j.t.delaney says

    I find PZ’s vehement opposition to libertarianism hypocritical. On the one hand, he goes to great lengths to discredit those who profess an unjustified faith in the supernatural. At the same time he apparently holds the view that the government is a benign and enlightened actor whose interventions usually achieve the goal at which they aim. However, I find little evidence to support this belief, and abundant evidence to contradict it. Is this not also an instance of unjustified faith?

    Nobody here has made the arguement that all government policies are inherently benign — only that government isn’t inherently evil, and that the free market isn’t the solution to every human problem.

  94. SteveM says

    Not all libertarians are 100% free market Ayn Rand nut jobs, some have the sense to realize that altruism is an evolutionary illusion of a largely social species, and that Ayn Rand’s philosophies and the free market both entail trespasses on the freedom of individuals and that they subsequently do need some control.

    Have you actually read any Rand? She vehemently rejected libertarians as anarchists. It is the Libertarians that are the radical “nut jobs”, not Rand. She always advocated the absolute necessity of government to enforce everyone’s rights. It is government’s role to regulate and mediate conflicts between individuals freedoms, e.g. my freedom to drive a car does not give me the right to run over pedestrians. Likewise, when she talked of the free market, she did not mean free from any and all rules; just free from artificial and arbitrary control by government. Fraud, embezzlement, theft etc would still be crimes to be enforced by the government.

    Earlier someone spoke of Libertarians expecting charities (churches) to pick up the “social safety net”. Maybe Libertarians do, but Rand was very clear that she expected that most people already give to charities what they can and that in a free market (and less taxation, “less” not “none”)they would have more and thus give more.

    While Ayn Rand championed the individual, she was no “individualist” in the sense that whatever I want to do is right and society be damned. But that it is when everyone recognizes that everyone else is just as equally entitled to their freedom and their existence as you are that society as a whole is the most productive and free.

    I don’t think there is anything in the U.S. Constitution that Rand objected to as the “proper” role of government. The problem is a lot of the stuff that has been added to it.

  95. David Marjanović, OM says

    I wonder whether this is a typo?

    Not necessarily. Aren’t her writings uncanny and scary?

  96. David Marjanović, OM says

    I wonder whether this is a typo?

    Not necessarily. Aren’t her writings uncanny and scary?

  97. windy says

    Actually, no. Being specialized enough usually takes one out of competition with more generalized conspecifics…

    Are you channeling Lynn Margulis? :) Sure, you can define natural selection as being about avoiding competition instead of about competing succesfully, but that’s just an unnecessarily complicated way of saying the same thing.

  98. jeffk says

    I’ve always found libertarians less offensive than conservatives, because while their beliefs may be rooted in bad philosophy, at least they’re not dependent on things that don’t exist. An atheist can be a libertarian, but not a conservative, so far as I can figure.

    The problem with libertarianism is that I would consider it a non-neutral philosophy in the sense that it can’t solve communal problems. When a libertarian encounters something the free market can’t fix, they’re forced to deny its existence, which makes them the worst of cranks.

  99. Moses says

    I’ll take libertarians seriously when Eve Online stops sucking.

    Posted by: Dustin | October 26, 2007 1:24 AM

    I played that game. The laize-faire economy sucked and evolved into, essentially, a hydraulic-despotism/oligopoly structure.

  100. says

    You know you might temper your criticism of libertarians if you realized the fact that a large percentage of them are fellow unbelievers, PZ.

    Why, no. You know I don’t believe in that framing crap—I say what I think, not what I think you want me to think.

    Sorry PZ – unlike you most of us have to operate in the real world.

    Heh. Right. You obviously have no idea what a professor’s salary is like…especially when that professor has two kids in college. You don’t know what the training for this position cost: years of living in poverty, literally. I grew up in a family of six kids, with a father who was a blue-collar laborer—I know what it’s like to live without health and dental care, with a parent working two jobs to make ends meet, and who worked himself into chronic ill health.

    People have this illusion that academia is a privileged fantasy land where we nestle in our well-insulated ivory towers and lie to one another about reality. Truth is, we’re all a bunch of lower-middle class to middle middle-class people who have exactly the same practical economic concerns as everyone else.

  101. CalGeorge says

    It’s not that I am against money being used to make for a better society, but that I don’t trust other people to make those decisions with my money, when I could make them directly myself.

    So tell us, what exactly would you do with all that money?

  102. Kseniya says

    It’s been said that liberals want to minimize the number of people who fail, and conservatives want to maximize the number of people who succeed.

    Hmmm. Unless we define a third outcome – a middle ground between success and failure – those two goals are equivalent, except perhaps when the statement is evaluated as rhetoric, the intent of which is to frame the conservative goal in “glass-half-full” terms and the liberal goal in “glass-half-empty” terms.

    Similarly, it has been said that liberals want to ensure the poorest and weakest members of society don’t fall through the cracks into oblivion and despair, and conservatives don’t give a damn either way. I would never say such a thing, though. That would be wrong.

  103. Kseniya says

    People have this illusion that academia is a privileged fantasy land where we nestle in our well-insulated ivory towers and lie to one another about reality.

    And drive Porsches and have trophy wives.

  104. David Marjanović, OM says

    On the other side, having control of your money seems preferable to having the government decide what to do with it. I would not “invest” my money in this war, and of course there would be no drug war.

    In theory, it is you who tells the government what to do with your money. If you don’t like what politicians propose doing with it, you just don’t vote for them. If there is no politician who represents your ideas, you run for office yourself. It’s called democracy.

    Of course, it’s not always that easy in reality. For example, in the USA you can’t run for president unless you’re a millionaire, because you have to pay your campaign yourself, and because the campaign lasts two full years.

    Earlier someone spoke of Libertarians expecting charities (churches) to pick up the “social safety net”. Maybe Libertarians do, but Rand was very clear that she expected that most people already give to charities what they can and that in a free market (and less taxation, “less” not “none”)they would have more and thus give more.

    It is still entirely surreal to expect that charities will take care of everyone. And apart from this, it makes basic help a mercy instead of a right.

  105. David Marjanović, OM says

    On the other side, having control of your money seems preferable to having the government decide what to do with it. I would not “invest” my money in this war, and of course there would be no drug war.

    In theory, it is you who tells the government what to do with your money. If you don’t like what politicians propose doing with it, you just don’t vote for them. If there is no politician who represents your ideas, you run for office yourself. It’s called democracy.

    Of course, it’s not always that easy in reality. For example, in the USA you can’t run for president unless you’re a millionaire, because you have to pay your campaign yourself, and because the campaign lasts two full years.

    Earlier someone spoke of Libertarians expecting charities (churches) to pick up the “social safety net”. Maybe Libertarians do, but Rand was very clear that she expected that most people already give to charities what they can and that in a free market (and less taxation, “less” not “none”)they would have more and thus give more.

    It is still entirely surreal to expect that charities will take care of everyone. And apart from this, it makes basic help a mercy instead of a right.

  106. Caledonian says

    PZ likes to paint broad strokes in bold, vivid color: Day-Glo on black velvet. Then he flaps his matador’s cape at us and incites us to frenzy.

  107. Caledonian says

    It is still entirely surreal to expect that charities will take care of everyone.

    It is entirely surreal to expect that everyone should be taken care of.

    And apart from this, it makes basic help a mercy instead of a right.

    Precisely!

  108. Moses says

    I can cite the example of my country, India, which spent close to four decades under ‘socialism’. It might sound funny, but we had to wait for up to 8 years to get a ‘land line’ (telephone)from the Government controlled telephone supplier (the phone instrument and the connection both took 8 years). Today, thanks to the entry of private players, it takes much, much less.

    Yes, the old Libertarian canard about the efficiency of the market and lure of profits. Yet it’s quite accepted, by non-ideologues, that if government didn’t step in, much of rural America would still not have telephones or electricity. Because it doesn’t PAY to have telephone and electric lines in rural areas and Corporations are otherwise not in the business of providing goods and services when there is no hope for profit.

    As for the anecdote, I suspect the reason for the telecom boom that allowed the faster obtaining of lines has to do with technological and economic reasons well beyond the removal of the “State Monopoly.” Especially when I consider that many European countries are still either state monopolies or heavily regulated and don’t suffer from the social, economic and technological barriers that, apparently, made getting a phone line such a chore in India. I would also point out that many of the Central American lassie-faire economies you’d avoid like the plague for their ills, had the same problems, even when privatized.

    So, really, no thanks and so what. Libertarianism has yet to demonstrate anything beyond it is a con-game for people who believe they’ll be on top of the laissez-faire economy. Nice and sexy if you luck out. But a life of squalor and poverty if you don’t. And this comes from the economic principles being enacted in the real-world; ultimately, it’s just going backwards to the gilded age.

  109. Caledonian says

    Being in favour of individual liberty makes you a liberal, not a Libertarian.

    So you’re arguing that libertarianism is a subset of liberalism? Or are you suggesting that libertarians are just crypto-fascists?

    “‘Crypto-fascist’ this, and ‘crypto-fascist’ that! You don’t even know what it means!”

  110. Kseniya says

    Being in favour of individual liberty makes you a liberal, not a Libertarian.

    True, you use the classic definition of Liberal, but there’s no denying that modern American liberalism has at times concerned itself with legislating for personal safety over personal liberty. It has produced legislation like mandatory helmet use by motorcyclists, a liberty-reducing (but life-extending) restriction and gun control (ditto). The flip side of the coin is the conservative penchant for telling people what God to pray to (and when) and how to have sex (and with whom). So far, the liberals haven’t written up any legislation requiring people to wear helmets during sex, so despite conservative claims to the contrary the liberals have a slight edge in the personal-liberty sweepstakes. But only slight. ;-)

  111. Caledonian says

    Truth is, we’re all a bunch of lower-middle class to middle middle-class people who have exactly the same practical economic concerns as everyone else.

    Tenure.

  112. Moses says

    We already know what happens when governments emasculate their own agencies, like the EPA and FDA, charged with protecting people from the excesses of industrial greed. Just look at the last few years of Republican one-party rule. The environment is ravaged, food and toys are poisoned, home owners are bankrupted, and shareholders swindled. People died.

    All that with just a relaxation of government oversight. Now imagine what happens if someone like Ron Paul abolishes these agencies altogether. I can, but I can’t for the life of me understand why libertarians never seem to. I’ve yet to find anyone who yearns for the return to the days of the robber barons.

    Posted by: tacitus | October 26, 2007 5:56 AM

    People forget that Libertarianism was practiced in America. It was called “The Gilded Age,” and while the elites became fabulously wealthy, the rest of America was horribly poor. For all but the wealthy, and a small middle class, it didn’t take just a husband to support a family, but the wife and children as well.

    Yet these people want to just piss away all these things that have made their lives possible. On the delusion that they’re going to, somehow, be on top.

  113. atlas1882 says

    PZ, I’m confused. On the one hand, you condemn people who advocate for personal liberty and responsibility manifested in the action of the free market because you hold them to be too idealistic and that their ideas are impractical. On the other, you propose a vision of democratic society in which the populace is informed and active in a limitless array of decisions the certainly does not conform to reality.

    One of the most frequent laments posted on this site is that people are uneducated, ignorant, and generally apathetic. What methods would you employ to transform society from its current state into the one you desire? As a libertarian, I have no problems with your attempts to persuade me verbally through eloquence and force of logic, but I do have a problem if you would instead try to force me to adopt your preferences through government action, punitive taxation and criminal sentencing.

    I definitely recognize a legitimate and limited scope for government activity. I share the views expressed by our founding fathers in the Constitution, Declaration of Independence, and supplementary documents such as the Federalist Papers. Government should be instituted among men to protect individuals rights to life, liberty, and the pursuit of happiness which I do not believe has a meaningful interpretation outside the protection of private property rights.

    Checks and balances are important, but they are designed to prevent the government from colluding to infringe upon the rights it was established to protect, not to improve its efficiency in areas where it has no authority to intervene.

    Perhaps you have a different idea of what it means to be a libertarian, but as one who self-identifies with that philosophy, I hope that my views may be considered representative of at least the core doctrines upon which virtually all other libertarians would agree. So the question is, which parts do you disagree with? Which principles do you find to austere to be accommodated by human nature? How do you justify the existence of entities such as the Departments of Agriculture and Education within the context of the Constitution? Is freedom worth protection per se, or only if it produces results that align with your sensibilities?

  114. David Marjanović, OM says

    Are you channeling Lynn Margulis? :)

    I hope not :-)

    Sure, you can define natural selection as being about avoiding competition instead of about competing succesfully, but that’s just an unnecessarily complicated way of saying the same thing.

    I’m not trying to define anything here. Where I come from is 1) the immense diversity of life with all those specialized species, specialized sexes and specialized life stages, and 2) the mid-20th-century knee-jerk reaction of attributing every extinction in the fossil record to competition, no matter what the evidence says (if it even says anything). Again: species outcompeting each other does happen. The dingo was introduced to Australia, and suddenly there were two species in the same place in the same ecological niche, of which one was considerably better at it (or at least most of it), so the Tasmanian tiger died out on the Australian mainland. If the Tassie tiger had had another food source that was less accessible to the dingo, it would most likely had survived, not much matter how well adapted the Tassie tiger actually was for it.

    I played that game. The laize-faire economy sucked and evolved into, essentially, a hydraulic-despotism/oligopoly structure.

    Wow. Exactly what I’d have predicted.

  115. David Marjanović, OM says

    Are you channeling Lynn Margulis? :)

    I hope not :-)

    Sure, you can define natural selection as being about avoiding competition instead of about competing succesfully, but that’s just an unnecessarily complicated way of saying the same thing.

    I’m not trying to define anything here. Where I come from is 1) the immense diversity of life with all those specialized species, specialized sexes and specialized life stages, and 2) the mid-20th-century knee-jerk reaction of attributing every extinction in the fossil record to competition, no matter what the evidence says (if it even says anything). Again: species outcompeting each other does happen. The dingo was introduced to Australia, and suddenly there were two species in the same place in the same ecological niche, of which one was considerably better at it (or at least most of it), so the Tasmanian tiger died out on the Australian mainland. If the Tassie tiger had had another food source that was less accessible to the dingo, it would most likely had survived, not much matter how well adapted the Tassie tiger actually was for it.

    I played that game. The laize-faire economy sucked and evolved into, essentially, a hydraulic-despotism/oligopoly structure.

    Wow. Exactly what I’d have predicted.

  116. Caledonian says

    It has produced legislation like mandatory helmet use by motorcyclists, a liberty-reducing (but life-extending) restriction

    The justification for that law isn’t an extension of life, but a reduction in health costs – since the public often picks up the bills for the slobs who injure themselves by riding without helmets, the argument goes, society has a right and an obligation to reduce the costs by controlling people’s actions.

    Why do we never have an examination of the horrors socialism has lead to? Why do we always look at the worst done in the name of ideologies we abhor, and never at the worst done in the name of the ideologies we favor?

    By ‘we’, I of course mean ‘you’. And I already know why.

  117. roystgnr says

    On the other hand, I’ve met a disproportionate number of really unpleasant, crass arrogant, rude people online who call themselves libertarians.

    Did they show up and unpleasantly interrupt one of these little bash-fests where because of their political beliefs they’d been called “selfish”, “small-minded”, undeserving of any “sense of respect”, “trash”, “spoiled children”, “deluded”, despicable, etc?

    How disproportionately rude of them.

  118. Kseniya says

    I’ve never been to India, but recently spoke to someone who had just returned from there. He said the electric and telephone wiring in the cities is haphazard and messy (think: spiderwebs) and the service is dreadful.

    Maybe the slow progression from horrible to dreadful has more to do with the rate of acquisition of technology and expertise than with the policital or economic systems through which the progess as interminably crawled. Of course, we can’t consider THAT idea – it’s not useful to the discussion.

  119. Sean says

    Moses, re comment #74.

    Back up your claims or kiss my ass you slandering piece of shit. I have not gone through self-inflicted, hellish periods of my life trying to live up to my ideals just to have you flounce along and in one post make broad accusations of rights violating, putrid behavior, whining, running to the goverment and selfishness.

    Your post reminds me of any number of fundie posts ranting about baby eating atheists, their genocidal urges, arrogance of denying God’s existence, and general evilness. Equal parts strawmen, misconceptions and flat-out lies.

  120. Thadd says

    “But the principle of “to serve people” can also be extended to universal health care, and pollution regulations, and professional licensing requirements, and product safety laws, etc. etc. etc. I for one don’t see why it is acceptably libertarian to have the State protect you from fire and violence, but not protect you from illness.”
    Actually, if the government could offer something like health care in an effective way I would be all for it as a service, I just haven’t seen a good plan in America yet (unfortunately it seems America is already so backward it may be almost impossible right now to do so). Quite frankly if I pay the government in taxes or a company out of my pay, I don’t care, as long as it works.
    As for pollution control or licensing, I think these are fine, as they are there to protect people’s freedoms from being trespassed by other individuals.
    Now could some charity do these same services? possibly, but for now, I am content to pay the government to do it, as I am surviving well enough right now.

  121. steve s says

    PZ’s just reminding us that he has little education in economics or poli sci. Nothing to get too worked up about. If he ever wants to learn about a really destructive political/economic group, he should look into a little-known movement called ‘communism’. 20th century ring a bell?

  122. David Marjanović, OM says

    It is entirely surreal to expect that everyone should be taken care of.

    Why? Over here it is almost the case.

    And apart from this, it makes basic help a mercy instead of a right.

    Precisely!

    So you really do lack empathy? Are you really a born asshole? That is hard to believe.

    If so, do you lack any trace of fear, too? What if you ended up in the situation of needing basic help?

    So you’re arguing that libertarianism is a subset of liberalism?

    I am, in any case. It’s just the extreme.

    As for the anecdote, I suspect the reason for the telecom boom that allowed the faster obtaining of lines has to do with technological and economic reasons well beyond the removal of the “State Monopoly.” Especially when I consider that many European countries are still either state monopolies or heavily regulated and don’t suffer from the social, economic and technological barriers that, apparently, made getting a phone line such a chore in India.

    It is true that India has suffered from decades of trying to approach the Soviet way — building heavy industry way beyond what was needed and neglecting the rest. But apart from this, the main difference between India and Europe is money.

    People forget that Libertarianism was practiced in America. It was called “The Gilded Age,”

    Not quite correct. The taxes on the richest reached 90 %. I kid you not.

    One of the most frequent laments posted on this site is that people are uneducated, ignorant, and generally apathetic. What methods would you employ to transform society from its current state into the one you desire?

    Education? Perhaps?

    Government should be instituted among men to protect individuals rights to life, liberty, and the pursuit of happiness which I do not believe has a meaningful interpretation outside the protection of private property rights.

    Well, Caledonian here wants to restrict the rights to life and the pursuit of happiness to those who can afford it.

  123. David Marjanović, OM says

    It is entirely surreal to expect that everyone should be taken care of.

    Why? Over here it is almost the case.

    And apart from this, it makes basic help a mercy instead of a right.

    Precisely!

    So you really do lack empathy? Are you really a born asshole? That is hard to believe.

    If so, do you lack any trace of fear, too? What if you ended up in the situation of needing basic help?

    So you’re arguing that libertarianism is a subset of liberalism?

    I am, in any case. It’s just the extreme.

    As for the anecdote, I suspect the reason for the telecom boom that allowed the faster obtaining of lines has to do with technological and economic reasons well beyond the removal of the “State Monopoly.” Especially when I consider that many European countries are still either state monopolies or heavily regulated and don’t suffer from the social, economic and technological barriers that, apparently, made getting a phone line such a chore in India.

    It is true that India has suffered from decades of trying to approach the Soviet way — building heavy industry way beyond what was needed and neglecting the rest. But apart from this, the main difference between India and Europe is money.

    People forget that Libertarianism was practiced in America. It was called “The Gilded Age,”

    Not quite correct. The taxes on the richest reached 90 %. I kid you not.

    One of the most frequent laments posted on this site is that people are uneducated, ignorant, and generally apathetic. What methods would you employ to transform society from its current state into the one you desire?

    Education? Perhaps?

    Government should be instituted among men to protect individuals rights to life, liberty, and the pursuit of happiness which I do not believe has a meaningful interpretation outside the protection of private property rights.

    Well, Caledonian here wants to restrict the rights to life and the pursuit of happiness to those who can afford it.

  124. says

    I see a lot of emoting, but not much actual argument going on here. Perhaps there are greedy libertarians, but there are greedy people in every group. I fail to see why that is a critique of libertarian ideas.

    Someone commented that the government was interfering with his “right to own slaves.” I’m not really sure why this person thinks that libertarians would support slavery, since they do not. Slavery is coercive, and coercion is anathema to libertarians.

    I think a lot of people, including Mieville, don’t really know that much about libterarian thought. They’re not all cultish Randians. Perhaps some are, but there are many, I would include myself, who have reached this position after much careful thought. I am influenced by thinkers such as Locke and Jefferson.

    For a reasoned approach to political liberty, everyone should check out the excellent blog Positive Liberty: http://www.positiveliberty.com

    In a simple video, Milton Friedman explains how markets can indeed be beneficial to human flourishing:

  125. says

    Moses:
    I guess there is one nugget of information that has not been mentioned: In India, there were heavy regulations (based on British laws made in the 19th Century and were obviously incapable of accommodating technological progress) that did not allow people to set up telecom companies. Yes, of course there were technological reasons, but as you say, there were also economic reasons. The Govt. did not want to lose out on the revenues (along with an unhealthy paranoia about security). India is more geographically diverse and spread out areawise than European nations, so it made even less sense to have a centralized approach. As for LatAm economies, if they were privatized, did they also have competition?
    All monopolists protect their interests and preventing unfair monopoly (by using fair, legal means) is what it is all about.
    The other part is that most of the ‘developed’ countries have been able to divorce a large part of their politics from the economy. Italy and Japan, I remember, had Prime ministers with notoriously short stints. But to a large extent, it did not affect their economies (in the 90s at least). this itself shows that Government interference in the economy was minimum and it allowed people to earn their living and prosper. And that, very simply, is my point.

    ” Yet it’s quite accepted, by non-ideologues, that if government didn’t step in, much of rural America would still not have telephones or electricity. Because it doesn’t PAY to have telephone and electric lines in rural areas and Corporations are otherwise not in the business of providing goods and services when there is no hope for profit.”

    That is where smart Government policies and guidelines come into play; The Government need not set up power plants and telephone companies, but allow special incentives etc. for them to set up infrastructure.

  126. Thadd says

    “There is no easy way to work out the moral issues involved in the possibility of increasing one persons freedom at the expense of another, since it is difficult to make interpersonal comparisons. (This is especially true if you consider not just negative freedom – i.e. freedom from constraint – but also positive freedom – the availability of choices.) Thinking that it is always obvious what is meant by increasing freedom is just naive.”
    Well duh, that is why I am happy to live in a democracy, where there is at least some ability for people to adjust bars and decide this on a case by case basis, which is necessary.
    Ideally it would be nice if everyone could have no constraints and a nice free market, it is certainly my ideal, and why I identify as a libertarian, but I realize that the constraints of humanity and the impossible nature of altruism keep this ideal from ever actually working. At present (and forever, baring some amazing change that is beyond human prediction at this point), the presence government seems not only to be a necessity, but the closest we can come to the ideal I believe in. There have always been leaders and rulers (within the social history of H. sapiens) and so I don’t think we can actually expect there not to be at some point.

  127. Kseniya says

    Cal, you got me – and I knew you would – but I was in a hurry… gah. I should have written what I meant, which was that the ostensible intent of the laws were to save lives or to improve the quality of life. That’s how they were framed, no? (And always are?)

    The underlying intent – and the efficacy – of those laws is for another thread, methinks. You know what’ll happen to this one if the gun-control topic takes over. ;-)

    Why do we never have an examination of the horrors socialism has lead to? Why do we always look at the worst done in the name of ideologies we abhor, and never at the worst done in the name of the ideologies we favor?
    By ‘we’, I of course mean ‘you’.

    And I already know why.

    Do you mean ‘you’ or ‘thou’?

    What is your answer to the question, “Why?”

    Perhaps “we” favor those ideologies which best promise to lead society in the direction we believe is most beneficial to its members, regardless of how those ideologies may have been abused in the past. (And what ideology hasn’t?)

    What ideology do you favor? You’ve often said you’re not a Libertarian. If you could put systems in place, what would they look like?

  128. Tulse says

    Thadd:

    if the government could offer something like health care in an effective way I would be all for it as a service […] As for pollution control or licensing, I think these are fine

    Tear up your Libertarian membership card, Thadd, ‘cuz it’s clear you ain’t one.

  129. David Marjanović, OM says

    Why do we never have an examination of the horrors socialism has lead to?

    Why do you buy the Soviet Union’s renaming of communism into “socialism”?

    Besides, I don’t believe in slippery slopes. If I did, I’d have to believe that the USA were at the same time a libertarian dystopia and a theocratic dystopia, and perhaps a communist dystopia too, even though those three states are mutually exclusive.

    By ‘we’, I of course mean ‘you’. And I already know why.

    You don’t know. You believe. On faith.

    If he ever wants to learn about a really destructive political/economic group, he should look into a little-known movement called ‘communism’. 20th century ring a bell?

    Ah, you must be the tu quoque fallacy. Nice to meet you.

    There is more than one way to do evil in this world, and we’re all well aware of that fact.

  130. David Marjanović, OM says

    Why do we never have an examination of the horrors socialism has lead to?

    Why do you buy the Soviet Union’s renaming of communism into “socialism”?

    Besides, I don’t believe in slippery slopes. If I did, I’d have to believe that the USA were at the same time a libertarian dystopia and a theocratic dystopia, and perhaps a communist dystopia too, even though those three states are mutually exclusive.

    By ‘we’, I of course mean ‘you’. And I already know why.

    You don’t know. You believe. On faith.

    If he ever wants to learn about a really destructive political/economic group, he should look into a little-known movement called ‘communism’. 20th century ring a bell?

    Ah, you must be the tu quoque fallacy. Nice to meet you.

    There is more than one way to do evil in this world, and we’re all well aware of that fact.

  131. steve s says

    tu quoque would be if I said libertarianism is good because communists are bad too. That’s not what I said. Read for more comprehension. I just said communists were worse.

  132. Tulse says

    steve s:

    If he ever wants to learn about a really destructive political/economic group, he should look into a little-known movement called ‘communism’. 20th century ring a bell?

    Because the only alternative to laissez-faire libertarian capitalism is communism…sure…

    Nandan:

    The Government need not set up power plants and telephone companies, but allow special incentives etc. for them to set up infrastructure.

    For extra credit, explain how government-overseen “special incentives” are not interference in the free market by the State.

  133. says

    PZ likes to paint broad strokes in bold, vivid color: Day-Glo on black velvet. Then he flaps his matador’s cape at us and incites us to frenzy.

    Once again,

    1) Caledonian makes unsupportable assertion;

    2) Unsupportable assertion gets dismantled;

    3) Rather than admit his position is untenable, Caledonian moves the goalpost to personalities rather than the issue.

    Lather, rinse, repeat.

    It is still entirely surreal to expect that charities will take care of everyone.

    It is entirely surreal to expect that everyone should be taken care of.

    And apart from this, it makes basic help a mercy instead of a right.

    Precisely!

    For once, I will give Caledonian some props here, though–unlike most Libertarians, he is refreshingly candid that it’s not *really* about the individual.

    To get back to the issue at hand, the Garifuna land grab attempt has been carried out many times historically in the developing world. If Libertarians were really interested in individual and property rights above all, I’d expect them to be all exercised about those violations, and demanding remedy.

    Strangely enough, I never see that.

  134. says

    Oh and as for the charge that it only works if you are on the right side of luxurious living, it is perhaps the only systems that allows more participation and more opportunities for others to prosper. Be it trade unions or any other monopoly, most of the barriers that are erected are to prevent others from entering into the arena. Libertarianism, while protecting the right to property and life, throws open the gates to those who would not have the chance. forgive me for harping on the Indian example again, but today, India has the highest number of billionaires in the world despite having dysfunctional economic policies. And thought the growth has not been as ‘inclusive’ as it should have been, ‘liberalizing’ the economy is perhaps the only lever that growing economies like India and China have to lift a large population out of poverty. And the results are showing, though slowly.

  135. David Marjanović, OM says

    In a simple video, Milton Friedman explains how markets can indeed be beneficial to human flourishing:

    Of course they can be. Just not the way he tried it in Chile.

  136. David Marjanović, OM says

    In a simple video, Milton Friedman explains how markets can indeed be beneficial to human flourishing:

    Of course they can be. Just not the way he tried it in Chile.

  137. David Marjanović, OM says

    I just said communists were worse.

    You didn’t state that in relative terms, but in absolute ones: you wrote communism is “really destructive” while libertarianism is not. And that is wrong.

    ‘liberalizing’ the economy is perhaps the only lever that growing economies like India and China have to lift a large population out of poverty. And the results are showing, though slowly.

    I agree, and I think everyone here agrees.

    But this is not libertarianism. Libertarianism is much, much more extreme.

  138. David Marjanović, OM says

    I just said communists were worse.

    You didn’t state that in relative terms, but in absolute ones: you wrote communism is “really destructive” while libertarianism is not. And that is wrong.

    ‘liberalizing’ the economy is perhaps the only lever that growing economies like India and China have to lift a large population out of poverty. And the results are showing, though slowly.

    I agree, and I think everyone here agrees.

    But this is not libertarianism. Libertarianism is much, much more extreme.

  139. David Marjanović, OM says

    Right, because Milton Friedman held political office in Chile

    I know he didn’t. I don’t think it makes a difference, given how faithfully the junta executed his suggestions.

    and was responsible for their fiscal policy.

    I didn’t even say that, and it doesn’t matter: his suggestions were executed, and the results were horrible, showing once again — by experiment — that free markets don’t always help.

  140. David Marjanović, OM says

    Right, because Milton Friedman held political office in Chile

    I know he didn’t. I don’t think it makes a difference, given how faithfully the junta executed his suggestions.

    and was responsible for their fiscal policy.

    I didn’t even say that, and it doesn’t matter: his suggestions were executed, and the results were horrible, showing once again — by experiment — that free markets don’t always help.

  141. Jim A says

    And drive Porsches and have trophy wives. Well one of my professors drove a Fiat Spyder and Married one of his students…Don’t know about the car, but he didn’t keep the job or wife for long…..

  142. Tulse says

    Be it trade unions or any other monopoly, most of the barriers that are erected are to prevent others from entering into the arena. Libertarianism, while protecting the right to property and life, throws open the gates to those who would not have the chance.

    Libertarianism prevents monopolies? How? Through the direct intervention and regulation by the State of the free market, thus infringing the personal liberty of corporate magnates? Or, like for other necessities, does it rely on the “charity” of robber barons not to act like despots?

  143. Nathaniel says

    PZ’s comments above about how he handles his class are relevant, because education is really the core problem with Libertarianism.

    Consider a simple case of “social” rather than economic Libertariansm (which seems to have more support here): smoking.

    Under a libertarian system, people can smoke or not, because they have the freedom to make their own risk assesements; they’re grown-ups and can make decisions. The question is, can they make INFORMED decisions? Under a completely Libertarian system, it’s unclear whose information to trust. People with an economic interest in you smoking have large megaphones; people who think it might be a bad idea have no percentage in telling you not to smoke, so why should they?

    But this statement is just the start. Red Dye #5? Lead paint on your window blinds? Is this prescription medicine right for you? Stocks or bonds? What college accredation is meaningful? Which insurance company will really pay up if my house burns down? Is this airline safe? There are just too many regulated industries and activities for any one person to make informed, educated decsions about all of them. That’s one reason we form big organizations like government: to help regulate things by having experts make some big decisions for everybody.

    That’s just one argument. The other involves indirect damage, like environmental damage or second-hand smoke: the costs of any one infraction might be small against any one vicitim, too small to redress, but the cumulative effects might be really bad. Tragedy of the commons.

    Geez, we really should be in a cramped dorm room with pizza on the bed for this.

    —Nathaniel

  144. Jenn says

    Look, people, let’s stop this.
    While we all love PZ we have to cut him some slack. He isn’t all-knowing, now is he? Every human being has flaws. One of his flaws seems to be having a scared cow thing about libertarianism. He just supplements his emotions for rational thought/debate about the subject. We all do it sometimes.
    What we have to remember is that he is a biologist using the forum that he has as an giant in his field to spread his opinions on a subject in which he is not an expert. Would we all care if Paris Hilton went on TV and spouted what she thought about evo-devo? No, we wouldn’t even give it a second thought.
    As a libertarian atheist enviromental scientist, I just glance over the things he writes about us. It’s not worth it to even respond to his emotive language-filled posts on the subject. So please, fellow libertarians on this site, lets not fight with PZ.
    When we comment on all his posts about it, it just encourages him.
    Let’s just let him have his way, and concentrate on promoting good science.

  145. says

    Yeah, those evil libertarians are responsible for 6 million deaths of Jews, and 10,000,000 Ukrainians.

    I guess you place more value to the Communists and National Socialists.

  146. nathan says

    I’ve noticed a few (imho) wrong beliefs underlying this discussion.

    1. Capitalism is unstable.I’m not sure what is meant by this, unless people here think that capitalism caused the Great Depression (which it didn’t — that was poor intervention on the part of the Fed in the money supply. Even the Fed itself recognizes this.)
    2. Capitalism makes the poor poorer.You pick an econometric measure, and you’ll see that the plight of the poor has radically improved in the last couple hundred years. The poor are getting better off over time, not worse. This is partly due to the fact that, unless violence is involved, transactions only take place when it would make both parties better off in the ex ante sense. I like ice cream more than I like this $5 bill, and you like the $5 more than the ice cream. We are both better off for it. Similarly, I like my paycheck better than I like staying home and sleeping all day. So I go into work and put in some labor. My employer and I are each better off.
    3. Libertarianism is inherently selfish. From the libertarian point of view, people with guns taking your money is, in every case, theft. No special exceptions are made if the thieves have been sent by some group of voters. There are no special moral categories at all, just people. So government largesse does not seem generous, since the money doesn’t really belong to the people handing it out. I realize this is hard to believe, but there were quite a lot of voluntary aid societies before governments started trying socialism in the 20th century. I think these would return in a free society. You are free to disagree, of course, but please do not call me selfish — I give to charities and would do so even more if I did have to pay taxes.

    I also think that the poor would in general be better off in a libertarian-style society, but this is understandably mind-blowingly counter-intuitive for most people. Kind of like evolution in that regard. In fact, here’s a nice bit from Michael Shermer, editor of Skeptic Magazine:

    People have a hard time accepting free market economics for the same reason they have a hard time accepting evolution: it is counterintuitive. Life looks intelligently designed, so our natural inclination is to infer that there must be an intelligent designer — a God. Similarly, the economy looks designed, so our natural inclination is to infer that we need a designer — a Government. In fact, emergence and complexity theory explains how the principles of self-organization and emergence cause complex systems to arise from simple systems without a top-down designer.

    PZ mentioned he was with Jefferson about government. I would point out that Thomas Jefferson would count as a libertarian under any reasonable definition of the term. “That government is best which governs least”, etc. Indeed, I do not think it would be inaccurate to think of the American Revolution as a libertarian revolution.

    Just because I feel like sharing, here are some other nice Jefferson quotes:

    “I would rather be exposed to the inconveniences attending too much liberty than to those attending too small a degree of it.”

