The Libertarian Standard » Health Care Property - Prosperity - Peace Sat, 16 May 2015 17:42:43 +0000 en-US hourly 1 A new website and group blog of radical Austro-libertarians, shining the light of reason on truth and justice. The Libertarian Standard clean The Libertarian Standard (The Libertarian Standard) CC-BY Property - Prosperity - Peace The Libertarian Standard » Health Care TV-G The Unintended – But Expected – Consequences of Obamacare Fri, 27 Sep 2013 09:54:50 +0000 The Patient Protection and Affordable Care Act – aka Obamacare – was expected by economists to cause economic changes.  (Here is the act in a handy 906-page .pdf file.)  Some predicted lower employment, either from employers’ reducing employees’ hours to keep them from being deemed full-time, or simply by firing employees whose marginal productivity isn’t more than the $300+ additional cost, per month, of complying with some of the employer mandates.

Put simply, mandating increased per-employee costs will cause employers to react, and the employees most at risk of losing hours or jobs will be the ones with the lowest productivity:  the minimum-wagers the government says it’s trying to protect.  Any time the government takes control of (more of) an industry, the result inevitably will be unintended consequences. People seek to do what produces the best outcomes for themselves; we are not the static, obedient walking statistics government pretends we are.  We actively seek ways to avoid burdens, because we need to feed our families.

Obamacare provides that employers cannot reduce employee wages to avoid the additional costs imposed on the employers, and every employer with 50 or more employees must participate in providing health care or face punitive fines. Individuals who are not covered by a welfare program (Medicare, Medicaid) or by their employer must purchase their own insurance on the new “health care exchanges” to be set up by the states, or pay a fine along with their income taxes every April 15.  Who are the people who don’t want medical insurance?  Healthy young males, who are expected to pay as much as $5,800 per year, essentially to subsidize health care for the poor and sick.  Their penalties will be far lower than that, at least at first, that we know of.  What do you think they will choose?

Enough about the act.  You can read about it from the links above.  Here are the consequences:

Those of you who told Trader Joe’s you won’t shop there any longer because they’re not covering health care for their part-timers should first read Trader Joe’s explanation (Trader Joe’s will give the employees cash and let them shop for themselves; that way, the employees get a tax break, and at any rate Trader Joe’s can’t offer the giveaway deal the government is forcing on everyone); and second, should be prepared not to shop in very many places any more:  Forbes writes of Walgreen and 17 other large retailers doing the same thing. Worse, 301 employers (that we know of so far) are cutting employee hours and firing people.  The most perverse part of that:  62 of the employers are private-sector, and 239 are government employers, including school districts.  In one survey of small businesses, 41% have delayed hiring, 20% have reduced hours, and 20% have reduced payroll, all because Obamacare would be too burdensome otherwise.

Another unintended consequence of creating government tax-and-spend “giveaways” that (as we saw above) threaten to harm the poor more than the rich:  Fraud.  Obamacare-related scams were and are being predicted—by federal officials, no less.  Thieves are expected to prey on the poor, the old, and the ignorant.  The fear is strong enough that the White House and the Justice Department have felt the need to reassure the public, with DOJ having to build a special initiative around the issue.  Here’s a list of the scams that have already been reported to law enforcement.

Some unintended consequences were not predicted by many, if at all.  Labor unions, the darling of the political left, are stung because they somehow could not foresee that employers would cut hours; and the Obama administration remarkably has refused to add special subsidies for them.

A headline from the notoriously left-leaning Pew research center:  Most uninsured Americans live in states that refuse to offer their own health insurance exchanges.  The people the government claimed it most wanted to help are going to have to use the federal exchanges.  (The real problem here, if you consider it a problem, is those people are the ones least likely to know they can use the federal system.)

Here’s a wild one:  Since Obamacare was enacted in 2010, 21 states have enacted new laws—and the federal government is powerless to stop this—banning private-insurance coverage of abortions.  THAT was certainly unexpected.

Obamacare subsidizes the health care of people who stay below certain income maxima.  The obvious and foreseeable unintended consequence of that, of course, is that some people at the margins will face incentives to earn less.  A dollar of additional income, for some, will mean losing a $5,000 subsidy.  It would be foolish for anyone facing that choice to work an additional hour and lose almost $5,000.

