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The Problem with Free Market Health Care

Updated on May 19, 2019

The von Mises Institute is a school of thought dedicated to economic principles propounded by Ludwig von Mises. There are several articles there relating to health care which I found interesting. This hub is about some of the problems as I see them of applying the economic principles of this school of thought, to health care.


The man himself, von Mises, said

“On the market of a capitalistic society the common man is the sovereign consumer whose buying or abstention from buying ultimately determines what should be produced and in what quantity and quality. “

(Ludwig von Mises- The Anti-Capitalistic Mentality-p1)

The formation of monopolies, cartels, oligopolies, barriers to entry, price fixing, predatory pricing etc. stems from corporate entities trying to (because of their very nature) counterbalance the consumer power von Mises talks about. To remove or reduce the “sovereignty” of the customer.

Optimum profit is what drives capitalism. A totally free market where the consumer is king is not conducive to optimum profit. So the idea of a totally free market is self defeating. Corporate entities will always be trying to turn a totally free market into a controlled market. For those doing the controlling, such a market is more profitable. Simply put, people will always cheat to profit.

So the question is not: regulated market or free market? The question is: regulated market (by state in favour of consumer, represented by many), or controlled market (by corporation in favour of profit, represented by few). The solution being proposed I believe sits somewhere between the two, but is aimed generally at giving consumers back that “sovereignty” that was lost to corporations and bad government policy.


A market controlled by the corporations is problem enough in any industry, but the problem becomes intolerable when it relates to the care and well-being of people, which should hold special status. And therein lies another problem with this approach.

Fail to make a distinction, let profit be the main driver in health care as apposed to the virtue of keeping people healthy and you effectively dehumanize people, whose health becomes no more than a commodity. The logical conclusion being that life itself (the product of health) is a commodity. The dimminishing of the human to that of commodity is one of the more serious problems of this approach. The speed of descent from this view to callousness is remarkable. Hans-Hermann Hoppe of the von Mises institute had this to say:

“Subsidies for the ill and diseased promote carelessness, indigence, and dependency. If we eliminate such subsidies, we would strengthen the will to live healthy lives and to work for a living. In the first instance, that means abolishing Medicare and Medicaid”

(Hans-Hermann Hoppe - A Four-Step Healthcare Solution)

Such sentiments can either be covered with a benevolent veneer of “helping” people be self sufficient and stand on their own two feet, or be justified by rationalisations like the theory that an “invisible hand” regulates a free market and allows people to benefit the common good by being individualists.

Praising Mammon

Neither of those can take away the essence of the above statement, or disguise the mainstay of the whole approach: selfishness and greed. That is the biggest problem with the free market approach in my opinion. It promotes selfishness and greed. It gives creedance to what the character Gordon Gekko said in the film Wall Street:

“ . . . greed, for lack of a better word, is good. Greed is right. Greed works. Greed clarifies, cuts through, and captures the essence of the evolutionary spirit. Greed, in all of its forms: greed for life, for money, for love, knowledge has marked the upward surge of mankind. And greed, you mark my words [will save] that other malfunctioning corporation called the USA”

(Michael Douglas as Gordon Gekko - Wall Street)

That speech was based on a coment by Ivan Boesky an American businessman who came to prominance in the eighties. The comment Boesky made was:

"Greed is all right, by the way. I want you to know that. I think greed is healthy. You can be greedy and still feel good about yourself."

(Ivan Boesky - Commencement Address, University of California, 1986)

Months later he recieved a ten-year prison sentence for fraud and illegal market manipulation.

A system based on greed is not sustainable. And it isn’t good enough to extol faith in the “invisible hand”. Indeed that metaphore itself has it’s own problems. Economist Joseph E. Stiglitz wrote: "the reason that the invisible hand often seems invisible is that it is often not there." If it’s not then, all you're left with is the greed and individualism. Anyone can see the fruits of those two human characteristics if they look at the current world financial crisis.

Part of the Puzzle

A degree of rationalization is needed to lower costs of health care. That’s recognized in the proposed reform, but the overall goal of the proposed health care reform is universal, affordable coverage, not profit. The driving force of a free market system is profit. Trusting market forces to regulate the system places a lot of trust in the laws of economics but, as history shows, it's all too easy to cheat to gain an advantage at the expense of others.

