Excuse me for getting a bit political here. I’d like to write briefly on the issue of freedom in health care markets, and specifically rhetorical strategies for those of us who believe that adding freedom to this industry will be good for patients, doctors, and tax payers.
Bleeding Heart Libertarians offer a criticism of common pro-market rhetoric.
As described in this article, there is a tendency for proponents of free-markets in health care to use some lousy rhetoric. When faced with the issue of what to do with people who choose not to prepare for a catastrophic event who then actually face that event, many pro-liberty types go about discussing the issue in a way that highlights their own ignorance and turns away others. They start by saying (and I’m paraphrasing here), “well, it was his fault,” then they say, “but there is charity,” and if they are relatively sophisticated will finally follow up with, “but look, the real problem is that costs are high because we’ve stifled the market.”
Rhetoric matters and all the more so with controversial topics such as health care finance. If we want to change peoples’ minds, we need to appeal to our audience. If we want to pat ourselves on the back and alienate those with different opinions, we’ll get no where fast.
Long’s third point (starting with “what caused the mess we see in health care?”) leads us to think about the effects of different institutional settings. The decision made in one institutional setting isn’t what we should expect in another. There is some imperfect safety net currently; although we can’t always count on it, the expected private cost of going without insurance is lower in our current world than it would be in a free-er world–that also means that in our current world the expected private cost of getting the el premo cable package instead of putting that money away, just in case, is lower than it would be in a free-er world. We will see a change in the institutions surrounding health care finance in a free market. If there is such thing as bail bonds, it isn’t a stretch to imagine a world with health care liens. Such an instrument would work much like real estate tax liens currently work. Or maybe not, after all, the point of a free market is that we can’t see the future. If we could, we wouldn’t need a market.
If you discuss points like these around the dinner table with your in-laws, you just might get them thinking. Show that you’re willing to listen and have an open mind, offer them interesting points that they can discuss rationally, and soon you’ll find yourself in a discussion where people leave a bit wiser then a fruitless argument.