    “The spirit of resistance to government is so valuable on certain occasions, that I wish it always to be kept alive.”

    “To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves and abhors, is sinful and tyrannical.”

    “The legitimate powers of government extend to such acts only as are injurious to others. But it does me no injury for my neighbor to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg.”

    And last, but certainly not least:
    “A wise and frugal government which shall restrain men from injuring one another, which shall leave them otherwise free to regulate their own pursuits of industry and improvement, and shall not take from the mouth of labor the bread it has earned. This is the sum of good government.”

    Are you sure you’re still with Jefferson, PZ?

    I am a libertarian. I am not, so far as I know, crazy or particularly selfish. I would not call myself “rabid” — I am perfectly willing to discuss these things calmly, and I don’t think you’re all idiots for disagreeing with me. (I held similar views to the prevailing ones here only about ~4 years ago.) I’m not out to fuck the poor, kick puppies, etc. What I believe about good government is fairly in line with Mr. Jefferson, actually.

    I don’t expect to convince any of you that I’m right, but I do hope a few of you will stop thinking we’re all crazy, heartless, baby-eating monsters. (The parallels between atheism and libertarianism are striking…)

    P.S., I think the Freedom Ship and Seasteading are indeed pretty fucking stupid ideas. ;-)

  147. Matthew Dean says

    I’m a bit disappointed to hear so much hate for libertarians from a site I enjoy to read so much. I think that liberals and libertarians have much common ground, and we shouldn’t spend so much time bickering.

    As to what has been said for about the free market here, I think that “belief” in the free market is quite evidence based. For example, if you look at this list of countries sorted by economic freedom (sorry about the heritage foundation here, I hate them too):
    http://www.heritage.org/research/features/index/countries.cfm

    you will find that those countries which are best to live in are clustered towards the top of that chart, while those countries which are terrible to live in are clustered towards the bottom.

    I think the government should be in the business of providing courts, police, national defense, and protecting public goods (firefighting, air quality, etc). I think other things (health care, schools, etc) should be provided by vouchers. Taxes are alright, as long as they are collected in a somewhat sensible manner (anyone want to defend the current US tax code?). Can anyone name anything else that the government absolutely must be in the business of providing?

    Also, I think the libertarian experiment has been tried before – in pre-china takeover Hong Kong. It worked quite well, if I recall.

  148. says

    Tulse:
    “For extra credit, explain how government-overseen “special incentives” are not interference in the free market by the State.”

    Ummm…I never said that I believe in absence of Government, I have said in my earlier comment that a ‘minarchy’ is a better option. For your reading pleasure from my earlier comment:
    ” I am not saying that we have anarchy: we are not ready (enlightened enough?) for it. We need the State and no realistic/practical person would say that we do not need Government. A minarchist position is closer to what I think will help society (Democratic society). I am in favour of a limited government that looks after basic things: protection of civil liberties and rights (including property rights), looking after defence and enforcement of contracts. ”

    So, when will I get my new grade sheet with the extra credit?

  149. poke says

    I don’t understand the praise for libertarian social theory. Take one example: drugs. I would like to see the “war on drugs” ended and people not convicted for ridiculous crimes like marijuana possession. That’s a position many libertarians and liberals share. At the same time, I think public programmes like rehabilitation, research into addiction, public education, AIDS prevention, needle exchange, etc, are vitally important, and should be provided by the government. Doctrinaire libertarianism would oppose that. It’s the same deal as with libertarian economic theory: it’s like an algorithm for taking good ideas and extending them into a bad ones.

  150. Grand Fromage says

    I’m confused. You’re with Jefferson but hate libertarians? Jefferson is /the/ prototypical libertarian.

  151. Jiggscasey says

    Well according to these anti libertarian posts any one who wants something other than to be part of the two party system is lazy and anyone who isn’t a democrat is evil.

    Some of us aren’t committed to a group think scenario. Forgive me for actually wanting to take home some of my money and not have the government run every aspect of my life.

    I think you are well intended PZ but I think you aren’t excercising good logic and your posting this article as a representation of libertarianism is really the presentation of a straw man. You should be better than that.

  152. H. Humbert says

    After reading through this thread, it seems a Libertarian is what you get after you take god belief away from a religious Conservative. They’re still lazy, selfish, greedy and cruel, but at least any lip service about the sanctity of human life has been done away with.

  153. says

    This is partly due to the fact that, unless violence is involved, transactions only take place when it would make both parties better off in the ex ante sense. I like ice cream more than I like this $5 bill, and you like the $5 more than the ice cream. We are both better off for it. Similarly, I like my paycheck better than I like staying home and sleeping all day. So I go into work and put in some labor. My employer and I are each better off.

    I like not dying better than dying, so obtaining health care should be treated exactly like shopping for electronics?

    From the libertarian point of view, people with guns taking your money is, in every case, theft. No special exceptions are made if the thieves have been sent by some group of voters. There are no special moral categories at all, just people.

    A serious libertarian thinker once explained to me that the government shouldn’t fund education or health care for poor children; “they should have chosen better parents”. Of course, I thought he was pulling my leg, but it turned out I was mistaken on that point.

    If libertarians are all about such extreme positions, then there’s not a lot of common ground to be had with people who can espouse such a position, and simultaneously claim to be all about the individual.

  154. jiggscasey says

    H Humbert.

    Please define this lazyness. And also how does the government forcing individuals to pay for social programs make those people forced to pay for them more compassionate?

  155. says

    I think the greed charge actually fits the accusers better than the accused. People want what isn’t their’s, and they try and get the government to take it for them. That bothers me. I am not wealthy by any stretch of the imagination, but I am fine living my own life. It bothers me when people think they know what I should be spending my money on better than I do. Spend your money on what you want, and I won’t say a thing, as long as you leave me alone.

    That is the basic core of a libertarianism – freedom from interference. I just don’t see what is so objectionable about that. So there are people who are unbelievably more wealthy than I am – how does that hurt me? Why should I think I am entitled to the what is their’s?

  156. says

    Thanks for the links, PZ. If there’s one thing I enjoy, it’s another shredding of libertarianism.

    To your observations, I add my own:
    http://kazimskorner.blogspot.com/2007/10/floating-libertarian-dictatorship.html

    From the article:

    On Freedom Ship there will be a jail, a “squad of intelligence officers,” and a “private security force of 2,000, led by a former FBI agent, [that] will have access to weapons, both to maintain order within the vessel and to resist external threats.” And while technically the law applied would be that of whichever state lends its flag, Freedom Ship officials make no bones that “the captain’s word will be final.”

    Who the hell is going to be stupid enough to sign up for that?

    It’s perfect. In the absence of “big government,” justice is distilled to obtain the smallest possible government: one guy. One completely unaccountable guy who makes all the rules. And if you don’t like his rules, maybe you’d like to take a little swim instead.

  157. roystgnr says

    Under a completely Libertarian system, it’s unclear whose information to trust.

    This is sadly true under any system. If Libertarianism forces you to admit that to yourself and thus makes you more skeptical of people who demand your trust (yes, even more skeptical of the people who won popularity contests), then so much the better.

  158. negentropyeater says

    Somehow, it seems to me that this discussion has a bit of “old news” feeling to it. Come on, the moral imperatives of this centuries politoco / economic sytems are not going to have much to do with last centuries.

    Striking the right balance between social democracy and free markets are 20th century problems. Friedmann, Jefferson, or Marx are going to have very little impact in defining this century.
    We already know what the key issues are going to be :
    1. how do we avoid that 20% of the world’s population continue living under the poverty line (less than 1$/day) ?
    2. how do we avoid that 20% of the world’s population continue emitting 80% of the total greenhouse gazes of the planet ?
    For this, 20th century politoco / economic models are not going to be very helpful.

  159. CalGeorge says

    Spend your money on what you want, and I won’t say a thing, as long as you leave me alone.

    What are you going to spend your money on?

    What do libertarians want to do with all that money?

  160. says

    I’m not sure how #1 is specifically a 21st-century problem. It seems that for most of history that has been the case. Is it somehow more problematic in this century than it has been previously?

  161. Tulse says

    nathan:

    You pick an econometric measure, and you’ll see that the plight of the poor has radically improved in the last couple hundred years. The poor are getting better off over time, not worse.

    It is over the last century that governments have realized they need to ensure the basic well-being of their citizens. Compared to 19th century England, 21st century America is far more regulated, but I would guess that only the most rabid libertarian would want to go back to the “charity” of workhouses.

    Nandan:

    I never said that I believe in absence of Government, I have said in my earlier comment that a ‘minarchy’ is a better option.

    OK, so explain how government-imposed “special incentives” to ensure rural electrification and telephony involve “protection of civil liberties and rights (including property rights), looking after defence and enforcement of contracts”. Why should the State be able to use force to confiscate money from me so that other people can live in the boonies with power and telephones? How is that “minarchy”?

    Mathew Wilder:

    Spend your money on what you want, and I won’t say a thing, as long as you leave me alone.

    I will be certain to leave you alone, as long as you agree to not use what my money paid for, such as the fire department, and the police department, and the water department, and the sanitation department, and public roads construction teams, and food safety agencies, and the medical licensing boards, and the product safety agencies, etc. etc. etc.

    And as Kazim noted from the Freedom Ship website:

    On Freedom Ship there will be a jail, a “squad of intelligence officers,” and a “private security force of 2,000, led by a former FBI agent, [that] will have access to weapons, both to maintain order within the vessel and to resist external threats.”

    I wonder if Blackwater is up for this gig?

  162. says

    What are you going to spend your money on?

    What do libertarians want to do with all that money?

    See, this is the problem – how is it anybody’s business but my own, how I spend my money? And “all that money” is slightly misleading – I make $1500/month. Needless to say, I would like to keep more of my money, and have the government take less of it.

  163. negentropyeater says

    Mathew, re. #1 what’s specific about this century, I think, is that I may live for example in France, where less than 1% of the population lives under the poverty line, but we will need to find a way to help solve the problem of, let’s say, Africa, without colonizing it nor imposing our own cultural and value system. And that is something we haven’t been very good in doing in the 20th century.
    Moreover, I defined 1. together with 2. They are very linked and cannot be handled separately.

  164. jdw says

    It might be nice to entertain a libertarian fantasy now and then. But in the real world, we have to serve someone (as the dylan song goes), whether or not you call it a government or a corporation. In the end, I’ll be back in my tech job, slaving away in my miserable cubicle – forever. The pink floyd song comes to mind – “where did you go, what did you dream? Welcome my son, welcome to machine.”

  165. brent says

    That is the basic core of a libertarianism – freedom from interference. I just don’t see what is so objectionable about that. So there are people who are unbelievably more wealthy than I am – how does that hurt me? Why should I think I am entitled to the what is their’s?

    Without “interference” you wouldn’t have any money to spend on anything at all. Its interference that prints bills to manage a system of exchange. Its interference that pays a police force to protect the things you own and protects you from bodily harm by those who would like to take your money. Its interference that builds the roads and other infrastucture that allows for a functioning economy in which you can make any money. Its interference that forces companies to adhere to workplace safety rules and minimal guidelines so that you can safely work to make money. Without government interference, it is quite clear that none of these things would exist and neither would all that money you would like to spend. I realize that these are incredibly obvious points but for some reason, they need to be explained to libertarians over and over. Living in a society has its costs. We can reasonably disagree over how much those costs should be but it is simply not reasonable to think you can have a stable society without those costs and without government intervention into many areas. The fact that many libertarians seem to think that it is reasonable to think so is the reason that so many people on this board find it to be an untenable position.

  166. Thadd says

    “Tear up your Libertarian membership card, Thadd, ‘cuz it’s clear you ain’t one.”
    Why, I choose to pay for and live under this government, I could leave it if I wanted, and I can actively vote for change if I feel it necessary. If others out vote my opinion, that is a balancing act of freedoms, part of necessity.
    If you look at governments as part of a free market of where you live and pay taxes they make a good decision. The problem is that libertarians in general look to government as a single force they are stuck with and that is naturally an evil thing. That is way too 1950s and provincial, in todays world, the libertarian ideas of free market can be extended to the level of the government (at least in western democracies). The idea of “if you don’t like it then leave” is only wrong if its forced, if its offered as a method of voting with one’s feet, it’s a freedom.
    One can be libertarian without hating the government, one simply is for minimizing government control.
    The idea of free market/anti-government libertarians is a bit of a stereotype of a much broader system of thinking.

  167. Matthew Dean says

    jdw
    It might be nice to entertain a libertarian fantasy now and then. But in the real world, we have to serve someone (as the dylan song goes), whether or not you call it a government or a corporation.

    See, I have never had a corporation take my money by force. If a corporation does not serve my interests, I do not utilize their services. However, the federal government threatens me with jail if I decide to remove myself from paying for the “war on drugs” it wages against its own citizens.

  168. Cody Jassman says

    Apparently PZ equates having the right to keep the money you earn — and by extension, having a right to your own time (time is money) with selfishness.

    If I wish to donate my own money for the good of others’ lives then that is a decision I should be making. A decision based on compassion rather than force.

    PZ, I’d be interested in hearing exactly what your so-called “real community of liberty” entails. Please describe the laws of your ideal country.

  169. CalGeorge says

    See, this is the problem – how is it anybody’s business but my own, how I spend my money?

    How are we supposed to decide whether Libertarianism is a good thing if none of you will tell us what you are going to spend that money on after taxation is abolished?

    Presumably, you would want to buy a few more guns.

    What else?

    Tell us!

  170. says

    What I wonder is why anyone thinks “Africa” is their problem to worry about. Who gave any invidual, or group, or country, the right to go around and try to fix other parts of the world?

    To Tulse: I never said I wanted to get rid of all taxation. Clearly no government can function without tax revenue. That doesn’t mean that many of the government programs are in principle or in effect good. When government starts to get its fingers into things, it is going to balloon. It seems to me there are great problems, say, with universal healthcare.

    I don’t want my tax money going to pay for medical care for people willingly endanger themselves, say by smoking. I work on a medical floor in a fairly large hospital and you wouldn’t believe how many smoking related illnesses we see. Should the government, then, tell people they can’t smoke if they are going to receive health care benefits? What about eating fast food, food with lots of trans fats, people who don’t exercise regularly? Why should people who don’t make an effort to keep themselves in good physical shape receive money to pay for their health care, money which might not be necessary otherwise? Who decides what sort of health care a person should receive? If the person is receiving government-funded health care, it will undoubtedly be the government. But why should I want the government to be in charge of making my health care decisions?

    What about controversial issues like abortion? Will that be covered by universal health care? Why should Christians who believe it is immoral be forced to pay for it?

    It is proposals for things like universal health care that I see as problematic, not police services. Although, police budgets could be tweaked quite a bit if the ridiculous war on drugs was ended. That money could go for things that mattered – like catching rapists and child molesters and prosecuting them more successfully.

  171. tomh says

    Matthew Dean wrote:
    the federal government threatens me with jail if I decide to remove myself from paying …

    Why do people keep talking about the government as though it’s something imposed from afar? In the US anyway, the government is a reflection of the people, elected by the people, and carrying out the majority of the people’s wishes. If people don’t like what the govenment is doing they can vote them out and vote in a different government. You may not like what the government does but if you can’t convince a majority that you’re right, well that’s one of the drawbacks of living with this system. You kind of have to go along with what the majority wants.

  172. brent says

    See, I have never had a corporation take my money by force. If a corporation does not serve my interests, I do not utilize their services. However, the federal government threatens me with jail if I decide to remove myself from paying for the “war on drugs” it wages against its own citizens.

    Corporations do not taken by force only because the government prevents them from doing so with laws and a publicly financed police force. The fact that you have a choice of services is also due to the fact that governments creates rules that prevent monopolies and allows for competition. The fact that this needs to be explained is absurd but here we are.

  173. Interrobang says

    So, Matthew Wilder, paid any attention to what happens when you flush your toilet lately? How about after your car leaves your laneway; I assume you drive, no self-identified Libertarian would ever take public transit.

    I think Mieville’s most interesting argument in the whole piece is about the Freedom Ship’s potential internal labour. One thing the vulgar capital-L Libertarians always seem to forget about, conveniently, is that while everyone’s off pursuing their dreams, who, pray tell, is collecting the garbage and taking care of the minutiae of daily life? (Or, as Jello Biafra once put it in a song lyric, “Anarchy sounds good to me, but someone has to fix the sewers.”)

    When you bring this oversight down to the micro level, at least with the vast majority of the vulgar Libertarians of the sort Mieville is criticising, you almost always encounter a double, self-reinforcing layer of male privilege and misogyny. How many of Libertarian men pay their wives for at least part of the services they render to them? Even if you assume arguendo that part of that payoff is in kind rather than cash (as in exchanging services for room and board, so to speak), if people actually had to contract on even the current iteration of the market for the sorts of services even working wives provide to their husbands, they’d be paying in the five or six figures a year for it. (This is one area where radical feminists and small-l libertarians often overlap — taken as a general social phenomenon, rather than on a case-by-case basis, we see marriage [YMMV] as an essentially coercive arrangement that hurts women more than it benefits them.)

    I’m willing to bet that a lot of these guys are just assuming that someone will be around to pick up after them. Why would they think differently, after all, since that’s been the case their entire lives? (Libertarianism, making the world even safer for the Patriarchy, since who knows when.)

  174. says

    CalGeorge – I do not own any guns, and don’t ever plan on owning any. Also, it seems obvious to me that freedom of choice is a good thing. Why do you think it is not? Why should freedom of choice have to be “proved good” before it is accepted? (Also note, I have nowhere said I want to get rid of all taxation.)

    Matthew Dean – excellent point.

  175. Hank Roberts says

    > See, I have never had a corporation take my money by force.

    Chuckle. By con, by captured regulation, by lobbyist-law, by monopoly, by stock fraud, by counterfeit product, by warranty wiggle, by false advertising, but not by ‘force’ — eh?

    Eaten high fructose corn syrup lately? Used electricity?

  176. says

    Tulse:
    Ahh…Shifting goal posts. Yes, theoretically, it should not be the job of the State. but practically, a workable option is when the interference is kept to a minimum and the number of reasons for which the Government has to use force is minimized. Taxes are monies taken by the Government to do what they promise to do. The assumption here is that they want to spread telephone connectivity to the boondocks. If that is not a mandate, it will not happen. But when it is, that’s where democratic representation, interest groups and individual freedom/ entrepreneurship get into a royal ‘crossed connection’. A higher probability towards an optimal solution comes from following the basics of libertarianism and democracy…individual freedom and consent. (of course, consent in a democratic set up may mean I end up paying for something I don’t agree with, but that is the tyranny of aggregates and inevitable in the real world.)

  177. CalGeorge says

    I don’t want my tax money going to pay for medical care for people willingly endanger themselves, say by smoking.

    Do you think it’s okay for the tobacco companies to make all those cigarettes? And woo people into becoming smokers?

    Should government be allowed to do something about that?
    Under the “do no harm” principle, they should be shut down.

  178. Matthew Dean says

    brent
    Corporations do not taken by force only because the government prevents them from doing so with laws and a publicly financed police force. The fact that you have a choice of services is also due to the fact that governments creates rules that prevent monopolies and allows for competition. The fact that this needs to be explained is absurd but here we are.

    Monopolies, you say? Like US Steel and GM? 30 years ago everyone was hand-wringing over what the government should do to break up those gargantuan monopolies. Now everyone is talking about government bailouts for their inevitable downfall. All it took was a little foreign competition (which was prevented from competing in the US by the government) to kill those titans, what other “monopolies” does the government need to break up?

    Why do people keep talking about the government as though it’s something imposed from afar? In the US anyway, the government is a reflection of the people, elected by the people, and carrying out the majority of the people’s wishes. If people don’t like what the govenment is doing they can vote them out and vote in a different government. You may not like what the government does but if you can’t convince a majority that you’re right, well that’s one of the drawbacks of living with this system. You kind of have to go along with what the majority wants.

    True, but the more the government controls, the less likely a politician is to conform to my particular view, right? If I really like a politicians view on what to do about highways, lets say, but he also thinks that gays should be put in prison and we faked the moon landing, I am in a bit of a dilemma. I will have to give my vote to a candidate who I perhaps don’t like so much on highways. Giving states more rights would fix this, as I could choose to move to a state which best conformed to my wishes for how government should be run.

  179. nathan says

    I like not dying better than dying, so obtaining health care should be treated exactly like shopping for electronics?

    Well, treated like shopping for any other service. If we had a free market in health care, medicine would be cheaper (AMA couldn’t artificially restrict the doctor supply by keeping med students out, and if you are bargaining over health services doctors will have to compete on price as well as service). Think about it — how come prices in medicine are going up with technology rather than down?

    A serious libertarian thinker once explained to me that the government shouldn’t fund education or health care for poor children; “they should have chosen better parents”. Of course, I thought he was pulling my leg, but it turned out I was mistaken on that point.

    Welp, I’m not that guy so I can’t answer for his silly reasoning. Of course children don’t pick their parents. But school can be a lot cheaper than it is, and it can be provided without violence. See home schooling, school co-ops, etc. Again, I don’t expect you to readily agree to this (I didn’t).

    If libertarians are all about such extreme positions, then there’s not a lot of common ground to be had with people who can espouse such a position, and simultaneously claim to be all about the individual.

    Extremity is a decidedly relative consideration. Abolitionists of slavery and people who favored democracy over monarchy were once considered quite extreme. I’m sure you now support both of these previously extreme views. Atheism is pretty extreme to most people, but we probably both nonetheless consider it true. Extremity does not impact the truth or falsehood of a proposition.

    And if you are a liberal, I would argue we have a lot of common ground. You probably favor freedom of speech, abolition of drug prohibition laws, separation of church and state, etc. Frederic Bastiat, who would definitely qualify as laissez-faire/libertarian, sat in the left wing of the French Legislative Assembly, from which the terms “left wing” and “right wing” derive. In my view, libertarians and liberals have a lot more in common than libertarians and conservatives.

    We agree on ends (a better life for everyone), we just differ on means (whether it’s ok to use violence to achieve those ends).

  180. says

    Why do people keep talking about the government as though it’s something imposed from afar? In the US anyway, the government is a reflection of the people, elected by the people, and carrying out the majority of the people’s wishes. If people don’t like what the govenment is doing they can vote them out and vote in a different government. You may not like what the government does but if you can’t convince a majority that you’re right, well that’s one of the drawbacks of living with this system. You kind of have to go along with what the majority wants.

    Indeed, and that is why we try to convince people of our viewpoint through argument, and not coercion.

    Corporations do not taken by force only because the government prevents them from doing so with laws and a publicly financed police force. The fact that you have a choice of services is also due to the fact that governments creates rules that prevent monopolies and allows for competition. The fact that this needs to be explained is absurd but here we are.

    Well, I’m not sure about your first claim. I don’t see how it would be in any corporations best interests to take money from people. No one would do business with them, and they would go bankrupt. But suppose you are right. No one I know is proposing that we abolish the police force, so the point is moot.

    About your second claim, I think the government might need to make laws about monopolies because of its own interference with the market. If there were no government subsidies of any corporations (as there should not be), then corporations would always have to compete against new entrepreneurs. The way things often are now, though, corporations become established, and then receive government subsidies, thus removing them from the competition of the market. If this were not the case, no monopoly laws would be needed.

    A free market means just that – free. No corporate welfare, no government intrusion in contracts between willing partners, freedom of choice for consumers. Again, why is this objectionable?

  181. travc says

    Unfortunately, people identifying themselves as libertarians have self-selected towards the fringe, as such groups (especially minor political parties in the US) do. If libertarianism was not associated with those nut-job extremists, then the core principles/philosophy could have a much broader ‘mainstream’ appeal.

    Personally, I tend to take the libertarian position as a good default. If there are compelling reasons to deviate from that position, then fine, but the argument is why there should be intervention, regulation, taxation, socialization… Arguing from the other direction (why shouldn’t government/society do something) tends to be fraught with dangers and unintended consequences of the first order.

    All that said, I support universal healthcare and all sorts of non-Libertarian (with the capital L) positions, since there really are convincing rational reasons. Hell, I think the economic arguments for universal heathcare are some of the best and most convincing ones that can be made… and am a bit annoyed that the current talking-points just ignore them (or at best just assert some partial conclusions while glossing over the convincing reasoning behind them).

    Anyways, ‘little l’ libertarianism seems to me like a perfectly fine POV, despite the fact that the organized ‘big L’ Libertarian movement is mostly a bunch of wankers.

  182. Madam Pomfrey says

    Who decides what sort of health care a person should receive? If the person is receiving government-funded health care, it will undoubtedly be the government. But why should I want the government to be in charge of making my health care decisions?

    Why should you want an insurance company with a strong profit motive to be in charge of making your healthcare decisions?

  183. Madam Pomfrey says

    Sorry, first paragraph should have been blockquoted. Preview button’s there for a reason.

  184. gwangung@u.washington.edu says

    If we had a free market in health care, medicine would be cheaper

    Easier said than done.

    A free market requires perfect information flow, which is more readily approximated in consumer, low stake markets.

    The big constraint in health care is NOT in institutions, but in time. All individuals cannot get the relevant information themselves–they MUST rely on 2nd and 3rd hand reports, which introduce massive inefficiencies into the market.

  185. says

    Do you think it’s okay for the tobacco companies to make all those cigarettes? And woo people into becoming smokers?

    Should government be allowed to do something about that?
    Under the “do no harm” principle, they should be shut down.

    I think people should be treated as adults, and allowed to make their own decisions. No cigarette company is forcing people to smoke against their will. I don’t see how its any of my, or your, or the government’s business if some people want to pay some other people to smoke tobacco.

    I don’t think the “Do no harm” principle applies here. The government is not harming anyone, and neither are the tobacco corporations. The only people being harmed are smokers, but they chose that, so it shouldn’t concern me, as long as I’m not forced to pay for their medical care.

    It is strange to me how patronizing some people can be. When it comes to atheism, we are all on board against paternalism – people should be given the truth,a nd not treated like infants when it comes to religious beliefs. I think the same principle should apply across the board.

  186. TheBlackCat says

    Basically, when pressed, it seems that at least here the libertarians are basically saying government is necessary, they just don’t agree with some of the programs it is currently involved in. But does that really need a new name? I am not aware of anyone who thinks government is perfect. I am not aware of anyone who doesn’t think certain government programs should be abolished. People disagree about which ones. But how, specifically, is libertarianism different than just being a citizen of a country? You can talk all you want about how great the free market is, you can say how much you like personal freedom, you can complain about the war on drugs, but you don’t have to be a libertarian to think those sorts of things. Libertarians do not have the sole claim to those concepts. What I want to know is what the fundamental difference is between libertarianism and everyone else. What is so different about your idea that you need a new category outside outside of “human”?

  187. Rev.Enki says

    Well, to add to the confusion of definitions for libertarianism (and Libertarianism)… I always thought of it basically as the following. Equality of opportunity is either completely misunderstood (at best) or is completely undesirable (at worst).

    The main thing that all libertarians have in common is the idea that all controls, democratic or otherwise, which seek to bring us closer to something resembling equality of opportunity are so onerous as to be undesirable in all (or virtually all) cases. They adhere to a very basic ideal of freedom which says that only government limits on the freedom of individuals are significant. Those imposed by individual circumstances and/or market conditions don’t matter enough to warrant any sort of social contract based intervention (ie. democratic government) to level out the field of opportunity in any way. They generally rationalize this part with anecdotes and fantasies of the lowly-born entrepreneur who rises to the top through his inherently superior genes/ideas, all the while completely ignoring the inconvenient fact that by far the best predictor of future success is choosing successful parentage. That, or they outright embrace a nasty form of outright Social Darwinism.

    The second major idea the seem to hold is that the system of interconnected games we call markets are, in all or nearly all cases, the best and most efficient predictors of future events. This requires them to gloss over, rationalize away, or otherwise fail to notice the very real empirical evidence (and obvious flaws in relating theoretical free market models to actual human behavior) that shows this idea to completely flat out wrong for a significant fraction of our real world problems. Most of them further shore up this ideological position with a massive slippery-slope rationalization that says all other alternatives inevitably approach dictatorial central planning.

  188. says

    Why should you want an insurance company with a strong profit motive to be in charge of making your healthcare decisions?

    I think I should decide. If I disagree with an insurance company, I can get different insurance, since the insurance company isn’t coercing me into taking their services. With government insurance, I would be coerced, and thus could not vote with my dollars.

  189. says

    If we had a free market in health care, medicine would be cheaper (AMA couldn’t artificially restrict the doctor supply by keeping med students out, and if you are bargaining over health services doctors will have to compete on price as well as service). Think about it — how come prices in medicine are going up with technology rather than down?

    Ah, the free market ‘magic’ that makes everything cheaper (except for when it doesn’t). Provide evidence that ‘the free market makes things cheaper’ and explanatory mechanisms for any evidence provided or stop citing it as some fundamental law of the universe.

    If you cannot, then please accept that reality is more complicated than your naively simplistic economic theory.

  190. nathan says

    the organized ‘big L’ Libertarian movement is mostly a bunch of wankers.

    Ha, agreed! (‘Little-l’ over here.)

  191. Madam Pomfrey says

    The government is not harming anyone, and neither are the tobacco corporations.

    So you think someone selling a toxic, addictive substance is not causing harm, just because people can “choose” whether or not to buy? Wow.

  192. jcw says

    David M,OM said,”Excuse me? I live in a functioning welfare state with free healthcare for all EU citizens.”

    If you are being serious with that statement just how does that work? Are all services, buildings, pharmaceuticals, and equipment donated? Is anyone in your healthcare system paid? Do any taxes support the system?

  193. TheBlackCat says

    Think about it — how come prices in medicine are going up with technology rather than down?

    Because modern medical technology is extremely expensive. Do you have any idea how much a single MRI machine costs?

  194. Matthew Dean says

    TheBlackCat
    Basically, when pressed, it seems that at least here the libertarians are basically saying government is necessary, they just don’t agree with some of the programs it is currently involved in. But does that really need a new name? I am not aware of anyone who thinks government is perfect. I am not aware of anyone who doesn’t think certain government programs should be abolished. People disagree about which ones. But how, specifically, is libertarianism different than just being a citizen of a country? You can talk all you want about how great the free market is, you can say how much you like personal freedom, you can complain about the war on drugs, but you don’t have to be a libertarian to think those sorts of things. Libertarians do not have the sole claim to those concepts. What I want to know is what the fundamental difference is between libertarianism and everyone else. What is so different about your idea that you need a new category outside outside of “human”?

    Of course government is necessary! We aren’t anarchists here. I also don’t think that libertarians have many “original” views if you look at current American politics (as in, there is no issue libertarians have to themselves that neither “liberals” nor “conservatives” don’t agree with, or at least pay lip service to). But just because we think that some government functions are good does not mean that we agree with much of what goes on with government, and libertarians would like to dramatically reduce the size of government more then either liberals or conservatives propose on their own.

  195. says

    So you think someone selling a toxic, addictive substance is not causing harm, just because people can “choose” whether or not to buy? Wow.

    Your quotation marks seem to imply that people do not choose to buy cigarettes. Why do you think this? Who is forcing any consumer to buy them?

  196. says

    Oh PZ, you’ve slighted me. I agree with you everywhere else, but I’m a proud libertarian. You’ve completely misunderstood the position! It’s not greed for being-a-dick’s sake, there is compelling moral reasoning behind it. You don’t have to agree, but common, we’re a far cry from creationists.

  197. Madam Pomfrey says

    With government insurance, I would be coerced, and thus could not vote with my dollars.

    IIRC, the National Health Service in the UK does not prevent anyone from seeking out privately financed care if they so desire (and, of course, if they can afford it). Any Brits here, feel free to correct me. I don’t recall any current political advocate of government-facilitated and/or government-financed healthcare suggesting that one single option will be forced on every US citizen; that’s more of a phantom fear/scare tactic than reality. Even the liberal presidential candidates are proposing systems with a mix of government and private services.

    As for picking and choosing insurance companies: in reality not everyone has the wherewithal to pick the company or plan that provides the best coverage, and don’t forget that those who can’t afford insurance end up going to emergency rooms for standard care, which drives up the cost for the rest of us.

  198. says

    What I wonder is why anyone thinks “Africa” is their problem to worry about. Who gave any invidual, or group, or country, the right to go around and try to fix other parts of the world?

    The fact that the West played a huge role in breaking it in the first place, and continues to benefit from it.

    Like I said, a lot of libertarians seem awfully selective about the corporate violations of individual and property rights that they get exercised about.

    Well, treated like shopping for any other service. If we had a free market in health care, medicine would be cheaper (AMA couldn’t artificially restrict the doctor supply by keeping med students out, and if you are bargaining over health services doctors will have to compete on price as well as service). Think about it — how come prices in medicine are going up with technology rather than down?

    And in the case of surveillance for infectious disease or malaria antibiotic resistance, a delay of 3 days in detection can mean thousands of lives lost. So exactly how many individuals’ actual lives, quality of life, and transaction costs are you prepared to sacrifice to time lost while Medicine-VHS vs. Medicine-Betamax plays out at every single leaf node?

  199. Dustin says

    I’m sure it’s been said, but I’ll say it again. People aren’t free when they’re sick, poor, uneducated and unemployed. It is by ensuring that people have access to education, healthcare and a good job that we make them free.

    In any case, libertarian market worship is as much a case of faith as any religion, it’s one where there is no such thing as an equilibrium which isn’t both stable and optimal. I suppose libertarians think it was market forces that stopped the child labor and pittances and poor houses that marred the beginning of the industrial age.

  200. negentropyeater says

    Americans really have a problem with Health care. When they are told that they rank #37, on par with one of their poorest neighbours, Cuba, of course the answer is that the UN is anti-american. And please note that those same people will tell you that free markets drive the cost down but they fail to explain why Americans are those who spend the biggest % of GDP on healthcare despite having such a poor track record.
    If there is one clear example of where free market economy doesn’t work, it’s healthcare.
    In France, we are very pleased with our system. Our only problem is that it makes our companies slightly less competitive because there are still many countries in the world that view healthcare as a luxury. If every country handled healthcare the way we do in France, the discussion would be over.
    Health care is a basic human right and should be handled that way. And please, don’t start with those slippery slope arguments about what should constitute a good normative behaviour. “I don’t want to pay for someone who smokes” “well, I don’t want to pay for someone who eats red meat” “and I don’t want to pay for someone who drives a car” “and I don’t want to pay for someone who is older than 60” “and I don’t want to pay for someone who doesn’t masturbate often enough” “and I …” How pathetic.

  201. Madam Pomfrey says

    Your quotation marks seem to imply that people do not choose to buy cigarettes. Why do you think this? Who is forcing any consumer to buy them?

    You’re deviating from the main point, but I’ll bite. Of course people choose to buy cigarettes. Once they’re addicted to nicotine, however, the issue of choice becomes less black and white. People can quit, but it becomes much more difficult once the addiction is established.

    The tobacco companies distribute material that is known to cause serious illness, along with a delivery system that enhances the addictive effect of this material. I believe someone who chooses to smoke is making a serious mistake. But those who are putting the poison out on the shelf and encouraging people to buy it are also culpable. I would imagine that this is a fairly basic point. Is it okay to sell cyanide pills on the street to make money? After all, smart people like us (smug, superior smirk) would never buy them, and the ones who do (more smug, superior smirks) just get what they deserve.