The issue is multi-faceted no doubt. Economic theory plays a part, but only a part. It’s sensible to bring the knowledge and expertise of economists to bear on the issue, but such expertise must be part of a wide ranging approach that encompasses all that we have to offer. Our intellect and understanding as well as our imagination, spirit, and, dare I say it, love.

Intellect and understanding tempered by those other aspects of our nature, applied in a pragmatic way is what I think the health care proposals are about. The von Mises school of thought has some interesting elements. But when we start trying to implement policies in support of some “ology” or “ism” or economic theory or school of thought and we focus our solution solely around that, then we become rigid, dogmatic and doctrinaire, and that's a starting point that leads to some very nasty places.

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  • Nathanville profile image

    Arthur Russ 

    4 years ago from England

    An excellent article Don, reading this and various views in the forums on the subject makes me appreciate the NHS (National Health Service) in Britain all the more. Britain found its solution to healthcare way back in 1948; I just hope that America finds an acceptable fair and just system someday.

  • jackclee lm profile image

    Jack Lee 

    4 years ago from Yorktown NY

    Interesting point. Just wondering what your opinion of the ACA? how has that worked out?

    If you care to debate me, here is a link to a hub I've created for such a forum -

  • Keith Engel profile image

    Keith Engel 

    9 years ago from Pittsburgh, Pennsylvania

    Free market healthcare? There is such a thing? Did you know that you can't purchase health care from a different state, that you can only purchase healthcare from the state that you reside? The reason being, each state government stipulates the minimum that has to be covered in the insurance policy for that state. Thus, as was pointed out, each state by having Government by interfering with these matters actually allows insurance companies to form their own mini monopolies in each state.

    There is no free market of health care. Want to see what true free market healthcare will be like, how many car insurance commercials do you see while watching TV?

  • Ron Montgomery profile image

    Ron Montgomery 

    11 years ago

    I really enjoyed this hub. I was attracted to it by your comments in the recent forum re: Libertarianism and the Gulf oil spill. You enjoy the give and take with the ideologues; I have grown tired of it due to the futility of matching logic against belief.

  • Evan G Rogers profile image

    Evan G Rogers 

    11 years ago from Dublin, Ohio

    Before I criticize, let me say thank you for the piece! I love reading opinions different from mine - it's like a battlefield where my arguments can hone their skills (or something...!)

    I mean everything I write with respect!

    You use Monopolies and cartels as a reason for why the free-market will fail when taking on an adventure.

    But, to everyone who reads this comment, I challenge you to find one single example of a monopoly or cartel that has ever existed without receiving interventionist benefits from a government.

    I've looked, everyone I've ever challenged (well over 50 people) and no one - no single person - can point to a single example.

    Unfortunately government tends to make things worse, and expecting people to work together without keeping their own self-interest as priority #1 just doesn't work.

    "It is not from the benevolence of the butcher, the brewer, or the baker, that we expect our dinner, but from their regard to their own self-interest. We address ourselves, not to their humanity but to their self-love, and never talk to them of our own necessities but of their advantages." -- Adam Smith

    I'm afraid that, in all reality, Monopolies and Cartels are the work of Government, not the free-market.

  • profile image


    11 years ago

    ledefensetech, no matter how much research I do, no matter what I say, you will always insist I've missed the point unless I convert to your point of view. You're like a fundamentalist missionary and I'm tired of debating with someone who prefers authority as the truth rather than truth as the authority.

    We disagree. End of discussion.

  • Don W profile imageAUTHOR

    Don W 

    11 years ago

    MagicStarER - Thanks for your comment. Your viewpoint is welcome.

    ledefensetech and ColdWarBaby - Thanks for your thoughtful dialogue which is a valuable contribution to the debate.

    Although solutions may not be ideal relative to our beliefs, worldviews and opinions, sensible dialogue is the starting point in trying to find solutions that at least improve upon the status quo. As Confucius said, a journey of a thousand miles begins with a single step. The current Health Care Bill that's on the table represents that first step.

