L. Neil Smith’s THE LIBERTARIAN ENTERPRISE
Number 921, May 7, 2017
by J. Neil Schulman
Special to L. Neil Smith’s The Libertarian Enterprise
Repeal and replace ObamaCare? Like this is hard to figure out?
Look. I’m an anarchist-libertarian but I also take notice of politics.
The libertarian position is getting the State completely out of the business of health, healthcare, healthcare insurance, and medicine, whether at the federal, state, or local level.
No drug laws.
No Drug War.
No requirements for drug prescriptions.
No legal penalties for possession or sale of any quantity of drugs, so long as no violence, force, coercion, or fraud is involved.
No FDA approval or control of pharmaceuticals, medical devices, or supplements.
No restrictions on the importation of pharmaceuticals.
No Drug Enforcement Agency.
No medical licensing of doctors, nurses, dentists, or any other healthcare provider.
The premise of a free society is that what you put into your body, what you see as beneficial for your pursuit of happiness, what free people trade, are all private matters protected as preexisting unenumerated rights under the 9th Amendment to the Constitution of the United States, and—since not specifically granted to any branch of the federal government within the text of the Constitution—denied all branches of the federal government under the 10th amendment.
Oh, and all federal legislation and regulations are null and void ab initio, and prosecutable as criminal activity “under color of law” under Title 18, Section 242 of the United States Code.
If you’re feeling generous all these restrictions are incorporated to the States as well under the 14th Amendment.
That’s the libertarian position. That’s my position.
So let’s move on. The “Overton window” of the politically possible is not where a libertarian like me is.
Conservatives and Minarchists (this latter a term coined by my old friend, Samuel Edward Konkin III) believe in restricting the State as much as humanly possible.
Democrats, liberals, progressives all favor Universal Health Care, also known as “Single Payer” also known as Socialized Medicine.
Even a former Nixon administration economist like Ben Stein sees this as inevitable.
I see a possible stopgap from destroying all remnants of the free market in medicine, health care, and health insurance.
It’s my point One in the list below.
The issue the Democrats, liberals, and progressives all use against the “Repeal and Replace” of the Affordable Care Act (ObamaCare) is the disposition of those with preexisting conditions. The “heartless” Republicans want to kill off the poor because they oppose (they really don’t oppose it) Universal Socialized Medicine.
So let’s remove everyone with a preexisting condition from the health insurance market by putting them all on Medicare.
Yes, this is single-payer. But it’s not universal single- payer. It limits those who are single-payer clients to those who are currently breaking the back of the health-insurance market.
The Affordable Care Act—by legally requiring those with preexisting medical conditions to be included in the insurance pool—denies the purpose and nature of insurance, as a market product, itself.
Insurance, by definition, is based on risk of something happening in the future, a happening to which there can be an actuarial projection.
Someone with a preexisting medical condition is to health insurance precisely like buying automobile liability insurance after you’ve already crashed. It’s a past, not future, event.
Take these people out of the insurance market by putting them all on Medicare and everyone else can participate in a market for health insurance.
It’s not a libertarian solution. It is, however, a solution that limits government and preserves a free-market in health insurance for everyone else.
It’s a conservative or Minarchist solution.
My other points all address increasing competition, breaking up medical and pharmaceutical cartels and increasing market entry to healthcare providers.
Here then is a nonlibertarian proposal for JNeilCare:
1. Anyone with a preexisting condition regardless of age can sign up for Medicare.
2. All restrictions and barriers to Americans purchasing pharmaceuticals from foreign manufacturers and foreign pharmacies are hereby repealed.
3. Any health-insurance-qualified provider is allowed to provide services directly to a patient at a cash discount of their choosing.
4. Any physician’s, surgeon’s, nursing, dental, or other medical or health service provider’s license issued by any state or U.S. territory is good throughout the United States and its territories. Any foreign physician, surgeon, nursing, dental, or other medical or health service provider licensed in any state or U.S. territory may practice anywhere in the United States and its territories.
5. Anyone may purchase health insurance from any company selling such policies regardless of location of either seller or buyer.
It ain’t libertarian but it sucks a whole lot less than the United States adopting Universal Socialist Single-payer Medicine.
Oh, and feel free to sweeten this with as much of the libertarian position as you can get away with.
J. Neil Schulman is a novelist, screenwriter, journalist, radio personality, filmmaker, composer, and actor. His dozen books include the novels Alongside Night and The Rainbow Cadenza, both of which won the Libertarian Futurist Societyâ€™s Prometheus Award for best libertarian novel, and the anthology Nasty, Brutish, And Short Stories. Read more about him.
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