Finally (for now), employers who have just over 50 employees will fire workers to stay below that magic number and avoid the extra burdens, as several of the links above demonstrate.  If a CEO and board of directors will sell their bank, aggressively take the risk of buying other banks, or sell assets to avoid certain burdens that come with size under the Dodd Frank Act, a small business owner whose business feeds his family will certainly fire workers to avoid Obamacare.

There will be more unintended consequences, both expected and unexpected. I’ll stop here.  (Just one more:  To be able to continue to make a profit—i.e., stay in business—insurers are going to limit the insureds’ choices of service providers.)  I’m not even the first person to write about this; many of the links above are to articles with “Obamacare” and “unintended consequences” in their titles.  I’m just the most recent to write about it, so I have the newest data.  Google “unintended consequences of Obamacare” regularly for updates.  The insurance exchanges open October 1, so the coming months will be a busy time for discovering new problems with government medicine (or rediscovering known ones).  We appear doomed to repeat the inescapable history of government intervention proved sour, so we might as well be informed about it.

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Finding affordable dentist like pulling teeth? Fri, 01 Feb 2013 15:27:18 +0000 It must be for some. And one man, 63-year-old Jose Santiago Delao of Texas, was willing to provide dental services on the cheap, despite not having a license. Eventually he landed on the authorities’ radar and was arrested following a complaint from a woman about a botched molar repair:

Delao admits he skirted the law, but isn’t remorseful.

“Jesus Christ didn’t need or didn’t have a license,” Jose Delao told Yahoo News during a jailhouse interview. “People hurt and they needed it. People didn’t have enough money to visit the regular dentist.”

Delao, a former dental lab technician, claims he couldn’t turn his back.

“It broke my heart,” he said, tapping his chest, “because I have the experience.”

But authorities say Delao, a native of Costa Rica, has never been a licensed dentist in Texas. If convicted, he could get two to 10 years in prison….

A survey of published news reports shows that as many as eight such underground dental clinics have been shutdown in the U.S. since last summer.

“I would clearly classify it as a problem,” said Dr. Frank Catalanotto, chair of the Department of Community Dentistry at the University of Florida. “It is potentially a big problem.”

I disagree that the problem is unlicensed dentistry. The problem is that there is obviously a market demand for low-cost dentistry that isn’t being met, probably because the barrier to entry in the field as a state-licensed dentist is so high, a barrier which licensed dentists have a vested interest in maintaining, as it protects their market share from would-be competitors like Delao. But people are far more likely to be uninsured for dental care than for medical care, or simply can’t afford to pay the high prices of mainstream dental work. Delao understood this and tried to meet the need, to his credit. He may have committed some crime (if, as the story reports, he did not let a patient leave when she wanted to), but trying to help people isn’t one of them.

(Cross-posted from A Thousand Cuts.)

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The crusade to humiliate women takes a sinister turn Tue, 21 Feb 2012 19:46:19 +0000 If a law currently up for vote in the Virginia House passes this week and is signed by Governor Bob McDonnell, it will require many women seeking an abortion to be raped.

No, you didn’t misread that.

The bill, which is similar to laws passed in seven other states, requires women to undergo an ultrasound procedure before an abortion is performed.  The ultrasound is not medically necessary; it has not even been rationalized as such by the bill’s defenders.  It is simply another tactic adopted by anti-abortion crusaders to humiliate women, in the hopes that they may change their mind about going through with the procedure.

But since most abortions are performed in the first trimester, and abdominal ultrasounds are not able to produce a clear image of the fetus in most cases, Virgina’s law mandates the use of transvaginal ultrasound – that is, a probe must be inserted in the women’s vagina to view the fetus.  Women cannot refuse this if they want to get an abortion, and the law does not allow for any exceptions such as rape or to protect the woman’s health.

I can’t even imagine what a rape victim who has become pregnant might think of this, after having already been violated once, and then being told by arrogant politicians that she must be violated again in order to undergo a commonly available medical procedure.  It also forces her doctor to perform a procedure that is not medically necessary, and violates their oath not to cause harm to their patient.  As one Virginia House Delegate pointed out, the bill may actually require doctors to sexually assault their patients, as it is a crime to vaginally penetrate women with any object without their consent.  (To add insult to injury, the woman must also pay for this state-mandated procedure.  Where’s Obamacare when you need it?)