  • ledefensetech profile image


    11 years ago from Cape Girardeau, MO

    CWB, great research, but I think you miss the point. Pennsylvania script, which was talked about by Franklin, was backed by land, rather than gold or silver. Which made sense. Gold and silver were scarce in the colonies, land was not. Furthermore, land is one of those things which you can't really make more of, so inflation is out of the picture. The Pennsylvania pound was the most successful because they did issue only enough to allow trade and not create inflation. The Federal Reserve is set up to deliberately create inflation. That's why I'm surprised to see you give at least, tacit approval of the Fed. Inflation hurts "working families" and the poor the most.

    Using land as a backing for currency is functionally no different than using gold, silver, tobacco, whiskey, sea shells or any other medium that has been used in the past. What is important is that the currency be backed by something other than ephemeral promises made by politicians who have every reason to inflate the currency in order to create programs that are then used to buy votes.

    The poison pill is not capitalism, but theft masquerading as banking and money that has no other baking than the "full faith and credit" of political hacks.

  • MagicStarER profile image


    11 years ago from Western Kentucky

    Amazing & brilliant analysis. The US economy is a mixture of socialism and capitalism. And is a democratic socialism. That is what most people who bray about the beauty of capitalism do not seem to comprehend. There is no such thing as a totally capitalistic country. The people who think there should be such a thing would do well to study economic models.

    You are totally right that capitalism has absolutely no place in the health and well-being of humans. The 2 are necessarily exclusive of each other. No profit, no "supply and demand" should be permitted regarding the well-being of the population.

    Optimal health should be the right of EVERYONE, regardless of wealth or ability to pay. Good health is NOT a commodity to be traded upon. There should be no middlemen (insurance companies) How can you INSURE wellbeing? You can't. Health insurance companies are nothing but criminals and thieves. They should not be allowed to capitalize on sick people.

    There is nothing wrong with a society taking care of its vulnerable, disabled, sick, or needy who are unable to do it themselves. You people who have a problem with that, don't seem to have any problem with your tax money going to the Middle East to massacre MILLIONS of innocent people, mostly women and children. Nor to support banks who are failing due to their own greedy and criminal actions. But, why do you have a problem with a much lesser amount to allow people to get medical care? This mentality demonstrates your own greed and selfishness, also your lack of compassion, and a blatant error in your priorities.

    Our hard-earned tax money should ALL be used for THE BENEFIT OF AMERICANS!!!! With the individuality and freedom of the individual respected and supported.

    I don't think government should be the decider of who gets what health care, either, though. Nor should health care be MANDATED. As the current health bill does, in its erroneous attempt to pacify the greedy insurance companies, who have monopolized our health care system and control our lives. This is a grave error. But our elected representatives are invested up to the necks in this corporate mafia. Now, they will hold a gun to our heads and MAKE us pay for their extortion.

    BUT, there is no reason why we can not use the existing programs, Medicare, Medicaid, and Social Security, to catch those who are falling through the cracks. Those low-income people who can not afford health care, and those who are ill but do not qualify at present - mostly these are low-income single people who have no minor children, and are under the age of 65, but too sick to work. This group is the group that is mostly doing without any medical care whatsoever. Those people, and those who do not earn enough to pay for health care.

    All that is needed here is a re-analysis of the present system, with the object of including those now falling through the cracks; and then we must curb and curtail the insurance companies who are profiting off our misery. With the object of getting rid of them entirely. The return of the billions of dollars they are skimming could make health care more affordable for everyone!

    Neither government control, nor corporate control are the answers. Common sense should be used instead. Something there seems to be a massive shortage of in this divided country.

  • profile image


    11 years ago

    Fiat monies have been very successful, even in America, on many occasions. The reason they "fail" is simply because the bankers, the money changers, will tolerate no threat to their supremacy. When fiat currency is used, profit is not a consideration.

    Benjamin Franklin was able to write:

    “There was abundance in the Colonies, and peace was reigning on every border. It was difficult, and even impossible, to find a happier and more prosperous nation on all the surface of the globe. Comfort was prevailing in every home. The people, in general, kept the highest moral standards, and education was widely spread.”

