Perhaps the most interesting thing about Libertarian views on healthcare – or on any issue for that matter – is that they draw key factors from the platforms of both the Democratic and Republican party. While discussing Libertarian views on a topic as broad and complex as healthcare, it is important to note that most views cannot be articulated simply. Rather, they require a degree of nuance to be voiced accurately. On a very generalized basis, Libertarians lean towards Democratic ideals on social issues and Republican ideals on fiscal issues. Since healthcare walks the line between these two, it is a particularly convoluted issue.
Democratic Views on Healthcare
To start with, though, let’s attempt to assess the positioning of the two major (or, perhaps more honestly, larger) political parties. Democrats and Liberals, generally, favor a positioning that they believe focuses on the care and needs of the people. While many may not support legislation that would create a Single Payer Healthcare System (generally the more moderate among the Democrats), there are a substantial number who do. The logic that supports such thinking can come from a variety of places: the idea that the government has an obligation to provide for the care of its citizens, that medical care is a basic human right, and that the idea of a lower or middle income family going bankrupt pursuing medical care is immoral in the extreme. Even among those Democrats and Liberals that don’t favor a Single Payer solution, there is a strong support for government protections and regulations – particularly looking towards preexisting conditions and appropriate safeguards. Thus, the general support for the Affordable Care Act (ACA) despite the fact that many Liberals still recognize it as an imperfect solution to a complex problem.
Republican Views on Healthcare
What about the Republicans and Conservatives in general, though? Well, while they do want to remove the government from many aspects of public life, many Republicans are willing to abide by the idea that certain areas of Healthcare do merit legislative action. While the ACA may be openly decried by Republicans, certain aspects of the legislation (such as certain protections for pre-existing conditions) do carry worth in the eyes of some. And, for many, this is the area where the divide between Republican views and Libertarian views on healthcare might be best articulated. Presently, Republicans are attempting to pass the Graham-Cassidy bill in an effort to dismantle the ACA (or Obamacare, if you prefer). However, Rand Paul (one of the more Libertarian-minded conservatives in the Senate) has pointed out this is an effort that will continue much of Obamacare. “Rand Paul, a definitive ‘no’ on Senate Republicans’ last-ditch effort to repeal and replace Obamacare, ‘won’t be bribed or bullied’ into supporting the bill, the Kentucky Republican said Friday. ‘Calling a bill that KEEPS most of Obamacare ‘repeal’ doesn’t make it true. That’s what the swamp does,’ Paul tweeted. ‘I won’t be bribed or bullied.’” The reality, then, seems to be that the goal of the Graham-Cassidy bill is less to dismantle Obamacare, and more to shift much of the funding and authority into the hands of the states. And, again, this may be the best place to observe a separation between the general Conservative mindset and that of Libertarians specifically.
Libertarian Ideals for Healthcare
What, then, would be the ideal solution from the Libertarian mindset? If the present Democratic effort is concerned with maintaining the existing ACA or shifting to Single-Payer, and the present Republican effort is concerned with weakening the ACA and shifting power to the states – where do Libertarian’s stand that is apart from these two positions? In essence – they take what was once a common Conservative line, but they hold to it (and even push it farther). Much of the Libertarian philosophy centers around the restrictive, limiting nature of government regulations. The view is that government intrusions into personal life are unmerited, and that government intrusions into professional life (including, in this case, medical care and pharmaceutical research) are detrimental to the public good. To this end – Libertarians generally feel that the government’s role in Healthcare should be diminished to as little as possible. To draw the Libertarian Party’s official site: “Government inappropriately controls our healthcare in many ways: Government and a handful of insurance companies have a virtual monopoly as payers. Because of this, they make most of the decisions about what kinds of healthcare are available. Government regulates where, when, and who may open new healthcare facilities. Government agencies greatly slow development of and access to new medicines, devices, and technologies that may improve quality of care and reduce cost of care.”
Healthcare as a Monopoly
The idea of a corporate monopoly is fairly easy for most to understand: a business that has dominated a portion of the market to the extent that they can control the prices and fear little in the way of competition. The Libertarian view that Healthcare represents a type of monopoly supported by the government, while objectionable to many, does carry a degree of truth. The ACA, and many other laws and pieces of legislation, are targeted at regulating the market. And while this doesn’t place a singular company on top, it does severely restrict how these companies function, how they conduct research and pharmaceutical trials, and how they provide care to those they serve. In essence, then – one could argue that the removal of these barriers to research and customer access could serve to trigger rapid medical advancements and greater patient access to care. Taking the argument just a bit further, one could also argue that by increasing patient’s ease of access we could see a reduction in costs. In essence, this view harkens back to the argument that the unrestrained market can act better for the people than any attempted government meddling will.
A Flawed System
What’s interesting to consider, though, is that while Democrats, Republicans, and Libertarians may each carry quite different views of the appropriate approach to fixing the Healthcare system – none of these three groups are denying that the existing system carries significant flaws. And while each group holds a different mindset regarding how to resolve these problems and repair these flaws, they each retain a commitment to advancing their agenda in the hopes of doing so. For Democrats, that largely means efforts to either repair flaws in the ACA or attempting to advance a Single-Payer alternative. For Republicans, at the moment, that means putting more of the power in the hands of the states. For Libertarians, though, which are the core consideration of this piece, the power truly resides in breaking away from reliance on the both the state and federal governments. Instead, they would hold that we should be allowing the market to serve the people and the people to choose their own paths forward. And while the issue of Healthcare remains inherently complex, there may well be a ring of truth in that sentiment.
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