  202. says

    It must be a sign that our bloated governments have too many employees that there are so many Dilbert fans, since no non-government worker could possibly relate to such an inefficient workplace.

    I just wonder why Scott Adams chose not to name the particular government his characters work for, instead setting the cartoon at a privately-owned corporation. It must somehow make the cartoon cheaper.

  203. says

    You’re deviating from the main point, but I’ll bite. Of course people choose to buy cigarettes. Once they’re addicted to nicotine, however, the issue of choice becomes less black and white. People can quit, but it becomes much more difficult once the addiction is established.

    I don’t see how that is my problem. Saying it is is infantilizing to the adults who choose this behavior. If they wanted to buy cyanide pills, let them. Why should we try to protect people from the consequences of their actions? I, nor you, nor the state are responsible for their well-being.

  204. nathan says

    Ah, the free market ‘magic’ that makes everything cheaper (except for when it doesn’t). Provide evidence that ‘the free market makes things cheaper’ and explanatory mechanisms for any evidence provided or stop citing it as some fundamental law of the universe.

    I cited two explanatory mechanisms in the very paragraph you quoted. I shall now amplify on each one in order to be a little more clear.

    The first part was the AMA. The AMA is a powerful union. They use government force by proxy in order to restrict the supply of doctors in order to keep doctor wages high. How come we can only have one medical licensure organization, and it has to be compulsory? If licensure organizations had to compete, they could not cartelize and restrict entry into the profession. More doctors -> cheaper medicine.

    If you look at the high wages and long hours worked, it definitely looks like we are in an artificial doctor shortage. The high wages should be attracting more doctors to the profession in droves, but compulsory licensure keeps many of them out. Only the doctors themselves benefit from this, and everyone else is poorer for it.

    The second mechanism was simple bargain-shopping. When you buy a car, you shop around, and car dealers have to compete on price and quality. If you could do the same for doctors, the prices would come down: Doctor A charges X dollars and has such and such rank in, say, Doctor Ratings Monthly [or whatever doctor-ranking publications/sites you happen to find credible]. Doctor B is cheaper, but his success rate with my operation is, say, some 5% lower. Then I can decide what level of risk I want to take vs. how much I want to spend.

    Doctors would have every incentive to have better stats, and ratings orgs would have every incentive to come up with more and better ways to rate doctors.

    With the system as it is now, we are very decoupled from the price system when we make medical decisions, and it becomes very difficult to allocate resources in a rational way. I think that more medicine would be available to more people if we really had an undistorted market.

    You are of course free to disagree with me. I defend my position mostly to show you that I’m not just pulling this free market stuff out of my arse. I sincerely believe these things. Maybe you think I’m crazy, but please at least believe that my intentions are good.

    If you cannot, then please accept that reality is more complicated than your naively simplistic economic theory.

    Of course reality is complicated. That’s why I fear some group of experts thinking they can dictate a health care system that I am forced to take part in. I fear any such attempt is both naive and doomed. I think decentralization is nearly always a better way to deal with massive complexity than top-down directives. (Wee, more parallels with evolution vs. creationism.)

  205. says

    Of course reality is complicated. That’s why I fear some group of experts thinking they can dictate a health care system that I am forced to take part in. I fear any such attempt is both naive and doomed. I think decentralization is nearly always a better way to deal with massive complexity than top-down directives. (Wee, more parallels with evolution vs. creationism.)

    I think this is a very important point. People have a tendency to see a problem, and then want to fix it. I think we should all be more skeptical of the proposed solutions to various problems. The impulse to help may be noble, but with imperfect information, and ideological blindnesses we might not even be aware of, centralized solutions are risky.

    Now, “market evangelists” are often accused of worshipping the market as all-solving mechanism. This is a caricature, though. In many cases the market can solve problems. But if it can’t, that does not mean that the government can. It seems to me that in some cases, there might be no solution. I think it is naive to think that there is a solution to every problem. We live in a messy world, and we should expect that sometimes things won’t work out at all the way we wish they would.

  206. TheBlackCat says

    But just because we think that some government functions are good does not mean that we agree with much of what goes on with government, and libertarians would like to dramatically reduce the size of government more then either liberals or conservatives propose on their own.

    Lots of people who aren’t Libertarian do not agree with much of what goes on with the government. Lots of people who aren’t Libertarian have problems with the war on drugs, with war in general, with nationalized healthcare, with overregulation. But just saying they want to shrink the government meaningless without specific rules about what is and is not good to have. And I have not seen any such rules here that are both feasible and any different than the sort of rules lots of non-libertarians support. So I will ask again: But how, specifically, is libertarianism different? Having a small government is a nice ideal, but without specifics about what is good and what isn’t then it just a bunch of hot air.

  207. Barn Owl says

    #193-

    They use government force by proxy in order to restrict the supply of doctors in order to keep doctor wages high.

    You link a reprint from a book that was published in 1962 as evidence for your conspiracy theory about the AMA? Seriously?

    Medical school enrollment increases each year in the US. Try looking at 2007 data from the American Association of Medical Colleges:

    http://www.aamc.org/newsroom/start.htm
  208. negentropyeater says

    Mathew, what you fail to understand, is, where does your argument start and end.
    The Law is supposed to be there to define what one is allowed to do or not. If one breaks the law, one shall pay a penalty or go to jail. As far as I am concerened, whatever the Law is at a particular moment, any human being should be entitled to the same minimum health care as anybody else, whatever he has done or not done in his life.
    It is much simpler to organise society that way than to start defining all kinds of rules and conditions such as, this guy was taking cocaïne, so if he has a heart condition, it’s his problem ,not mine. And this guy was smoking cigareetes so again, why should society pay, etc…
    If you want to organise the world that way, it will never work.
    Just think of health care as part of the basic human right that comes with being born on this planet and get done with it. There are sufficient other inequalities in life so that you can have the feeling of being special.

  209. Dustin says

    I fear any such attempt is both naive and doomed.

    Here’s the thing about your personal incredulity — I don’t actually give a shit about it. You should be forced to take part in a health care system for the same reasons you’re forced to take part in paying for roads and an education system. Even if you aren’t using them directly, you’re still using them. And it isn’t something that you’d ought to be able to opt out of, because having those things isn’t just a benefit. Without roads or literacy, political philosophy will be as useful as a driver’s manual. It’s the same thing with health care.

    Have you bothered to do draw a few supply and demand curves to see what happens when health insurance is the only option people have for paying for medications and medical services? I mean, I assume you have, you’re a libertarian and you all profess to be masters of economics. Since the people with insurance aren’t sensitive to price increases, they’ll continue to use the services no matter how far up that price goes. You get two ways of turning a profit… one where even people without insurance can afford medication and one where the price will continue to escalate until the companies are able to turn a profit just from the people who have insurance. The presence of large numbers of consumers whose habits aren’t sensitive to price increases will always drive the system away from the first situation and into the second. Guess where we are?

    How come we can only have one medical licensure organization, and it has to be compulsory?

    Ever had surgery in Tijuana? No? Gosh, why not?

  210. Robert says

    Sad to see that PZ is such an enemy of liberty, along with many of this blog’s readers. It appears your beef with religion is not so much the control it attempts to exercise over us, but that you’re not the one who’s currently doing the controlling.

    And to the banal objection that “we’re ruled by the majority,” once again you conveniently forget a little document called the Bill of Rights. I know, an outdated and irksome thing which you undermine at every turn while paying it lip service. Sorry if some of us object to your plans for a New Socialist Order in which we’re merely pawns to your grand social engineering schemes. They don’t exactly have a very successful track record.

  211. chaos_engineer says

    Libertarians are almost universally opposed to the initiation of force.

    Yes, but they’re using a weird definition of the word “force”.

    Suppose you’re a citizen of a country, and you spend a year enjoying the benefits of that citizenship. The country has open borders, so if you’re not happy with that set of benefits, you’re free to move to any other country that will let you in. At the end of the year, the country bills you for the cost of providing those benefits. In Libertarian-speak, making you pay that bill is an “initiation of force” and you’re morally entitled to shoot the bill-collector.

    Not only that, but if the country is a democracy, and I vote that you should have to pay your bills, then I’m “initiating force” just by casting my vote.

    And if I argue that the government should provide any new benefits, then I’m also “initiating force”, even if I’m supporting an unpopular idea that’s not likely to come up for a vote anytime soon.

    Now, here’s the tricky part. This only applies if the government is collecting the bills. Suppose I buy all the streets around your house, convert them to toll roads, and charge you a million dollars to use them. If you try to sneak across the road to buy food, then you’re “initiating force” against me by trespassing, and I can shoot you!

    Strange but true: Suppose we dissolved the US government, and then started a corporation called UsCo that had basically the same set of rules. (In other words, we’d issue one share of stock to everyone, and then rewrite the Constitution, changing “citizen” to “shareholder”.) Libertarians would be more than happy to pay their membership dues. I’d be trying to make this happen, but, frankly, making Libertarians happy is pretty much at the bottom of my list of priorities.

  212. Matthew Dean says

    TheBlackCat
    Lots of people who aren’t Libertarian do not agree with much of what goes on with the government. Lots of people who aren’t Libertarian have problems with the war on drugs, with war in general, with nationalized healthcare, with overregulation. But just saying they want to shrink the government meaningless without specific rules about what is and is not good to have. And I have not seen any such rules here that are both feasible and any different than the sort of rules lots of non-libertarians support. So I will ask again: But how, specifically, is libertarianism different? Having a small government is a nice ideal, but without specifics about what is good and what isn’t then it just a bunch of hot air.

    OK, heres a basic definition:

    The libertarian strives always for freedom, both individual, and economic. The government should not get involved in decisions the individual makes, unless those decisions directly harm others. The individual may harm himself in this process, but that is the responsibility of the individual, and the government should not get involved in those decisions.
    The government should also get involved as little as possible in fiscal decision-making. The individual knows best how to spend their own money, and the bureaucrat sitting in his office in Washington will never be able to efficiently manage that individuals funds for him. If the individual squanders his money, that is no ones fault but his own, and he will suffer the consequences for it.

    There is more to it then that, but that is the baseline for a “libertarian”.

  213. Madam Pomfrey says

    The impulse to help may be noble, but with imperfect information, and ideological blindnesses we might not even be aware of, centralized solutions are risky.

    Yes, which is why we have the Centers for Disease Control, a taxpayer-funded government agency whose cutting-edge basic and applied research contributes to our information becoming a bit less imperfect.

  214. says

    The second mechanism was simple bargain-shopping. When you buy a car, you shop around, and car dealers have to compete on price and quality. If you could do the same for doctors, the prices would come down: Doctor A charges X dollars and has such and such rank in, say, Doctor Ratings Monthly [or whatever doctor-ranking publications/sites you happen to find credible]. Doctor B is cheaper, but his success rate with my operation is, say, some 5% lower. Then I can decide what level of risk I want to take vs. how much I want to spend.

    This is exactly what I’m talking about. This is nothing but hand-waving dreck.

    a) When you buy a car, you shop around,
    b) car dealers have to compete on price and quality.

    So that’s your claim? A leads to B because you say it? And that’s the ideal to which you’re comparing doctors?

    Do you understand what I mean by providing evidence (as compared to simplistic allegories)?

    If you could do the same for doctors, the prices would come down: Doctor A charges X dollars and has such and such rank in, say, Doctor Ratings Monthly [or whatever doctor-ranking publications/sites you happen to find credible]. Doctor B is cheaper, but his success rate with my operation is, say, some 5% lower. Then I can decide what level of risk I want to take vs. how much I want to spend.

    I’ll just say it. Your little thought experiment sounds fine if you’re talking about elective surgery. Last time I was hit by a car, I was a little to preoccupied to consider which hospital emergency would give me the most bang for my buck.

    At any rate, a thought experiment is not evidence, nor is the description you provided anything like an explanation robust enough to be considered compelling on its own merit.

  215. Dustin says

    I’ll go further: people who don’t want to pitch in for health care are freeloaders. They’re deriving economic benefits from those of us who are lucky enough to be able to afford health care without feeling that they should have any obligation for that health care.

    I mean, I expect that libertarians aren’t so bone headed that they can’t recognize that healthy people produce more. Everyone benefits from a healthy work force.

  216. Rev.Enki says

    Re: the Friedman discussion (*way) above: anyone who doesn’t think Milton Friedman was quite strongly involved with Pinochet is either unaware of the Chicago Boys, is completely daft, or is a nasty little fucking liar. Those, or combinations of them, appear to be the only serious possibilities.

  217. TheBlackCat says

    How come we can only have one medical licensure organization, and it has to be compulsory? If licensure organizations had to compete, they could not cartelize and restrict entry into the profession. More doctors -> cheaper medicine.

    All we have to do to see the results of this is to look at so-called “alternative medicine”. We have people selling sugar pills as cures for cancer, people waving their hands in the air and claiming it can cure diabetes. And we have huge numbers of people believing them. People die every day because they take these quack “medical treatments” instead of proven, safe, effective and simple treatments for common problems. We have doctor shopping right now between proven effective real doctors and proven worthless quacks and people go to the quacks in droves. The reason why people do this is irrelevant, imagine how bad it would be if people didn’t have any body like the AMA that they could even marginally trust to tell them who is safe to go to and who isn’t.

    People don’t have the time, money, or scientific knowledge to accurately assess the effectiveness of different treatments. They have to trust the experts. Without regulation to make sure that the experts are trustworthy we will get what we have now with alternative medicine, nice, plausible-sounding quackery that people use because they simply do not know any better, nor could they reasonably be expected to know any better. That is not to say that all alternative medicine is quackery, some may very well work in certain situations. But in a situation like alternative medicine today the only accountability is to market forces and thus the person who succeeds is the one who can tell the most believable lies. There is no punishment for lying as long as people continue to believe you, and people will believe you as long you can make it sound plausible to people without college-level biology, physics, and chemistry (which is not particularly difficult).

  218. Jason says

    negen,

    Americans really have a problem with Health care. When they are told that they rank #37, on par with one of their poorest neighbours, Cuba, of course the answer is that the UN is anti-american.

    My answer is that that ranking is basically meaningless. It doesn’t tell us anything meaningful about the quality of health care in the U.S. compared to other countries.

    And please note that those same people will tell you that free markets drive the cost down but they fail to explain why Americans are those who spend the biggest % of GDP on healthcare despite having such a poor track record.

    What “poor track record?” The reasons why America spends so much on health care are complex, but a large part of it is that America is simply richer and that total spending is largely determined by market forces rather than government budgets.

    In France, we are very pleased with our system.

    In France, your health care system is going bankrupt. It chronically runs huge deficits, and major reform is needed to either cut benefits, raise taxes, or increase out-of-pocket and private insurance costs to French consumers in order to protect the long-term solvency of your public health insurance fund. A similar problem is looming for Medicare in the U.S., which is projected to start spending more than it collects in taxes in about a decade.

  219. says

    It appears your beef with religion is not so much the control it attempts to exercise over us, but that you’re not the one who’s currently doing the controlling.

    Precisely. When it comes to religion, its okay to be up in arms about people trying to tell you how to live. When it comes to politics, it seems if you aren’t trying to impose your personal views about the good life and the good society, you’re a pariah.

  220. Madam Pomfrey says

    If they wanted to buy cyanide pills, let them. Why should we try to protect people from the consequences of their actions?

    Your assertion was that tobacco companies do not cause harm by selling cigarettes, simply because people can choose whether or not to buy them. This conclusion does not follow. I asked you whether or not people should be allowed to sell poison; you shifted the discussion to whether or not people should be prevented from buying it, which is a very different issue.

  221. nathan says

    You link a reprint from a book that was published in 1962 as evidence for your conspiracy theory about the AMA? Seriously?

    No, I linked to it to help explicate my argument. Ol’ Milton and I do not agree on everything, but I happen to think he was right about the AMA. I could find you more recent sources that say essentially the same thing, but I thought that classic piece summed it up well.

    As for the loaded “conspiracy theory” term, well, I suppose you could call it that. What do you call a bunch of people getting together to benefit themselves at the expense of others, employing force in the process? I mean, that’s what unions are for. They’re great if you’re the ~13% (or so, I forget the exact number) of the work force that is unionized, but everyone else pays higher prices for everything union-made. So in a sense you could call that a “conspiracy”, but it’s not really a secret plot or anything.

    Medical school enrollment increases each year in the US. Try looking at 2007 data from the American Association of Medical Colleges

    The population and economy are also growing. I would expect enrollment to be increasing over time. Good to hear it’s the largest class ever! But they are still a compulsory monopoly, and they are still restricting entry. If we could allow someone to compete with the AMA, we would be better off for it. Monopolies are, IMHO, pretty much always bad.

  222. Colugo says

    Notes:

    – Friedrich Hayek, pinko:

    Hayek, 1982, ‘Law, Legislation, and Liberty’ v. 2: “There is no reason why in a free society government should not assure to all, protection against severe deprivation in the form of an assured minimum income, or a floor below which nobody need descend.”

    – Libertarianism is profoundly offensive to progressives because they see it as antithetical to their core value, altruism.

    – Denouncing libertarianism is a salient social capital-enhancing signal; it is an announcement that one is an anti-anti-altruist – and hence is a form of indirect altruism.

    – Of course, economic libertarians would argue that they are in fact more altruistic because collectivism leads to immiseration and economic freedom raises living standards.

    – In reality, the right is anti-altruistic and the left is pseudo-altruistic. Just kidding. Kind of.

    – Sure, libertarianism is silly. But remember: No Objectivism, no The Question, no Rorschach – the best character in The Watchmen.

    Let’s tweak the above excerpt a bit to describe another political tendency: “Claiming a lineage with post-Enlightenment revolutionary Romanticism, as well as in some cases with the resoundingly portentous blatherings of Noam Chomsky, all of its variants are characterized, to differing degrees, by fervent, even cultish, faith in what is quaintly termed “Global” Justice, and extreme antipathy to that vaguely conceived bogeyman, “the corporatocracy,” with its manipulative and financial powers.”

  223. tomh says

    Matthew Dean wrote: A whole lot of vague stuff

    Those are pleasant principles but I don’t get where you draw the line. You want government police and courts but not other particular government services. I don’t see why I should have to pay for police if I want to defend myself. How do you know which services are in and which are out?

  224. says

    This thread has gone on so long there’s scant chance of anybody reading this, I figure (hell, I haven’t even read this whole mess) but I wanted to throw in a metaphor I find both useful and topically appropriate.

    An unfettered free market – the libertarian ideal – is essentially equivalent to natural selection on Dawkins’ “Selfish Gene” model. It has the same attributes of creating escalating complexity and sophistication through what are essentially undirected, semi-random processes. That is, while individual entrepreneurs may have “intelligent designs” for their businesses, from a bird’s-eye view the whole market resembles the teeming mass of the gene pool, trying out different combinations of reproductive strategies, keeping and rewarding what works, and ruthlessly purging what doesn’t.

    Just like real natural selection, the outcomes will be diverse – the evolutionary process has given us everything from kittens and cuttlefish to hammerhead sharks and cryptosporidia. This is why both sides of the argument never seem to be short of examples – libertarians tend to emphasize the Fords and Microsofts of the world, while liberal-socialist types like myself can point to Enron and Infinium Labs.

    The corrolary to all this, and my real point, is that some kind of governmental control over the market is necessary to guide it into producing only those kinds of expressions that are beneficial to society at large, or at least, not overly harmful – to make dogs out of wolves. In short, the function and aim of government in a capitalist society should be to domesticate the free market.

  225. Jason says

    Dustin,

    You should be forced to take part in a health care system for the same reasons you’re forced to take part in paying for roads and an education system. Even if you aren’t using them directly, you’re still using them. And it isn’t something that you’d ought to be able to opt out of, because having those things isn’t just a benefit. Without roads or literacy, political philosophy will be as useful as a driver’s manual. It’s the same thing with health care.

    Could you state your argument here a bit more clearly? Why should “participation in a health care system” be mandatory, but not, participation in, say, a “food system” or a “housing system?” Why should health insurance be universal and mandatory, but not, say, car insurance or homeowners’ insurance or disability insurance?

  226. nathan says

    Re: a million posts
    There is no free market in health care. Please everyone recognize this. There is significant government intervention in the health care sector, distorting it significantly from what a free market would look like.

  227. says

    There is no free market in health care. Please everyone recognize this. There is significant government intervention in the health care sector, distorting it significantly from what a free market would look like.

    Perhaps you’ll answer my question about a free market in medicine, then:

    And in the case of surveillance for infectious disease or malaria antibiotic resistance, a delay of 3 days in detection can mean thousands of lives lost. So exactly how many individuals’ actual lives, quality of life, and transaction costs are you prepared to sacrifice to time lost while Medicine-VHS vs. Medicine-Betamax plays out at every single leaf node?

  228. Matthew Dean says

    K. Signal Eingang
    The corrolary to all this, and my real point, is that some kind of governmental control over the market is necessary to guide it into producing only those kinds of expressions that are beneficial to society at large, or at least, not overly harmful – to make dogs out of wolves. In short, the function and aim of government in a capitalist society should be to domesticate the free market.

    What needs domesticating? The sole example you had, Enron, did harm to lots of people and paid dearly for it. Government courts took care of it, which is not at all inconsistent with libertarianism.

    Infinium Labs hasn’t harmed anyone, as far as I know, except the boneheaded shareholders who are purchasing stock. And that is there fault, now isn’t it?

    Can you name an “out of control” corporation which really really needs the government to get into the boardroom and start ordering people around? That goes to anyone, really, I would love to hear it.

  229. TheBlackCat says

    The libertarian strives always for freedom, both individual, and economic. The government should not get involved in decisions the individual makes, unless those decisions directly harm others. The individual may harm himself in this process, but that is the responsibility of the individual, and the government should not get involved in those decisions.

    Great in theory, but a bit thorny in practice. Take tobacco for instance. The tobacco companies are making a decision to sell a known poison to consumers. That decision directly harms others. So should tobacco companies be banned from selling tobacco? What about if bottled water company knowingly sold water with high levels of dangerous contaminants? Would you oppose punishing them? What if they didn’t know, but were lax in reasonable safety precautions? After all, everybody should know that it is possible that something could go wrong with the bottling of the water and thus they are knowingly taking a risk when drinking it. These are all cases where the decision of individuals causes direct harm to others.

  230. Matthew Dean says

    thalarctos
    Perhaps you’ll answer my question about a free market in medicine, then:

    As other people getting immunized from disease helps me, I have no problem with some government involvement in this sector. But just because government is needed there does not mean our tax dollars should pay for the cancer surgery of man who smokes his lungs black with tar or the drunk driver who wraps himself around the telephone pole (although I would be for a voucher-based universal healthcare).

  231. says

    Libertarianism is profoundly offensive to progressives because they see it as antithetical to their core value, altruism.

    I understand this position, but disagree with it. Libertarians do not think government should be in the business of altruism. Nor can you can make people altruistic by forcing them to pay for things that you think are altruistic.

    Of course, making people altruistic isn’t your goal, which is having certain ends, that altruism might lead to, met. I don’t think, though, that a liberal society should be in the business of dictating which altruistic goals everyone should support. That should be an invididual decision. If you want to donate money that will pay for health care for a COPD-er, or someone with diet-induced diabetes, that’s fine. I would rather donate my money, if I choose to donate at all, to more deserving patients – say, children with cancer.

    A liberal society is one where each person gets to pursue their own vision of the good life. Not everyone’s vision of the good life is as altruistic as yours. But they should be able to pursue their own vision without your vision being imposed upon them.

  232. Caledonian says

    The corrolary to all this, and my real point, is that some kind of governmental control over the market is necessary to guide it into producing only those kinds of expressions that are beneficial to society at large, or at least, not overly harmful – to make dogs out of wolves. In short, the function and aim of government in a capitalist society should be to domesticate the free market.

    Domestication tends to be a deeply destructive process that creates endforms that are unable to survive on their own and require constant human intervention to exist.

    Compare dogs to wolves, cows to auroch, cats to wildcats. They’re dumber, slower, and weaker, with impaired instincts that would quickly lead to their extinction outside of human breeding facilities.

    Guess what happens when you try to domesticate a market?

  233. Caledonian says

    The tobacco companies are making a decision to sell a known poison to consumers. That decision directly harms others.

    Consumers are making a decision to buy a known poison. That decision directly harms others.

    Should people be forbidden to purchase tobacco?

  234. says

    Why do liberals feel so threatened by libertarian secessionism? You guys seem to have some inordinate fear that if people are allowed to leave the system, the whole thing will collapse. The obsession with not allowing people to opt out doesn’t just extend to the fear that a handful of libertarians might stop paying taxes while living on a ship in the middle of the ocean (where presumably they won’t be consuming any government services), but seems to pervade your approach to all social programs. It’s not enough to collect a payroll tax to help the poor in their retirement or to cover their medical expenses – everybody must hand over their money now so the government can decide how to administer it. It’s not enough to subsidize education – everyone except those wealthy enough to pay twice must go through the public school system.

    This isn’t about capitalism as much as it is about choice. I wouldn’t begrude socialists an opportunity to set up their own communities centered around their conception of the collective good – indeed, they have as much a right to do so as I do not to participate.

    Leaving aside disagreements about how to interpret various bits of evidence on matters related to public policy, much of ideological variation can be explain by different people having different preferences for risk, justice, privacy, autonomy, etc – libertarianism tries to address this by minimizing the rules that apply to society at large and letting people make their own arrangements, since the law applies to all. Liberal, in constrast seem to seek some one-size-fits-all solution based around their own preferences, which they tend to treat failing to share as immoral. The attitude towards paying taxes is an excellent example, since you guys seem to find it inconcievable that someone may view the costs of the useless and harmful applications of government to outweigh the benefits and believe that little of that useless and harmful activity can be effectively constrained without general reductions of the scope of governmental authority, you assume that anybody who wishes to reduce taxes is interested solely in their own pocket book. And yet you’re quick to bristle that at any suggestion that anything other that detached altruism shapes your agenda.

    PS The Mievielle article is intellectually sloppy crap filled with false dichotomies (“As respectful of “order” as the most polite bourgeois, they cannot conceive of pirates as antecedents, only as threats. (“As indeed they might be, were there any seasteads to plunder.) By distancing themselves from this antiestablishment hydrarchy, the libertarian seasteaders unwittingly identify with the other hydrarchy that Linebaugh and Redicker discuss: the imperialist, maritime state” – Libertarians don’t want to be pirates, so they must want to be imperialists. Ok…), flat out unfamiliarity with the subject (Actually, scholarly work on self-organization in the absence of a controlling legal authority by pirates is popular among libertarians of an anarchistic bent),
    quote mining (despite noting that the LP advocate open borders (as do most other libertarian groups and publications with a stance on it), it digs up some “journal” that I’ve never heard of to argue that libertarians are actually racist immigration restrictionists), and self-serving tenuous extrapolations (some libertarians planning on living on a ship want the captain to have the final say on law enforcement matters on the ship becomes all libertarians wanting dictatorships. Impecable reasoning there.), all dressed up in prose which tries to hard to project errudition while laying on the vacuous underlying arguments like a cheap suit. If you’re going to link to a takedown of libertarianism, at least chose one that contains well-constructed arguments.

  235. Dustin says

    but not, participation in, say, a “food system” or a “housing system?”

    Actually, we demand participation in both. That’s the welfare that Ayn Rand thumpers love to hate.

  236. nathan says

    And in the case of surveillance for infectious disease or malaria antibiotic resistance, a delay of 3 days in detection can mean thousands of lives lost. So exactly how many individuals’ actual lives, quality of life, and transaction costs are you prepared to sacrifice to time lost while Medicine-VHS vs. Medicine-Betamax plays out at every single leaf node?

    Health- and life-insurance companies would have every incentive to watch out for these things and help prevent them, because it would make a huge difference to their budgets. And you can subscribe to Medicine-VHS while I subscribe to Medicine-Betamax and neither of us are the worse off for it. One of the market’s chief advantages over democracy is that it’s not winner-take-all (contra Stephen Colbert’s “let the market decide” jokes). We can all have our cakes and eat them, too. Yay diversity!

    Another major benefit is, if Medicine-Betamax is getting expensive or ineffective or even just bitchy on the phone, I can go subscribe to Medicine-DVD.

    The threat of people voting with their feet provides a powerful set of checks and balances. It’s more accountability than you get from people noisily voting on Turd Sandwich vs. Giant Douche every four years, especially when their core criteria are loving jebus and hating gays.

  237. Madam Pomfrey says

    As other people getting immunized from disease helps me, I have no problem with some government involvement in this sector.

    But libertarianism isn’t about selfishness?

    If you don’t want to pay for the cancer surgery of “man who smokes his lungs black with tar,” you might want to consider levying some punishments on the highway robbers that sold him the tar to begin with. Or do you also find them blameless, just because the guy could have chosen not to buy?

  238. Caledonian says

    PZ:

    The whole point of a class is to help students learn…and when I see students doing poorly, it isn’t an opportunity to hand out an F, it’s a responsibility to step in and try to help them learn.

    Because that’s what they pay for, and what you’re paid for.

    Do you have an open classroom, PZ? Do you teach and assist anyone who wishes to learn? Or are you paid to work in an institution where people have to pay lots and lots of money for the privilege of being taught?

    You may fancy that you can give your knowledge and your spare time to projects like this website and ‘education’, and it’s your right to give whatever charity you wish. But by all means, let’s be honest: you’re a capitalist, selling your expertise. You don’t give it away for free.

    Would you continue working in your position if they stopped paying you?

  239. says

    Guess what happens when you try to domesticate a market?

    I know you didn’t initiate the comparison Caledonian, but are you guys fucking kidding me? You’re comparing markets to species?

    Seriously, is this what passes for political/economic discussion?

    I’m surprised no one has yet pontificated under which system more angels could dance on the heads of pins.

  240. Madam Pomfrey says

    Consumers are making a decision to buy a known poison. That decision directly harms others.
    Should people be forbidden to purchase tobacco?

    See my post above. You are conflating two separate issues. I do not believe people should be forbidden to purchase tobacco. I do believe that people, and institutions, should not be allowed to sell known poisons to make a profit.

  241. Caledonian says

    I know you didn’t initiate the comparison Caledonian, but are you guys fucking kidding me? You’re comparing markets to species?

    Of course not, you collection of randomly moving molecules. I’m comparing markets to ecosystems.

  242. CalGeorge says

    The only people being harmed are smokers, but they chose that, so it shouldn’t concern me, as long as I’m not forced to pay for their medical care.

    Completely ignores the issue of second-hand smoke.

  243. Caledonian says

    Madam Pomfrey:

    I do believe that people, and institutions, should not be allowed to sell known poisons to make a profit.

    Even when the people know what they’re buying?

    Put this another way: what drugs aren’t poisons, Madam? What medications are incapable of causing serious harm or death?

    Shall we suspend all pharmacological sales to satisfy you?

  244. Matthew Dean says

    TheBlackCat
    Great in theory, but a bit thorny in practice. Take tobacco for instance. The tobacco companies are making a decision to sell a known poison to consumers. That decision directly harms others. So should tobacco companies be banned from selling tobacco? What about if bottled water company knowingly sold water with high levels of dangerous contaminants? Would you oppose punishing them? What if they didn’t know, but were lax in reasonable safety precautions? After all, everybody should know that it is possible that something could go wrong with the bottling of the water and thus they are knowingly taking a risk when drinking it. These are all cases where the decision of individuals causes direct harm to others.

    Consumers are making an informed decision to consume something known by all to be harmful. If they wish to poison themselves with tobacco, it is none of my business. If they don’t know tobacco is dangerous because they never pick up a newspaper, not my problem. They should accept responsibility for their own actions.

    As for the bottled water company, they should be punished for inflicting harm on consumers for providing something they said was safe. And government regulation (FDA) sure isn’t needed. Who has the biggest incentive to make sure the water is safe? Would anyone buy Dasani if it was revealed that some bottles were infected by E. Coli?

    Doesn’t the private road corporation have a huge incentive all by themselves to make sure their roads and bridges are really really safe? Does RoadCorp want their name splashed all over the news next to images like this?

    Would you ever ride on one of RoadCorps roads again after such a disaster? No? Well you are still driving on government roads, because you have to. Competition makes for much better safety then government.

  245. says

    But just because government is needed there does not mean our tax dollars should pay for the cancer surgery of man who smokes his lungs black with tar

    No surgery at all, or yes on prostate surgery/no on lung surgery, or what combination? Will that criterion change, depending on research shows on correlations between smoking and other forms of cancer than lung cancer? What about an ex-smoker who develops lung cancer 20 years later? Did the cigarettes cause the cancer in that case, and is that the determining factor in whether you would pay or not?

    or the drunk driver who wraps himself around the telephone pole

    How about a passenger in the car? How about a 350-pound driver who had a single glass of white wine 4 hours before the accident–was he drunk on that amount of alcohol, and did it cause the accident? If not, would that change your decision?

    (although I would be for a voucher-based universal healthcare).

    What about the people no insurance company will touch because of pre-existing risk, genetic or non-genetic? Are they just screwed by definition under your system?

    What is the clear, rational, and unambiguous basis on which you draw the line for your decisions? It seems to me that under your supposedly simpler system, the transaction costs to all involved grow exponentially.

  246. says

    Madam Pomfrey, why are you so determined to take responsibility away from adults who freely chose to make decisions harmful themselves, but no one else?

    Alcohol, in excess, is a poison too. Should we prohibit alcohol sales because every year some irresponsible college first-years CHOOSE to drink too much?

    What about people who eat too much McDonald’s and have cardiac disease? Should we outlaw trans- and saturated fats and high calorie foods?

    Again, I say, treat people as adults, and let them make their own decisions. It is not part of government’s job to make decisions for people.

  247. Madam Pomfrey says

    Put this another way: what drugs aren’t poisons, Madam? What medications are incapable of causing serious harm or death?
    Shall we suspend all pharmacological sales to satisfy you?

    Well now, that’s a slippery slope if I ever heard one, and a very bad analogy to boot. Caledonian, your mind is usually sharp and I’m surprised to see this coming from you.

  248. says

    Of course not, you collection of randomly moving molecules. I’m comparing markets to ecosystems.

    No you weren’t. None of your examples were ecosystems:

    Domestication tends to be a deeply destructive process that creates endforms that are unable to survive on their own and require constant human intervention to exist.

    Compare dogs to wolves, cows to auroch, cats to wildcats. They’re dumber, slower, and weaker, with impaired instincts that would quickly lead to their extinction outside of human breeding facilities.

    Guess what happens when you try to domesticate a market?

    However, I loved the play on my d’écran. Was that also a reference to the supposed movement of individuals in a free market?

  249. Jason says

    Dustin,

    Actually, we demand participation in both. That’s the welfare that Ayn Rand thumpers love to hate.

    We do? The vast majority of food and housing consumed by Americans is funded and provided privately, not through the government. Insurance against the vast majority of risks to people’s financial security is voluntary, not mandatory. Why should health care be different?

  250. says

    thalarctos, you seem to be making our case for us. There is no clear line to draw between which surgeries/medical treatments people deserve, and which they don’t. So, it seems it is better to let people pay for their own medical care, than to make arbitrary judgments just so we can feel good about providing universal health care.

  251. TheBlackCat says

    Should people be forbidden to purchase tobacco?

    No, I am not arguing that at all. I am saying that under Matthew’s definition of Libertarianism tobacco companies would have to be banned from selling tobacco. My point is that his definition sounds nice but is too simplistic to work in the real world.