    When Benjamin Franklin went over to England to represent the interests of the Colonies, he saw a completely different situation: the working population of this country was gnawed by hunger and poverty. “The streets are covered with beggars and tramps,” he wrote. He asked his English friends how England, with all its wealth, could have so much poverty among its working classes.

    His friends replied that England was a prey to a terrible condition: it had too many workers! The rich said they were already overburdened with taxes, and could not pay more to relieve the needs and poverty of this mass of workers. Several rich Englishmen of that time actually believed, along with Malthus, that wars and plague were necessary to rid the country from manpower surpluses.

    Franklin’s friends then asked him how the American Colonies managed to collect enough money to support their poor houses, and how they could overcome this plague of pauperism. Franklin replied:

    “We have no poor houses in the Colonies; and if we had some, there would be nobody to put in them, since there is, in the Colonies, not a single unemployed person, neither beggars nor tramps.”

    His friends could not believe their ears, and even less understand this fact, since when the English poor houses and jails became too cluttered, England shipped these poor wretches and down-and- outs, like cattle, and discharged, on the quays of the Colonies, those who had survived the poverty, dirtiness and privations of the journey. At that time, England was throwing into jail those who could not pay their debts. They therefore asked Franklin how he could explain the remarkable prosperity of the New England Colonies. Franklin replied:

    “That is simple. In the Colonies, we issue our own paper money. It is called ‘Colonial Scrip.’ We issue it in proper proportion to make the goods and pass easily from the producers to the consumers. In this manner, creating ourselves our own paper money, we control its purchasing power and we have no interest to pay to no one.”

    "The information came to the knowledge of the English Bankers, and held their attention. They immediately took the necessary steps to have the British Parliament to pass a law that prohibited the Colonies from using their scrip money, and then ordered them to use only the gold and silver money that was provided in sufficient quantity by the English bankers. Then began in America the plague of debt-money, which has never since brought so many curses to the American people."

    The Roman Empire was built using fiat money. Rome began its decline when the money changers took control of the currencies thanks to wars.

    "In 48 BC Julius Caesar took back the power to coin money from The Money Changers and minted coins for the benefit of all. With this new plentiful supply of money he build great public works projects. By making money plentiful Caesar won the love of the common men. But The Money Changers hated him. Some believe this was an important factor in Caesars assassination. One thing is for sure, with the death of Caesar, came the demise of plentiful money in Rome. Taxes increased, as did corruption.

    Just as in the case of America today, usury and debased coin became the rule. Eventually the Roman money supply was reduced by 90%. As a result the common people lost their lands and their homes. Just as it is about to happen soon in America. With the demise of plentiful money the masses lost confidence in the Roman government and refused to support it. Rome plunged in the gloom of the dark ages."

    Fiat money worked flawlessly for Lincoln. He was killed by european bankers when they realized he wished to make its use permanent.

    In 1862, President Lincoln went to the bankers to seek funding for his effort to keep the Union intact. Since they did not wish for his success in that endeavor they offered usurious loans at rates of interest as high as thirty-six percent. Lincoln declined this offer and instead began the printing of what came to be known as “Greenbacks”. They were declared full legal tender, issued by the government without interest and used to finance the military effort. He later made it clear that he intended for this monetary system to become a permanent fixture of the Republic saying in part: “…the taxpayers will be saved immense sums of interest. Money will cease to be master and become the servant of humanity.”

    The response of the bankers in London was actually printed in the Times of London making clear to anyone who could read exactly what motivated these criminals.

    "If that mischievous financial policy, which had its origin in the North American Republic, should become indurated down to a fixture, then that government will furnish its own money without cost. It will pay off debts and be without a debt. It will have all the money necessary to carry on its commerce. It will become prosperous beyond precedent in the history of civilized governments of the world. The brains and the wealth of all countries will go to North America. That government must be destroyed or it will destroy every monarchy on the globe.”

    The poison pill is the profit motive and kapitalism is based on profit. Profit is the ONLY purpose for its existence and profit is preeminent.

    Profit before people, before peace, before freedom, even before life.

