Since all statist policies are interrelated, let’s analyze their nature by dealing with three that affect us severely in one way or another: the drug war; prescription drugs and devices; and, regulatory licensure in the health care industry.
Thou Shalt Not Alter Your State Of Mind, With Exceptions
The so-called War on Drugs has been an abysmal failure. It has failed to curtail the supply of and demand for illicit drugs. It’s also failed miserably to respect rights, though that assuredly wasn’t its goal. Each individual has a right to purchase items from others and to use those items as he or she desires, while respecting the rights of others. Any government that attempts to deny this simple fact by making certain items illegal to purchase and possess, simply drives this aspect of the free market into the black market.
Thus, the bigger the drug war becomes, the worse conditions on the black market become. People who work in the supply chain of illicit drugs, from growing or manufacturing them to delivering and selling them, have to spend time and resources eluding capture by the drug warriors and literally fighting for market share through gang-related turf battles, as well as bribing cops. Supply costs thereby increase drastically, and drugs become incredibly more expensive than they would be in a free market. The high prices in a black market for otherwise cheap substances encourage both dealers and users to do many immoral and unjust things, in order to keep doing business and keep getting their fixes. But this isn’t the half of it.
By far the worst effects of the drug war are the consumption of billions of tax dollars, further corruption of police and other governmental agencies, and substantial increases in rights-violations inflicted on the entire citizenry, as well as drug suppliers and users. Many innocent people are harassed, spied on, searched, and generally disrespected—and of course their time is wasted in the process. Others less fortunate are falsely accused and arrested, falsely convicted, injured or even killed, and their property is ruined or seized. Police and DEA officers generally commit these egregious rights-violations with impunity. In the police club, where monopolized and tax-funded membership has its privileges and immunities, paid leave is considered a strong penalty for harming or killing innocent people. “To protect and serve—those in charge” is plainly their real motto.
Of course, those actually involved in the black market of illicit drugs face the brunt of the drug war; the rest of us are considered collateral damage—as are all innocents in all wars. A sizable percentage of all drug law offenders (up to a quarter or even a third, though the statistics are hard to pin down because crimes such as theft are categorized as non-violent) have committed no aggression on their fellow citizens, no physical violence or property rights infringement. Those who have aggressed against others are arrested and incarcerated primarily because of robbery for drug money, drug deals gone bad, and fights over turf.
Drug law offenders’ prison sentences may also be more severe than sentences for criminals who’ve been convicted solely on the basis of aggression against others and their property. Around a quarter of inmates in state prisons and about half in federal prisons in America are there because of drug related offenses. That translates into many hundreds of thousands of people, or millions if you count the entire corrections system, including those on probation and parole—all stemming from prohibition laws. Disputes over the statistics don’t really matter, though, because the principle of individual rights still stands: Even if one person’s life is ruined and he or she is put in a cage for doing something in which there’s no complaining party (no victim), then members of the justice system, particularly judges, police officers, and jailers, reveal themselves to be the real criminals.
As the drug war has stepped up its enforcement over the last few decades, inmate numbers have increased in concert, and so have prisons, prison guards, probation and parole officers, administrators, and corrections facilities. Many of these groups, after all, have big unions with highly motivated lobbyists.
Clearly, there are two types of people who really want to continue the drug war: people who work in law enforcement and people who sell drugs. Curious bedfellows aren’t they? Both drug warriors and drug dealers make their living from drug prohibition. Meanwhile, politicians constantly mouth platitudes about keeping the streets safe for our children.
The demand for drugs obviously drives the supply; without a demand, there would be no market for suppliers. Prohibition just creates extra difficulties and costs for suppliers, and hence, higher prices for buyers and, in turn, higher profits for dealers. But the drug warriors don’t care about these basic economic facts. They care about the immorality of those who sell, buy, and use certain drugs, similar to the alcohol warriors during that failed attempt at prohibition. Since they see such behavior as immoral, no amount of economic arguments will change their minds, especially when they’re making their living via prohibition laws. Ironically, they don’t see their own behavior as immoral and unjust, even though it involves violating people’s rights in the most intense manner. Such is the nature of governmental force.