It’s not even cognizant of the doctor-patient relationship that is generally so well-respected – except when women’s medical choices are involved.  Then it’s absolutely imperative that the government asserts jurisdiction over a women’s vagina, to ensure she’s actually making the best medical decisions for herself.  It’s not just humiliating; it is paternalistic in its very worst sense.

Note that I haven’t even addressed the issue of abortion itself.  That is because regardless of where one stands on abortion – if one considers it murder, or the right of a woman to make decisions regarding her own property (i.e., her body) – this intrusion by the state into private medical affairs, which would not be tolerated under virtually any other circumstances, is simply not justifiable.  And perhaps anti-abortion crusaders are aware of that, and are adopting these tactics to set up a constitutional challenge that leads to a Supreme Court review of Roe v. Wade, hopefully this time to overturn it for good.

Regardless of the anti-abortion camp’s motives, their degrading and humiliating tactics are despicable.

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Helmet Laws and Needless deaths Mon, 04 Jul 2011 16:49:46 +0000 Yahoo News reports the death of a motorcyclist during a protest ride against New York’s helmet laws. While it is certainly tempting to simply cite this as a case of someone “asking for it” and getting it, consider the specifics of this case: Philip Contos was riding without a helmet at this place and at this time specifically because he was protesting against the state. Whether or not he normally wore a helmet, even, is irrelevant. He would not have been riding there and then if not for the state. The sad truth is that protesting laws against risky behavior unfortunately requires actually engaging in risky behavior. I, a nonsmoker, despise anti-smoking laws. How could I protest against these laws, however? By engaging in the banned behavior is the most obvious way. So, too, with helmet laws.  At minimum, Contos’s death, whenever it would have happened, would not have happened at that time at that place, under those circumstances, except for the meddling of the busybodies who claim the right to decide what is best for a 55 year old man.

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On Rand Paul and Slavery Sat, 14 May 2011 01:48:44 +0000 Reason’s Matt Welch criticizes Rand Paul for Paul’s assertion that the right to healthcare implies slavery. While it is true that in minds of many, the term “slavery” specifically refers to chattel slavery as practiced in the United States prior to the end of the American Civil War, the term itself is not so limited. And this is not the first time that a prominent person has used the term in regard to employment restrictions: Curt Flood was well known for saying “A well paid slave is nonetheless, a slave.” The same applies here. Indeed, I have compared modern attitudes and events to slavery myself, more than once. Of course, there are critical differences between Rand and Flood and myself, with melanin levels likely being the most important one. But just as Flood’s comparison in the past was apt, so to is Paul’s comparison in the present an accurate description. It is easy to see that there have been far worse tortures in the past than waterboarding, or even beatings, but I would certainly still call the latter “torture.” So, too, would I call forced labor of any sort “slavery.” Wearing a smock rather than rags does not change the name.

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Article: Healthcare Is Not a Human Right Tue, 19 Oct 2010 03:49:36 +0000 Of all the arguments favoring the coordination and control of the healthcare industry by the central planning agency of the state, the healthcare-is-a-human-right argument seems to be the most convincing one, even to those who may favor a free market approach to the problem of coordination of scarce health resources. How can we as a society possibly deny healthcare to someone in need? Shouldn’t the state assume that task?

Gabriel E. Vidal is the chief operating officer of a hospital system in the United States. He has a BA in politics, philosophy, and economics and an MBA in finance.

Read the Full Article by Gabriel E. Vidal

Afterwards, discuss it below.

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Grading the Pledge to America Fri, 24 Sep 2010 05:01:39 +0000 So….the Republicans have put out their Pledge to America. Is it any good?

Jeffrey Tucker sums it up pithily by juxtaposing short quotes from it and the Declaration of Independence:

Declaration of Independence (1776): “That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it…”

A Pledge to America (GOP, 2010): “Whenever the agenda of government becomes destructive of these ends, it is the right of the people to institute a new governing agenda and set a different course.”

If this goes on, related fellow TLS blogger Daniel Coleman to me, in another 100 years it will be “Whenever a subpoint of policy within a government agenda becomes destructive to these ends, it is the right of the people to organize a committee to change those subpoints of policy and replace them with better subpoints.”