    Let me give another example: drunk driving. Drunk drivers are putting everyone else at risk, but those people have to willingly accept the risk by driving. So should drunk driving be legal or illegal? If you accept the argument that directly harming others is illegal than drunk driving should be illegal. If you accept the argument that people have to willingly accept the tobacco companies’ risky product then drunk driving should be legal because people have to willingly accept the risk of driving on road with potential drunk drivers. To take it a step further, people have to willingly accept the risk that they will be mugged when they leave the house. Does that mean mugging should be legal?

    My point is that simplistic definition like Matthew was promoting is useless in practice no matter how nice it might sound. Any attempt to use it consistently would lead to extreme situations that no sane person would accept. If no sort of behavior that puts other at risk is allowed then it leads to nothing being legal. If people have to take responsibility for their risks then it leads to everything being legal. In the real world we have to balance risks and benefits from actions on a case-by-case basis, no simple one-paragraph rule will work (unless it is an exceedingly long paragraph).

  252. Madam Pomfrey says

    Madam Pomfrey, why are you so determined to take responsibility away from adults who freely chose to make decisions harmful themselves, but no one else?

    Matthew, why are you so determined to shift the discussion repeatedly to the buyer, and absolve the seller — an earlier link in the chain — from all responsibility? Why does the buyer carry all the responsibility, while the seller has none? How does allowing rapacious profiteers to sell poison somehow turn people into “adults”?

    It’s an obvious logical error to group items that are largely beneficial but may cause harmful side effects (most prescription drugs) with things that cause little or no benefit and whose primary effect is harmful (tobacco). You guys should know better.

  253. Matt says

    Libertarianism is profoundly offensive to progressives because they see it as antithetical to their core value, altruism.

    I also disagree, with all due respect. Libertarianism says, basically, “Let me do what I want, and if it causes damage, we’ll deal with redress later.” As other, wiser posters have already stated, this invokes images of Hardin’s Tragedy of the Commons, but more to the point, what this position does is enshrine selfish, short-term thoughtless behavior in a market economy. In the libertarian scenario, superfund sites (for example) aren’t a problem – it’s OK to dump toxic materials if it suits your needs, if it helps your economics. The fact that such behavior may create situations which are fundamentally irremediable doesn’t seem to register on libertarian radar – they just keep beeping on “redress, redress, redress!” (or at least the ones I’ve talked to do).

    That’s not anti-progressive; it’s anti-long-term-thinking, which speaks directly to a point in Mieville’s essay, where he states “In its maundering about a mythical ideal-type capitalism, libertarianism betrays its fear of actually existing capitalism, at which it cannot quite succeed. It is a philosophy of capitalist inadequacy.” In other words, if a given actor can’t run a business profitably while working within responsible norms, then libertarianism becomes the answer because it absolves an actor of any prior restraints regarding forseeable consequences of their actions.

  254. says

    Infinium committed outright fraud, and I think a stronger or more active SEC could have prevented it – or, to make a weaker but more defensible argument, the SEC is the only thing that stands between us and a million Infiniums. It’s entrepreneurship imitating “The Producers” – you can make more money on a failed product you *aren’t* actively developing than one that you are.

    Enron, frankly, didn’t get punished for harming people – their entire business was *based* on harming people (see “The Smartest Guys In The Room” for some examples of how Enron made its money). They got punished for failing. The stock market not only failed to rein them in, it rewarded them for their unsound business and accounting practices just as long as the balance sheets keep coming in black. If they’d somehow managed to avoid going bankrupt in the process of bleeding the California energy market to death, they’d still be the toast of Wall Street today. Besides which, it’s unclear in a libertarian society whether they would have been punished, or whether their bankruptcy would have been considered punishment enough.

    For other examples, cripes, see Upton Sinclair’s “The Jungle”, see the Ford Pinto, see Halliburton, “missile defense” and the entire defense contractor/war lobbyist axis, see lead-based paint in children’s toys and e. coli in freaking SPINACH… An approach that says “well, sure, these guys did grievous harm to society but at least some of them paid for it afterwards” is willful blindness. It’s the same philosophy that cuts education and spends twice the money saved on prisons. We need incentives for companies to behave responsibly in the here and now, every day, and that requires oversight. The free market, strictly speaking, cannot provide any incentive to act morally, it can only provide incentives not to get caught acting immorally.

  255. Colugo says

    Libertarianism and collectivism are expedient conditional tactics that some reify into universal and timeless principles. But when it comes to their self-interest (extended to nepotism and cronyism), everyone seeks to privatize benefits and externalize costs. Under the right conditions, even the staunchest leftist becomes a free marketeer and the most hardline of libertarians sees the wisdom of welfarism.

  256. Madam Pomfrey says

    In other words, if a given actor can’t run a business profitably while working within responsible norms, then libertarianism becomes the answer because it absolves an actor of any prior restraints regarding forseeable consequences of their actions.

    Exactly, which is why in their minds the poison seller is never subject to accountability or even basic responsibility. The consequences are always some other guy’s fault.

  257. CalGeorge says

    Alcohol, in excess, is a poison too. Should we prohibit alcohol sales because every year some irresponsible college first-years CHOOSE to drink too much?

    What about people who eat too much McDonald’s and have cardiac disease? Should we outlaw trans- and saturated fats and high calorie foods?

    No, but we should tax ’em up the wazooo!

  258. Dustin says

    Why should health care be different?

    I’m not saying it should be. We have ways of ensuring that people aren’t starving and that they can find a place to live. Objections to that claim on the grounds that neither of those programs are as effective as they should be should probably be directed to those neocons everyone was getting hot for eight years ago.

    Whether most of the housing in the country is privately funded is entirely beside the point. I’m not saying we should provide everyone with a luxury house in the woods, and I’m not saying that we should provide everyone’s elective surgery. I’m not saying that we should buy everyone a filet for every meal. I am saying that people should be fed.

    The fact is, we have subsidized housing and government housing grants so that people can get on their feet. We have food stamps and grants so that people can feed their children. We have financial aid programs to make sure that people can go to college. How much of any of those sectors is available out of pocket if we care to pay extra for it is beside the point. Why don’t we make sure that people can at least be healthy?

    And, I’m sure it’s been brought up several times already, but the riff that public health care or single payer doesn’t work simply doesn’t square with the statistics.

  259. TheBlackCat says

    As for the bottled water company, they should be punished for inflicting harm on consumers for providing something they said was safe.

    Consumers should know that there is a risk of contamination in bottled water just as they should know there is a risk of cancer with cigarretes. After all, as you said, if they don’t know it is “because they never pick up a newspaper, not my problem.”

    Who has the biggest incentive to make sure the water is safe? Would anyone buy Dasani if it was revealed that some bottles were infected by E. Coli?

    Lots of people buy herbal remedies despite the fact that is has been shown that they often have dangerous levels of contaminants. Lots of people buy bottled water despite the fact that the fact that the regulations on bottled water are more lax than those on tap water.

    Lots of people continued to buy lettuce during the E. coli outbreak, and far more people buy it now after the scare is over despite the fact that they know it could re-occur at any time. If another E. coli outbreak happens it is “because they never pick up a newspaper, not my problem”, right? They should know the risk. Tell me, do you know off the top of your head which company it was that was responsible for distributing the tainted lettuce? Do you check your lettuce to make sure it didn’t come from that company? Do you check your other food as well? Do you ask restaurants what company supplies the lettuce in your salad? If not then you have no one to blame but yourself if you get sick, right? (note that I do not agree with that position myself)

  260. says

    Health- and life-insurance companies would have every incentive to watch out for these things and help prevent them, because it would make a huge difference to their budgets.

    They also have every incentive to deny care you’ve already paid in advance for, because not paying out is always more cost-effective in the short term than paying out.

    Corporate unwillingness to share proprietary data is one of the biggest reasons why we do not have a functioning widespread electronic medical record system in the US, even though research consistently shows it would lead to improved health care and delivery. The US is getting lapped on EMR advantages, not only by Europe and Japan as might be expected, but by countries in the developing world that are leapfrogging over us.

    Insurance companies don’t have any monetary incentive to share data on how they’re doing, nor on how many claims they’re denying in order to avoid paying out money. Why you think they would act against that incentive, I have no idea.

    And you can subscribe to Medicine-VHS while I subscribe to Medicine-Betamax and neither of us are the worse off for it. One of the market’s chief advantages over democracy is that it’s not winner-take-all (contra Stephen Colbert’s “let the market decide” jokes). We can all have our cakes and eat them, too. Yay diversity!

    You miss the point. As the old joke goes, “that’s the beauty of standards–there are so many of them”. Except, when there are multiple competing standards of disease reporting, nobody wins: the effectiveness of disease surveillance and response depends on the accuracy of the reports in the aggregate, which in turn depends upon normalization and standardization of the data.

    If you miss a huge sudden uptake in emergency-room respiratory complaints indicating H5N1 avian influenza or SARS or whatever in the aggregate population overall, because none of the various reports using different data standards was able to detect it all alone, the virus isn’t going to wait to see what standard shakes out of the market. It’s a clear case where a regulated standard needs to be enforced, or the data is absolutely meaningless.

  261. Rey Fox says

    “Would you ever ride on one of RoadCorps roads again after such a disaster? No?”

    I suppose not. But fortunately, I’d be able to choose between a number of different roads existing in roughly the same physical space made by different companies to take me to the same destination.

    Oh, wait, that’s utter fantasy.

  262. Matthew Dean says

    thalarctos
    No surgery at all, or yes on prostate surgery/no on lung surgery, or what combination? Will that criterion change, depending on research shows on correlations between smoking and other forms of cancer than lung cancer? What about an ex-smoker who develops lung cancer 20 years later? Did the cigarettes cause the cancer in that case, and is that the determining factor in whether you would pay or not?
    How about a passenger in the car? How about a 350-pound driver who had a single glass of white wine 4 hours before the accident–was he drunk on that amount of alcohol, and did it cause the accident? If not, would that change your decision?

    Sounds like excellent decisions for private insurance companies to make. A good argument to privatize healthcare.

    What about the people no insurance company will touch because of pre-existing risk, genetic or non-genetic? Are they just screwed by definition under your system?

    I don’t think that situation would happen in a voucher-based system, but supposing if it did there are hospitals where no one will be turned away, regardless of if the person can pay or not. These hospitals exist with the help of private charity, which I think is an excellent solution for these types of circumstances.

  263. says

    Matthew, why are you so determined to shift the discussion repeatedly to the buyer, and absolve the seller — an earlier link in the chain — from all responsibility? Why does the buyer carry all the responsibility, while the seller has none? How does allowing rapacious profiteers to sell poison somehow turn people into “adults”?

    It’s an obvious logical error to group items that are largely beneficial but may cause harmful side effects (most prescription drugs) with things that cause little or no benefit and whose primary effect is harmful (tobacco). You guys should know better.

    Okay, why should the seller be at fault? Why should anyone be at fault? If someone wants to sell poison, and someone else wants to buy it, what is it to you?

    Also, I don’t think there is a real difference between nicotine and “medicine.” There is nothing harmful with smoking a cigar every now and then, as say, my uncle, does. At least, no more harm than having a beer with supper every now and then.

    Alcohol abuse is a terrible disease. I work on a medical floor that specializes in treating ETOH withdrawal. I’ve seen first hand it’s terrible effects. Does that mean I think alcohol should be outlawed? No! Just because it is bad for some people doesn’t mean it is bad for everyone.

    Likewise with tobacco. If some people want to enjoy it occasionally, they probably won’t suffer any ill effects. If others want to use it more often, how is it my business, or the responsibility of the tobacco company, if they suffer ill effects? You keep asking if I think the company should be absolved – I answer, they shouldn’t be indicted in the first place! Why do you think your preferences should be imposed on others?

  264. Caledonian says

    Kseniya:

    What ideology do you favor? You’ve often said you’re not a Libertarian.

    I favor no ideology.

    Here, let me clarify that: I favor no-ideology.

    If you could put systems in place, what would they look like?

    Wu wei!

  265. says

    The last thing I’ll write on this, but Caledonian expertly misses my point. Sure, domesticated animals are less dangerous than wild ones, and a “domesticated ecosystem” requires some kind of upkeep. That’s fine. We’re not doing this for the benefit of the ecosystem, we’re doing it for the benefit of the humans that have to live in it. There’s a reason, I’m sure, that Caledonian lives in a well-groomed suburb and not in a rain forest teeming with jaguars and candiru.

  266. Caledonian says

    Brownian:

    No you weren’t. None of your examples were ecosystems:

    One was.

    And in a way, they all were. Just not on the same level of implementation.

  267. tomh says

    Mathew Wilder wrote:
    There is no clear line to draw between which surgeries/medical treatments people deserve, and which they don’t. So, it seems it is better to let people pay for their own medical care …

    Now I understand. Health care for everyone that can afford it. What could be fairer than that?

  268. Caledonian says

    You want to know what shape society would take? You want to know how to fix the world? I’ll tell you.

    A novice was trying to fix a broken Lisp machine by turning the power off and on.
    A master, seeing what the student was doing, spoke sternly: “You cannot fix a machine by just power-cycling it with no understanding of what is going wrong.”

    The master turned the machine off and on.
    The machine worked.

  269. Jason says

    Dustin,

    So what are you proposing, exactly? What kind of health care reform do you seek? If you agree that health care funding and delivery should largely remain in the private sector, what different or increased role for the government are you proposing? Please be specific. Asking questions like “Why don’t we make sure that people can at least be healthy?” doesn’t tell me anything meaningful about the kind of policy changes you actually seek. The question is pretty silly anyway, since we obviously cannot “make sure” that anyone is healthy, let alone everyone.

    I am not necessarily opposed to some kind of “universal health care” system. I am not necessarily opposed to some kind of individual mandate to purchase health insurance. But the basic nature of the reform matters crucially. I am strongly opposed to a dramatic reform of American health care to create a British- or Canadian- or French-style single-payer system.

  270. Madam Pomfrey says

    Also, I don’t think there is a real difference between nicotine and “medicine.” There is nothing harmful with smoking a cigar every now and then, as say, my uncle, does. At least, no more harm than having a beer with supper every now and then.

  271. TheBlackCat says

    Likewise with tobacco. If some people want to enjoy it occasionally, they probably won’t suffer any ill effects. If others want to use it more often, how is it my business, or the responsibility of the tobacco company, if they suffer ill effects? You keep asking if I think the company should be absolved – I answer, they shouldn’t be indicted in the first place! Why do you think your preferences should be imposed on others?

    The company still made a decision that causes direct harm. You have not explained how to make this work with your definition of Libertarianism.

  272. says

    These hospitals exist with the help of private charity, which I think is an excellent solution for these types of circumstances.

    I–I don’t even know what to make of this. What?

    OK, so if we would all prosper in a libertarian system because we’d have more incentive to do something because of the profit motive whatchamajiggy and nobody wants to pay more taxes but there will still be free hospital care for the people who fall through the cracks because providing services for them isn’t profitable because people will still be motivated to pay for free hospital care even though they’re sureshot comsumers who vote with their dollars at the slightest whiff of inefficiency and wha?

    The people who hate paying taxes, right? They’re going to choose to support the free hospitals through charity?

    Does your brain work at all?

  273. says

    thalarctos, you seem to be making our case for us. There is no clear line to draw between which surgeries/medical treatments people deserve, and which they don’t. So, it seems it is better to let people pay for their own medical care, than to make arbitrary judgments just so we can feel good about providing universal health care.

    That’s fine, but you shouldn’t pretend that your rationing health care on the ability to pay is anything but purely arbitrary, then. If health care is only for rich people, that’s a certainly a coherent position, but I rarely hear Libertarians admit it so candidly in public.

    Due to an abdominal blood clot and complications from it, I ran up a hospital bill of over $200,000 about 5 years ago. My husband’s health insurance was better than mine at the time, so it paid most of the bill. A month or so after my release, my husband was laid off. If I had had the blood clot in December rather than September, I could not have afforded care.

    How is it all rational to argue that I deserved superb medical care for a blood clot in September but not in December because of the relation of a corporation to my husband, and another relation of that corporation to a health-insurance corporation? Which is what rationing health care on ability to pay reduces to.

  274. Dustin says

    The linear algebra of econometrics had ought to be replaced with the I Ching. Statistics and game theory are rent asunder by the might of magic Taoist principles.

    This conversation just got far too stupid for me. I won’t be entertaining it any longer.

  275. says

    Brownian:

    No you weren’t. None of your examples were ecosystems:

    One was.

    And in a way, they all were. Just not on the same level of implementation.

    Yes, in a way. But much less in a way than, say, actual fucking ecosystems are.

    If you really wanted to compare ecosystems and not species to markets, you would have done so.

  276. says

    No surgery at all, or yes on prostate surgery/no on lung surgery, or what combination? Will that criterion change, depending on research shows on correlations between smoking and other forms of cancer than lung cancer? What about an ex-smoker who develops lung cancer 20 years later? Did the cigarettes cause the cancer in that case, and is that the determining factor in whether you would pay or not? How about a passenger in the car? How about a 350-pound driver who had a single glass of white wine 4 hours before the accident–was he drunk on that amount of alcohol, and did it cause the accident? If not, would that change your decision?

    Sounds like excellent decisions for private insurance companies to make. A good argument to privatize healthcare.

    You got me there, Matthew, because as has been demonstrated time and time again, no for-profit company would ever use ambiguity or exceptions in a contract to hold onto money by weaseling out of providing care to someone who’s already paid for it in advance.

  277. Matthew Dean says

    TheBlackCat
    Consumers should know that there is a risk of contamination in bottled water just as they should know there is a risk of cancer with cigarretes. After all, as you said, if they don’t know it is “because they never pick up a newspaper, not my problem.”

    The bottled water company claims its product is safe, but sells contaminated products due to poor QA, it should be punished by giving monetary compensation to the victims (and it will be punished by the market by going out of business). The tobacco company sells products it knows are not safe, but people buy it knowing the consequences of their actions. One is the fault of the company, one is the fault of the individual. I don’t really see where the problem is?

    The company still made a decision that causes direct harm. You have not explained how to make this work with your definition of Libertarianism.

    No they didn’t. They provided a service demanded by the people. You cannot keep people from doing things which they consent to do freely (remember prohibition?). The tobacco tax is the most regressive tax we have.

  278. Kseniya says

    The government interferes with the marketplace yet again, to the detriment of all.

    Guess what happens when you try to domesticate a market?

    Interesting metaphor, but it fails. The market should be a servant, not a ravenous, amoral and omnivorous beast.

    Wolves make lousy servants, and terrible masters.

    I think the greed charge actually fits the accusers better than the accused. People want what isn’t their’s, and they try and get the government to take it for them.

    “People want what isn’t their’s.”

    Oh Mathew. MathewMathewMathew.

    Speak for yourself, sir.

    Must you people always get this backwards??? Jesus H. Christ on a Hobby Horse! You think most liberal voters want benefits for themselves? That’s a reflection of YOUR mindset. Time to get honest with yourself. You just don’t want to give up a chunk of change to help someone you’ve never met who might need help. Either that, or you’ve been listening to Limbaugh too long, and think that people who support the concept of social safety nets just want to “loot the public treasury” for their own gain. Holy Moses on a Muffin!

    Otherwise, you make some good points. ;-)

  279. Colugo says

    Ra’s al Ghul once actually had a good point when he asked Batman whether he would rather walk by his side through a wild jungle or an orderly zoo.

    Batman, of course, replied “I’ll walk by your side nowhere, Ra’s.” But the larger point still holds; we still have to choose between the two, or at least from within a continuum of those alternatives.

  280. Kseniya says

    Cal,

    Ok, but seems to me that you’re not an anarchist… soooo… I think this is the point where I quit trying to slap a label on you.

    Wu wei!

    Oh! Well! I think I get it now! Thanks for clearing that up for me. :-D

  281. Matthew Dean says

    Brownian
    The people who hate paying taxes, right? They’re going to choose to support the free hospitals through charity?

    Yep.

    Assume there was no government-funded healthcare. Would you donate to a private hospital/health company? I sure would (actually I do right now). If they pulled bastard moves, such as denying people care, etc, I would support someone else.

    Does your brain work at all?

    Yep.

    thalarctos
    You got me there, Matthew, because as has been demonstrated time and time again, no for-profit company would ever use ambiguity or exceptions in a contract to hold onto money by weaseling out of providing care to someone who’s already paid for it in advance.

    Did they breach the contract? If so a court of law will hold them accountable. Even if they put loopholes into the contract, they can still be held accountable by a court if they willfully tried to deceive their clients. After something like that happened, people can (and indeed should) take their voucher money to a different insurance company, one who wouldn’t do that. A system like this is already in place in Holland (I think) and is very effective.

    The alternative is the government health care system, such as Britains. “Wait 15 months for your chemo” type systems.

  282. Kseniya says

    Okay, why should the seller be at fault? Why should anyone be at fault? If someone wants to sell poison, and someone else wants to buy it, what is it to you?

    Leaping Leviticus on a Lazy-Boy! Are you really that naive idealistic?

    How about this:

    If someone wants to sell poison, but markets it as a harmless yet essential component of an active lifestyle while lying about the ingredients, the by-products of its consumption, and the effects of those by-products * – what’s it to you? Or to me? Or to anybody?

    Caveat emptor, dude!! Rock on! God damn that intrusive gummit for interfering with my right to be fucked over by uscrupulous purveyors of snake-oil!

    ________________________________
    Note: * (based on a true story)

  283. Jason says

    Due to an abdominal blood clot and complications from it, I ran up a hospital bill of over $200,000 about 5 years ago. My husband’s health insurance was better than mine at the time, so it paid most of the bill. A month or so after my release, my husband was laid off. If I had had the blood clot in December rather than September, I could not have afforded care.

    Anecdotes are not a good basis for public policy. You most likely would have received care even if you had not had health insurance. The quality of the care might not have been as high, or it might have left you in substantial debt, but you most likely would have received the care.

    There is little evidence that health insurance either improves health significantly, or provides much protection against the risk of major financial loss due to illness. Yes, for a specific person in a specific situation, it can make a huge difference. But in general, the effect seems to be small.

  284. says

    Did they breach the contract? If so a court of law will hold them accountable. Even if they put loopholes into the contract, they can still be held accountable by a court if they willfully tried to deceive their clients.

    Sounds like a great plan, because nothing tops off the chemotherapy or radiation or major sugery experience quite like a protracted lawsuit against a company with deep pockets and a clear financial incentive to prevent setting a precedent.

    After something like that happened, people can (and indeed should) take their voucher money to a different insurance company, one who wouldn’t do that.

    Yes, they’ll have their pick of all those insurance companies who are falling all over themselves to insure people with pre-existing conditions.

  285. Tulse says

    Caledonian:

    I favor no ideology.
    Here, let me clarify that: I favor no-ideology.

    Ah, yes — I have always found Caledonian to be remarkably ideology free.

    There really should be an HTML entity for “eye-roll”.

    Jason:

    I am strongly opposed to a dramatic reform of American health care to create a British- or Canadian- or French-style single-payer system.

    Because lower costs and lower infant mortality rates and longer life expectancies and lower overhead costs really suck!

    Perhaps if one wants a health care system to maximize “liberty” then it makes sense to oppose universal health care. I for one want a health care systems that attempts to maximize “health”. (And that’s one of the reasons I am now a citizen of Canada.)

  286. Kseniya says

    There is no clear line to draw between which surgeries/medical treatments people deserve, and which they don’t. So, it seems it is better to let people pay for their own medical care, than to make arbitrary judgments just so we can feel good about providing universal health care.

    Your model doesn’t account for the “deserves but can’t afford” case, which is already all too common, unless of course you’ve intentionally conflated “deserves” with “can afford”. Have you?

    C’mon now. It’s not just about “feeling good” about it. This is not about tossing a quarter to street drunk on Christmas Eve. Once again, you reveal more about your own mindset than about the issues being addressed.

  287. says

    Anecdotes are not a good basis for public policy.

    I am certainly not putting it up against a randomized controlled trial (RCT), but a case study is not exactly anti-evidence, either.

    You most likely would have received care even if you had not had health insurance. The quality of the care might not have been as high, or it might have left you in substantial debt, but you most likely would have received the care.

    Even an actual anecdote trumps your supposition about what might have happened, though.

    In any case, I am not asking you to provide RCTs; I am asking you to explain the coherence, as well as the fairness (“fair” as asserted by Matthew above), of a principle under which the same individual deserved primo health care in September 2002 and sub-primo care + massive debt in December 2002.

  288. Jason says

    Tulse,

    Because lower costs and lower infant mortality rates and longer life expectancies and lower overhead costs really suck!

    No, not for those reasons. Your statement is interesting. It implies that you think the differences in IMR and average life expectancy between the U.S. and other countries are caused by differences in their health care systems. What evidence makes you think that? There is an enormous body of evidence against it.

  289. TheBlackCat says

    The bottled water company claims its product is safe, but sells contaminated products due to poor QA, it should be punished by giving monetary compensation to the victims (and it will be punished by the market by going out of business). The tobacco company sells products it knows are not safe, but people buy it knowing the consequences of their actions. One is the fault of the company, one is the fault of the individual. I don’t really see where the problem is?

    As I keep saying, people should know that buying water is not completely safe just as they should know that buying tobacco is not completely safe. And I have never heard a bottled water company say that there is zero risk to drinking their water.

    No they didn’t. They provided a service demanded by the people. You cannot keep people from doing things which they consent to do freely (remember prohibition?).

    Tobacco causes direct harm. That is a fact. The people who are selling it are therefor doing direct harm to their customers. That you think the customers should know they are being harmed is irrelevant under the rules you provided. Harm is harm. Under your rules selling tobacco should be illegal. If you wish to change your definition that is fine, but nowhere in your definition does it say that you are allowed to cause direct harm as long as the people you are harming accept the risk. The fact that these sorts of qualifiers are necessary to make the definition work in the real world only proves my point that the definition is useless in practice.

    The tobacco tax is the most regressive tax we have.

    This isn’t about taxes, this is about your own rules, the definition of libertarianism that you provided.

  290. Colugo says

    The UK system (like ours) has its own unique serious problems. Poor access to dentists, antibiotic resistant bacteria in hospitals, lower cancer survival.

    http://www.medscape.com/viewarticle/561737

    “New reports from EUROCARE suggest that cancer care in Europe is improving and that the gaps between countries are narrowing. However, comparisons with US statistics suggest that cancer survival in Europe is still lagging behind the United States. The reports are published online August 21 in Lancet Oncology and scheduled for the September issue.

    One of the main messages from both reports is that in Europe, “for most cancers, survival has increased and between-country survival differences have decreased over time,” notes an accompanying commentary by Mike Richards, CBE, from the United Kingdom’s Department of Health. However, the differences between countries are not trivial, and “many more lives could be saved if the outcomes of all countries were brought up to the standards of the best” (ie, Norway, Sweden, and Finland), he comments. The United Kingdom in particular comes out badly in the tables, showing cancer survival rates that are among the worst in Europe. …

    One of the reports compares the statistics from Europe with those from the United States and shows that for most solid tumors, survival rates were significantly higher in US patients than in European patients. …

    …PSA testing … probably accounts for the very high survival from prostate cancer seen in the United States, the authors comment.

    Further analysis of these figures shows that, in the case of men, more than half of the difference in survival between Europe and United States can be attributed to prostate cancer. When prostate cancer is excluded, the survival rates decreased to 38.1% in Europe and 46.9% in the United States. For women, the survival rate of 62.9% for all cancers in the United States is comparable to that seen in the wealthiest European countries (eg, 61.7% in Sweden, 59.7% in Europe)…”

    It is noteworthy that US has more medical imaging machines per capita than many other Western countries.

  291. Jason says

    thalarctos,

    In any case, I am not asking you to provide RCTs; I am asking you to explain the coherence, as well as the fairness (“fair” as asserted by Matthew above), of a principle under which the same individual deserved primo health care in September 2002 and sub-primo care + massive debt in December 2002.

    I’m not saying there is any change in what the individual “deserves.” You might as well ask why someone living in a poor African country doesn’t “deserve” the same quality of health care as an insured American. What people “deserve” isn’t the issue. The issue is how we should organize our health care system.

  292. brent says

    Well, I’m not sure about your first claim. I don’t see how it would be in any corporations best interests to take money from people. No one would do business with them, and they would go bankrupt. But suppose you are right. No one I know is proposing that we abolish the police force, so the point is moot.

    Private entities routinely employ force to compel others to provide resources they might not otherwise. These private entities range from individual pimps in Anytown America to large corporations like Exxon in Nigeria. The only reason this sort of exploitation is not more widespread is because it is illegal and governments are granted the right by the citizenry to punish entities that engage in this behavior.

    No one I know is proposing that we abolish the police force, so the point is moot.

    A police force is not just a police force. It is a taxation to pay for a police force. Hundreds of laws and government agencies that govern the behavior of that police force. Public resources and infrastructure that supports that police force. An effective police force depends upon government intrusion at many levels. And most of all, it is a force that compels people to obey the directives of the State. Your cool with all that? Then I guess we don’t disagree at all.

    About your second claim, I think the government might need to make laws about monopolies because of its own interference with the market. If there were no government subsidies of any corporations (as there should not be), then corporations would always have to compete against new entrepreneurs. The way things often are now, though, corporations become established, and then receive government subsidies, thus removing them from the competition of the market. If this were not the case, no monopoly laws would be needed.

    Large corporations routinely use their power and influence to disable competitors to the extent they are allowed. It is pure nonsense to believe that this endeavor would be less effective in the absence of government intervention. For the robber barons of the 19th Century, it was mere child’s play to control entire industries and prevent the growth of even the smallest challenges to their dominance. Even with the controls in place today, it is not difficult for large corporations to very effectively limit their competition and become larger. The simple truth is that if I have more money then everyone else, I can control the market in many ways if there is no force of law to stop me. I can limit advertising opportunities for my competitors. I can buy out the necessary raw materials for my product. I can sell my items so cheaply that I take a loss until my competitors go out of business. Entrepreneurship will very quickly become irrelevant in an unregulated marketplace. That is the reality to anyone who actually pays attention to the way large corporations operate even under regulation. For some reason, libertarians are unable to grasp this and if you are trying to understand why your critics do not take your position seriously, this is one of the reasons.

  293. Tulse says

    Jason:

    you think the differences in IMR and average life expectancy between the U.S. and other countries are caused by differences in their health care systems.

    In part, yes. Looking at Canada, we have very similar lifestyle issues (obesity, smoking, etc.) at the US does, but on almost all meaningful health stats, Canadians are healthier than Americans, while spending about half as much per capita on health care.

    What evidence makes you think that?

    The fact that industrialized nations with some form of universal health care all have better health outcomes than the richest nation on the planet. Are you saying that access to adequate health care has no impact on health statistics?

  294. Matthew Dean says

    TheBlackCat
    Tobacco causes direct harm. That is a fact.
    Yep. The people harm themselves with the tobacco. They were under no false presences.

    The people who are selling it are therefor doing direct harm to their customers. That you think the customers should know they are being harmed is irrelevant under the rules you provided. Harm is harm. Under your rules selling tobacco should be illegal. If you wish to change your definition that is fine, but nowhere in your definition does it say that you are allowed to cause direct harm as long as the people you are harming accept the risk. The fact that these sorts of qualifiers are necessary to make the definition work in the real world only proves my point that the definition is useless in practice.
    My brief description was by no means all-inclusive. I don’t see why my 2 paragraph description of libertarianism not including every possible scenario makes libertarianism useless in practice. If you would like to learn more about libertarianism, perhaps this link will prove useful:
    http://en.wikipedia.org/wiki/Libertarianism

  295. says

    The only pipe dream or utopian fantasy is the one where people think that a state monpoly, which they are forced to give money to, will do right by them.

    It is not a utopian pipe dream to say that its better to let consumers CHOOSE how they spend their money. All their money.

  296. David Marjanović, OM says

    I’ve noticed a few (imho) wrong beliefs underlying this discussion.

    Capitalism is unstable. I’m not sure what is meant by this

    Then you don’t know it’s wrong! :-)

    I think I was clear enough: if you leave the free market to itself, competition dies out, and monopolies emerge, be it because one corporation has outcompeted all others in its field, be it because there are megamergers, be it because a cartel is formed. Without competition, it’s not a free market anymore. All the advantages of the free market come from competition.

    The biggest force for the freedom of markets in the world is the EU Competition Commissar doing things like forbidding megamergers. Capitalism has to be constantly protected from itself; interventions from outside are needed again and again to keep the free market free.

  297. David Marjanović, OM says

    I’ve noticed a few (imho) wrong beliefs underlying this discussion.

    Capitalism is unstable. I’m not sure what is meant by this

    Then you don’t know it’s wrong! :-)

    I think I was clear enough: if you leave the free market to itself, competition dies out, and monopolies emerge, be it because one corporation has outcompeted all others in its field, be it because there are megamergers, be it because a cartel is formed. Without competition, it’s not a free market anymore. All the advantages of the free market come from competition.

    The biggest force for the freedom of markets in the world is the EU Competition Commissar doing things like forbidding megamergers. Capitalism has to be constantly protected from itself; interventions from outside are needed again and again to keep the free market free.

  298. negentropyeater says

    Jason,

    this is becoming ridiculous. There is not one country in the world that is looking at America as a model of how to manage healthcare.
    The USA is THE case study on how not to do it, and the data is there to demonstrate it. Despite this, still a large % of the American population still lives in a delusion that their system is quite Ok (they’ll admit to the fact that some improvements can be made, but won’t change the system).
    It really must hurt the American pride to know that on such a basic issue as healthcare, they are the worst in class.
    Of course Jason, we know of the huge body of evidence you are talking about. Paid by the private insurance companies. It’s the same as the huge body of evidence against Anthropic Global Warming. Paid by the Oil and Gaz inustry. Or the existence of WMD in Irak. Paid by the CIA. This has become a number one specialty of the big american politico economic system. Don’t you think that those arguments are a bit tiresome and fucking immoral.
    Sorry but I somewhat lost my temper in reading this neverending defense of the worst healthcare system in the world (oh, sorry, not the worst, still better than Lesotho).

  299. Colugo says

    Nationmaster: Death from cancer
    http://www.nationmaster.com/graph/hea_dea_fro_can-health-death-from-cancer

    #1 Netherlands: 433 deaths per 100,000
    #2 Italy: 418 deaths per 100,000
    #3 Hungary: 411 deaths per 100,000

    #9 United States: 321.9 deaths per 100,000

    Cancer post-diagnosis 5-year survival rates
    http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/08/21/ncancer121.xml

    No. 1, both female and male: United States with 62.99% and 66.3%, respectively. England: 52.7%, female and 44.8%, male.

    I’m less interested in the ‘marketized vs socialized medicine’ debate than in debunking the common “grass-is-greener” view of Europe.

  300. says

    The only pipe dream or utopian fantasy is the one where people think that a state monpoly, which they are forced to give money to, will do right by them.

    It is not a utopian pipe dream to say that its better to let consumers CHOOSE how they spend their money. All their money.

    So in lieu of any evidence for observations or mechanisms, we’re supposed to be compelled by unsupported assertions and the occasional capitalised word?

    Yes, O High Priest, I hear and obey….

  301. syntyche says

    I typically find that most of the people who argue adamantly against universal healthcare have never lived in a country where such a system exists. Prove me wrong, Matthew Dean?

    I now return you to your regularly scheduled argument.