I recently heard a drug prevention advocate during a radio interview say that he didn’t care how much the government spends on the drug war—it’s for the good of the people! In other words, he didn’t mind the previous hundreds of billions of tax dollars used, and he doesn’t mind squandering billions more to fund his crusade to supposedly make the world a better place. Of course, he never said anything about contributing any of his own money. The stupidity in his viewpoint was not in wanting to make the world a better place. Rather, it was in trying to prevent people from making voluntary exchanges and ingesting certain substances; it was in wanting to initiate aggression against those he deemed immoral. This is the sort of hypocrisy that turns morality on its head.
Here’s a revealing international fact: Despite Iran’s Islamic government’s draconian laws against anything deemed immoral, such as drugs, it’s considered to have the highest per capita use of heroin. Ultimately, legislating morality, in the name of whatever religious dogma, can never achieve the desired results. Forcing harmless people to do things, or not do things, against their will is itself the primary immoral act. To deny people’s use of their own judgment (hypocritically judging their judgment as faulty) only fosters more immorality.
Drug users, including users of alcohol and tobacco (and other things deemed ingestible), aren’t persuaded to behave differently or to adopt new values by being disrespected, injured, killed, or thrown in cages and kept there for years. People who use drugs may or may not be addicted, and they may or may not understand what’s truly required to live “the good life.” But if there were no prohibition on certain substances, people would have to take full responsibility for their own choices. Whoever desired to influence their choices would have to refine their skills of persuasion.
The end of prohibition will entail the end of the black market and all its terrible repercussions. (Of course, all other black markets, such as for prostitution and gambling, ought to be ended as well, for similar economic and moral reasons.) The prices of drugs will then become vastly lower, offering little value to drug dealers as well as to their antagonists, the drug warriors. People could purchase drugs not only easily like they do today (even in prisons, which provides absolute proof that prohibition doesn’t work), but also safely and inexpensively.
Even though drugs will be much cheaper and available for sale at drug stores, for instance, drug usage initially won’t be much different than today’s (regular usage of around five percent for marijuana and around one percent for other illicit drugs, which is considerably less than regular usage of alcohol, statistically a far more dangerous substance). Yet after ending drug prohibition, everyone’s rights will be respected in this realm, and people will be free to seek treatment without fear or punishment. Over time, the percentage of users will probably decrease, on account of no more huge financial reasons to push drugs on people and no more allure of forbidden fruits—no more rebelling against authorities who seek to control people’s behavior.
The more responsibility people assume for their choices, the better their choices become. Self-ownership fosters accountability for one’s thoughts and actions; it discourages passing the buck. This leads us directly to the big topic of pharmaceuticals.
Thou Shalt Not Take Full Responsibility For Your Own Treatment—Authorities Will Handle That
Prescription drugs and devices are another example of that bane of a market economy known as regulation. Regulation is insidious and sometimes its consequences don’t seem as noticeable as prohibition laws and their ensuing black market effects. Regulations actually create gray markets, ones in which people’s choices are restricted and altered, which adversely affects prices, supply, distribution, and demand for goods and services. As a result, many consumers seek back-door, oftentimes illegal, avenues for more accessible and cheaper goods and services. You’ve probably heard of persons buying their prescription drugs in Mexico or Canada, or traveling to India for surgery (medical tourism) performed at a small fraction (about a tenth) of the price in the United States.
Like the drug war, those who strongly advocate regulation of prescription drugs and devices are typically those who benefit financially from it. After all, if you didn’t have to go to your doctor (of any specialty) to obtain a prescription, and could just make purchases directly, it would certainly cut out the middle man. Of course the middle man, primarily a creation of lobbyists such as the American Medical Association (AMA) and the American Pharmacists Association (APhA) says that you need him, that he’s for your own good, for your own safety. To further emphasize this, he leaves you no choice but to have him help you.
