Why we can’t have nice things
To start things off, I’m a utilitarian libertarian which is basically, “do what does the most good for the most people”. I view governments as a tool for society and not any more or less inherently evil that any other part of our society (i.e. corporations/business). With that in mind…
TLDR; We can’t have nice things because we as a country fail to take full advantage of our democratic government to work for the common good. We act like it’s a dictatorship and that our votes don’t matter, and as a result we neither get the benefits of a democracy nor the benefits of a dictatorship (decisive / quick action).
I spent a decent amount of time (5 years or so) working for a small company that was trying to solve the problem of securely sharing electronic health records between independent care providers (i.e. people who don’t share the same electronic health record system). This got me into understanding the intricacies of how our healthcare system works and why the efforts to bring it into the digital age with electronic records has been a very slow, painful, and expensive process.
I understand that most people don’t have the privilege of getting paid for understanding the healthcare beast and we are all busy with other aspects of our lives and just are not going to research something like this in depth for fun. While I can talk all day about the nitty gritty details, I do have some high level observations from my experience:
– In a democracy, governments are a tool used by the people and are not any more or less evil than anything else in a democratic society. Other people, corporations, and governments can all hinder or help your freedom depending on the circumstances.
– Free markets, which are markets free of government regulation and control are not magical entities from which only goodness flows.
– Governments are not magical entities that can be trusted to always act on your behalf, and yes, they can and do spend money in wasteful ways.
– The healthcare market is different from the market for consumer goods and the market has failed to evolve into a well functioning system for PATIENTS. Emphasis on the PATIENT part. I do believe the healthcare market has evolved into a well functioning system for healthcare businesses.
– The healthcare system we have is mostly market based, with government regulations governing safety, privacy, and the like. Outside of regulations, Medicare/Medicaid is an example of a government provided insurance and the veterans administration is an example of a government run healthcare system – specifically for the military.
– There are two primary things that government can do to improve our current system. First is to institute single payer insurance. As a patient, I want an insurance company that will exist for the long term, won’t drop me for pre-existing conditions, is not attached to my employer, and doesn’t have a profit motive to make my claims process crappy. This single step will reduce the amount of administrative red tape and dramatically improve the patient experience with finding, obtaining, and paying for care.
– I do think that keeping government in control of insurance plays to the strengths of government, while allowing private companies and the market system to actually provide the care plays to strengths of companies. I believe this hybrid system will function better than a purely socialized system or a purely market system.
– The second thing that the government can do is to create and manage an identity management system. If you are legally living in this country, you should have a Government provided ID and the ability for various governments to use that ID to determine things like voter eligibility and eligibility for various government services. Companies (like healthcare) can use the number to identify you. Companies can also use it to verify your eligibility for employment. It’s probably not obvious, but the lack of a government identifier makes it very difficult to share electronic health records between companies. It’s completely possible to have a trustworthy and convenient voting process, and but it’s impossible without a strong system of identification.
I think everyone seems to be initially drawn to libertarian-ism because of feelings that the government is evil / taxes are bad. I would encourage folks to step back and view things from a different perspective. The way I think of things is that people are shit (including me). Society is a way to keep mutually shitty people from constantly going to war and have some semblance of a peaceful existence. We have lots of different ideas on how to structure a society, and each system has various benefits and pitfalls. Markets / regulations / governments are tools and can be used either well or used poorly. I would encourage folks to keep an open mind and try to avoid falling into the trap that thinking that some particular ideology is the only way to go.
Article from r/Libertarian: For a Free Society