  302. says

    The issue is how we should organize our health care system.

    Yes. I am asking you to demonstrate if there is anything more to your proposal for organization of the health-care system than simply the local minimum which the arbitrary nature of your criteria for rationing care makes it appear to be.

  303. CalGeorge says

    Capitalism has to be constantly protected from itself…

    Yes! It gave us slavery, after all.

  304. Tulse says

    I typically find that most of the people who argue adamantly against universal healthcare have never lived in a country where such a system exists.

    I’ve lived in both kinds of countries, and I am certain which version I prefer. In Canada I can choose my own doctor (in other words, it’s a free market in that respect). I don’t have to worry about losing insurance if I lose my job (or worry about retaining an awful job just to maintain health care). I don’t have any of the ridiculous HMO restrictions that my US-based mother-in-law dealt with (including limitation of what doctors she could see) while dying of cancer. And, when insurances costs and taxes are figured in, I pay far less for my health care in Canada than the equivalent I would get in the US.

    The US system is insane. Only someone in the grip of an ideology could argue otherwise.

  305. syntyche says

    The US system is insane.

    Yes, that was essentially my observation when I moved to the US.

  306. Matthew Dean says

    syntyche
    I typically find that most of the people who argue adamantly against universal healthcare have never lived in a country where such a system exists. Prove me wrong, Matthew Dean?

    Uh, I am arguing for universal healthcare – in a voucher-based system.

  307. TheBlackCat says

    My brief description was by no means all-inclusive. I don’t see why my 2 paragraph description of libertarianism not including every possible scenario makes libertarianism useless in practice.

    Then we get back to the problem of how libertarianism is different. No one is debating that a reasonable amount of freedom is a good thing. No one is arguing that letting the free market operate in a reasonable manner is not a good thing. I agree that tobacco should be legal. You provided a nice idealistic definition, but when I actually tried to apply it to a real situation you immediately abandoned it in favor of the much more nuanced and much more complicated way of doing things that everyone else uses. So I still fail to see how your idea of libertarianism is at all special. The wikipedia article doesn’t help with that very much, a lot of empty rhetoric but little information on how to apply it in practice.

  308. Kseniya says

    Regarding the admittedly fine quality of health care available here in the USA, let’s not confuse that quality with the fairness or efficiency of the health-care access and financing systems.

  309. Matthew Dean says

    TheBlackCat
    Then we get back to the problem of how libertarianism is different. No one is debating that a reasonable amount of freedom is a good thing. No one is arguing that letting the free market operate in a reasonable manner is not a good thing. I agree that tobacco should be legal. You provided a nice idealistic definition, but when I actually tried to apply it to a real situation you immediately abandoned it in favor of the much more nuanced and much more complicated way of doing things that everyone else uses. So I still fail to see how your idea of libertarianism is at all special. The wikipedia article doesn’t help with that very much, a lot of empty rhetoric but little information on how to apply it in practice.

    Are libertarians “liberal” or “conservative”? They are neither, they are different. Also, I only made one qualification to my small definition, hardly “abandoning it in favor of a much more nuanced and much more complicated way of doing things”. You are splitting hairs.

  310. Jason says

    Tulse,

    In part, yes. Looking at Canada, we have very similar lifestyle issues (obesity, smoking, etc.) at the US does, but on almost all meaningful health stats, Canadians are healthier than Americans, while spending about half as much per capita on health care.

    You cannot assume that other differences between Canada and the U.S. are not responsible for their differences in IMR and average life expectancy simply because the countries are broadly “similar” in certain respects. Even a small difference in the rates of smoking, or the amount of exercise their citizens get, or education levels, or some other environmental, cultural or socioeconomic characteristic could entirely account for the differences in IMR and average life expectancy. In order to attribute differences in aggregate health indicators to differences in health care systems, you would need to control, at least roughly, for all those other factors.

    The fact that industrialized nations with some form of universal health care all have better health outcomes than the richest nation on the planet.

    But this is just factually incorrect, if by “health outcomes” you mean something like “health indicators that are attributable to the nation’s health care system.” Again, there is a huge constellation of environmental, cultural and socioeconomic factors that contribute to the aggregate health and longevity of national populations. Everything from the rate of smoking, to the climate, to air pollution levels, to stress. These factors vary significantly between different countries. There is abundant evidence that the effects of a nation’s health care system on the health of its population is swamped by these other factors.

    Are you saying that access to adequate health care has no impact on health statistics?

    No, I’m saying that health care has only a small impact on health statistics. You need to describe at least roughly what you mean by “adequate” health care before a clear sense can be given to your question.

  311. Tulse says

    Uh, I am arguing for universal healthcare – in a voucher-based system.

    How would a voucher-based system differ that radically from a single-payer system, especially in terms that are relevant to libertarianism? I’m not clear on what you’re proposing as a “voucher-based system”.

  312. negentropyeater says

    “The US system is insane.”

    when I moved to the US from France, what surprised me was not the insanity of the US system (my company had warned me already, and as an Expatriate, I was lucky to get full coverage for which my employer was paying an astronomical amount).
    No, what surprised me the most is how tenacious Americans were in defending their system. Americans have this thing of believing that they are the greatest nation on earth for EVERYTHING. I don’t know if it is in the food, but it is impossible for Americans that have not lived abroad to even imagine that on some issues of human developement they are far from being a model for the world.
    As Frenchman, I’d been forced to swallow my pride. Afterall, we too believed not long ago that we were comming straight out of Jupiter’s thigh. Now, we’ve realised that we are just a mid size power, that our language is hardly spoken anywhere, and that even our wines are terribly overpriced.

  313. syntyche says

    Uh, I am arguing for universal healthcare – in a voucher-based system.

    Come on, you knew very well that I was referring to your favourite bogey-man, nationalized, single payer healthcare.
    I’ll take that as a no.

  314. says

    I _used_ to be a Libertarian, then I spent 2 tours in Iraq and saw how people actually behaved without the presence of a functioning government to keep them in check. :-P

  315. Tulse says

    Jason:

    there is a huge constellation of environmental, cultural and socioeconomic factors that contribute to the aggregate health and longevity of national populations. Everything from the rate of smoking, to the climate, to air pollution levels, to stress. These factors vary significantly between different countries. There is abundant evidence that the effects of a nation’s health care system on the health of its population is swamped by these other factors.

    So the US is just generally the unhealthiest industrialized nation to live in? And this is an argument for libertarianism?

  316. Jason says

    negen,

    Jason, this is becoming ridiculous. There is not one country in the world that is looking at America as a model of how to manage healthcare. The USA is THE case study on how not to do it, and the data is there to demonstrate it.

    I’m not sure exactly what you mean by “model,” but the trend in countries with single-payer health care systems, including Britain, Canada and France, is towards greater privatization. The role of private, for-profit health insurance and health services is growing, and the role of state-funded services is shrinking. I expect this trend to continue as governments find it increasingly difficult to fund the constant stream of new drugs, new tests and new surgeries that the medical-biotech industry is producing.

    Of course Jason, we know of the huge body of evidence you are talking about. Paid by the private insurance companies.

    No, it’s not paid for by the insurance companies, and I think it’s quite clear that you don’t know about the evidence. If you did, you might not be so certain in your conviction that the U.S. health care system is inferior. Look at some of the statistics Colugo has been citing, for example.

  317. Madam Pomfrey says

    Americans have this thing of believing that they are the greatest nation on earth for EVERYTHING.

    You probably haven’t encountered the postmodernist types who think it’s America’s fault if a lightbulb burns out in China. Thankfully they’re mostly confined to college English and comparative literature departments, and have virtually no political power. However, it is sometimes amusing to watch them go so far left that they start defending right-wing theocracies just because the leaders of said theocracies have bashed the US.

  318. Matthew Dean says

    Tulse
    How would a voucher-based system differ that radically from a single-payer system, especially in terms that are relevant to libertarianism? I’m not clear on what you’re proposing as a “voucher-based system”.

    In a voucher-based system, everyone would be issued a voucher of a set amount of money, which they would use to find an insurance company (or to simply pay the hospital/doctor directly) to cover their health expenses. The benefit to this approach is that the insurance companies must compete for your money, instead of simply getting money and giving you shoddy care (like most universal healthcare systems). It will also be quite a lot cheaper then most single-payer models.

  319. Jason says

    Tulse,

    So the US is just generally the unhealthiest industrialized nation to live in?

    No, that’s not true, either. And I’m not arguing for libertarianism, I’m arguing against single-payer health care, and more broadly against any really drastic change to our health care system. As I said, I am not necessarily opposed to some kind of “universal coverage,” but the devil is in the details.

  320. Ben Terry says

    It seems that there is this overwhelming tendency to accuse people who don’t trust the government with their money of selfishness, greed, and so on. That seems like a bad-faith assumption. For example, CalGeorge strongly implies that such people would all be out buying HDTVs, guns, and pit bulls to sic on poor folks with this new found wealth. That is just mean spirited, baseless rhetoric.

    I would be completely content to have money direct deposited out of my paycheck for a variety of things (social education, social healthcare, utility stuff, etc.), but because I don’t want to be forced to support those things I oppose, I am also assumed only be looking out for myself.

    Why don’t we get to turn the question around and accuse supporters of the current system of being cold hearted war mongers that love the idea of forcibly taking money from other people and giving the money to an idiot so he can blow up brown people? (Speaking as an American…)

    Social spending is so trivial compared to outrageous military spending, various governmental pork shoveling and deals to rich buddies with your and my money, etc. that I would gladly pay up. I want to be morally comfortable with the money I supply to others. Now, in my original post I said that I’m not a libertarian, because I don’t believe capitalism is inherently just. I don’t know if a “listener supported” government could work practically. I think you’d need some sort of public showing of who has (or has not) contributed what, etc.

    It’s just dreams and ideas. They are not dreams born out of greed and misanthropy, however, and I think that should be recognized, regardless of how feasible you believe the ideas may be.

  321. TheBlackCat says

    Are libertarians “liberal” or “conservative”? They are neither, they are different.

    My point is that they are not different. They have a set of opinions that are common to a large number of people from both parties. All the differences you talk about disappear when applied to the real world. It is like saying there are three groups, republican, democrat, and anti-dictator. But anti-dictator does not diferentiate you from republicans or democrats, you need to have characteristics that are significantly different than those held by members of the other two groups.

    Also, I only made one qualification to my small definition, hardly “abandoning it in favor of a much more nuanced and much more complicated way of doing things”.

    You pretty much threw out the entire definition. When asked to actually apply it you did the exact opposite of what your definition called for. That is not “qualifying” it. If I said all religion is bad, and then qualified it by saying that Christianity is okay, then I would be saying that not all religion is bad. If you say that people should never allowed to cause direct harm except when you think it is okay to cause direct harm then you are saying that it is sometimes okay to cause direct harm.

    You are splitting hairs.

    .

    You are the one splitting hairs by trying to say that libertarianism is its own category over minor, or perhaps even nonexistent, differences with existing groups. I will continue to hold this position until you provide some difference that you are actually willing to stick to.

  322. Tulse says

    Mathew, in the single-payer system I live under, it is the care providers who compete for health-care money, and not insurance companies, which surely is a more free-market-like system where it counts (namely, in providing incentives for good care). I am not at all clear why including middle-men like insurance companies improves the system, or how it would make things cheaper. All of the studies I have seen suggest that up to 33% of health care costs in the US are due to insurance companies and their bureaucracies — how would simply paying them via vouchers lower those costs?

  323. says

    In a voucher-based system, everyone would be issued a voucher of a set amount of money, which they would use to find an insurance company (or to simply pay the hospital/doctor directly) to cover their health expenses.

    Does the government set reimbursement rates and caps under this plan, like in Medicare? And does it compel insurance companies to take all comers, rather than cherry-picking only the best risks?

    Because if it does either or both of those, it sounds like you’re just shifting the regulatory burden, and I don’t see what’s particularly Libertarian about such a hybrid public-private system. And if it doesn’t, how do you prevent cartels (or do you?)?

  324. Tulse says

    Jason:

    As I said, I am not necessarily opposed to some kind of “universal coverage,” but the devil is in the details.

    I’m a bit confused then — if universal coverage does not bring health benefits, why would you not oppose it? And what is it specifically about single-payer than you find objectionable? Or is your position more of a “we can’t get there from here” argument?

  325. says

    the trend in countries with single-payer health care systems, including Britain, Canada and France, is towards greater privatization

    Yes, but not necessarily for the reasons you think. I live in Alberta, where the provincial government has pretty well led the charge towards greater privatisation in health care in Canada for ideological and anti-federalist reasons alone.

  326. negentropyeater says

    If Colugo’s statistics are evidence, then I understand the way you reason.
    You can only make decisions for or against a particular mode of management by looking at total wieghing of many aggregate numbers. One particular piece of data has nothing to do with the issue. It’s like showing me data that in Madagascar the average temperature has gone down in order to defend the view that AGW doesn’t exist.
    This is why there is a “neutral” body, the UN, that valorizes all the different factors (access, cost, medical parameters, life expectancy, perception etc…), which is a complex issue, and publishes a report where it evaluates all the different important factors.
    Now that report shows that the US is ranked #37 in the world (France #1) and only achieves this ranking (this is the best part) because Americans self-value their system highly. If it weren’t for that favorable parameter, it would be ranked even lower.
    Please provide a link to a report that shows differently, and that has not been paid for by the private medical insurance companies.

  327. Colugo says

    Nationmaster: US health rankings

    http://www.nationmaster.com/red/country/us-united-states/hea-health&all=1

    Clicking on the links for individual categories (and ignoring Third World and Eastern Europe countries) there are some interesting statistics. Some of them confirm the “USA is terrible, Western social democracies are wonderful” view, but others might be surprising. Some thing to keep in mind: the US is larger in geography and population and more heterogeneous (on any number of demographic parameters), as well as richer per capita than most Western countries. We also lead in innovation of drugs and technology, and in a sense subsidize or at least benefit the rest of the world in this regard.

  328. Colugo says

    negentropyeater: “You can only make decisions for or against a particular mode of management by looking at total wieghing of many aggregate numbers.”

    True. But if the cancer survival statistics of the US and UK were reversed, the critics of the US system would be trumpeting that as a key piece of evidence for their side. Overall assessments are important, but so are specifics – not because they determine which is better, but because they give clues to particular strengths and weaknesses determined by which areas are given priority. In other words, how the system allocates care.

  329. syntyche says

    colugo —
    interesting list, but given

    Total expenditure on health as % of GDP 14.6% [1st of 185]

    On average, it’s still a pretty piss-poor result, no?

    In fact, I don’t really see any statistics there that surprise me. Could you perhaps point one out some that you were referring to?

  330. Xanthir, FCD says

    I read a very good (free) book recently called Freehold. It’s very good sci-fi, and also happens to be unabashedly libertarian-wank. The book is largely about the conflict between the Earth government of the UN, and the libertarian government of the planet Grainne.

    I don’t normally like libertarian-wank, though it’s relatively common in sci-fi. This one was decent, though, if for nothing else than because it tempered its libertarianism. The taxes thing was the big one. You could refuse to pay taxes, and there was no penalty. However, if you were ever called to court (which was relatively likely, such as to file grievances against a company), you would have to pay your back taxes plus interest. So really the only way to avoid taxation was to move out into the boonies and be a hermit farmer.

    As well, government power (frex) was owned purely by Citizens, people who amassed sufficient personal wealth and then gave it all to the government. The leaders are essentially in poverty and depend on the largesse of the public. This is interesting, but I have *no* idea how one would actually manage this. Wouldn’t it be easy for two partners in a successful firm to agree that one of them would become a Citizen and the other would support him?

  331. Tulse says

    Colugo, could you point out the stats from NationMaster that you think are relevant? I’m not seeing much that I find surprising, at least on the “good” side.

  332. Matthew Dean says

    My point is that they are not different.

    They are different. Anyone with a brain can see that.

    You pretty much threw out the entire definition.

    No I didn’t.

    All the differences you talk about disappear when applied to the real world.

    No they don’t. When they are applied to the real world is where the differences shine through.

    You are the one splitting hairs by trying to say that libertarianism is its own category over minor, or perhaps even nonexistent, differences with existing groups.

    Libertarianism has huge differences with both of the major political parties in this country.

    I will continue to hold this position until you provide some difference that you are actually willing to stick to.

    Conservatives say drugs are bad. Liberals say drugs are bad. I say drugs are fine, as long as you keep them to yourself and take personal responsibility.

  333. tomh says

    Madam Pomfrey wrote:
    You probably haven’t encountered the postmodernist types who think it’s America’s fault if a lightbulb burns out in China. Thankfully they’re mostly confined to college English and comparative literature departments, and have virtually no political power.

    Perhaps he meant the overwhelming majority of the American population and our leaders who do have political power all of whom think America can do no wrong. Just look at how much better off we are with them than we would be if a few English majors had political power.

  334. Jason says

    Tulse,

    in the single-payer system I live under, it is the care providers who compete for health-care money, and not insurance companies, which surely is a more free-market-like system where it counts (namely, in providing incentives for good care).

    Huh? First, it is not clear to me in what sense Canadian health care providers “compete” for funding. But more importantly, private health insurers obviously do compete. An insurer that provides better coverage at lower cost is likely to attract more customers than one that provides worse coverage at higher cost. All private insurers compete in this way, not just private health insurers.

    I’m a bit confused then — if universal coverage does not bring health benefits, why would you not oppose it?

    Some varieties of universal coverage may produce benefits. But even then, the benefits are likely to be modest in comparison to our current system.

    And what is it specifically about single-payer than you find objectionable?

    It tends to create underfunding and rationing (Britain, Canada), or financial insolvency (France, and Medicare in the U.S.).

  335. Jason says

    Yes, but not necessarily for the reasons you think. I live in Alberta, where the provincial government has pretty well led the charge towards greater privatisation in health care in Canada for ideological and anti-federalist reasons alone.

    It’s happening in Canada as a whole, not just in Alberta. One of the big recent triggers was the Chaoulli case from Quebec. The Supreme Court of Canada ruled that the Quebec Health Insurance Act and the Hospital Insurance Act prohibiting private medical insurance violated the Quebec Charter of Human Rights and Freedoms. That decision set the stage for a big expansion of private health insurance in Canada. It prompted the Canadian Medical Association to publicly affirm its support for private health insurance. The Court stated in its decision:

    The evidence in this case shows that delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care. The evidence also demonstrates that the prohibition against private health insurance and its consequence of denying people vital health care result in physical and psychological suffering that meets a threshold test of seriousness.

  336. says

    Haven’t any of you folks heard of socialist libertarians? Not all libertarians are advocates of free-for-all capitalist markets. But reading these posts, it looks like everyone thinks libertarian = right wing (capitalist) libertarians.

    You guys need to go read some Chomsky or Kropotkin or something.

  337. Colugo says

    syntyche: “it’s still a pretty piss-poor result, no?”

    Surem it certainly stands room for improvement at that level of expenditure.

    Some more statistics not in line with “US is worse than Western Europe in all ways” view:

    US maternal mortality rate is the same as Germany and lower than France.

    Heart disease death rate is higher in Sweden, Iceland, Finland, Norway than US.

    US life expectancy slightly higher than Denmark.

    And so on. Look through the categories.

    If you want to say, “Well, the US should be doing even better because it has more money” that’s fair, but these statistics do add nuance to “the US is is every way worse health-wise” stereotype.

  338. Tulse says

    Jason:

    First, it is not clear to me in what sense Canadian health care providers “compete” for funding.

    In Ontario, doctors are re-imbursed by the province for procedures that they perform. In other words, doctors have an incentive to provide good care and thus attract patients, because this directly affects their bottom line. In principle, this kind of system is pretty darned close to a “free-market” as far as patients are concerned — the only real difference is where the money is coming from. (In practice, of course, the fee paid for procedures is set, and there are other limitations, but generally, the system is where doctors can compete with each other for patients, and if patients aren’t happy, they can find another doctor.)

    But more importantly, private health insurers obviously do compete. An insurer that provides better coverage at lower cost is likely to attract more customers than one that provides worse coverage at higher cost. All private insurers compete in this way, not just private health insurers.

    That wasn’t my question — my question was how would including a middle-man between the doctor and patient lead to lower costs than the single-payer system? Single-payer models don’t involve profit, and work with efficiencies of scale that aren’t available in with multiple for-profit insurers handling payouts to doctors.

    And what is it specifically about single-payer than you find objectionable?
    It tends to create underfunding and rationing (Britain, Canada), or financial insolvency (France, and Medicare in the U.S.).

    Don’t kid yourself — the US system already rations, it just does so based on ability to pay, rather than any sensible scheme. If the US offered the same level of health care to all of its citizens that Canada does, it would also face issues of how to distribute that care. It avoids that only by rationing based essentially on how much money those needing treatment have. The difference between the US and Canada is not whether there is rationing, but on what principle it should be based.

  339. tomh says

    Tlazolteotl wrote:
    Haven’t any of you folks heard of socialist libertarians? Not all libertarians are advocates of free-for-all capitalist markets.

    There are socialist libertarians and free-for-all capitalist libertarians? Well, it’s obviously not economic policy that defines a libertarian, so … what the heck is it?

  340. Nix says

    `Health care for everyone that can afford it’ indeed. I’ve had numerous arguments with libertarians over universal healthcare: generally they say that those who can’t pay should suffer or die. A lot of them even say that this is true of pregnant mothers.

    If I’d been born in the world those people seem to want, I’d be dead now: the NHS spent around a million quid (in 1976 that was real money) keeping me alive at birth.

    (Thankfully, even in the US someone turning up with a 10-week premature twin baby with jaundice and pneumonia and Rh-factor incompatibility and patent ductus arteriosus and some sort of horrid skin infection I can’t remember the name of would be classified as an emergency case, and thus treated regardless of parental wealth, I understand. Libertariaville is not here yet.)

  341. Tulse says

    Jason, the Canadian Supreme Court decision you note was a bit more nuanced than you relate — the issue was the prohibition of any private insurance, rather than having a public system as a whole. Given that the justice’s decisions positively referenced mixed models like Germany and Sweden, I would hardly call this decision a victory for a fully-private system.

    It prompted the Canadian Medical Association to publicly affirm its support for private health insurance.

    Imagine doctors wanting to charge whatever they want? How could they possibly support that unless public health care was terrible?

  342. Colugo says

    Why the US system is so much more expensive:
    http://www.medscape.com/viewarticle/452954_4

    “First, the inputs used for providing hospital care in the United States – health care workers’ salaries, medical equipment, and pharmaceutical and other supplies – are more expensive than in other countries. …. (H)ealth care workers’ salaries are higher in the United States than in other countries. Second, the average U.S. hospital stay could be more service-intensive than it is elsewhere. … Third, the U.S. health system could be less efficient in some ways than are those of other countries. The highly fragmented and complex U.S. payment system, for example, requires more administrative personnel in hospitals than would be needed in countries with simpler payment systems.”

    “Canada has far fewer computed tomography (CT) and magnetic resonance imaging (MRI) scanners per capita than the United States does. … Canada’s health system also delivers far fewer highly sophisticated procedures than does the U.S. system. For example, the U.S. system delivers four times as many coronary angioplasties per capita and about twice the number of kidney dialyses.”

    Also, on the Nationmaster statistics look at the specific categories of cancer, including male and female rankings. Some of you are being pretty dismissive of the cancer statistics, which the US performs well on. Like I said, US allocation in high tech medical imaging for diagnostics is probably part of the reason for that.

  343. Tulse says

    With regards to Chomsky, I’ve heard him speak favourably of anarcho-syndicalism, which given that it opposes the private ownership of the means of production. I very much doubt that anyone typically described as “libertarian” would have any truck with that principle.

    Anarchism isn’t the same as libertarianism — they may share certain principles in common, but they aren’t identical.

  344. Jason says

    Tulse,

    In Ontario, doctors are re-imbursed by the province for procedures that they perform. In other words, doctors have an incentive to provide good care and thus attract patients, because this directly affects their bottom line.

    Yes, Canadian doctors compete for patients in the limited sense you describe, but their compensation is determined by government budgets rather than market prices. It’s only competition within an environment of wage and price controls set by the government.

    That wasn’t my question — my question was how would including a middle-man between the doctor and patient lead to lower costs than the single-payer system?

    The statement of mine you quoted wasn’t a response to that question. It was a rebuttal to your claim that the state-funded Canadian system “surely is a more free-market-like system” than the privately-funded U.S. system. With regard to your question, your premise is false. Both systems include a “middle-man.” In the U.S. it is the insurer, and in Canada it is the government.

    Single-payer models don’t involve profit, and work with efficiencies of scale that aren’t available in with multiple for-profit insurers handling payouts to doctors.

    First, Canada’s “single-payer model” obviously does involve profit. The difference is that the profit is only on the health care delivery side (drug companies, MRI machine manufacturers, surgical equipment suppliers, etc.) rather than both funding and delivery. But more importantly, the assumption that the absence of profit produces greater efficiency is not supported by evidence. Ditto for your claim of efficiences of scale.

    Don’t kid yourself — the US system already rations, it just does so based on ability to pay, rather than any sensible scheme.

    Yes, the U.S. also rations to some extent. But the evidence suggests that the rationing is worse in Canada (and even worse than that in Britain). When spending is constrained by government budgets, instead of being allowed to rise indefinitely in response to demand, serious rationing is the likely result. The clearest examples of this are of course the economies of the former communist nations, where the supply of all consumer products and services was limited by state spending, but the same effect is at work in Canada’s health care system. There really is no question, after almost a century of experience with different economic systems, that markets are much better at matching up supply and demand than governments.

  345. David Marjanović, OM says

    That is the basic core of a libertarianism – freedom from interference. I just don’t see what is so objectionable about that. So there are people who are unbelievably more wealthy than I am – how does that hurt me? Why should I think I am entitled to the what is their’s?

    No, it doesn’t hurt me at all.

    I just think I have a right not to die from poverty. That’s all. If someone is capable of making one billion after the other (in spite of reasonable taxes), let them.

    Some people here need to realize that nobody on this thread is arguing for communism or any other version of the government micromanaging the economy. We all support the free market. We just think nobody should be allowed to fall deeper into poverty than a certain level. That’s all.

    It’s perfect. In the absence of “big government,” justice is distilled to obtain the smallest possible government: one guy. One completely unaccountable guy who makes all the rules. And if you don’t like his rules, maybe you’d like to take a little swim instead.

    Well said.

    See, I have never had a corporation take my money by force. If a corporation does not serve my interests, I do not utilize their services.

    One word: monopoly.

    Oh yes, there are global monopolies and near-monopolies. Microsoft comes to mind, but that’s just the shiniest one.

    However, the federal government threatens me with jail if I decide to remove myself from paying for the “war on drugs” it wages against its own citizens.

    What a utopia must be a democracy where you could simply vote the government out and a new one in.

    What I wonder is why anyone thinks “Africa” is their problem to worry about. Who gave any invidual, or group, or country, the right to go around and try to fix other parts of the world?

    Even if you pathologically lack all compassion, you should be able to use your reason to figure out that, yes, it is your problem. For example, poor people will not buy your products. Doesn’t have to be “Africa”, can be the Working Poor in your very own city, too.

    It seems to me there are great problems, say, with universal healthcare.

    Which must be why every halfway rich country except the USA has it.

    Sure, some of the problems you mention are genuine problems, but not one of them is a reason not to have universal healthcare. You can discuss them later (as is in fact being done right now in Austria). That’s what a democracy is for.

    Well, treated like shopping for any other service. If we had a free market in health care, medicine would be cheaper (AMA couldn’t artificially restrict the doctor supply by keeping med students out, and if you are bargaining over health services doctors will have to compete on price as well as service). Think about it — how come prices in medicine are going up with technology rather than down?

    You do know that you Americans pay more for their healthcare than anyone else in or around the First World?

    One reason is that your government doesn’t get the idea of negotiating with the pharma companies about drug prices. That is unique — American exceptionalism the other way around.

    The way things often are now, though, corporations become established, and then receive government subsidies, thus removing them from the competition of the market. If this were not the case, no monopoly laws would be needed.

    You are kidding.

    I think I should decide. If I disagree with an insurance company, I can get different insurance, since the insurance company isn’t coercing me into taking their services. With government insurance, I would be coerced, and thus could not vote with my dollars.

    Guess what: all insurance companies have profit as their motive. All of them will do anything they can to avoid paying you. Once your risk of disease is high enough, no insurance company will insure you, unless you happen to be rich.

    Universal healthcare does not necessarily mean the absence of insurance companies. In Austria, the state is the only health insurer; in Germany, you can choose between the state and a number of private companies that are more expensive but reportedly provide better services.

    The German model actually gives you more freedom than the US one: in the German model, you actually can choose, no matter how poor and/or sick you are, and you will always find an insurance which, furthermore, actually will pay you when you need it.

    I repeat: more freedom.

    What’s not to like? :-)

    David M,OM said,”Excuse me? I live in a functioning welfare state with free healthcare for all EU citizens.”

    If you are being serious with that statement just how does that work?

    I’m not an expert on that. I’m sure the Internet is full with information on that, though.

    Are all services, buildings, pharmaceuticals, and equipment donated?

    This is quite different between countries.

    Is anyone in your healthcare system paid?

    Obviously!

    Do any taxes support the system?

    Yes, plenty. (For example the quite high taxes on cigarettes, but I think most of the money comes from the sales tax.) We get a good return on all those taxes. Again: in sum we pay less than you Americans.

    If you look at the high wages and long hours worked, it definitely looks like we are in an artificial doctor shortage. The high wages should be attracting more doctors to the profession in droves, but compulsory licensure keeps many of them out. Only the doctors themselves benefit from this, and everyone else is poorer for it.

    We have something similar in Austria, too. This is a case where a freer market would clearly be an advantage, as far as I can see.

    It is also a case where an intervention into the free market — breaking up the cartel and making sure it doesn’t form again — is necessary to make the market free again. It is a case where the free market has been left to itself and immediately stopped being free.

    I think this is a very important point. People have a tendency to see a problem, and then want to fix it. I think we should all be more skeptical of the proposed solutions to various problems. The impulse to help may be noble, but with imperfect information, and ideological blindnesses we might not even be aware of, centralized solutions are risky.

    Fine, but in this case — universal healthcare — you merely need to look abroad a little to find plenty of experiments running. The information is out there. Learn it, and then make your decisions, instead of acting as if this were the first attempt to introduce universal healthcare in the history of the world.

    Medical school enrollment increases each year in the US.

    Yep, over here too. Austria has more medicine graduates and fewer working doctors than needed.

    Strange but true: Suppose we dissolved the US government, and then started a corporation called UsCo that had basically the same set of rules. (In other words, we’d issue one share of stock to everyone, and then rewrite the Constitution, changing “citizen” to “shareholder”.) Libertarians would be more than happy to pay their membership dues.

    Very good point.

    What “poor track record?”

    Tens of millions of US citizens have no health insurance at all, and you ask “what ‘poor track record’?”

    Hayek, 1982, ‘Law, Legislation, and Liberty’ v. 2: “There is no reason why in a free society government should not assure to all, protection against severe deprivation in the form of an assured minimum income, or a floor below which nobody need descend.”

    Agreed. This is the welfare state (or “social state”) we EU citizens are so happy to have.

    Why should health insurance be universal and mandatory, but not, say, car insurance or homeowners’ insurance or disability insurance?

    Isn’t it? AFAIK car insurance is mandatory over here for all who have a car. Isn’t that even different between different US states?

    What needs domesticating? The sole example you had, Enron, did harm to lots of people and paid dearly for it. Government courts took care of it

    …after the harm was done and people had lost their pensions.

    (Not that getting one’s pensions in shares is a remotely sane idea.)

    Of course, making people altruistic isn’t your goal, which is having certain ends, that altruism might lead to, met. I don’t think, though, that a liberal society should be in the business of dictating which altruistic goals everyone should support. That should be an invididual decision.

    You don’t need altruism to justify any of those goals. Again: if you have a company, you benefit if your workforce is healthy and not starving. Continue thinking along these lines…

    Because that’s what they pay for, and what you’re paid for.

    Do you have an open classroom, PZ? Do you teach and assist anyone who wishes to learn? Or are you paid to work in an institution where people have to pay lots and lots of money for the privilege of being taught?

    Caledonian, major shock for you: From 1975 to 2000, studying at a university was free in Austria. Graduating from the longer of the school types (so you had been to school for 12 years) gave you the right to a higher education. Was quite a success in getting people from non-rich backgrounds into the universities without getting anyone out of them.

    And then, in 2000, a right-right coalition came to power. Over huge protests, it introduced what is basically a tax on students. It is 363.36 € per semester (twice that for non-EU foreigners), non-rich (not just poor) people get it back after they’ve paid it, and at first it didn’t even go to the universities, but straight into the budget hole (over here, the conservatives still want fiscal responsibility…). Now it does go to the universities — after the same amount has been cut off the university budgets, so the universities have gained nothing, and lost money in sum, because the budget cuttings go on, or at least did so till last year (I don’t know if the new government has stopped that). But I digress.

    Of course not, you collection of randomly moving molecules. I’m comparing markets to ecosystems.

    So that’s what it looks like when Caledonian is being sarcastic.

    thalarctos, you seem to be making our case for us. There is no clear line to draw between which surgeries/medical treatments people deserve, and which they don’t. So, it seems it is better to let people pay for their own medical care, than to make arbitrary judgments just so we can feel good about providing universal health care.

    You are still assuming that people can pay for their own healthcare. You are living in the counterexample.

    I don’t think that situation would happen in a voucher-based system, but supposing if it did there are hospitals where no one will be turned away, regardless of if the person can pay or not. These hospitals exist with the help of private charity, which I think is an excellent solution for these types of circumstances.

    And you simply assume there are and always will be enough such hospitals, and they’ll never go bankrupt.

    Dude, if it were so, it wouldn’t be a problem to live in the USA and not have health insurance.

    I favor no ideology.

    Here, let me clarify that: I favor no-ideology.

    And no-ideology is not an ideology…? What exactly does the hyphen mean?

    If you could put systems in place, what would they look like?

    Wu wei!

    Which wu? Five? Animal? The surname (one of the three Cantonese Ng)? Which wei? Hi? For? Give us the tones if you speak Chinese with us.

    Anecdotes are not a good basis for public policy. You most likely would have received care even if you had not had health insurance. The quality of the care might not have been as high, or it might have left you in substantial debt, but you most likely would have received the care.

    See, over here it wouldn’t have left her in any debt, no matter if September or December, and the quality would always have been equally high.

    Do you, “in general”, care for human lives or not?

  346. David Marjanović, OM says

    That is the basic core of a libertarianism – freedom from interference. I just don’t see what is so objectionable about that. So there are people who are unbelievably more wealthy than I am – how does that hurt me? Why should I think I am entitled to the what is their’s?

    No, it doesn’t hurt me at all.

    I just think I have a right not to die from poverty. That’s all. If someone is capable of making one billion after the other (in spite of reasonable taxes), let them.

    Some people here need to realize that nobody on this thread is arguing for communism or any other version of the government micromanaging the economy. We all support the free market. We just think nobody should be allowed to fall deeper into poverty than a certain level. That’s all.

    It’s perfect. In the absence of “big government,” justice is distilled to obtain the smallest possible government: one guy. One completely unaccountable guy who makes all the rules. And if you don’t like his rules, maybe you’d like to take a little swim instead.

    Well said.