Liberty Central, the Establishment’s attempt to co-opt the Tea Party, has a poll asking us to grade the Pledge. Head on over there and tell them what you think of it. Fellow TLS blogger Jacob Huebert has a couple of good posts on about Liberty Central, the Tea Party, the Pledge, and Glenn Beck.

The Liberty Central poll only lets you grade the Pledge as a whole. Here is a quick graded breakdown of important aspects of the Pledge, with short reactions by me in parentheses:


  • Stop job-killing tax hikes — Grade: A. (It’s a start, but better to abolish taxes.)
  • Allow small businesses to take a tax deduction equal to 20 percent of their income — Grade: A. (Ditto.)
  • Require congressional approval for any new federal regulation that would add to the deficit — Grade: C.  (How about no new regulations period? Better yet, repeal all existing ones.)
  • Repeal small business mandates in the new health care law. — Grade: A.

Cutting Spending

  • Repeal and replace health care reform law — Grade: Unknown, probably B or lower. (Replace with what?)
  • Roll back non-discretionary spending to 2008 levels before TARP and stimulus (will save $100 billion in first year alone) — Grade: B.  (Should roll back more.)
  • Establish strict budget caps to limit federal spending going forward — Grade: B, maybe C.  (How strict? Will these caps be lifted periodically like the national debt ceiling?)
  • Cancel all future TARP payments and reform Fannie Mae and Freddie Mac — Grade: Unknown, no higher than a B. (Reform Fannie and Freddie how? Better to abolish them.)

Reforming Congress

  • Will require that every bill have a citation of constitutional authority — Grade: C. (Won’t stop Constitutional-but-still-bad bills, and the Constitution is a “living” document anyway.)
  • Give members at least 3 days to read bills before a vote — Grade: C.  (Little impact; they still won’t read them.)


  • Provide resources to troops — Grade: F. (Get troops out of foreign countries. Cut the military and intelligence budgets.)
  • Fund missile defense — Grade: F. (Worthless boondoggle.)
  • Enforce sanctions in Iran — Grade: F.  (Act of war.)

Overall: F. The military provisions outweigh the good things. How about ending the War on Drugs, rolling back the surveillance and police state, and ending aggression against immigrants? In any case, put not your faith in campaign promises.

I think I’m being generous. What do you think? How would you grade the Republicans’ Pledge to America?


Cross-posted at Is-Ought GAP.

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Back to Basics: Self-Ownership and Organ Donations Sat, 07 Aug 2010 19:27:45 +0000 Ronald Bailey, over at Hit & Run, asks, “Should a person who is dying of an incurable illness be allowed to donate his organs before the disease kills him?” This strikes me as a very odd question to ask, especially given who is doing the asking. Hit & Run is the blog for Reason Magazine, a publication I have been led to believe has some libertarian bent. Yet, oddly, it seems they are still mulling over the most fundamental principle of libertarianism: self-ownership.

Once it is recognized that the fellow from the story, Gary Phebus, is a self-owner, the answer to Bailey’s initial question becomes blindingly obvious – a resounding yes. What would it mean to be a self-owner but be unable to use one’s body and its parts as one wished? Surely, any libertarian must recognize the right to commit suicide and the right to donate one’s organs after death, which is all this amounts to. Why the struggle?

But maybe what Bailey meant to ask is “should a person who is dying of an incurable illness donate his organs before the disease kills him?” Note the difference between these two questions: the former asks whether we should restrain someone by force from donating their organs, while the latter asks whether someone should choose to donate their organs.

On this question, I must part ways again with Bailey who says,

On the one hand, it is certainly wrong to take a vital organ, even if given voluntarily, from a healthy person. On the other hand, Phebus is not healthy. In any case, harvesting organs from Phebus would violate the medical ethical principle: “First, do no harm.” Phebus’ generous impulse moves me, but I fear that honoring it would create dangerous precedents.

First, I am not sure it is certainly wrong to take a vital organ, if given voluntarily, from a healthy person. What if a healthy, 60 year old grandmother has a 10 year old granddaughter who needs a new heart to survive, but the line to get a new heart is so long (thanks to government prohibition of organ markets, of course) that she has only a slim chance of surviving? Would it be certainly wrong for the doctors to take the grandmother’s donation to her ailing granddaughter? I cannot see why. Indeed, I would think that the grandmother is not only acting in a permissible manner, but in an admirable manner, and a doctor who refused to allow this would seem to be cold and cruel.