It’s really quite incredible—full-fledged adults in a technologically advanced, information-filled civilization are told that they must be forced to do things that are beneficial for them. The racket of prescription drugs and devices is maintained under the guise of helping us, but in actuality it prevents us from making our own sensible decisions. This naturally lessons our responsibility to make appropriate choices, and it places a false kind of responsibility in the hands of State-stamped medical authorities. It soon becomes a cycle of self-fulfilling prophecy: The authorities are in charge of pharmaceutical and medical treatment, essentially of our well-being, so we’re supposed to follow their guidelines and allow the State to tell us what to do; then, we reflexively accept what the authorities tell us, relinquishing our needs for critical thinking, self-reliance, and independent judgment; it’s all being taken care of by authorities, so why take responsibility?
Meanwhile, the Food and Drug Administration (FDA) makes sure that doctors can’t perform or prescribe, and pharmacists can’t sell, anything that hasn’t been adequately tested. “Adequately tested” means many years of R&D, trial phases, and hundreds of millions of dollars spent in concert with meetings with FDA supervisors.
This is again purported to be for consumers’ own good. Of course, it’s difficult to convince all the millions of people who’ve suffered and died on account of the FDA’s regulatory hindrances. This certainly gives renewed meaning to the phrase “killing you with kindness.” Even though persons are needlessly suffering and dying on a daily basis because of this regulatory agency, drug and device companies continue to obey its directives. The tragic impact on those desiring immediate treatment can’t be overestimated.
Such regulations also tend to deprive medical companies of their ability to take full responsibility for the quality and efficacy of their products and services. Why think independently when the Feds are micromanaging your business or feeding you with tax dollars!
Naturally, the consumer market for medicine in this political climate suffers enormously. A perversely structured third party payment system is a direct result of governmental regulation. The health care insurance industry is a fantastic case study in intrusive meddling by the State. Of course managed health care, poor hospital service, and obscene prices, along with assembly-line doctors who’re frustrated by unmotivated patients and mounds of paperwork, necessarily follow. Prescription drug benefits for the elderly (among others) put the icing on the health care-welfare cake.
Drug companies, patients, doctors, health care workers, administrators, and insurers need not remain mired in this system of unrelenting unreason. They just need to identify and understand the real causes of this mess, so that their solutions don’t merely compound the problems, which were themselves created by prior “solutions.” Rather than calling on government to make things better, they need to advocate allowing the free market to increase competition and customer satisfaction, decrease prices, innovate quicker, simplify and streamline all realms of health care. Doing so will foster a much more fulfilling environment for patients and providers.
Thou Shalt Not Do Business Without Joining The State Guild—Licensure
This again takes us directly to the issue of guilds. One of the things typically instituted in any profession, predominantly at the state level, is a mandatory system of occupational licensure. The government makes it illegal to practice without a license, which is obtained through a state-controlled, profession-managed process. Clearly, this is the modern day version of the mercantilist guild system. Professionals seek to restrict the supply of potential competitors—and thus your choices as a consumer in this market—by becoming the equivalent of grandmasters who determine the nature of the practitioner’s path from apprentice to journeyman.
Again, like any other governmental regulation, licensure is always claimed to be for the good of consumers. Fear-mongering tactics have become commonplace: “You wouldn’t want to be treated by someone without a license, would you?” “At least with a licensed professional, you know whom you’re dealing with.” “You should find a licensed professional.” And let’s not forget the bureaucratic argument: “Government contracts require that we hire only licensed professionals, so we must enact licensure in our state, or else we’ll have to hire licensed people from other states!”
In truth, the only proper judge of whether a service has been rendered properly is the consumer of that particular service. If the customer is happy, then the opinions of others, irrespective of their declared level of expertise, are hardly relevant. Even in the case of fraud that’s alleged by outsiders to the transaction, justice can only be achieved by convincing the customer that he or she has been wronged and should therefore seek restitution. In other words one should use reason, not the force of preventive law. In today’s market, for example, consumers of faith healing, therapeutic touch, and homeopathy no doubt pose a major persuasive challenge; oftentimes their belief in the effectiveness of the service is the only thing that matters to them. Then again, perhaps the ills of State-controlled medicine encourage people to seek market alternatives where they’re allowed to exist, that is, where they don’t seriously encroach on State-controlled medical turf.