    See, I have never had a corporation take my money by force. If a corporation does not serve my interests, I do not utilize their services.

    One word: monopoly.

    Oh yes, there are global monopolies and near-monopolies. Microsoft comes to mind, but that’s just the shiniest one.

    However, the federal government threatens me with jail if I decide to remove myself from paying for the “war on drugs” it wages against its own citizens.

    What a utopia must be a democracy where you could simply vote the government out and a new one in.

    What I wonder is why anyone thinks “Africa” is their problem to worry about. Who gave any invidual, or group, or country, the right to go around and try to fix other parts of the world?

    Even if you pathologically lack all compassion, you should be able to use your reason to figure out that, yes, it is your problem. For example, poor people will not buy your products. Doesn’t have to be “Africa”, can be the Working Poor in your very own city, too.

    It seems to me there are great problems, say, with universal healthcare.

    Which must be why every halfway rich country except the USA has it.

    Sure, some of the problems you mention are genuine problems, but not one of them is a reason not to have universal healthcare. You can discuss them later (as is in fact being done right now in Austria). That’s what a democracy is for.

    Well, treated like shopping for any other service. If we had a free market in health care, medicine would be cheaper (AMA couldn’t artificially restrict the doctor supply by keeping med students out, and if you are bargaining over health services doctors will have to compete on price as well as service). Think about it — how come prices in medicine are going up with technology rather than down?

    You do know that you Americans pay more for their healthcare than anyone else in or around the First World?

    One reason is that your government doesn’t get the idea of negotiating with the pharma companies about drug prices. That is unique — American exceptionalism the other way around.

    The way things often are now, though, corporations become established, and then receive government subsidies, thus removing them from the competition of the market. If this were not the case, no monopoly laws would be needed.

    You are kidding.

    I think I should decide. If I disagree with an insurance company, I can get different insurance, since the insurance company isn’t coercing me into taking their services. With government insurance, I would be coerced, and thus could not vote with my dollars.

    Guess what: all insurance companies have profit as their motive. All of them will do anything they can to avoid paying you. Once your risk of disease is high enough, no insurance company will insure you, unless you happen to be rich.

    Universal healthcare does not necessarily mean the absence of insurance companies. In Austria, the state is the only health insurer; in Germany, you can choose between the state and a number of private companies that are more expensive but reportedly provide better services.

    The German model actually gives you more freedom than the US one: in the German model, you actually can choose, no matter how poor and/or sick you are, and you will always find an insurance which, furthermore, actually will pay you when you need it.

    I repeat: more freedom.

    What’s not to like? :-)

    David M,OM said,”Excuse me? I live in a functioning welfare state with free healthcare for all EU citizens.”

    If you are being serious with that statement just how does that work?

    I’m not an expert on that. I’m sure the Internet is full with information on that, though.

    Are all services, buildings, pharmaceuticals, and equipment donated?

    This is quite different between countries.

    Is anyone in your healthcare system paid?

    Obviously!

    Do any taxes support the system?

    Yes, plenty. (For example the quite high taxes on cigarettes, but I think most of the money comes from the sales tax.) We get a good return on all those taxes. Again: in sum we pay less than you Americans.

    If you look at the high wages and long hours worked, it definitely looks like we are in an artificial doctor shortage. The high wages should be attracting more doctors to the profession in droves, but compulsory licensure keeps many of them out. Only the doctors themselves benefit from this, and everyone else is poorer for it.

    We have something similar in Austria, too. This is a case where a freer market would clearly be an advantage, as far as I can see.

    It is also a case where an intervention into the free market — breaking up the cartel and making sure it doesn’t form again — is necessary to make the market free again. It is a case where the free market has been left to itself and immediately stopped being free.

    I think this is a very important point. People have a tendency to see a problem, and then want to fix it. I think we should all be more skeptical of the proposed solutions to various problems. The impulse to help may be noble, but with imperfect information, and ideological blindnesses we might not even be aware of, centralized solutions are risky.

    Fine, but in this case — universal healthcare — you merely need to look abroad a little to find plenty of experiments running. The information is out there. Learn it, and then make your decisions, instead of acting as if this were the first attempt to introduce universal healthcare in the history of the world.

    Medical school enrollment increases each year in the US.

    Yep, over here too. Austria has more medicine graduates and fewer working doctors than needed.

    Strange but true: Suppose we dissolved the US government, and then started a corporation called UsCo that had basically the same set of rules. (In other words, we’d issue one share of stock to everyone, and then rewrite the Constitution, changing “citizen” to “shareholder”.) Libertarians would be more than happy to pay their membership dues.

    Very good point.

    What “poor track record?”

    Tens of millions of US citizens have no health insurance at all, and you ask “what ‘poor track record’?”

    Hayek, 1982, ‘Law, Legislation, and Liberty’ v. 2: “There is no reason why in a free society government should not assure to all, protection against severe deprivation in the form of an assured minimum income, or a floor below which nobody need descend.”

    Agreed. This is the welfare state (or “social state”) we EU citizens are so happy to have.

    Why should health insurance be universal and mandatory, but not, say, car insurance or homeowners’ insurance or disability insurance?

    Isn’t it? AFAIK car insurance is mandatory over here for all who have a car. Isn’t that even different between different US states?

    What needs domesticating? The sole example you had, Enron, did harm to lots of people and paid dearly for it. Government courts took care of it

    …after the harm was done and people had lost their pensions.

    (Not that getting one’s pensions in shares is a remotely sane idea.)

    Of course, making people altruistic isn’t your goal, which is having certain ends, that altruism might lead to, met. I don’t think, though, that a liberal society should be in the business of dictating which altruistic goals everyone should support. That should be an invididual decision.

    You don’t need altruism to justify any of those goals. Again: if you have a company, you benefit if your workforce is healthy and not starving. Continue thinking along these lines…

    Because that’s what they pay for, and what you’re paid for.

    Do you have an open classroom, PZ? Do you teach and assist anyone who wishes to learn? Or are you paid to work in an institution where people have to pay lots and lots of money for the privilege of being taught?

    Caledonian, major shock for you: From 1975 to 2000, studying at a university was free in Austria. Graduating from the longer of the school types (so you had been to school for 12 years) gave you the right to a higher education. Was quite a success in getting people from non-rich backgrounds into the universities without getting anyone out of them.

    And then, in 2000, a right-right coalition came to power. Over huge protests, it introduced what is basically a tax on students. It is 363.36 € per semester (twice that for non-EU foreigners), non-rich (not just poor) people get it back after they’ve paid it, and at first it didn’t even go to the universities, but straight into the budget hole (over here, the conservatives still want fiscal responsibility…). Now it does go to the universities — after the same amount has been cut off the university budgets, so the universities have gained nothing, and lost money in sum, because the budget cuttings go on, or at least did so till last year (I don’t know if the new government has stopped that). But I digress.

    Of course not, you collection of randomly moving molecules. I’m comparing markets to ecosystems.

    So that’s what it looks like when Caledonian is being sarcastic.

    thalarctos, you seem to be making our case for us. There is no clear line to draw between which surgeries/medical treatments people deserve, and which they don’t. So, it seems it is better to let people pay for their own medical care, than to make arbitrary judgments just so we can feel good about providing universal health care.

    You are still assuming that people can pay for their own healthcare. You are living in the counterexample.

    I don’t think that situation would happen in a voucher-based system, but supposing if it did there are hospitals where no one will be turned away, regardless of if the person can pay or not. These hospitals exist with the help of private charity, which I think is an excellent solution for these types of circumstances.

    And you simply assume there are and always will be enough such hospitals, and they’ll never go bankrupt.

    Dude, if it were so, it wouldn’t be a problem to live in the USA and not have health insurance.

    I favor no ideology.

    Here, let me clarify that: I favor no-ideology.

    And no-ideology is not an ideology…? What exactly does the hyphen mean?

    If you could put systems in place, what would they look like?

    Wu wei!

    Which wu? Five? Animal? The surname (one of the three Cantonese Ng)? Which wei? Hi? For? Give us the tones if you speak Chinese with us.

    Anecdotes are not a good basis for public policy. You most likely would have received care even if you had not had health insurance. The quality of the care might not have been as high, or it might have left you in substantial debt, but you most likely would have received the care.

    See, over here it wouldn’t have left her in any debt, no matter if September or December, and the quality would always have been equally high.

    Do you, “in general”, care for human lives or not?

  347. Jason says

    Tulse,

    Jason, the Canadian Supreme Court decision you note was a bit more nuanced than you relate — the issue was the prohibition of any private insurance, rather than having a public system as a whole.

    Yes, I didn’t mean to suggest that the ruling called for replacement of the public system with a private one. I cited it in response to Brownian’s post suggesting that the rise of private insurance in Alberta was the result of conservative political action. The point is that private insurance, which was previously almost unknown in Canada (because of laws like the one in Quebec that the court struck down), is now firmly established and growing. It is likely to grow further as the government finds it increasingly difficult to fund the demand for health care services.

    Imagine doctors wanting to charge whatever they want? How could they possibly support that unless public health care was terrible?

    So why haven’t they supported it all along, if, as you charge, their position is determined by financial self-interest?

  348. Madam Pomfrey says

    You are still assuming that people can pay for their own healthcare.

    This is because they project their own mindset on their critics and see things through one single lens focused on themselves. They accuse even the mildest critic of forcing his or her own preferences on everyone else in a quasi-communist way, when in reality they are attempting to force their own perceived lack of need on the entire society.

  349. syntyche says

    If you want to say, “Well, the US should be doing even better because it has more money” that’s fair, but these statistics do add nuance to “the US is is every way worse health-wise” stereotype.

    I don’t think anyone’s arguing that. What I’m saying is that the available evidence suggests that countries with single payer models perform better at a population level for a lower resource expenditure.

    I fully acknowledge that there are things the US healthcare does very very well. Even given this, it’s only for those who can afford it or afford the insurance for it.

    Also, what the statistics fail to address is the unholy pain-in-the-assedness of navigating the US healthcare system.

    The months of sorting out bills. Haggling with insurance companies over covered and non-covered charges. Hours on the phone dealing with people who have a financial incentive to screw you over. Deciding whether or not to go to the doctor now, but accepting that when you subsequently change insurance that condition won’t be covered due to it being pre-existing. Or, waiting until that new insurance kicks in before going to see a doctor and hoping that it isn’t serious. Being denied insurance because you didn’t tick the box saying you had a yeast infection three years ago. These are the kinds of things that I never even thought about before I moved here. I was sick. I went to the doctor. End of story.

    Seriously, it’s a hellish nightmare, compared to what I’m used to at least. You really can’t know until you’ve experienced both.

  350. says

    Which wu? Five? Animal? The surname (one of the three Cantonese Ng)? Which wei? Hi? For? Give us the tones if you speak Chinese with us.

    It’s a Taoist concept. From Wikipedia:

    Wu wei (Traditional Chinese characters: 無為 Simplified Chinese characters: 无为) is an important tenet of Taoism that involves knowing when to act and when not to act. Wu may be translated as not have; Wei may be translated as do, act, serve as, govern. The literal meaning of Wu Wei is “without action” and is often included in the paradox wei wu wei : “action without action” or “effortless doing”.

  351. Jason says

    David M,

    Tens of millions of US citizens have no health insurance at all, and you ask “what ‘poor track record’?”

    Yes, I do. Do you have an answer? Ostentatious expressions of surprise are not an answer. I’m guessing from your comment that you think health insurance is important to health. But as I have already said, the evidence that health insurance produces better health is weak. The largest study ever conducted on the relationship between health insurance and health is the RAND Health Insurance Experiment. The study tracked large numbers of families under different kinds of health insurance plan for 15 years. One group was on a “free” plan, which covered almost all of their medical expenses, and another was on a “catastrophic” plan with a very large deductible. Over the 15 years of study, the families with full coverage consumed 40 percent more health-care dollars than the other groups, but researchers couldn’t detect any measurable differences in health.

    This basic finding has been confirmed by numerous other studies. Although it obviously can make a huge difference in individual cases, across large populations there just isn’t much of a relationship between health insurance and health.

    Isn’t it? AFAIK car insurance is mandatory over here for all who have a car. Isn’t that even different between different US states?

    Most or all states mandate only third-party liability coverage. There is no mandate on drivers to buy insurance for losses or harm to themselves. Obviously, the losses from a major car accident can be very substantial–in the tens of thousands of dollars or more.

  352. Brian Macker says

    My favorite comment for sheer bigotry was by one H. Humbert

    “They’re still lazy, selfish, greedy and cruel, but at least any lip service about the sanctity of human life has been done away with.”

    There were many other people hear with similar comments, all bigots.

  353. Madam Pomfrey says

    Jason, ere are the key findings from the RAND study you cite:

    –In a large-scale, multiyear experiment, participants who paid for a share of their health care used fewer health services than a comparison group given free care.
    –Cost sharing reduced the use of both highly effective and less effective services in roughly equal proportions. Cost sharing did not significantly affect the quality of care received by participants.
    –Cost sharing in general had no adverse effects on participant health, but there were exceptions: free care led to improvements in hypertension, dental health, vision, and selected serious symptoms. These improvements were concentrated among the sickest and poorest patients.

    http://www.rand.org/pubs/research_briefs/RB9174/index1.html

    The study dealt with cost sharing, not with insurance vs. no insurance. I don’t see anything here implying that health insurance in general does not produce better health.

  354. Jason says

    What I’m saying is that the available evidence suggests that countries with single payer models perform better at a population level for a lower resource expenditure.

    Then please produce this evidence. I’d really like to see it. And please don’t repeat the “lower infant mortality rate = better health care system” assertion. It’s utter nonsense, for the reasons I have already explained.

    Here is the abstract of a recent study comparing the health care systems of the U.S. and Canada. The study found not only that access to treatment for illness was somewhat greater in the U.S. than in Canada, but that the relationship between income and health (the so-called “health-income gradient”) is actually slightly steeper in Canada than in the U.S. This obviously undermines the claim that Canada’s health care system is more egalitarian. Quote:

    Does Canada’s publicly funded, single payer health care system deliver better health outcomes and distribute health resources more equitably than the multi-payer heavily private U.S. system? We show that the efficacy of health care systems cannot be usefully evaluated by comparisons of infant mortality and life expectancy. We analyze several alternative measures of health status using JCUSH (The Joint Canada/U.S. Survey of Health) and other surveys. We find a somewhat higher incidence of chronic health conditions in the U.S. than in Canada but somewhat greater U.S. access to treatment for these conditions. Moreover, a significantly higher percentage of U.S. women and men are screened for major forms of cancer. Although health status, measured in various ways is similar in both countries, mortality/incidence ratios for various cancers tend to be higher in Canada. The need to ration resources in Canada, where care is delivered “free”, ultimately leads to long waits. In the U.S., costs are more often a source of unmet needs. We also find that Canada has no more abolished the tendency for health status to improve with income than have other countries. Indeed, the health-income gradient is slightly steeper in Canada than it is in the U.S.

  355. David Marjanović, OM says

    The US system is insane. Only someone in the grip of an ideology could argue otherwise.

    No, I don’t think so. Ignorance alone is enough. Along, of course, with the ignorance of being ignorant.

    There is abundant evidence that the effects of a nation’s health care system on the health of its population is swamped by these other factors.

    Care to cite some?

    No, what surprised me the most is how tenacious Americans were in defending their system. Americans have this thing of believing that they are the greatest nation on earth for EVERYTHING.

    For a very long time, they were simply right. From 1766 to the 1950s or so, the USA was the greatest nation on Earth for just about everything. How many First World countries were there in the 1950s? USA, Canada, Australia, NZ?

    BTW, the child soldiers in the Congo still speak French.

    I’m not sure exactly what you mean by “model,” but the trend in countries with single-payer health care systems, including Britain, Canada and France, is towards greater privatization.

    Fine with me, as long as it stays impossible not to have health insurance.

    We also lead in innovation of drugs and technology, and in a sense subsidize or at least benefit the rest of the world in this regard.

    Maybe I’m just too tired at 1 at night… I don’t see how the stuff behind the comma follows from the stuff in front of it. Please explain.

    As well, government power (frex) was owned purely by Citizens, people who amassed sufficient personal wealth and then gave it all to the government. The leaders are essentially in poverty and depend on the largesse of the public. This is interesting, but I have *no* idea how one would actually manage this.

    One word: lobbyism.

    Yes, Canadian doctors compete for patients in the limited sense you describe, but their compensation is determined by government budgets rather than market prices. It’s only competition within an environment of wage and price controls set by the government.

    And is that bad? As long as the doctors make a profit, I mean — and they do.

  356. David Marjanović, OM says

    The US system is insane. Only someone in the grip of an ideology could argue otherwise.

    No, I don’t think so. Ignorance alone is enough. Along, of course, with the ignorance of being ignorant.

    There is abundant evidence that the effects of a nation’s health care system on the health of its population is swamped by these other factors.

    Care to cite some?

    No, what surprised me the most is how tenacious Americans were in defending their system. Americans have this thing of believing that they are the greatest nation on earth for EVERYTHING.

    For a very long time, they were simply right. From 1766 to the 1950s or so, the USA was the greatest nation on Earth for just about everything. How many First World countries were there in the 1950s? USA, Canada, Australia, NZ?

    BTW, the child soldiers in the Congo still speak French.

    I’m not sure exactly what you mean by “model,” but the trend in countries with single-payer health care systems, including Britain, Canada and France, is towards greater privatization.

    Fine with me, as long as it stays impossible not to have health insurance.

    We also lead in innovation of drugs and technology, and in a sense subsidize or at least benefit the rest of the world in this regard.

    Maybe I’m just too tired at 1 at night… I don’t see how the stuff behind the comma follows from the stuff in front of it. Please explain.

    As well, government power (frex) was owned purely by Citizens, people who amassed sufficient personal wealth and then gave it all to the government. The leaders are essentially in poverty and depend on the largesse of the public. This is interesting, but I have *no* idea how one would actually manage this.

    One word: lobbyism.

    Yes, Canadian doctors compete for patients in the limited sense you describe, but their compensation is determined by government budgets rather than market prices. It’s only competition within an environment of wage and price controls set by the government.

    And is that bad? As long as the doctors make a profit, I mean — and they do.

  357. Jason says

    Madam,

    The study dealt with cost sharing, not with insurance vs. no insurance.

    Huh? The difference between “insurance” and “no insurance” is a difference in cost-sharing. In fact, most families on the RAND study’s “catastrophic” plan had to pay virtually all their health care expenses out of pocket. Only if they contracted a “catastrophic” illness above the high deductible did the insurance share in any of the costs.

    I don’t see anything here implying that health insurance in general does not produce better health.

    Then I guess you missed this:

    In general, the reduction in services induced by cost sharing had no adverse effect on participants’ health.

  358. David Marjanović, OM says

    These are the kinds of things that I never even thought about before I moved here. I was sick. I went to the doctor. End of story.

    Maybe that’s why, in spite of all those strikes, France has a higher productivity than the USA.

    ———–

    Thanks, thalarctos. So it seems like Caledonian just proposes doing nothing and watching…

    ———–

    And please don’t repeat the “lower infant mortality rate = better health care system” assertion. It’s utter nonsense, for the reasons I have already explained.

    Then what do you propose to do about the scandalously high US infant mortality?

    In the U.S., costs are more often a source of unmet needs.

    Hm…

    And what about the debts that uninsured Americans apparently regularly plunge themselves into?

  359. David Marjanović, OM says

    These are the kinds of things that I never even thought about before I moved here. I was sick. I went to the doctor. End of story.

    Maybe that’s why, in spite of all those strikes, France has a higher productivity than the USA.

    ———–

    Thanks, thalarctos. So it seems like Caledonian just proposes doing nothing and watching…

    ———–

    And please don’t repeat the “lower infant mortality rate = better health care system” assertion. It’s utter nonsense, for the reasons I have already explained.

    Then what do you propose to do about the scandalously high US infant mortality?

    In the U.S., costs are more often a source of unmet needs.

    Hm…

    And what about the debts that uninsured Americans apparently regularly plunge themselves into?

  360. says

    Looks like you missed this one, Jason:

    Ann N Y Acad Sci. 2007 Oct 22; [Epub ahead of print]. Health Insurance and Access to Health Care in the United States. Hoffman CB, Paradise J. Kaiser Commission on Medicaid and the Uninsured, Henry J Kaiser Family Foundation, 929 Signorelli Circle, St. Helena, California, 94574, United States. Health insurance, poverty, and health are all interconnected in the United States. This paper synthesizes a large and compelling body of health services research—finding a strong association between health insurance coverage and access to primary and preventive care, the treatment of acute and traumatic conditions, and the medical management of chronic illness. Moreover, by improving access to care, health insurance coverage is also fundamentally important to better health care and health outcomes. Research connects being uninsured with adverse health outcomes, including declines in health and function, preventable health problems, severe disease at the time of diagnosis, and premature mortality.

    I mean, if insurance isn’t a part of providing better health outcomes, then just what the hell are you and all the privatization crowd advocating our paying for it for?

  361. TheBlackCat says

    They are different. Anyone with a brain can see that.

    Then I must not have a brain. Spell it out for me.

    No I didn’t.

    Another in-depth rebuttal I see.

    No they don’t. When they are applied to the real world is where the differences shine through.

    Then how can it be this hard to just tell me what these differences are and then stick to them?

    Conservatives say drugs are bad. Liberals say drugs are bad. I say drugs are fine, as long as you keep them to yourself and take personal responsibility.

    I know plenty of liberals and plenty of conservatives who don’t think drugs are bad at all. In fact I don’t know anyone personally who supports the war on drugs. It seems you might have certain ideas about what liberals and conservatives believe, but like you have stated about libertarians neither liberals nor conservatives are coherent groups that all share the same set of beliefs. That have certain opinions in common that differentiate one from the other, but not everyone in the group even shares all of those opinions. I am still waiting for any sort of fundamental difference between libertarianis as you accept it and everyone else. Just saying over and over they exist and that I am an idiot for not being able to see them is not going to convince me.

  362. syntyche says

    Then please produce this evidence. I’d really like to see it. And please don’t repeat the “lower infant mortality rate = better health care system” assertion. It’s utter nonsense, for the reasons I have already explained.

    Then pick your metric. Infant mortality. Life expectancy. Cancer rate. Odds are, countries with single payer systems will rank higher. I must have missed your critique of using these numbers (forgive me, its a long thread). The only statement I can find is

    My answer is that that ranking is basically meaningless.

    Which isn’t a particularly compelling counter-argument.

    In any case, given that I explicitly said “On a population level” my statement, as written, is completely accurate. Here, let me quote it again for you

    the available evidence suggests that countries with single payer models perform better at a population level for a lower resource expenditure.

    Now what part of that, specifically, do you have a problem with?

  363. Jason says

    David M,

    Care to cite some?

    The Institute of Medicine estimates that about 19,000 Americans die prematurely each year because of inadeqate health insurance. To put that in perspective, about 435,000 are estimated to die each year from smoking, about 365,000 from poor diet and physical inactivity, about 85,000 from alcohol consumption, about 43,000 from motor vehicle crashes, about 29,000 from firearms, and about 17,000 from use of illicit drugs. Even a small reduction in the rate of smoking would save more lives than providing health insurance to everyone.

    And is that bad?

    Yes, it’s bad.

  364. TheBlackCat says

    Dieing and having bad health are not the same thing. You can be very sick for a long time due to a lack of health insurance and not die from it. But most of the problems from tobacco, like lung cancer and emphysema, have very high mortality. Similarly heart disease from poor diet and lack of physical activity has a high mortality rate as well. On the other hand breaking your leg, for instance, can cause permanent problems if not properly treated but is far less likely to kill. Mortality rates are probably not the best measure of quality of life, which is another very important issue.

  365. Jason says

    synt,

    Then pick your metric. Infant mortality. Life expectancy. Cancer rate. Odds are, countries with single payer systems will rank higher. I must have missed your critique of using these numbers (forgive me, its a long thread).

    See my post #299, for example. Or my latest one, #350.

    Here, let me quote it again for you
    the available evidence suggests that countries with single payer models perform better at a population level for a lower resource expenditure. Now what part of that, specifically, do you have a problem with?

    All of it. The whole thing. There is no serious evidence that “single-payer models perform better at a population level” at preventing, diagnosing or treating illness. In fact, as the cancer diagnosis/survival statistics that Colugo has cited, the NBER study I cited, and other lines of evidence suggest, the U.S. health care system may perform better.

  366. abelian jeff says

    The anti-libertarians seem to think that in a libertarian society, the poor would be left completely to their own devices to die of starvation and disease. This couldn’t be further from the truth.

    The most obvious reason is that charities would still exist, just as they exist in a non-libertarian society.

    The less obvious reason is that the same people who voted in a government which cares for the poor would continue to care for the poor in the absence of a government. To say otherwise is ridiculous… a total straw-man argument. Only the most jaded cynics would believe that in a libertarian society, those with money would be unwilling to part with any of it to help those without any. What libertarians are opposed to (among other things) is the government’s forceful redistribution of their money.

  367. Madam Pomfrey says

    Jason, obviously I didn’t “miss” that conclusion, since I quoted it above as part of the RAND study’s key findings. Looks you bleeped over the part that starts with “free care,” though.

    Cost sharing in general had no adverse effects on participant health, but there were exceptions: free care led to improvements in hypertension, dental health, vision, and selected serious symptoms. These improvements were concentrated among the sickest and poorest patients.

    Now I wonder why you didn’t address that part? Well, gee…

  368. syntyche says

    Notice I didn’t say “single payer health models”. I said “countries with single payer models”.

    Still dispute it?

  369. Caledonian says

    Thanks, thalarctos. So it seems like Caledonian just proposes doing nothing and watching…

    Ha ha ha!

    You fail.

  370. Caledonian says

    Caledonian, major shock for you: From 1975 to 2000, studying at a university was free in Austria.

    No, it wasn’t free. It simply wasn’t paid for by the students.

    Graduating from the longer of the school types (so you had been to school for 12 years) gave you the right to a higher education. Was quite a success in getting people from non-rich backgrounds into the universities without getting anyone out of them.

    And what good is that? Now so many people have a university degree that it’s useless at distinguishing qualified candidates. Of course, anyone without one is now at a disadvantage…

    It’s why a high school diploma is now virtually worthless, when once graduating high school was as important as graduating from university is now.

  371. says

    Now I wonder why you didn’t address that part? Well, gee…

    Madam Pomfrey, I’m having a little trouble following the logic, but I think it’s something like: it doesn’t matter that the uninsured don’t have private health insurance because private health insurance makes no difference at all in outcomes, which is why we should turn the entire health-care delivery system over to that sector.

    Or something. Hell, I can’t tell anymore what he’s advocating.

  372. Caledonian says

    Don’t kid yourself — the US system already rations, it just does so based on ability to pay, rather than any sensible scheme.

    That’s utterly absurd – you are abusing the concept of ‘rationing’ horribly.

    By your logic, we also ration yachts, diamond-studded wristwatches, and five-star restaurants.

  373. says

    By your logic, we also ration yachts, diamond-studded wristwatches, and five-star restaurants.

    Only if you consider health care a luxury good.

  374. Caledonian says

    PZ mentioned he was with Jefferson about government. I would point out that Thomas Jefferson would count as a libertarian under any reasonable definition of the term. “That government is best which governs least”, etc. Indeed, I do not think it would be inaccurate to think of the American Revolution as a libertarian revolution.

    I wouldn’t take what PZ claims he believes very seriously. Rather, I would look at what he does.

    Incidentally, studies have shown that Americans tend to behave the same way as other people in their economic class do, regardless of what they claim to believe.

    I will note that PZ has not attempted to fairly distribute his wealth so that he’s equal with the poorest people in his society. And he most certainly hasn’t made the distribution on the global scale. By the standards of most of humanity, and essentially everyone historically, he’s incredibly wealthy. I don’t know how much money he gives to charity, or whether he makes donations to the government in addition to what he pays in taxes. But I doubt he does especially much of either, and probably not more than most of the libertarians he’s slandering.

  375. tomh says

    thalarctos wrote:
    Only if you consider health care a luxury good.

    Which obviously these folks do. It’s stated pretty clearly by some, you can have the best health care you can afford, and if you can’t afford any some charity will probably help you out.

  376. Jason says

    synt,

    Notice I didn’t say “single payer health models”. I said “countries with single payer models”.

    So you did.

    Still dispute it?

    Yes. But even if it’s true, it’s irrelevant. The issue here is the performance of different kinds of health care system, not of different countries. I’m not sure what it even means to apply the word “performance” to a country in this context.

  377. Jason says

    Madam,

    Jason, obviously I didn’t “miss” that conclusion, since I quoted it above as part of the RAND study’s key findings.

    No you didn’t.

    Cost sharing in general had no adverse effects on participant health, but there were exceptions: free care led to improvements in hypertension, dental health, vision, and selected serious symptoms. These improvements were concentrated among the sickest and poorest patients.

    Right, there were exceptions. But as the conclusion I quoted states, in general cost-sharing was found to have no adverse effect on health. Since what we’re discussing here is the merits of health care policy overall (single-payer vs. multi-payer, universal coverage vs. partial coverage), that seems to me the most significant finding. If health insurance produces significant benefits for particular subpopulations, that might have policy implications for those subpopulations (an expansion of Medicaid, say), but it doesn’t alter the general conclusion.

  378. Madam Pomfrey says

    Cost sharing in general had no adverse effects on participant health

    I didn’t quote this? Can you read?

  379. Jason says

    Dieing and having bad health are not the same thing. You can be very sick for a long time due to a lack of health insurance and not die from it. But most of the problems from tobacco, like lung cancer and emphysema, have very high mortality. Similarly heart disease from poor diet and lack of physical activity has a high mortality rate as well. On the other hand breaking your leg, for instance, can cause permanent problems if not properly treated but is far less likely to kill. Mortality rates are probably not the best measure of quality of life, which is another very important issue.

    Your argument here makes no sense. Mortality from smoking is just the tip of the iceberg of the damage it causes to “quality of life.” For every person who dies each year due to smoking, there are probably a hundred who are suffering from heart disease, hypertension, emphysema, cancer or various other serious diseases caused or exacerbated by smoking. Ditto for poor diet, lack of physical activity, use of alcohol and drugs, and so on. These things cause far, far more illness and premature death than inadequate health insurance.

  380. Jason says

    I didn’t quote this?

    Yes, I see now you did. You just conveniently neglected to highlight it, choosing instead to focus on the exceptions to the study’s general finding on health.

  381. Colugo says

    With careful analysis of the strengths and weaknesses of various systems, we can craft a better system that avoids some of the pitfalls that others have experienced while addressing existing weaknesses in our own. There needs to be a discussion of priorities that takes into account the fact that there are always trade-offs. I don’t think Americans want to stop being the leaders of biomedical innovation or to move away from high-tech diagnostics. Some of these trade-offs might involve tough ethical issues dealing with both the beginning and end of life. (Of course, that would be the case even under a completely private system.) Currently there is an overly complicated, haphazard, and sometimes arbitrary aspect to coverage; I know this from my own experience.

    The question is this: What is the utility that ought to be maximized? Answer: The general welfare of the national polity. That does not necessarily mean that healthcare ought to be wholly socialized; no one particular policy is mandated by that answer.

    For some people on both left and right, healthcare is about moral and ideological posturing. My pragmatic perspective is that effectiveness is more important than these considerations. I suspect that a hybrid system, with public coverage calibrated to need, will be most effective. But I do not know the details of what such a system should be. That’s why we need a clear-eyed assessment of the differential outcomes of various Western healthcare systems in multiple areas, rather than an uncritical emulation of Europe or a defensive valorization of the market.

    Penatal and perinatal health should be the first priority. This is not just a matter of coverage, but also community outreach, education, and prevention, intervention. This issue is not just about nutrition and pathogens but also the social epidemiology of smoking, alcohol, and maternal stress. Informed by the developmental programming and life history plasticity research of David Barker, James Chisholm and others, an applied field of intergenerational health can help ensure a more promising future for those born into less privileged circumstances. And this will lead to enhanced health, productivity, and unity of the country as a whole.

  382. syntyche says

    Yes.

    OK. Can we accept as a first premise that the US spends more on healthcare per capita than countries with single payer healthcare systems?

    http://www.nationmaster.com/red/country/us-united-states/hea-health&all=1

    As a second, If you can’t look down this list and see that, more often than would be expected statistically, the United States ranks in the lower half of OECD countries in health metrics (those relevant to large industrial democracies), then I’m afraid our discussion is over.

  383. Colugo says

    Let me add to what I wrote about prenatal health policy:

    Perhaps it is time for a new conception of freedom, which begins with freedom from developmental insult.

  384. Caledonian says

    Perhaps it is time for a new conception of freedom, which begins with freedom from developmental insult.

    Yes, you could add it to the list of the other insane conceptions in the Universal Declaration of Human Rights.

  385. Jason says

    David M,

    See, over here it wouldn’t have left her in any debt, no matter if September or December, and the quality would always have been equally high.

    Really? People in Canada never get into debt because of an illness? They never get into debt because they lose income from taking time off work (or losing their job entirely) as a result of the illness? They never get into debt from purchasing private medical care to avoid a waiting list, or after being turned down for treatment by Canada’s public health care system? They never get into debt over indirect, uncovered or non-medical-bill expenses arising from their illness, like child care, or non-prescription medications?

    Of course, sick people do get into debt in all of these ways and more. The only part of the financial risk due to illness that your health care system protects them from is costs for covered medical services, and those costs may be much less than the uncovered and indirect costs of their illness that they will still have to find a way of paying themselves.

  386. Jason says

    synt,

    OK. Can we accept as a first premise that the US spends more on healthcare per capita than countries with single payer healthcare systems?

    Yes. The U.S. spends more per capita than every other country in the world.

    As a second, If you can’t look down this list and see that, more often than would be expected statistically, the United States ranks in the lower half of OECD countries in health metrics (those relevant to large industrial democracies), then I’m afraid our discussion is over.

    You just added that OECD qualifer, which obviously changes things dramatically. Before, you said “countries with single payer models,” not “OECD countries” (or even “OECD countries with single payer systems”).

    I’m not going to to bother checking your new claim, because as I have already pointed out, it’s irrelevant. The issue here is the merits of different kinds of health care system, not the health status rankings of different countries.

  387. Kseniya says

    I believe the key to understanding Caledonian’s Wu wei can be found in the very first sentence of the Wiki entry: “[~] is an important tenet of Taoism that involves knowing when to act and when not to act.” It’s not simply a matter of sitting around doing nothing, it’s about being in harmony with what Is. Whether or not this approach will solve some of the health care problems we face here in the USA is open to discussion. ;-)

    The concept of “effortless doing” can be illustrated, I think, by something an Indian friend of mine once said, which can be summarized thus: “If you say ‘I do my best to be polite’ you are not actually being polite.” I don’t necessarily agree – effort matters, and grace under pressure, even if by choice rather than by nature, is still grace – but I get the point.

  388. Ichthyic says

    Yes. The U.S. spends more per capita than every other country in the world.

    Just curious if you have ever bothered to consider the effects that different base costs have on that figure?

    take just prescription medications as an example, though just about every aspect of medical care in the US costs more.

    sure, it’s easy to spend more per capita when the costs are more to begin with, and still get less done.
    which is why looking at money spent per capita isn’t as relevant to actual health care value than one might think.