But this case seems even more in favor of the donation going through given the point that Bailey himself acknowledges: the donor is not healthy. He suffers from an incurable disease that will cause him to painfully waste away for the remainder of his shortened life. This is a case where even mainstream thinkers can often justify euthanasia, yet Bailey is balking at someone throwing in that he will also donate his organs? What’s going on here? How can adding beneficence and charity to the act harm the case in favor of euthanasia?

The last two sentences seem to take a swing at answering that, with an appeal to the principle of nonmaleficence and the “dangerous precedents” involved in breaking it. I think, however, even on his own terms, this should be permissible. I do not see what harm is done by the doctors in accepting the donated organs; this seems beyond question. What Bailey is really referring to is the ethics of euthanasia, a topic far too in-depth and complex for a full treatment in this blogpost. I will make one point on this though: it does not follow that by shortening someone’s life, you do them harm. Few people believe that we should extend our life at any cost and I doubt very much that Bailey is one of them. If one can live a shorter, more virtuous and happy life, that is preferable to living a longer, more vile and miserable life. So it cannot be said that a doctor who gives his patient the ability to choose the former over the latter does him harm, indeed, it would seem that a doctor who prevents his patient from taking that course is the one who does harm.

Finally, it would seem to me that the most dangerous precedent of all that can be set in this case is to prevent Mr. Phebus from doing with his body what he pleases and thereby denying the essential right of self-ownership.

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The Coming Obamacare Healthcare Inequality: Concierge Medical Services Mon, 31 May 2010 23:20:54 +0000 My wife and I have a great doctor. She has a small clinic nearby with a few other doctors, who are also all very good. Our doctor has a waiting list for people who want to be her patient. We have over the years recommended several people, even some who live 20 miles away, to her. She is very nagging–in a good way. She makes you promise to get a physical, eye exam, etc., intervenes to get you an appointment with a specialist if you need one, etc. Follows up by phone, and so on. She is great.

She recently announced to us that she is moving to some kind of “concierge” service–she figures she basically provides that kind of above-average service already, and this is a way to reduce her patient load (from about 4000 to about 400), and escape some of the regulatory burden that Obamacare is going to impose. So she’s picking a select group of her current patients–about 10% of them–and they will be allowed to remain her patients–for $1600/year each. Now, we love our doctor, so will probably do this. And 3600 of her patients will now lose their favorite doctor. Thanks, in part, to Obamacare.

So, you can see what’s coming. The affluent will have to pay more–in our case, $3200 a year more–but for even better service than we already get. And others will have increasingly slim pickings. Case in point, I mentioned this to some friends, and my TLS co-blogger Brian Martinez noted: “This is what my wife’s doc did, too. Went to a concierge system. Unfortunately we couldn’t justify the extra expense and pay for health insurance for the rest of the family. So my wife had to leave her doctor of 10 years and find a new one, and she hates to switch doctors.”

Expect to see more of this. I had never heard of it before and am still waiting to hear the details from our doctor (some information will be mailed later), but a google search revealed that this is indeed a growing trend; see Health care reform laws prompt surge in ‘concierge medicine’, Are Concierge Medical Services on the Upswing?, and Royal Pains: Can Concierge Medicine Coexist With Obama’s Healthcare Plan?

So, Obamacare will only exacerbate healthcare “inequalities,” and diminish the quality of care of many people. The government will then use this as an excuse to bash “greed” and “inequality,” and clamp down further, driving us closer to outright socialized medicine. As one of the articles above noted, “Critics say boutique medicine will only exaggerate the health insurance crisis. Many doctors may leave traditional family practices — widening the gap between the affluent and the poor.” As Martinez noted to me, “You know all the good doctors with wealthy patients will follow this route and as you say it will prompt the regime to crack down on this ‘greedy’ practice. [expletive deleted] Obama.”

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Article: What’s Really Wrong with the Healthcare Industry Sat, 29 May 2010 12:30:36 +0000 The real problem with the American healthcare system is that prices are continually rising, making healthcare unaffordable to an ever-increasing fraction of the population. And recent healthcare legislation has addressed none of the causes of high prices.

Read the Full Article by Vijay Boyapati

Afterwards, discuss the article below.

[The article is also available at]

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