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I’m friends with many different sorts of people, as my Facebook feed would attest. My acquaintances range from Anarcho-capitalists to religious conservatives to people who are, well … socialists. I’m frequently reminded of that fact whenever I log on and find things like this:
When I saw this yesterday, I was sorely tempted to respond. However, Facebook doesn’t lend itself to carrying out this sort of chewing, so I decided to bring it here to begin digesting it. Yet, where does one even begin with such a movable feast?
For starters, some additional details. The post came from a friend of mine (who shall remain nameless here) who shared this complaint from a fellow disabled person — he too is a paraplegic and is a college instructor. Admittedly, if you’re disabled, the situation described is a serious impediment. His complaint extends further though, and goes on to indict the free market as this is a thing which it “cannot solve” and a situation about which we should be “ashamed.”
Let’s begin by clearing the ground of the underlying complaint. If we take it at face value, I can see several issues from the get-go. Even not knowing the whole story, how plausible is it to think that a company whose client is in good standing with them would simply elect to stop taking their money? I suppose it’s possible, but there are service providers for nearly everything, and a great deal of competition to boot. A comparable service is likely available at similar prices. Perhaps this person is in arrears on payments to their in-home assistance? Perhaps she’s earned a reputation among such service-providers as a person who pays slowly or not at all? Maybe she’s just a pill to deal with. Relatedly, doesn’t she have any family who could help her? Does she have friends or perhaps her employer values her enough to lend assistance in this matter? These are all fundamentally unknowable to us unless we were to honestly discuss the details with her, but more importantly: these are issues which have nothing to do with the Free Market and its ability to help consumers of products and services meet producers at agreed-upon prices.
Now I want to tackle my friend’s complaint head-on. In this particular case, he accuses the Free Market of “not being able to solve” this problem … which is approximately like accusing hammers of being bad because you can’t eat soup with them.
Wrapped up in his complaint is also a series of incorrect assumptions: First, that people have a “right” to healthcare, second, that the Free Market deprives people of this “right” and third that we even have a “free market” in healthcare to begin with.
The assertion that we have a “Right” to healthcare has been widely asserted and frequently debunked. For starters, Rights are things which don’t cost other people anything for you to exercise. My right to swing my arm stops at the end of other people’s noses. Economically, healthcare is a competitive, exclusive consumer good. If one person consumes a unit of healthcare, it is unavailable for another person to use. Somebody must pay for that unit of healthcare … unless we are going to expropriate people’s labor and turn them into healthcare-providing slaves. But the left doesn’t like or comprehend that resources like “the number of hours healthcare providers work” are finite but demand is essentially infinite. The Free Market (nominally) allows for the division of those finite resources via the price mechanism.
Next comes the idea that the Free Market is bad because of how it divides up this limited resource. Is it also bad because it divides people’s labor in every other field in the same fashion, with certain jobs or skills being more valuable than others? Brain Surgeons earn considerably more than tellers at Wal-Mart. Is that fact merely arbitrary or is it entirely appropriate given the very rare combination of desire, skill and years of training which go into making a person a Brain Surgeon? Not to mention the fact that if you need a brain surgeon, you probably don’t want a Wal-Mart teller to wield the blade. (Bob’s Discount Brain Surgery’s prices can’t be beat! We consistently get three stars on Yelp!)
Last comes the notion that we even have a genuinely “Free Market” in healthcare, which is a laughable idea on its face. Is there an industry in this nation which is subject to more government regulation or subsidy than Healthcare? Far from being a “free market,” healthcare more closely resembles a “state-funded agency” when you consider where the monetary inputs come from. In 2013, some 64% of all healthcare spending was provided by the Government via programs such as Medicare, Medicaid, sCHIP and the VA. It’s arguable that part of the reason why Healthcare is so expensive in the first place is that the Government has flooded the zone with so much money that the “third party payer effect” hopelessly distorts the price mechanism. After all, are you going to be more or less likely to order an expensive meal and dessert at a restaurant if you knew somebody else was picking up the tab?
But all of this misses the fundamental point: that without there being some manner of free market in health care… many of the services which the central planners’ dream of divvying up more equitably simply wouldn’t exist in the first place. When I say “The left doesn’t appreciate The Miracle” (in the Goldbergian, Suicide of the West sense) the mere existence of these services is a manifestation of it.
The fact that services such as personal healthcare assistants who will come to your home to do things like “help you bathe” exist in the first place is largely because of the free market. But the left presumes the production of such goods and services as if the market for that labor were static. The thought that such a thing wouldn’t exist without that market doesn’t seem to occur to them, just as its mere existence doesn’t imply their right to have it.
Then there’s the aspect of the future to consider. My contention is that my friend is fundamentally incorrect in his assertion that the Free Market can’t solve this problem – especially if “solving” it in his mind means free healthcare for everybody. In fact, the exact opposite is the case. Who else but the free market and the entrepreneurs associated with it have any hope of easing the burdens with which the disabled live? Is it possible that Honda or Toyota could develop a “home healthcare assistance robot” that can help people meet these basic needs — like this one — and obviate the need for more expensive home healthcare workers? We may never find out if the left get their way, as I can see their next complaint warming up in the bullpen: It isn’t “fair” because only the “Rich” could afford to purchase such golems.
This is at its core the lack of gratitude that Jonah talks about in Suicide of the West: That because The Miracle of Democratic Capitalism doesn’t produce a utopia or Immanentize the Eschaton that it is necessarily grubby, bad and in need of being throttled. But the left doesn’t consider the alternative, where we don’t even get the luxury of contemplating how to divide up such riches in a fashion more pleasing to their eyes. They might, in their anger and impatience kill the very process through which these problems are ultimately ameliorated.
I’m certainly not ashamed to make that argument.