    The issue here is the merits of different kinds of health care system, not the health status rankings of different countries.

    since obviously per capita spending isn’t exactly a great measure of the merit of a health care system either, what exactly would you propose in order to compare?

  389. Ichthyic says

    They never get into debt from purchasing private medical care to avoid a waiting list, or after being turned down for treatment by Canada’s public health care system? They never get into debt over indirect, uncovered or non-medical-bill expenses arising from their illness, like child care, or non-prescription medications?

    seems to me like you could get factual answers to your own questions if you ever bothered to spend some time researching them.

    my guess would be you would like to whip out the canned responses from Feux News instead though.

  390. Colugo says

    Ichthyic: “Just curious if you have ever bothered to consider the effects that different base costs have on that figure?”

    That’s also true of military spending. Those figures that the US spends X times more than China or Russia don’t take into account conscripted manufacturing labor, very low personnel benefits, and other reduced costs. Of course, the US still spends far more on defense. But adjusting for costs would reduce the appearance of overkill by some degree.

  391. Barn Owl says

    Since nathan has failed to provide evidence for the vast AMA/USMLE conspiracy, beyond an excerpt from a 1962 book by Milton Friedman, I’m left to conclude that:
    1. He has as much knowledge about current medical education and healthcare policy in the US as I do about reality TV, or Slovakian folk dances, or grammar rules in the Tibetan language.
    2. As I’ve long suspected from RL encounters, adherence to stupid conspiracy theories has significant comorbidity with Libertarianism. Big black helicopters, anyone? Should I be checking the stickers on the backs of TXDoT highway signs for messages from the New World Order?

    #251-

    Sounds like excellent decisions for private insurance companies to make. A good argument to privatize healthcare.

    Yes, because I definitely want some insurance dweebs, with business or accounting degrees from Whatsamatta U, to make decisions about medical treatment, the next time I have major surgery or a serious illness. Perhaps they’ll suggest the latest woo therapy, and save me a lot of money, since a dead person requires no food or shelter. Or health insurance. In Libertarian Land, we’re *all* experts on everything…we’re adults, and we know what’s best for our own welfare.

    #285-

    It is not a utopian pipe dream to say that its better to let consumers CHOOSE how they spend their money. All their money.

    Did you forget about people who don’t have discretionary income? You know, the ones who spend their entire paychecks on basic necessities, for themselves and their families?

    Yes, I though you might have.

    #219-

    But just because government is needed there does not mean our tax dollars should pay for the cancer surgery of man who smokes his lungs black with tar or the drunk driver who wraps himself around the telephone pole

    So, Libertarians want every adult to have the freedom to make his or her own lifestyle choices, regardless of how unhealthy those choices may be AND in a society that lacks government regulation of pollutants, food quality, tobacco additives, alcohol consumption, etc. Moreover, there will be no need or government support for public health policies, preventative medicine, biomedical research, or basic health education. And then we’ll deny healthcare to all those people who were unaware of the risks (to themselves or to their offspring), or who inherited cancer/ cardiovascular disease/ neurodegenerative disorder susceptibility genes from ignorant parents who should never have reproduced. UNLESS, of course, they can cough up the big bucks to pay for the treatments.

    Seems cruel and inhumane to me…perhaps even sociopathic.

  392. says

    Abelian Jeff, you make an excellent point that should be seconded. Less taxes only means more money in the hands of the people, who could donate it where they chose. Donations to charity could only go up.

    To CalGeorge – slavery is inimical to capitalism. From a purely pragmatic standpoint, it is inefficient. (And from a libertarian position, immoral.) Look, for example, at England. Capitalism, fueled by the industrial revolution, began sooner in England, than in America. Slavery was also abolished sooner in England than in America. Coincidence?

  393. Caledonian says

    So, Libertarians want every adult to have the freedom to make his or her own lifestyle choices, regardless of how unhealthy those choices may be AND in a society that lacks government regulation of pollutants, food quality, tobacco additives, alcohol consumption, etc.

    The government organizations dedicated to those tasks haven’t actually been doing very well lately.

  394. Terry says

    Go back and read the original post PZ references. It is a loony discussion of some floating nation that was planned to be a libertarain haven. A ridiculous straw man.

    PZ is a conundrum. How can someone who does not want god rammed down his throat turn around and want socialized medicine, smoking regulations, dietary restrictions, etc etc ad infinitum?

    It seems some of my fellow atheists have substituted the state and the poor/downtrodden for the deity as far as a moral imperative.

    ‘Give me liberty or give me death’ …particularly in the face of the do-gooders of the left and the right.

  395. CalGeorge says

    For example, CalGeorge strongly implies that such people would all be out buying HDTVs, guns, and pit bulls to sic on poor folks with this new found wealth. That is just mean spirited, baseless rhetoric.

    In a Libertarian Utopia, a pit bull and a gun would be wise purchases. Since the poor people will have to be moved from private property to private property (since state-owned land no longer exist) the guns and pit bulls will come in handy.

    Without rate caps on cable t.v., the HDTV might be one of those super-luxury items no one can afford. But hey, LiberTopia T.V. could feature reality shows about all the slugs who made bad choices and failed to thrive or to become decent, upstanding property owners. The rich people could watch this sad morality play on their giant HDTVs and feel validated, the way all the right-wingers now feel validated by Fox News.

    What a wonderful world it would be.

  396. melior says

    The startling notion of coagulated ship-city has unsurprisingly been featured in fiction

    Somewhat modestly, China Mieville manages to completely overlook mentioning his own marvelous (and award-winning) story about a floating ship-city, The Scar. I recommend it highly, and his other fiction too.

  397. Zarquon says

    PZ is a conundrum. How can someone who does not want god rammed down his throat turn around and want socialized medicine, smoking regulations, dietary restrictions, etc etc ad infinitum?

    Because he has empathy, and because they work. Sorry if that’s beyond your comprehension Mr Sociopath.

  398. Caledonian says

    When the original poster in a thread starts off at the intellectual level of “atheists are monsters because you can’t be moral without God”, things can only go downhill. And they have.

    Oh noes! I’m against the idea that charity is a thing people can be entitled to, so I must be an unfeeling, sociopathic monster. But since I’m a Ku Klux Klan member, too, I guess that makes sense. It certainly explains why I drink the blood of unbaptised Jewish babies and kill puppies for Satan in my spare time.

  399. Tulse says

    I drink the blood of unbaptised Jewish babies and kill puppies for Satan in my spare time.

    That’s a relief, Caledonian — I figured your hobbies were much worse…

  400. Ian Gould says

    “Libertarians have a big disadvantage over their Donkey and Elephant counterparts: We don’t actually KNOW if their way of doing things would work or not. We’ve never tried it. PZ will admit that with Dem/Rep it’s a lesser of two evils. No libertarian experiment has been conducted, to my knowledge.”

    Actually libertarianism represents almost exactly a reversion to the economic and social policies of the 18th and 19th centuries.

    We know what effect abolishing labor laws and product safety laws would have because we know why those laws were introduced in the first place.

  401. Zarquon says

    It’s because libertarians believe poor people should suffer for their poverty and that being poor is a moral failure that it’s obvious that Libertarianism is the same shit as Social Darwinism.
    “Oh no some people didn’t even have to work as hard as my granddaddy to get healthcare (even though I was born into cmfortable middle class existence)”

    Labelling the provision of basic social infrastructure as “charity” just shows how hateful they are.

  402. says

    One major problem with libertarians’ arguments is that rarely do they actually define just what “liberty” is- and liberty is a very nebulous concept to pin down. Most libertarians rely on a legal conception of liberty, along the lines of what people are and aren’t allowed to do. Suppose that we take a hypothetical libertarian and place him in the middle of the Pacific Ocean on a big rubber raft(rather relevant in this case, don’t you think?), with nothing but his swim trunks. Said libertarian is legally free to do pretty much anything- take PCP, fire a machine gun, you name it. However, his lack of resources makes his _practical_ freedom in this case just about worthless. Few would argue that this hypothetical libertarian has more practical liberty/freedom than a typical American, despite the typical American having significantly more legal restrictions.

    Libertarian policies would make the poor even less well off and greatly reduce their practical liberty. For libertarians to yammer about “liberty” while desiring to implement a system which intentionally and unapologetically denies practical liberty to so many shows a staggering level of hypocrisy.

  403. jcw says

    “David M,OM said,”Excuse me? I live in a functioning welfare state with free healthcare for all EU citizens.”

    In response #334
    Do any taxes support the system?
    Yes, plenty. (For example the quite high taxes on cigarettes, but I think most of the money comes from the sales tax.) We get a good return on all those taxes. Again: in sum we pay less than you Americans.

    I guess its not quite free. If you were trying to say that you pay less than Americans, that’s what you should say. Saying your healthcare is free is bunk. There is no free healthcare anywhere, someone is paying for it.

  404. Joe Bob says

    Caledonian (speaking of PZ):

    But by all means, let’s be honest: you’re a capitalist, selling your expertise. You don’t give it away for free.

    According to that reasoning, anyone in who doesn’t “give it away for free” is a capitalist. E.g. any salaried employee, even the lowest-paid.

    This is proof that you don’t know the first thing about capitalism.

  405. Graculus says

    So you’re arguing that libertarianism is a subset of liberalism? Or are you suggesting that libertarians are just crypto-fascists?

    1) Yes, Libertarianism is a subset of philisophical liberalism.

    2) No, that is an unintended consequence of Libertarianism. A bug, not a feature.

  406. Graculus says

    since obviously per capita spending isn’t exactly a great measure of the merit of a health care system either, what exactly would you propose in order to compare?

    How about service and outcome metrics. Average longevity, natal mortality, percentage of people with access to healthcare, etc.

    In which scores Western nations with universal health care (no matter what the particulars) has the US beat.

  407. Jon says

    Although I am not a “Libertarian”, I am if I can possibly generalize myself to be a “Green Moderate-Libertarian” – Too much central command economy stagnates the economy. Also, it has a tendency to lower individual incentive (which is conducive to stagnation). At the same time I am against monopolies…

  408. johannes says

    > But some anarchists have done a lot of bad things for real, from
    > French history

    Sorel? But he was a renegade and became a fascist.

    > over Soviet history

    Ukraine was at least able to feed itself and even produce a surplus under Machno, wich is more than can be said about earlier (Skoropadski, Petljura) and later (Stalin, Hitler) rulers of this country. If anybody did “a lot of bad things” in Soviet/Machno relations, it was the Soviet side; first they let Machno and his army do the dirty jobs for them (drive the French out of Odessa), then they turned against their former ally.
    The Antonov revolt and other such uprisings, on the other hand, are to badly documented for proper assessment by modern historians, but I think the much-abused peasants had a right to defend themselves against the red and white armies that plundered them.

    > to WWI instigation

    The guy who shot Franz Ferdinand was a (Serbian) nationalist, not an anarchist.

    > to outright terrorism,

    You are right on this point, some (by no means all) anarchist used terrorism. But those who favoured “direct action” and violence most were usually the first ones to abandon their former anarchist views and become fascist. The terrorists of the seventies, on the other hand, while often called “anarchists” by the contemporary press, were either nationalists (ETA, IRA, the several Palestinian groups) or adherents of some strain of stalinism or another, usually maoism.

  409. johannes says

    > But some anarchists have done a lot of bad things for real, from
    > French history

    Sorel? But he was a renegade and became a fascist.

    > over Soviet history

    Ukraine was at least able to feed itself and even produce a surplus under Machno, wich is more than can be said about earlier (Skoropadski, Petljura) and later (Stalin, Hitler) rulers of this country. If anybody did “a lot of bad things” in Soviet/Machno relations, it was the Soviet side; first they let Machno and his army do the dirty jobs for them (drive the French out of Odessa), then they turned against their former ally.
    The Antonov revolt and other such uprisings, on the other hand, are to badly documented for proper assessment by modern historians, but I think the much-abused peasants had a right to defend themselves against the red and white armies that plundered them.

    > to WWI instigation

    The guy who shot Franz Ferdinand was a (Serbian) nationalist, not an anarchist.

    > to outright terrorism,

    You are right on this point, some (by no means all) anarchist used terrorism. But those who favoured “direct action” and violence most were usually the first ones to abandon their former anarchist views and become fascist. The terrorists of the seventies, on the other hand, while often called “anarchists” by the contemporary press, were either nationalists (ETA, IRA, the several Palestinian groups) or adherents of some strain of stalinism or another, usually maoism.

  410. Caledonian says

    According to that reasoning, anyone in who doesn’t “give it away for free” is a capitalist. E.g. any salaried employee, even the lowest-paid.

    Lowest is irrelevant. Favoring state control of the means of production leads to some interesting consequences when you ARE a means of production.

    Is PZ in favor of having the government determine his wages?

  411. Terry says

    > 382: PZ is a conundrum. How can someone who does not want god rammed down his throat turn around and want socialized medicine, smoking regulations, dietary restrictions, etc etc ad infinitum?

    -Zarquon 385: Because he has empathy, and because they work. Sorry if that’s beyond your comprehension Mr Sociopath.

    > Lots of things work – Mussolini made the trains run on time – but that doesn’t make them acceptable. I don’t see how the tyrrany of the (m)asses limiting someone’s choice of doctors, or forcing them to pay into a system they won’t use, or forcing them to wait until some bureaucrat hears their case is empathetic. And please define what basic necessities of life you think ought to be our shared responsibility – a house? a car? a coat? one visit to the doctor? a sports car? a computer? season tickets to the Red Sox? – it never ends. Each of us defines for him/herself what these necessities are, and pursues them with their own zeal in a capitalist/libertarian society. Thus everyone is about as happy as they allow themselves to be (A. Lincoln).

    Socialism has been tried many times over the past 175 years or so, always with bad consequences. Read: Heaven on Earth – History of Socialism. It competes with organized religion, to which it has numerous parallels, as to which is the most mortal philosphy in the history of mankind.

    ***
    A common definition for libertarianism might be tough to find. I would not favor a complete absence of government, which as many have pointed out (and mistaken for libertarianism) is anarchy. Freedom to enter into contracts of all types, as long as they don’t harm the person or property of another, and freedom from externally imposed obligations is a good working definition. When examining a system of government I try to imagine it from the perspective of each type of citizen and see if it would be onerous.

    The US Constitution is definitely within the libertarian framework, but many of the social improvement programs (Socialist Security etc) are not. Libertarians do not favor, for example, exclusively private highways. But we do favor the option of having private highways under the same conditions as granted to (usurped by?) the government.

    Zarquon, yours are rather pitiful posts. And your final ad hominem attack was also mis-directed. It’s Dr Sociopath.

  412. Caledonian says

    Lots of things work – Mussolini made the trains run on time

    Actually, he didn’t. But this is a very commonly-repeated claim, so the mistake is understandable.

    http://www.snopes.com/history/govern/trains.asp

    Evidently a powerful central authority can’t make society run even with unlimited power. Huh. Who would’ve predicted that?

  413. Tulse says

    Is PZ in favor of having the government determine his wages?

    Since he’s at a publicly-funded university, isn’t that pretty much the case?

  414. Joe Bob says

    Caledonian:

    Favoring state control of the means of production leads to some interesting consequences when you ARE a means of production. Is PZ in favor of having the government determine his wages?

    A while ago PZ was a capitalist, and now he’s a “means of production” menaced by control of the state. You could at least be consistent in your name-calling.

  415. Caledonian says

    Since he’s at a publicly-funded university, isn’t that pretty much the case?

    Not really, no. Although I’m not intimately familiar with the details of how his particular university manages things.

    People who talk a great deal about the glories of socialism usually don’t actually like the effects of planned economies. A person striving for tenure might be one of the rare folk who do.

  416. Caledonian says

    A while ago PZ was a capitalist, and now he’s a “means of production” menaced by control of the state. You could at least be consistent in your name-calling.

    Um… you can easily be both.

  417. Joe Bob says

    Ah, Caledonian, so you’re saying PZ is both a capitalist and a wage slave. How thick-headed of me not to understand immediately…

    You’re just making up BS as usual. This blog would be a lot more interesting without you. You’re just noise.

  418. Tulse says

    People who talk a great deal about the glories of socialism usually don’t actually like the effects of planned economies.

    Yeah, I do get tired of all the pangyrics to Marxism that PZ keeps spouting here.

    (I cannot emphasize enough how handy an “eye-roll” character would be…)

  419. Xanthir, FCD says

    #334:

    As well, government power (frex) was owned purely by Citizens, people who amassed sufficient personal wealth and then gave it all to the government. The leaders are essentially in poverty and depend on the largesse of the public. This is interesting, but I have *no* idea how one would actually manage this.
    One word: lobbyism.

    Heh, that’s precisely what I was alluding to. Lobbyism would be fucking *rampant*. So I fail to see how this was supposed to solve anything.

  420. Caledonian says

    Ah, Caledonian, so you’re saying PZ is both a capitalist and a wage slave. How thick-headed of me not to understand immediately…

    Um, no. Let’s start out with the problems here:

    1) Being a wage slave and a capitalist isn’t a contradiction.
    2) I’m not saying PZ is a wage slave.
    3) I’m pretty sure PZ took a competitive position within his field, salary-wise, and he’s certainly not giving away his income to ensure a “fair distribution”.

    I guess you *are* too thick-headed to understand.

  421. syntyche says

    yes, I added OECD. I had assumed we weren’t talking about the merits of the US healthcare system vs. the Bostwanan healthcare system. If you were, then yeah, I agree. The US is pretty high on the list. By the way, do you happen to know the percentage of OECD countries with some form of single-payer national healthcare?

    OK, so basically you’re going to cherry-pick statistics and studies that support your argument, and ignore or dismiss as “irrelevant” those that don’t.

    I, on the other hand, will accept that, for instance, cancer survival rates are highest in the US. But intellectual honesty demands that I also consider seriously the statistics that show that the US healthcare system does not results in the outcomes that might be predicted of the most expensive in the world. Like I said, if you can’t do the same, then this is a pretty pointless discussion.

  422. says

    OK, so basically you’re going to cherry-pick statistics and studies that support your argument, and ignore or dismiss as “irrelevant” those that don’t.

    Apparently so, since he didn’t bother addressing the Kaiser study.

    I’m still waiting eagerly to hear why–if private insurance is as ineffective in improving outcomes as Jason claims–the whole privatization crowd is advocating handing the health-care delivery system over to them.

  423. Robin Levett says

    Matthew Dean said:

    In a voucher-based system, everyone would be issued a voucher of a set amount of money, which they would use to find an insurance company (or to simply pay the hospital/doctor directly) to cover their health expenses. The benefit to this approach is that the insurance companies must compete for your money, instead of simply getting money and giving you shoddy care (like most universal healthcare systems). It will also be quite a lot cheaper then most single-payer models.

    …and water would run uphill…

    How would creating structural overcapacity be cheaper than a single payer model? By which I mean – hospitals don’t grow on trees, nor do they build themselves instantaneously in response to market demand. Doctors don’t train in weeks. Health market demand is generally pretty inelastic in terms of timing. For a voucher-based system to create supply competition, therefore, there has to be excess capacity available at any one time – or there could be no choice.

    Colugo commented on poor access to dentists – does he know why it has happened?

  424. Torbjörn Larsson, OM says

    Whoa! I was just alerted to that the thread took off while I was busy elsewhere, but that was an understatement. I hope to catch up later in the unlikely event someone reacted to my comments. (Yes, I know, an unwarranted presumption. But just in case…)

  425. Torbjörn Larsson, OM says

    Whoa! I was just alerted to that the thread took off while I was busy elsewhere, but that was an understatement. I hope to catch up later in the unlikely event someone reacted to my comments. (Yes, I know, an unwarranted presumption. But just in case…)

  426. David Marjanović, OM says

    The Institute of Medicine estimates that about 19,000 Americans die prematurely each year because of inadeqate health insurance. To put that in perspective, about 435,000 are estimated to die each year from smoking, about 365,000 from poor diet and physical inactivity, about 85,000 from alcohol consumption, about 43,000 from motor vehicle crashes, about 29,000 from firearms, and about 17,000 from use of illicit drugs. Even a small reduction in the rate of smoking would save more lives than providing health insurance to everyone.

    Is that an argument not to introduce universal health insurance?

    IMHO 19,000 dead are 19,000 too many.

    And is that bad?

    Yes, it’s bad.

    Why?

    ———-

    The anti-libertarians seem to think that in a libertarian society, the poor would be left completely to their own devices to die of starvation and disease. This couldn’t be further from the truth.

    The most obvious reason is that charities would still exist, just as they exist in a non-libertarian society.

    Yet another one who either simply assumes that there will always be enough charities for everyone or who simply doesn’t care.

    Newsflash: it didn’t work in Pinochet’s Chile, and it didn’t work in Yeltsin’s Russia.

    Apart from that, I don’t like rights being turned into a dependence on mercy.

    Ha ha ha!

    You fail.

    No, you fail.

    Failure to explain is a failure, too.

    No, it wasn’t free. It simply wasn’t paid for by the students.

    Fine. It was, in the end, paid for with taxes. Which is a good idea, because letting people study is an investment. People who graduate from a university are going to get higher-paid jobs and pay more in income tax etc. over the rest of their lives than their education cost.

    Now so many people have a university degree that it’s useless at distinguishing qualified candidates.

    Wow! I caught Caledonian at making an argument from ignorance! No, pretty few people have a university degree. Austria is way behind much of the rest of Europe in the number of graduates per population. The politicians only disagree in what to do to “raise the academician quota”. One reason for the low number seems to be that it’s not easy to find a job after university. People who have undergone different educations after the highschool equivalent* find getting a job, at least in the so-called real world, easier.

    * Well… from what I’ve read, a US highschool graduation would be quite worthless over here, but I digress.

    ———–

    Right, there were exceptions. But as the conclusion I quoted states, in general cost-sharing was found to have no adverse effect on health. Since what we’re discussing here is the merits of health care policy overall (single-payer vs. multi-payer, universal coverage vs. partial coverage), that seems to me the most significant finding.

    So you are arguing that universal healthcare has few benefits?

    Now, let’s see. Do the costs outweigh the benefits?

    ————-

    That’s why we need a clear-eyed assessment of the differential outcomes of various Western healthcare systems in multiple areas, rather than an uncritical emulation of Europe or a defensive valorization of the market.

    “An uncritical emulation of Europe” is not possible anyway because each European country has its own approach. As mentioned, the state is the only health insurer in Austria, but only one among several in Germany. In the UK, the state not only pays for but provides the healthcare, and so on.

    ———–

    Yes, you could add it to the list of the other insane conceptions in the Universal Declaration of Human Rights.

    OK, Caledonian. That’s it. You are insane. Your lack of empathy is pathological. You are not ignorant (thank you for the link to how Mussolini merely said he had made the trains run on time — honestly), you are not stupid, you are ill under your scalp. I shall henceforth heed the advice in comment 406.

    ————

    Really? People in Canada never get into debt because of an illness?

    What do I know about Canada? I’ve only lived in Austria and France for any serious amounts of time so far.

    They never get into debt because they lose income from taking time off work (or losing their job entirely) as a result of the illness?

    Over here (again: no idea about Canada), people continue to get paid most of their income when ill (as attested by a doctor), and it’s forbidden to lay them off for being ill.

    But let’s suppose your implications about Canada are right. Now, in the USA, you have these causes for debt by illness, and in addition, you have the costs of healthcare itself. Which is preferable?

    They never get into debt from purchasing private medical care to avoid a waiting list, or after being turned down for treatment by Canada’s public health care system?

    How would purchasing private health insurance get you off a waiting list? The private insurance companies don’t have their own doctors who don’t take publicly insured patients, do they?

    Does Canada’s public health care system turn anyone down?

    And over here, you’re paid for having young children and not being rich. Socialism. Muahah.

    ————-

    It’s not simply a matter of sitting around doing nothing, it’s about being in harmony with what Is.

    Which is meaningless. Isn’t it?

    ————-

    PZ is a conundrum. How can someone who does not want god rammed down his throat turn around and want socialized medicine, smoking regulations, dietary restrictions, etc etc ad infinitum?

    “Socialized medicine”. How scary. Look! Communism!!!1!

    Smoking regulations? My freedom ends where yours begins, right? Well, your freedom to smoke might conflict with my freedom to breathe. What shall we do in such hypothetical cases?

    What do you mean by “dietary restrictions”?

    ————

    Labelling the provision of basic social infrastructure as “charity” just shows how hateful they are.

    I don’t think it’s hate. I think it’s a complete lack of emotion about their conspecifics. I think it’s pathological.

    ————

    Although I am not a “Libertarian”, I am if I can possibly generalize myself to be a “Green Moderate-Libertarian” – Too much central command economy stagnates the economy. Also, it has a tendency to lower individual incentive (which is conducive to stagnation). At the same time I am against monopolies…

    You are merely not a communist. That doesn’t make you a libertarian.

    If you support the occasional state intervention to prevent a monopoly from forming or to break an existing one, you are not a libertarian.

    ———-

    (I cannot emphasize enough how handy an “eye-roll” character would be…)

    Just write :roll: and pretend this is a forum where writing that produces the appropriate smiley. :-)

    ———-

    I don’t see how the tyrrany of the (m)asses limiting someone’s choice of doctors,

    Dude, the opposite is the case. Over here, and in Canada as explained above, you can go to any doctor you choose. In the USA, your insurance company makes most of that choice for you.

    or forcing them to pay into a system they won’t use,

    So? There are people who never get ill?

    or forcing them to wait until some bureaucrat hears their case

    This — waiting till some insurance accountant decides why not to pay for your healthcare — is what you get in the USA, not elsewhere.

    And please define what basic necessities of life you think ought to be our shared responsibility – a house? a car? a coat? one visit to the doctor? a sports car? a computer? season tickets to the Red Sox? – it never ends.

    The slippery slope is a logical fallacy. On the issue of definition, that’s what a democracy is for.

    Keep in mind that by your lack of logic, I am living in ruins here.

    Socialism has been tried many times over the past 175 years or so, always with bad consequences. Read: Heaven on Earth – History of Socialism.

    The slippery slope is still a logical fallacy.

    (Completely apart from the strange fact that you’ve fallen for the USSR’s relabeling of communism as socialism.)

    ———-

    I, on the other hand, will accept that, for instance, cancer survival rates are highest in the US.

    So will I, for the record, but wait a minute… what are cancer diagnosis rates like? (Do such numbers even exist?)

  427. David Marjanović, OM says

    The Institute of Medicine estimates that about 19,000 Americans die prematurely each year because of inadeqate health insurance. To put that in perspective, about 435,000 are estimated to die each year from smoking, about 365,000 from poor diet and physical inactivity, about 85,000 from alcohol consumption, about 43,000 from motor vehicle crashes, about 29,000 from firearms, and about 17,000 from use of illicit drugs. Even a small reduction in the rate of smoking would save more lives than providing health insurance to everyone.

    Is that an argument not to introduce universal health insurance?

    IMHO 19,000 dead are 19,000 too many.

    And is that bad?

    Yes, it’s bad.

    Why?

    ———-

    The anti-libertarians seem to think that in a libertarian society, the poor would be left completely to their own devices to die of starvation and disease. This couldn’t be further from the truth.

    The most obvious reason is that charities would still exist, just as they exist in a non-libertarian society.

    Yet another one who either simply assumes that there will always be enough charities for everyone or who simply doesn’t care.

    Newsflash: it didn’t work in Pinochet’s Chile, and it didn’t work in Yeltsin’s Russia.

    Apart from that, I don’t like rights being turned into a dependence on mercy.

    Ha ha ha!

    You fail.

    No, you fail.

    Failure to explain is a failure, too.

    No, it wasn’t free. It simply wasn’t paid for by the students.

    Fine. It was, in the end, paid for with taxes. Which is a good idea, because letting people study is an investment. People who graduate from a university are going to get higher-paid jobs and pay more in income tax etc. over the rest of their lives than their education cost.

    Now so many people have a university degree that it’s useless at distinguishing qualified candidates.

    Wow! I caught Caledonian at making an argument from ignorance! No, pretty few people have a university degree. Austria is way behind much of the rest of Europe in the number of graduates per population. The politicians only disagree in what to do to “raise the academician quota”. One reason for the low number seems to be that it’s not easy to find a job after university. People who have undergone different educations after the highschool equivalent* find getting a job, at least in the so-called real world, easier.

    * Well… from what I’ve read, a US highschool graduation would be quite worthless over here, but I digress.

    ———–

    Right, there were exceptions. But as the conclusion I quoted states, in general cost-sharing was found to have no adverse effect on health. Since what we’re discussing here is the merits of health care policy overall (single-payer vs. multi-payer, universal coverage vs. partial coverage), that seems to me the most significant finding.

    So you are arguing that universal healthcare has few benefits?

    Now, let’s see. Do the costs outweigh the benefits?

    ————-

    That’s why we need a clear-eyed assessment of the differential outcomes of various Western healthcare systems in multiple areas, rather than an uncritical emulation of Europe or a defensive valorization of the market.

    “An uncritical emulation of Europe” is not possible anyway because each European country has its own approach. As mentioned, the state is the only health insurer in Austria, but only one among several in Germany. In the UK, the state not only pays for but provides the healthcare, and so on.

    ———–

    Yes, you could add it to the list of the other insane conceptions in the Universal Declaration of Human Rights.

    OK, Caledonian. That’s it. You are insane. Your lack of empathy is pathological. You are not ignorant (thank you for the link to how Mussolini merely said he had made the trains run on time — honestly), you are not stupid, you are ill under your scalp. I shall henceforth heed the advice in comment 406.

    ————

    Really? People in Canada never get into debt because of an illness?

    What do I know about Canada? I’ve only lived in Austria and France for any serious amounts of time so far.

    They never get into debt because they lose income from taking time off work (or losing their job entirely) as a result of the illness?

    Over here (again: no idea about Canada), people continue to get paid most of their income when ill (as attested by a doctor), and it’s forbidden to lay them off for being ill.

    But let’s suppose your implications about Canada are right. Now, in the USA, you have these causes for debt by illness, and in addition, you have the costs of healthcare itself. Which is preferable?

    They never get into debt from purchasing private medical care to avoid a waiting list, or after being turned down for treatment by Canada’s public health care system?

    How would purchasing private health insurance get you off a waiting list? The private insurance companies don’t have their own doctors who don’t take publicly insured patients, do they?

    Does Canada’s public health care system turn anyone down?

    And over here, you’re paid for having young children and not being rich. Socialism. Muahah.

    ————-

    It’s not simply a matter of sitting around doing nothing, it’s about being in harmony with what Is.

    Which is meaningless. Isn’t it?

    ————-

    PZ is a conundrum. How can someone who does not want god rammed down his throat turn around and want socialized medicine, smoking regulations, dietary restrictions, etc etc ad infinitum?

    “Socialized medicine”. How scary. Look! Communism!!!1!

    Smoking regulations? My freedom ends where yours begins, right? Well, your freedom to smoke might conflict with my freedom to breathe. What shall we do in such hypothetical cases?

    What do you mean by “dietary restrictions”?

    ————

    Labelling the provision of basic social infrastructure as “charity” just shows how hateful they are.

    I don’t think it’s hate. I think it’s a complete lack of emotion about their conspecifics. I think it’s pathological.

    ————

    Although I am not a “Libertarian”, I am if I can possibly generalize myself to be a “Green Moderate-Libertarian” – Too much central command economy stagnates the economy. Also, it has a tendency to lower individual incentive (which is conducive to stagnation). At the same time I am against monopolies…

    You are merely not a communist. That doesn’t make you a libertarian.

    If you support the occasional state intervention to prevent a monopoly from forming or to break an existing one, you are not a libertarian.

    ———-

    (I cannot emphasize enough how handy an “eye-roll” character would be…)

    Just write :roll: and pretend this is a forum where writing that produces the appropriate smiley. :-)

    ———-

    I don’t see how the tyrrany of the (m)asses limiting someone’s choice of doctors,

    Dude, the opposite is the case. Over here, and in Canada as explained above, you can go to any doctor you choose. In the USA, your insurance company makes most of that choice for you.

    or forcing them to pay into a system they won’t use,

    So? There are people who never get ill?

    or forcing them to wait until some bureaucrat hears their case

    This — waiting till some insurance accountant decides why not to pay for your healthcare — is what you get in the USA, not elsewhere.

    And please define what basic necessities of life you think ought to be our shared responsibility – a house? a car? a coat? one visit to the doctor? a sports car? a computer? season tickets to the Red Sox? – it never ends.

    The slippery slope is a logical fallacy. On the issue of definition, that’s what a democracy is for.

    Keep in mind that by your lack of logic, I am living in ruins here.

    Socialism has been tried many times over the past 175 years or so, always with bad consequences. Read: Heaven on Earth – History of Socialism.

    The slippery slope is still a logical fallacy.

    (Completely apart from the strange fact that you’ve fallen for the USSR’s relabeling of communism as socialism.)

    ———-

    I, on the other hand, will accept that, for instance, cancer survival rates are highest in the US.

    So will I, for the record, but wait a minute… what are cancer diagnosis rates like? (Do such numbers even exist?)

  428. David Marjanović, OM says

    And is that bad?
    Yes, it’s bad.

    Why?

    Oops. This should have read:

    ————

    And is that bad?

    Yes, it’s bad.

    Why?

  429. David Marjanović, OM says

    And is that bad?
    Yes, it’s bad.

    Why?

    Oops. This should have read:

    ————

    And is that bad?

    Yes, it’s bad.

    Why?

  430. Jack says

    PZ:

    Please don’t engage Caledonian. I’m getting very tired of the guy, and all the pointless back-and-forth with him.

    Interesting. You’re “tired” of someone who rationally and politely defends his political views but you’re happy to post polemics about a set of views you make no effort to understand. I have a great deal of respect for your work countering the baseless claims of creationists, but I find it very strange that you seem constitutionally incapable of applying that same intellectual rigor to your own beliefs.

    Look through this thread. There is very, very little rational argument against libertarian positions, but a great deal of invective. As an outside observer, you and many of the other commenters here appear to hold your left wing views with the same unquestioning faith as any creationist believes in the bible.

    Stick to the evolution/creation wars. When you stray into politics you come across as foolish and hypocritical.

    Jack

  431. Jason says

    synt,

    yes, I added OECD. I had assumed we weren’t talking about the merits of the US healthcare system vs. the Bostwanan healthcare system.

    You referred to “countries with single payer models,” so that’s what I responded to. Do you now accept that simply comparing aggregate health stats like infant mortality rate and average life expectancy between countries does not tell us anything meaningful about the relative merits of their health care systems, or do you still claim that such comparisons allow us to rank those systems as better/worse?

    OK, so basically you’re going to cherry-pick statistics and studies that support your argument, and ignore or dismiss as “irrelevant” those that don’t. I, on the other hand, will accept that, for instance, cancer survival rates are highest in the US. But intellectual honesty demands that I also consider seriously the statistics that show that the US healthcare system does not results in the outcomes that might be predicted of the most expensive in the world.

    I deny that I have cherry-picked anything. You again seem to be confusing a nation’s aggregatate health indicators with “outcomes” of its health care system. These are not the same thing. You cannot infer the latter from the former. The average life expectancy of a national population is the “outcome” of a vast constellation of factors, from the rate of smoking, to the rate of violent crime, to the levels or air and water pollution, to the prevailing patterns of diet and exercise, to dozens of other things. It tells us nothing whatsoever about how effective the nation’s health care system is at preventing, diagnosing or treating illness. In order to evaluate the effectivess of a health care system, we need to look specifically at data on prevention, diagnosis and treatment. If you think you have such data demonstrating that the U.S. health care system is inferior to those of other countries, then produce it. But stop wasting time with this nonsense about average life expectancy and infant mortality.