    And by the way, any common thief or kidnapper can deprive you of your life or liberty and there's a word that has lost any meaning. Kapitalists,which include the members of our illustrious privatized political system, are by far the commonest of thieves.

    Thanks for the links. I'll have a look.

  • ledefensetech profile image


    11 years ago from Cape Girardeau, MO

    I think you might find that we agree on quite a few different ideas. Where we but heads is over the definition of words. What you call capitalism, or kapitalism, I call corporatism, or in this case korporatism, since I share your contempt of this form of economy.

    Aristotle and Plato may have said that money is an invention of humanity, and they have a point, but some money is better than others. Have you ever heard of the Scholastics? You might find this article and book illuminating:

    The School of Salamanca conforms remarkably to Adam Smith's writings, but predated him by several centuries. Aristotle and Plato didn't have the wealth of information that the Scholastics had access to, especially the disastrous policy of Rome:

    Fiat currencies will always falter and fail. The temptation to reap the short term rewards of monetary inflation is just too great for any group to behave responsibly, whether they be private banks or government entities like the Fed. In a sense we're both right. By blending government and business we get something that is neither fish nor fowl. I still give the government the edge because only the government can compel you to do something you'd rather not, because only government can deprive you of life or liberty.

    Why do you think Obama is threatening the banks to go along with his schemes for the banks? If they don't he'll have the FDIC audit them, which will pretty much put them out of business. Hardly the sort of environment in which the banks control much of anything wouldn't you say.

    I suppose that's the way they do things in Chicago. It was the home, after all, of Al Capone. It shouldn't be too surprising to see politicians from that city act like gangsters.

  • profile image


    11 years ago

    The one thing I will happily agree upon, ledefensetech, is the elimination of the central bank in its present form. There's nothing wrong with the concept of banks as long as they are not privately owned, for-profit entities.

    If you just can't get your head around life without currency then the only workable form is complete fiat.



    I can tell you now, as I have before, we will never reach agreement regarding kapitalism, which I spell that way as an indication contempt. Therefore, as I have also said before, we shall simply agree to disagree. Take it or leave it. I will not engage in pointless, circular argument.

    "There are many doctrines of a less essential nature ... In these we may think and let think; we may 'agree to disagree.'

    -- John Wesely, 1770

  • ledefensetech profile image


    11 years ago from Cape Girardeau, MO

    Sure scarcity allows for higher prices. Business hinders government? How so? Oh you mean Enron, which arose out of incomplete deregulation of the CA power grid. Or perhaps Goldman Sachs getting sweetheart deals from the Obama administration. Or perhaps GE getting all sorts of goodies from the political leadership thorough Cap and Trade legislation. Or perhaps you mean the Universal Healthcare Bill rolling back limits on lawyer pay for malpractice cases. Oh yeah, that's the fault of business, not of government corruption.

    Specifically about healthcare, the AMA acts as a de facto monopoly. Only their doctors get to practice medicine and only their schools get to certify doctors. A bit of a conflict of interest, wouldn't you say?

    You do have a point about the central bank. What you ignore are the laws put in place to keep the central bank in power. Why is it every bank chartered to do business in the US must be fractional reserve? Would you not agree that the first thing to do would be to eliminate the central bank?

    None of that is capitalism, even if you do change the spelling to look kool. Neither is it free market. Therein lies the problem.

  • profile image


    11 years ago

    Because scarcity provides an excuse for higher prices ledefensetech.

    The illusory law of supply and demand is manipulated by the kapitalist system for short term gain in favor of long term stability. Higher prices on the necessities of life widen the gap between the rulers and the ruled. You either own or you are owned. Buy or Die.

    It is an inherent characteristic of kapitalism to seek monopoly. It's as natural as water flowing downhill.

    You continue to labor under the delusion that "government" is hindering "business" when the complete opposite is the case.

    I've explained it to you before. You choose do disregard the facts. THAT'S YOUR CHOICE AND YOU'RE WELCOME TO IT.

    The so-called government is a wholly owned subsidiary of the korporatocracy.

    We are living under a form of government best described as a plutocracy.

    The usurious central bank is at the top. The korporations are their children. The politicians are merely employees. The people are naught but chattel.

