Tuesday, September 1, 2009

Hsieh OpEd: "The Free Market Is Not Another Form of Rationing"

PajamasMedia has just published my latest OpEd on health care:
"The Free Market Is Not Another Form of Rationing"

Here is the introduction:
As the health care debate rages, many conservatives have correctly argued that government-run "universal care" will lead to medical rationing. To control costs, the socialized health systems of Canada and Great Britain routinely restrict patients' access to expensive services. A Canadian with a possible brain tumor might wait months for his government-approved MRI scan, whereas an American can receive one within days.

Liberals will typically counter that a free market is just "another form of rationing" -- but by price rather than government decree. It is unjust, they say, that patients with money (or good insurance) can receive MRI scans whereas those without money cannot. Hence, they contend, the government must intervene to guarantee a supposedly fair distribution of medical services.

Too often, conservatives then concede this moral high ground to the liberals and defend the free market on purely economic grounds -- e.g., a free market would lower costs for everyone. This is a serious mistake. Supporters of the free market should not allow opponents to characterize the marketplace as a form of rationing, let alone an unjust one. Instead, supporters should defend the free market as morally just because it respects individual rights...
(Full text of "The Free Market Is Not Another Form of Rationing".)

Some commentors have stated that this argument of rationing is just "linguistic". I disagree, and in fact that's the key point of my piece.

It's similar to the fallacy some people commit when they claim that newspapers choosing to publish some pieces and not others is "just another form of censorship". That's completely wrong. Their uncoerced choice to publish one piece over another is the exercise of the right to free speech. In contrast, it would be censorship if the government told the newspaper which pieces they could not publish (or were required to publish).

Similarly, it's a serious category error to equate uncoerced exchanges in a free market with rationing. Rationing inherently involves compulsion, which is the exact opposite of the free market. The market is how we exercise our rights, and rationing is wrong precisely because violates those rights. (Thanks to Tom Stone for this analogy.)

I'd like to thank Craig Biddle for his comments on an earlier version of this piece. Diana, Ari Armstrong and I have also had several discussions on this subject, and Ari has written a series of blog posts on this topic.

The brief Ayn Rand quote comes from:
Ayn Rand, Letters of Ayn Rand, “Letter to Bill Mullendore,” (New York: Dutton, 1995), p.322.

Update: Thank you, Glenn Reynolds, for the Instalanche!