  432. Caledonian says

    Apart from that, I don’t like rights being turned into a dependence on mercy.

    Charity is by its nature dependent on mercy, and mercy is something that one cannot be entitled to.

    As for your statement regarding the Declaration of Rights, I’d love to hear a defense of some of its more, shall we say, ‘interesting’ articles.

    But I forget – I’m mentally ill, crazy under the scalp, and you’re ignoring me.

  433. Jason says

    thalarctos,

    Apparently so, since he didn’t bother addressing the Kaiser study.

    I’m not sure why you think I need to address it. The findings described in the text you quoted seem to be broadly consistent with the results of the RAND study and the other evidence that has been presented here. I suspect you did not read your quote very carefully, and are jumping to conclusions. There’s a difference between an “association” or “connection” (that is, a correlation) and a causal relationship. There’s a difference between “access” to health care, and a health benefit from health care. There’s a difference between a benefit to a specific subpopulation (such as people with chronic illness) and a benefit to the general population. You might want to read your quote again, and think carefully about the precise meaning of the statements made by the authors.

  434. says

    You might want to read your quote again, and think carefully about the precise meaning of the statements made by the authors.

    I have. This is the abstract’s description of the specific part of the study I want you to reconcile with your assertion:

    Research connects being uninsured with adverse health outcomes, including declines in health and function, preventable health problems, severe disease at the time of diagnosis, and premature mortality.

    If you need access to the full article but don’t have it, let me know.

  435. Jason says

    David M,

    Is that an argument not to introduce universal health insurance?

    It’s an argument that universal health insurance would do little to reduce the rate of illness and premature death. It’s an argument that other kinds of policy (such as stronger anti-smoking policies) would probably produce a greater improvement in health and longevity at lower cost.

    Why?

    Because government control of prices and wages distorts markets and tends to produce shortages or surpluses.

    So you are arguing that universal healthcare has few benefits?

    Yes.

    What do I know about Canada? I’ve only lived in Austria and France for any serious amounts of time so far.

    The same questions apply to Austria and France.

    Over here (again: no idea about Canada), people continue to get paid most of their income when ill (as attested by a doctor), and it’s forbidden to lay them off for being ill.

    I find this very hard to believe. Could you cite the relevant laws? In any case, replacement of income lost due to illness or disability is not part of a health care system, it’s part of a social security system. If we are to provide universal insurance covering not only medical bills but also all or most income lost due to illness, the cost will be even higher. No politician of either party is proposing any such thing.

    How would purchasing private health insurance get you off a waiting list?

    By getting you the treatment you’re waiting for through a private provider.

    The private insurance companies don’t have their own doctors who don’t take publicly insured patients, do they?

    I’m not sure if they “have their own doctors” but they certainly allow Canadians who can afford it to “jump the queue” and get health care services ahead of those who wait for treatment under the public system. The ban on private insurance in Quebec was precisely the law at issue in the Chaoulli case. Also, the doctors and the insurance are not necessarily Canadian. They may be American. Lots of wealthier Canadians come to the U.S. for health care services in order to avoid long waits for services in Canada.

    Does Canada’s public health care system turn anyone down?

    Yes.

  436. Jason says

    thalarctos,

    This is the abstract’s description of the specific part of the study I want you to reconcile with your assertion: Research connects being uninsured with adverse health outcomes, including declines in health and function, preventable health problems, severe disease at the time of diagnosis, and premature mortality

    I’m not sure which assertion of mine you mean by “your assertion.” I’ve made lots of assertions. State the assertion you mean, and explain why you think the text you quote above is not consistent with that assertion, and then I’ll know what you’re talking about.

  437. says

    Any one of your assertions that there is no link between insurance and health outcomes or between health care and health outcomes will do.

  438. Jason says

    thalarctos,

    Any one of your assertions that there is no link between insurance and health outcomes or between health care and health outcomes

    I didn’t say there is no link at all. The relevant finding of the RAND study is “In general, the reduction in services induced by cost sharing had no adverse effect on participants’ health.”

  439. Colugo says

    Caledonian: “Charity is by its nature dependent on mercy, and mercy is something that one cannot be entitled to.”

    That’s an arcane philosophical point which is not really relevant. From a wholly pragmatic perspective, it is in the service of self-interest for one’s group be as strong and robust as possible, because groups compete against other groups. (Sometimes in a theoretically non-zero sum game, such as the global economy.) Promotion of group strength involves the action of market forces, which are known to enhance economic health. But some intervention will be necessary to promote desirable outcomes.

    You yourself have noted the importance of developmental conditions for later cognitive performance – and hence productivity. Capricious and hazardous developmental environments also promote short-term survival strategies associated with violence, low trust, and low productivity (adaptive developmental plasticity – see life history theory as discussed by Chisholm et al.).

    Maximizing self-interest requires the maintenance of a strong, healthy, and productive group. A healthy group is generated by healthy individuals, which is in turn the result of development under good conditions. Market forces are necessary to economic viability and robusticity, but they are not sufficient to ensure salutary developmental outcomes across the entire group. Therefore, collective (state) intervention in developmental health is in the service of self-interest.

    Just as “selfish” genes cooperate in their common interest, selfish individuals cooperate in their common interest. That includes promoting the developmental health of all members of the group in order to achieve high productivity and other collectively beneficial outcomes.

  440. says

    I’m asking how you reconcile

    Research connects being uninsured with adverse health outcomes, including declines in health and function, preventable health problems, severe disease at the time of diagnosis, and premature mortality.

    with your comments such as #273:

    There is little evidence that health insurance either improves health significantly, or provides much protection against the risk of major financial loss due to illness. Yes, for a specific person in a specific situation, it can make a huge difference. But in general, the effect seems to be small.

    and #278:

    It implies that you think the differences in IMR and average life expectancy between the U.S. and other countries are caused by differences in their health care systems. What evidence makes you think that? There is an enormous body of evidence against it.

    and #299:

    No, I’m saying that health care has only a small impact on health statistics.

    and #323:

    Some varieties of universal coverage may produce benefits. But even then, the benefits are likely to be modest in comparison to our current system.

    I’m simply asking you to back up those assertions with specifics, preferably quantitative, and demonstrate how they fit in the bigger picture of the body of evidence Kaiser reviewed.

  441. says

    Just as “selfish” genes cooperate in their common interest, selfish individuals cooperate in their common interest. That includes promoting the developmental health of all members of the group in order to achieve high productivity and other collectively beneficial outcomes.

    I’d take that even a step further and assert that Thatcher’s intellectual heirs–in asserting the equivalent of “there is no such thing as society”–are being denialists about the fact that we evolved from (and still are) social apes.

  442. Jason says

    thalarctos,

    It’s kind of hard for me to “reconcile” two statements when I see no conflict between them and you refuse to describe the conflict you think there is. Explain the nature of the alleged conflict, and then I’ll respond. Again, you might want to think about the difference between correlation and causation before you offer your description of the alleged conflict.

  443. says

    “My freedom ends where yours begins, right? Well, your freedom to smoke might conflict with my freedom to breathe. What shall we do in such hypothetical cases?”

    Well, it depends who owns the property. If you come around to my place, you can smoke as much as you like in the garden or on the drive. Inside, though, no smoking. My house, my rules.

    If I own a pub or restaurant, I should be able to set the rules too. The fact that others can enter isn’t justification. If you don’t like smoke, don’t go to pubs or restaurants where people smoke.

    I prefer to patronise businesses that are smoke-free (and I prefer spending time at friends places that are smoke-free), but I don’t think I am justified in personally strong-arming those who disagree into doing as I see fit.

    If you have a “right to breathe”, surely, that means we should have publicly subsidised air pumps going underwater so when you go diving, you can enjoy your right to breathe. You do not have a positive right to breathe – you have the right not to have someone else take away your liberty to breathe, which is a different thing entirely. If a group of people want to get together in a room and blow dangerous chemicals in one another’s face for hours on end, that’s their prerogative. My solution is simple – don’t join in.

    As for the democracy that’s been buzzed about in this thread. What a crock. Democracies are determined heavily by the politicians who exist in them. When voting happens, where voting happens, who gets on the ticket, how districts are made up, what powers political bodies have (House and Senate, House of Commons and House of Lords), how political bodies are structured, how votes are counted (first-past-the-post, Condorcet, instant runoff etc.). Did I have a choice about this? No. To say “if you don’t like the government, vote for a different one” is nonsense.

    That is the whole point about civil liberties and human rights – they aren’t democratic. If 51% of the people in Arbitrary Land Mass X decide that they want to put me in a prison cell, that doesn’t mean it’s just dandy – in the same way that if 51% of the people decide that evolution never happened or JEWS DID WTC!!, it doesn’t make it true. Truth isn’t subject to the will of the populace, and neither are individual rights.

  444. says

    @Jason:

    For you not to see any conflict between:

    Research connects being uninsured with adverse health outcomes, including declines in health and function, preventable health problems, severe disease at the time of diagnosis, and premature mortality.

    and

    There is little evidence that health insurance either improves health significantly, or provides much protection against the risk of major financial loss due to illness. Yes, for a specific person in a specific situation, it can make a huge difference. But in general, the effect seems to be small.

    means that you consider

    declines in health and function, preventable health problems, severe disease at the time of diagnosis, and premature mortality

    to be a small effect.

    I’m asking you to back up that assertion with numbers, and to explain how you refute the evidence to the contrary.

  445. David Marjanović, OM says

    Interesting. You’re “tired” of someone who rationally and politely defends his political views

    If only he did. He doesn’t even try to defend them, he simply takes them for granted.

    Is that an argument not to introduce universal health insurance?

    It’s an argument that universal health insurance would do little to reduce the rate of illness and premature death. It’s an argument that other kinds of policy (such as stronger anti-smoking policies) would probably produce a greater improvement in health and longevity at lower cost.

    Nobody said you shouldn’t do anything against smoking. This isn’t an either-or issue after all. If universal healthcare would mean 19,000 fewer deaths per year, what reason is there not to introduce it?

    Why?

    Because government control of prices and wages distorts markets and tends to produce shortages or surpluses.

    Do you have any evidence if that’s the case here? I don’t deny the tendency, I just want to know if it applies here.

    What do I know about Canada? I’ve only lived in Austria and France for any serious amounts of time so far.

    The same questions apply to Austria and France.

    Well, over here I’ve never heard of anyone getting in debt over such things. It might occasionally happen with chronic illnesses, but even that is certainly rare.

    Over here (again: no idea about Canada), people continue to get paid most of their income when ill (as attested by a doctor), and it’s forbidden to lay them off for being ill.

    I find this very hard to believe. Could you cite the relevant laws?

    Sorry, I’m currently ill and tired, and I don’t really know where to look for an Austrian law (let alone a French one). All should be online, but I’m not going to dig them up anytime soon. What I can tell you for sure is that the USA is rather unique in the First World in how close it is to hire-and-fire.

    Incidentally, hiring people is very difficult over here, too. This is due to bureaucracy and the “wage side costs” — taxes and health insurance contributions, among other things.

    In any case, replacement of income lost due to illness or disability is not part of a health care system, it’s part of a social security system.

    Nope, it’s done by the employer.

    Does Canada’s public health care system turn anyone down?

    Yes.

    Well, strange.

    To say “if you don’t like the government, vote for a different one” is nonsense.

    In a two-party system*, it sure is…

    * I know full well that neither USA nor UK are somehow required to have a two-party system in theory. But in the latter, it’s hard to avoid that the biggest party gets well over 50 % of the seats in parliament, even if it has way under 50 % of the votes, and in the former, voting for a government means voting for a president, and presidential runs always have two candidates in the end, each of which needs the support of a party. As long as these things stay as they are, both countries are doomed to have a two-party system in practice.

  446. David Marjanović, OM says

    Interesting. You’re “tired” of someone who rationally and politely defends his political views

    If only he did. He doesn’t even try to defend them, he simply takes them for granted.

    Is that an argument not to introduce universal health insurance?

    It’s an argument that universal health insurance would do little to reduce the rate of illness and premature death. It’s an argument that other kinds of policy (such as stronger anti-smoking policies) would probably produce a greater improvement in health and longevity at lower cost.

    Nobody said you shouldn’t do anything against smoking. This isn’t an either-or issue after all. If universal healthcare would mean 19,000 fewer deaths per year, what reason is there not to introduce it?

    Why?

    Because government control of prices and wages distorts markets and tends to produce shortages or surpluses.

    Do you have any evidence if that’s the case here? I don’t deny the tendency, I just want to know if it applies here.

    What do I know about Canada? I’ve only lived in Austria and France for any serious amounts of time so far.

    The same questions apply to Austria and France.

    Well, over here I’ve never heard of anyone getting in debt over such things. It might occasionally happen with chronic illnesses, but even that is certainly rare.

    Over here (again: no idea about Canada), people continue to get paid most of their income when ill (as attested by a doctor), and it’s forbidden to lay them off for being ill.

    I find this very hard to believe. Could you cite the relevant laws?

    Sorry, I’m currently ill and tired, and I don’t really know where to look for an Austrian law (let alone a French one). All should be online, but I’m not going to dig them up anytime soon. What I can tell you for sure is that the USA is rather unique in the First World in how close it is to hire-and-fire.

    Incidentally, hiring people is very difficult over here, too. This is due to bureaucracy and the “wage side costs” — taxes and health insurance contributions, among other things.

    In any case, replacement of income lost due to illness or disability is not part of a health care system, it’s part of a social security system.

    Nope, it’s done by the employer.

    Does Canada’s public health care system turn anyone down?

    Yes.

    Well, strange.

    To say “if you don’t like the government, vote for a different one” is nonsense.

    In a two-party system*, it sure is…

    * I know full well that neither USA nor UK are somehow required to have a two-party system in theory. But in the latter, it’s hard to avoid that the biggest party gets well over 50 % of the seats in parliament, even if it has way under 50 % of the votes, and in the former, voting for a government means voting for a president, and presidential runs always have two candidates in the end, each of which needs the support of a party. As long as these things stay as they are, both countries are doomed to have a two-party system in practice.

  447. Jason says

    thalarctos,

    means that you consider …. to be a small effect.

    Well, first, the study finding you quoted doesn’t describe the magnitude of the effect, so it may indeed be small. So where is conflict? But even if the effect is not small, there is still no conflict between the study finding and the statements of mine you cite. The study finding describes merely a statistical association, not a cause-and-effect relationship. One obvious causal possibility, for some cases at least, is that “declines in health and function, preventable health problems, severe disease at the time of diagnosis, and premature mortality” cause “being uninsured” rather than the reverse. This is especially plausible in light of the association between health insurance and employment. In other words, a person who becomes seriously ill may lose their job. As a result of losing their job, they lose their health insurance. The lack of health insurance is an effect of illness in such cases. Another possibility is that both poorer health and lack of health insurance are caused by some third factor, such as low income, or low level of education. This again is plausible in light of evidence such as the NBER study finding that the health-income gradient is virtually the same in Canada as it is in the United States (slightly worse in Canada, in fact). If lack of health insurance, rather than low income, were a significant cause of poorer health, we would not expect this finding, because everyone in Canada has health insurance regardless of income.

  448. Jason says

    David M,

    Nobody said you shouldn’t do anything against smoking.

    I didn’t say anyone did say that.

    This isn’t an either-or issue after all. If universal healthcare would mean 19,000 fewer deaths per year, what reason is there not to introduce it?

    The fact that the money it would require could probably produce a larger reduction in deaths if spent in a different way. Every spending decision involves a choice between alternatives, and the total amount available for spending is finite.

    Do you have any evidence if that’s the case here? I don’t deny the tendency, I just want to know if it applies here.

    You mean apart from decades of experience in the former Soviet Union and other communist nations, where the government set wages and prices of virtually all occupations and all goods and services, and shortages or surpluses were endemic?

    Well, over here I’ve never heard of anyone getting in debt over such things.

    Well, what’s you’ve heard of is not evidence. It’s anecdote. Do you have any data on the rate of illness-related bankruptcy in Austria or France?

    Incidentally, hiring people is very difficult over here, too. This is due to bureaucracy and the “wage side costs” — taxes and health insurance contributions, among other things.

    Yes, indeed. The potential adverse effects of the taxes needed to pay for universal health insurance on the national labor market is also one of the factors that needs to be considered in any serious evaluation of the merits of the policy.

    Nope, it’s done by the employer.

    Again, could you provide some evidence for this claim? If, say, an Austrian construction worker loses an arm to cancer, or some other disease or injury, and can never go back to his job, are you seriously saying that his employer is required by law to continue paying his full wages indefinitely? Again, this seems highly implausible. I would strongly oppose such a law in the United States.

  449. says

    Youch! Suddenly I lost a whole lot of respect for PZ Myers.

    It’s been a while since I’ve seen someone who claim to be a skeptic promote such a hateful and meritless ad hominem attack on a vast group of different individuals. Actually, being a libertarian myself, i feel really stepped on and misunderstood. I’m trying to come to grips with the claim that the wish for freedom and ownership of ones own body, mind and property really is a result of the lack of empathy and altruistic tendencies that everyone else posesses, but I really can’t because is so ridiculously hateful and predjudiced.

    Right now I feel the same way I do when some insane christian fundamentalists tells me that I’ll rot in Hell for my sins…

  450. Colguo says

    Hardline libertarians and many (not all) leftists make parallel errors due to being informed more by ideology than by pragmatism.

    Libetarians fail to understand how enhancing collective interests can promote individual interests. Sanitation infrastructure, public schools, public roads, and many other government goods and services create a safer, more livable society for rich and poor alike. Public health studies show that even the children of the wealthy suffer in a degraded socioecological environment. Similarly, libertarians do not understand how inappropriate attempts to enhance individual interests can hurt both individual and collective interests. For example, permitting so much freedom in the market that wholesale monopolization occurs and the economy becomes distorted, inefficient, and stacked in favor of those who already have power. Gilded Age socialist and anarchists were right about the injustices and dysfunctions of under-regulated capitalism.

    Leftists often fail to understand to how enhancing individual interests can promote collective interests. Many have a moral antipathy to the profit motive. Also, many leftists do not appreciate that inappropriate policies intended to enhance collective interests, like excessive suppression of market forces, can be bad for both the group and individuals. Mid-20th Century libertarian critics of socialism were right about markets more efficiently determining prices and providing incentives than a command economy can. What those libertarians got wrong is that while the market is efficient, it is imperfect and vulnerable to distortion and so requires regulation and redistribution.

    A pragmatic mixed system nurtures individual interests that promote collective interests, like healthy market activities, and enhances collective interests for the benefit of the individuals that comprise the group, such as public services. It also harnesses private and public institutions to serve the common welfare. One example of that is DARPA, a combination of state goals, investment in science, and business corporations that produces defense technologies that enhance the strength of the group.

  451. Tulse says

    LordMarius:

    It’s been a while since I’ve seen someone who claim to be a skeptic promote such a hateful and meritless ad hominem attack

    Hateful? You think that saying “I think the institutionalized selfishness, petty small-mindedness, and bourgeois values run amuck of the libertarians represent the worst of America” is hateful? Man, you’ve really got thin skin.

  452. Sean says

    Yeah, hateful.

    Take a perspective in your life which has evolved over a period of decades. This aspect has been pondered, dwelled, researched and debated repeatedly. You have tried everything in your power to be true to this worldview, even when it has had measureable personal cost.

    Now imagine a whole crowd of people start dogpiling insults, the least of which have been selfish, petty and small-minded on you for this. Yeah, hateful and really rubs the fur backwards.

  453. Zarquon says

    It’s no more hateful than when PZ rags on every other American religious cult like Scientology or Mormonism. Libertarianism is just another example of US craziness.

  454. Robin Levett says

    Jason

    You’ve made a number of cracks about the UK healthcare system. Do you know anything about it?

  455. Tulse says

    Sean, tell me how what you describe wouldn’t cover a fundamentalist coming here. Just because you have a lot of emotional investment in a particular worldview doesn’t mean that people telling you it’s wrong is somehow a “hateful” act.

  456. Captain C says

    “The startling notion of coagulated ship-city has unsurprisingly been featured in fiction…”

    Don’t forget Hagbard Celine’s yellow submarine in Wilson & Shea’s Illuminatus! trilogy.

  457. says

    A clarification in Brazil’s case: one of the main causes of the long wait and crappy telephone service was that, starting by the end of the last dictatorship, the whole asector was marked for privatization and thus public investment in it was all but entirely cut.

    After cell phones arrived, the point became somewhat moot. However, phone lines were made so expensive that many people go without now. Millions have “pre-paid” cell phones, adding scraps of credit here and there, but mostly just receiving calls (which you don’t need credit for). It’s something of a canibal system; more efficient, perhaps, but not really a panacea, by any stretch.

  458. Ichthyic says

    Don’t forget Hagbard Celine’s yellow submarine in Wilson & Shea’s Illuminatus! trilogy.

    IIRC, “Earth” by David Brin also features a coagulated ship-city (built on old garbage scows?)

  459. Robin Levett says

    Mathew Wilder said:

    To CalGeorge – slavery is inimical to capitalism. From a purely pragmatic standpoint, it is inefficient. (And from a libertarian position, immoral.) Look, for example, at England. Capitalism, fueled by the industrial revolution, began sooner in England, than in America. Slavery was also abolished sooner in England than in America. Coincidence?

    There were many reasons why slavery was abolished in England (and Wales) sooner than in America; one of them being that slavery was considered contrary to the common law of England & Wales before America existed as a political entity – indeed, before the industrial revolution anywhere – “Cartwright’s Case in 1569, … held “that England was too pure an air for a slave to breathe in”” (http://www.anti-slaverysociety.addr.com/huk-slavery.htm)

    Abolition of slavery in the West Indies and the slave trade is a separate matter – and again was not fuelled by any problem “capitalism” had with slavery as an institution, but largely by moral outrage. Serious work began with Quakers in 1783, and culminated in the 1833 Abolition of Slavery Act, abolishing slavery throughout the British Empire. The Act was heavily opposed by “capitalism” (in the form of British West Indian plantation interests), because the sugar trade was dependent upon slavery for its profitability.

  460. Ian Gould says

    “Do any taxes support the system?
    Yes, plenty. (For example the quite high taxes on cigarettes, but I think most of the money comes from the sales tax.) We get a good return on all those taxes. Again: in sum we pay less than you Americans.”

    This bears repeating.

    Even in the countries most like the US (e.g. Australia, Canada, the UK)libertarianism gets even less creence than in the US.

    This is despite the fact that taxes are higher in these countries and we all have some form of the dreaded “socialised medicine”.

    Put simply, we pay more for government services but we get far more for our money.

    Maybe that’s because our government hasn’t been run for decades by peopel who’re ideologically convinced that government is innately corrupt and inefficient.

    Has anyone else run into libertarians who when confronted with even the most blatant examples of political corruption just shrug and mutter “well the government would have just wasted the money anyway.”

  461. Ian Gould says

    A further note:

    Australia is currently in the thirteenth year of government by the Liberal/National coalition. The Liberals, rather confusingly for North Americans, are the conservative party here.

    Our current Prime Minister, John Howard, boasts of being “the most conservative Prime Minister Australia as ever had” and follows the US line on issues such as Kyoto and the Iraq war with a fervour that borders on the homoerotic.

    Howard has instituted massive reforms (seldom if ever for the better) in areas as diverse as taxation; labor relations; immigration; refugee resettlement and indigenous reconciliation.

    There’s one area though that he’s barely touched – health care.

    That’s because the Medicare national health system developed by successive Labor and Liberal governments is wildly popular and essentially sacrosanct.

    A canny politician like Howard is pragmatic enough to recognise a policy that works and is broadly supported even if it doesn’t fit with with his ideology.

  462. Ian Gould says

    “Did they breach the contract? If so a court of law will hold them accountable. Even if they put loopholes into the contract, they can still be held accountable by a court if they willfully tried to deceive their clients.”

    You know that standing to sue usually lapses on the death of the insured party, right?

  463. Ian Gould says

    “The USA is THE case study on how not to do it, and the data is there to demonstrate it. Despite this, still a large % of the American population still lives in a delusion that their system is quite Ok (they’ll admit to the fact that some improvements can be made, but won’t change the system).”

    In the Boer War and again in world War I the British found that large proportion of their soldiers were simply medically unfit for service.

    The rudiments of the welfare state started to be introduced in Britain from the 1920’s because even the conservatives came to understand that national survival was at stake.

    Americans are now shorter or average than Europeans, reversing the situation of the past several centuries.

    US life expectancy is now comparable to that in Cuba and Portugal.

    At some point the American elites are probably going to realise that the current US health system is a threat to America’s very survival.

  464. Ian Gould says

    “We also lead in innovation of drugs and technology, and in a sense subsidize or at least benefit the rest of the world in this regard.”

    I keep hearing that assertion and superficially it certainly seems to make a degree of sense.

    But I’ve never seen the hard data (e.g. medical r&d research as a percentage of GDP; drug patents per capita) to back it up.

    I also take note of the extremely large and highly innovative European drug industry (Glaxo Wellcome; Novartis etc).

    Can anyone point me to the proof that the US system does actually resutl in more R&D and innovation?

    Meanwhile I take note that one of the most important recent advances in public health is the Human Pappilomavirus vaccine developed by the Australian company CSL.

    The US system effectively discourages vaccine development – why spend R&D dollars on a one-off vaccine that sells for $500 when you could be developing a reformulated insulin product that diabetics will be buying for decades to come?

  465. Ian Gould says

    “I deny that I have cherry-picked anything. You again seem to be confusing a nation’s aggregatate health indicators with “outcomes” of its health care system. These are not the same thing. You cannot infer the latter from the former. The average life expectancy of a national population is the “outcome” of a vast constellation of factors, from the rate of smoking, to the rate of violent crime, to the levels or air and water pollution, to the prevailing patterns of diet and exercise, to dozens of other things. It tells us nothing whatsoever about how effective the nation’s health care system is at preventing, diagnosing or treating illness. In order to evaluate the effectivess of a health care system, we need to look specifically at data on prevention, diagnosis and treatment.”

    So the US system is really more efficient than all the other systems and the shorter US life expectancy is due to …. something else.

  466. Ian Gould says

    “Because government control of prices and wages distorts markets and tends to produce shortages or surpluses.”

    As does dominance of a private market by a cartel – like,say, US HMOs.

  467. Ian Gould says

    “You mean apart from decades of experience in the former Soviet Union and other communist nations, where the government set wages and prices of virtually all occupations and all goods and services, and shortages or surpluses were endemic?”

    How about centuries of experience from all over the world prior to the introduction of the modern welfare state?

  468. Ian Gould says

    “If I own a pub or restaurant, I should be able to set the rules too. ”

    Damn right but you start pimping out one preschooler or selling just one vial of crack or running one bare-knuckles “to the death” bumfight and the oppressive hand of state tyranny is all over you.

  469. Colugo says

    Medical innovation, including vaccines

    Pediatrics
    http://pediatrics.aappublications.org/cgi/content/abstract/100/6/1015

    “In the last 20 years, two thirds of all new vaccines provided worldwide have been produced by a US network of independent industrial, governmental, and academic partners engaged in vaccine research and development. …The major partners are the federal government; four large companies—two US-headquartered (Wyeth-Lederle Biologics and Vaccines and Merck & Co), two foreign firms (SmithKline Beecham and Pasteur Mérieux Connaught); and academia. Of the $1.4 billion that fund US vaccine research and development annually, 46% comes from vaccine sales, 36% from taxpayers, and 18% from risk capital.”

    Inter Press Service
    http://ipsnews.net/news.asp?idnews=36931

    “Ann Katrin Akalin, spokesperson of the German AIDS Foundation, says the EU is contributing only six percent of the world’s total public financing for research on a vaccine. “This is too little,” Akalin told IPS.

    “The International AIDS Vaccine Initiative (IAVI) estimates that about 1.2 billion dollars are needed yearly for financing the research,” Akalin said. “As late as 2005, only 760 million dollars were available for this research.”

    In all 88 percent of this money was channeled by governments, mostly the United States which contributes 92 percent of official resources for vaccine research.”

    Günter Verheugen, Vice-President of the European Commission responsible for Enterprise and Industry:
    http://europa.eu/rapid/pressReleasesAction.do?reference=SPEECH/05/226&format=HTML&aged=1&language=EN&guiLanguage=en

    “Another disquieting tendency taking place in the pharmaceutical sector, which is one of the most promising fields of biotechnology. Here, we are confronted with a move of research and production of innovative drugs outside Europe.

    Let me just give you a few simple figures which may illustrate the state of play of our pharmaceutical sector, an industry which is strongly affected by the life science revolution.

    While in the late 1980s only 41% of the top 50 innovative drugs were of American origin, in the late 1990s the U.S. percentage climbed to 62%. Europe has remained more or less static at 18% respectively 21%. In 1990, the pharmaceutical industry spent 50% more on research in Europe than in the U.S. In 2001, the situation was reversed with 40% spent more in the U.S. In 1992, 6 out of the 10 top medicines in worldwide sales were European, while in 2002 this figure had fallen to just 2.”

  470. Colugo says

    Note: That Pediatrics article I excerpted* is from ’97, so the 20 period it menations is from the late 70s to the late 90s. I’ll try to find a more recent source on vaccine innovation in the US.

    *When it shows up – it’s in holding (did it trigger a filter?).

  471. Kevin Klein says

    I must say I’m terribly disappointed in PZ and many of the readers who posted here. If this blog is supposedly devoted to reason and the scientific method then why is this post and its responses so full of name calling and straw man arguments? Half of the people here can’t seem to tell the difference between a libertarian and an anarchist for FSM’s sake. And why must every Libertarian subscribe to the most extreme Libertarian position? That’s like thinking that all Democrats must be Socialists. If that sounds awfully Fox-Newsy to you, then you can understand how disappointed I am.

  472. Dave says

    “Americans are now shorter or average than Europeans, reversing the situation of the past several centuries.”
    This is a new item I have seen used to pummel the American health care system. Like so many others talking points, it begs for explanation but is instantly used instrumentally to promote left wing ideology. It could easily be turned around and used as a positive statistic to feather America’s pride. Why, we are so nice in this country, letting in short foreigners, that the average height of our citizens has declined.

  473. Tuck says

    Ditto on my loss of respect for PZ. It is highly hypocritical to contend on the one hand that we be judicious in demanding evidence for religious claims, and in the political arena make bold faced statements like the one above without the evidence to back it up. Obviously he has a stereotype without justification. Meeting and judging a scattering of libertarians is no different then meeting and judging a group of athiests.

    I take personal offense. Debatable questions like the merit of publically financed education vs. vouchers is furthered little by an ad hominim attack (libertarians are “petty small mindedness”) is a sad statement by a supposed openminded individual.

    I am 1) poor (sub $30k salary anyway), 2) over 30, 3) volunteer 4) give to charity and 5) libertarian. I would not be, nor am I aware of others who see me, as PZ describes. Shame on you!

  474. Ian Gould says

    “This is a new item I have seen used to pummel the American health care system. Like so many others talking points, it begs for explanation but is instantly used instrumentally to promote left wing ideology.”

    And catchphrases like “leftist ideology” are used endlessly to prmote libertarian ideology.

    “Why, we are so nice in this country, letting in short foreigners, that the average height of our citizens has declined.”

    Ah yes the charming “libertarianism would work if not for all those black/yellow/brown people” argument. As in “It’s not law handgun laws that are responsible for America’s high murder rate it’s the blacks.” Or “American healthcare costs more because of all those illegal immigrants.”

    But I’m sure we shouldn’t read anything into Stormfront’s endorsement of ron Paul.

  475. Ian Gould says

    “In 1990, the pharmaceutical industry spent 50% more on research in Europe than in the U.S. In 2001, the situation was reversed with 40% spent more in the U.S.”

    Somehow I doubt that if this discussion were occurring in 1990 you’d be citing R&D figures as evidence of the innate superiority of the European health care system(s).

    One problem with this metric is that European and American pharmaceutical companies sell into each other’s markets and for that matter operate R&D facilities in them.

    The distribution of drug patents may have as much to do with patent laws and tax treatment of R&D as it does with the respective healthcare systems.

  476. Torbjörn Larsson, OM says

    OK, I briefly scanned the comments and I don’t think anything was addressed to my sorry comments.

    At the same time it is impossible to catch up on such a mammoth thread. Too bad, but I’m sure that with this interest the subject and the controversy around it will surface again.

  477. Torbjörn Larsson, OM says

    OK, I briefly scanned the comments and I don’t think anything was addressed to my sorry comments.

    At the same time it is impossible to catch up on such a mammoth thread. Too bad, but I’m sure that with this interest the subject and the controversy around it will surface again.

  478. Reader says

    Would anyone buy Dasani if it was revealed that some bottles were infected by E. Coli?
    And this would be voluntarily revealed to the customer by the company that markets/makes Dasani? You mean they won’t go out of their way to bury it, shift blame to another party or the customer, start a “scientific” debate and parade experts to deny any link between Dasani and infection/people getting sick? Are you sure you live on planet earth?

    I mean there are no government laws coercing them to not tell the truth and not accept responsibility for their mistake. You might want to check out what Union Carbide-Dow did in Bhopal, India, where the government for all practical purposes, didn’t intervene. Were there regulations stopping Union Carbide from taking responsibility and paying suitable compensation to people killed? Or maybe the poor people in the area should have donated to a charity hospital to take care of sick people.

    Coming to the tobacco industry, does a customer really know all the information about the product to make an informed choice? Or did he decide on the basis of certain cleverly designed ads that rely on the sub-conscious mind – a fact and a mechanism that an average customer wouldn’t be privy to? Did the tobacco industry in the US not hire “scientific” experts to deny any links between their product and addiction+health risks? Or are you saying it’s OK for a company to tell lies to sell a product, and it’s incumbent on the customer to do all the research and wade through scientific reports before he heads to the corner store to buy a pack? If he has no scientific training or education, he’s basically fcuked. Do you really do this kind of research before you buy any and all product(s) from the store? Is this how people are supposed to live in your libertarian utopia – based on basic mistrust of the seller?

    Does the Nestle chocolate bar mention on the wrapper that Nestle used slave/child labor for the product you’re about to consume, and that it discourages breast-feeding by selling formulas in countries that don’t even have clean drinking water? Is this information found in mainstream media and easily available, or does a customer have to dig for it? Would Nestle willingly put such information about its business policies upfront and not lie if asked about it, which I as an informed citizen have a right to know? I’d be very happy to let the free market take its course if Nestle was transparent and open, and provided such information to the customers before the customer bought the product.

    So, Matthew. Rationalize away. ;)

  479. Colugo says

    Ian Gould: “Somehow I doubt that if this discussion were occurring in 1990 you’d be citing R&D figures as evidence of the innate superiority of the European health care system(s).”

    But I wasn’t arguing about the innate superiority of the American system over the European. My point was not to generically bash socialized medicine or Europe. I was arguing for a nuanced comparative analysis that looks at relative strengths and weaknesses in multiple areas. Only that approach can help craft a policy that promotes the best aspects of different systems and avoids their flaws, or at recognizes trade-offs in these systems. Many of the commenters on this thread have a knee-jerk, defensive, blinkered approach, insisting that European healthcare is superior to the U