  • ledefensetech profile image


    11 years ago from Cape Girardeau, MO

    No, someone does not deserve to die because they can't pay for treatment, but the real questions are why costs continue to increase and are there policies in place that restrict the supply of healthcare. The answer to the latter is yes. Why would you restrict the supply of healthcare, do you think?

  • Don W profile imageAUTHOR

    Don W 

    11 years ago

    ledefensetech - The real question is does someone deserve to die because they can't afford to pay?

  • Don W profile imageAUTHOR

    Don W 

    11 years ago

    ColdWarBaby - Thanks. You also make a good point in boiling it down to the fundamental question.

  • ledefensetech profile image


    11 years ago from Cape Girardeau, MO

    OK Don, if you can think of a better system, by all means please clue us in. Can you think of a socialistic method that will work better than a capitalistic system?

  • profile image


    11 years ago

    Your data and analysis are impeccable Don. Excellent work.

    Unfortunately, such attributes often attract ideologues who are incapable of critical thinking or simply recognizing facts.

    The health care debacle makes very clear the essential flaw in any for-profit system. Such systems consider absolutely nothing but the "bottom line". Boiled down to its essence, like crack cocaine, it's very simple; Buy or Die.

    If you can't afford to pay, you don't deserve a life.

    I wouldn't have such a problem with people like ledefensetech and misha if they would just admit that's what they believe.

  • Don W profile imageAUTHOR

    Don W 

    11 years ago

    The aim is to achieve the stated goals of affordable, universal health care. Battles of ideology aren't helpful. The argument moved on from socialism vs. capitalism years ago. For proponents of Von Mises anything that doesn't promote laissez faire economics is socialist. That is a distortion that feeds into negative connotations and paranoia surrounding communism, left over from the time Von Mises wrote many of his books in the 50s, 60s and 70s. The Von Mises Institute itself has stated its goal is to "undermine statism in all its forms".

    This hub is not a defence of socialism or "statism". It's a critique of applying the Von Mises school of thought to health care, and how the goal of trying to "undermine statism in all its forms" does not lend itself well to solving real world problems with realistic solutions. Those solutions may fall into a category that can be called socialism, but so be it. The usefulness of a solution is more important than the label placed on it.

    Promoting solutions because they conform to an academic school of thought causes politics to become "rigid, dogmatic and doctrinaire". Proponents of Von Mises present that school of thought in a way that suggests a laissez faire economics can solve all the problems facing the world. I believe that idea is wrong. Indeed, I believe the idea that a school of thought (whatever it may be) can solve all problems is outdated and unhelpful.

    Problems are multifaceted and what is needed are not socialist solutions, or libertarian solutions or institutes whose goal is to "undermine statism". What is needed are multifaceted, pragmatic solutions that work. Nothing more, nothing less.

  • ledefensetech profile image


    11 years ago from Cape Girardeau, MO

    Actually those posts do address why costs are going up. The fact that you don't believe socialized anything causes costs to go up keeps you from seeing that.

    It was the CRA coupled with things like Fannie and Freddy, which gave banks a place to dump bad loans, that caused this mess. Again, you don't believe that government can do any wrong, so you don't see it. That's great, if you don't want to believe it, that's your right. But the only way to fight bad information is with good.

    Besides, if we do wind up going down the road of socialized medicine, I'll be able to give a big "I told you so" in a few years. By then I'll have completed school and opened up a medical tourism facility with my relatives in Mexico, so we, at least, will be OK.

  • Don W profile imageAUTHOR

    Don W 

    11 years ago

    Misha - Helping the vulnerable is an aspect of civilised society. If there was a vulnerable person without food I'd first expect YOU to help them, then I'd expect you to find out what your government was doing to help.

    The bottom line is that individualism, greed and selfishness do not work. It was individualism, greed and selfishness on the part of financiers, investors and borrowers that caused the current financial mess. Systems based on those attributes fail. It's time to stop being precious about our favourite "isms" and start looking at working solutions.

  • Don W profile imageAUTHOR

    Don W 

    11 years ago

    ledefensetech - that doesn't actually address any of the points made. It is undeniable that with private run health care profit is the main driver, and leads to attitudes like this: "Subsidies for the ill and diseased promote carelessness, indigence, and dependency". That one sentence is everything that is wrong with the free market approach.

