Saturday, August 8, 2009

Health Care: An Anarchist Approach

A Sensible Policy Agenda

Bottom line: the thing government officials could do to reduce health care costs would be to get out of the way. They could:
1. Stop offering protection to patents and copyrights.
2. Eliminate hospital accrediting and professional licensing rules, leaving a variety of flexible, competing market-based certification systems to do the job..
3. Limit malpractice awards to actual damages plus the costs of recovery (including reasonable legal fees)
4. Repeal regulations that prevent the sale of insurance across state lines and the prevent the operation of what amount to insurance schemes by health professionals.
5. Alter the tax code to de-link employment and insurance. (This change would have the potential to boost net taxes, of course, if it weren’t made in tandem with the tax cuts for which I’ve argued.)
6. Replace the FDA approval process with competitive private certification systems.

And government officials could also ensure that ordinary people had the resources needed to pay for (newly much less expensive) health care. They could:

1. Eliminate licensing, zoning, and related restrictions that help people from starting small, low-capital businesses.
2. Eliminate rules that prevent poor people from entering business regarded as off-limits (like selling non-approved pharmaceuticals—which could, again, be certified by competitive, voluntary, market-based certification services).
3. Eliminate rules that force poor people to choose between the kind of housing middle-class planners and neighborhood busybodies prefer—and no housing at all.
4. Eliminate import duties.
5. Dramatically slash the tax burden at the state and federal level—sharply increasing the standard income tax deduction and the Earned Income Tax Credit—and making corresponding reductions in spending.

Notice how this package of reforms would work. It would ensure that poor people had more money. By eliminating monopolies (and quasi-monopolistic market distortions like tax subsidies for particular insurance choices), it would also ensure that prices for health care services—whether purchased directly or provided via insurers—were lower. By keeping a competitive market in place, it would ensure that competitive market pressures would tend to elevate overall product and service quality. And because it wouldn’t involve the installation of yet another czar, or the equivalent, because it would leave people free to make their own health-care choices, it would preserve liberty rather than limiting it. It would achieve all three of the goals proponents of current health-care reform measures say they want.

But such a plan would be anything but a continuation of the status quo. It would be a dramatic attack on the status quo, one that redistributed wealth from privileged monopolists to ordinary people, and dramatically increased the likelihood of access to inexpensive, high-quality medical care for all Americans.

read the entire essay

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