  • Misha profile image


    11 years ago from DC Area

    I love this "health care is a necessity" argument. Food is much greater necessity. Do you want your government to provide food for you, too? :)

  • ledefensetech profile image


    11 years ago from Cape Girardeau, MO

    So why is it that in the early 20th century when 90 percent of hospitals were for profit, that we didn't have the runaway costs associated with healthcare today when 90 percent of hospitals are socialized?

    Note especially what Freidman calls Gammon's Law, it explains not only why Britons have to wait so long for healthcare, but also explains why we, increasing the amount we spend per student on public education, and yet the quality of students we get decreases year by year.

  • Don W profile imageAUTHOR

    Don W 

    11 years ago

    The answer to the question you start with is: lack of choice combined with the nature of health care, i.e. it's necessity. You can choose not to buy a new stereo system and suffer the consequence of not having a new stereo system. A monopolised market cannot force you to buy a stereo. You can also choose not to buy health care and suffer the consequences of not having health care. However the consequences of not having health care include disability, incapacity and death. That's the leverage right there. Having a choice between an overpriced, unfair health care policy and death isn't really a choice. It's more akin to extortion. So it's the nature of health care that serves as the mechanism that forces people to buy regardless of price and service. Over-priced, bad service beats illness and death.

    I didn't suggest "because a person seeks profit, that is an evil in and of itself", I suggested adopting a free market model for health care makes profit the main driver, and there are serious moral and ethical implications to that.

    I don't agree that "Profit is, rather, an indication that the entrepreneur is doing something that people like". I think it can also be an indication s/he is doing something people don't like but have to put up with because they have no choice.

    By "government-backed monopoly" I assume you mean the public option. If that is included in the bill (chances are it won’t be) it would have quality targets and would be competing in the same market, with the same rules as other for-profits and non profit groups.

    I don't make any claims about the "evils" of capitalism. That’s putting words in my mouth. I’m just suggesting the problems as I see them of a free market system as applied to health care. This is not about capitalism per se. There are pitfalls and benefits of capitalism (or any ism you care to mention), but that's a whole other discussion.

    So "How do you force someone to make a choice they otherwise would not?", I think I've already said. Simple. Give them the choice between what you're offering or illness and death. Amazing how many people will choose what you’re offering over death. The current proposals are simply about changing that dynamic, about giving people a real choice and about allowing private companies to make profit, but shifting away from profit as the main driver of health care.

    Thanks for reading and commenting ledefensetech.

  • ledefensetech profile image


    11 years ago from Cape Girardeau, MO

    You're right Don, about the whole monopoly angle, but what mechanism allows a monopoly to force people to purchase their goods and/or services? Or more to the point, what is the mechanism in a free market society, if there is one and what is the mechanism in a controlled market society?

    You also assume that just because a person seeks profit, that is an evil in and of itself. Profit is, rather, an indication that the entrepreneur is doing something that people like, thus most sovereign customers are willing to continue the business relationship with a particular business entity. This does not hold true in which a government-backed monopoly exists. People are not commodities, but individuals that a company has to provide a good service to, otherwise they'll lose the custom. It's only in centralized bureaucratic environments that you see people relegated to numbers.

    If you really look hard at the problem, you'll see that many of the evils you claim come from capitalism actually come from interference in free markets. You talk about greed and mammon, but don't provide any concrete examples of what keeps a person going back to a particular company for goods or services. That is the issue here. How do you force someone to make a choice they otherwise would not?

  • Don W profile imageAUTHOR

    Don W 

    11 years ago

    It's something some people seem to miss, or just ignore. Thanks for your comment.

  • William R. Wilson profile image

    William R. Wilson 

    11 years ago from Knoxville, TN

    You said it!

    "let profit be the main driver in health care as apposed to the virtue of keeping people healthy and you effectively de-humanise people, whose health becomes no more than a commodity. The logical conclusion being that life itself (the product of health) is a commodity. The dimminishing of the human to that of commodity is one of the more serious problems of this approach."


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