Few consumers realize that licensure is just another political scheme that, among other very bad things, dramatically increases the costs of health care services. Because all practitioners are ordered to comply with the rules and regulations as set forth in law—which typically require many years spent in governmentally funded and accredited graduate schools, supervision at state-designated workplaces, state board exams, and various professional fees and continuing education mandates—a license to practice represents an enormous conglomeration of direct and indirect expenses. These expenses have to be recouped somehow. And guess who gets stuck with the bill? Consumers. Because licensed practitioners face no competition from non-licensed practitioners, higher prices are guaranteed to consumers by the State. I don’t suppose anyone cares to say thank you.
Health care services shouldn’t be immune from market forces and the need for successful business practices. Reputation for quality service is the key to good business, and this is no different in the health care industry. Licensure tends to replace professionals’ reputations in the eyes of their customers with governmentally enforced stamps of approval. This obviously dilutes the power of reputation in the marketplace and lessens the responsibilities of professionals to their customers.
Simply put, you can’t provide a quality service if your main focus is not on your customers’ needs and their level of satisfaction (business 101). The creation of artificial, coercive barriers to entry for competition is not in line with quality service. Using special interest groups in concert with the force of government isn’t good customer service, by any standard. Creating a virtual guild system that scoffs at efficiency, accountability, and affordability isn’t good customer service either.
For practitioners to follow a regimented, caste-like system of professional qualifications and requirements makes a mockery of individual initiative and personal responsibility, as well as independent creativity. This, in turn, discourages many educated and motivated people from entering and practicing in particular professions—professions that they would otherwise enjoy. Consequently, supply of health care options decreases, which drives up prices. Diversity of opinion and expertise narrows, which restricts innovation and efficiency in these particular sectors of the marketplace.
Needless to say, mostly those who agree to conform and obey authorities become practitioners, which doesn’t bode well for consumers either. Would you rather go under the knife of a bureaucratically controlled guildmaster, or a self-controlled, reputation-oriented, profit-driven professional? Again, the more a person relies on his or her own judgment in making decisions based on immediate information, rather than based on the collective pronouncements of a bureaucratic process, the better those decisions will be. Happy and free professionals tend to produce happy and healthy customers. Unhappy and unfree professionals tend to produce unhappy, and sometimes dead, customers.
The practice of health care, be it physical therapy, psychotherapy, nursing, dentistry, general medical practice or medical specialty (for example, neurosurgery) ought to be treated no differently than any other market industry. That is, it ought to be left alone, unfettered, free to operate based on the law of supply and demand. Unfortunately, the influential professionals within these practices, like those in many other occupations, have convinced themselves and most of the public that their coercively based system is rather good for everyone.
Such a system soon becomes the opposite of what was intended, which was to make excellent health care available and affordable for everyone. Then again, maybe that wasn’t the intention. Politicians’ and lobbyists’ standard policy position to create a “universal health care system” represents an even more foolhardy attempt at alleged customer service. It’s a move from semi-Socialism to Communism within this industry. We only need look at Canada to witness the effects of such a system, where people are now clamoring for private, free market alternatives to being put on the government’s waiting lists.
Some really bad things would be guaranteed if statist health care were fully implemented in America: Government would now have an endless supply of new problems to fix without the proper tools to fix them—with more regulations and more red tape for still more bureaucrats to wrap practitioners in (mummy fashion, this time); more favors would be dished out to various conniving interests, wasting still more tax dollars; and, government would ration the ensuing health care shortage and bloated demand by having you sit in an exceedingly long line of uncomfortable chairs. Definitely no express check outs here. As political humorist P.J. O’Rourke has quipped, “If you think health care is expensive now, wait until you see what it costs when it’s free.” Naturally the only proper solution is to fully deregulate and privatize this market.
So, when the market of health care is freed from statist control, what will really happen? Will many charlatans take advantage of the newly unregulated and unlicensed occupations, preying on gullible and naive consumers? Will many people die from improper drug dosage and usage conflicts (all too common in hospitals today, by the way)? Will doctors not be able to make a good living because of too much competition?
Just like any other aspect of the economy that’s allowed to function in accordance with the unencumbered choices of individual buyers and sellers, we will witness the opposite of people’s initial fears and misguided economic concepts. Motivated entrepreneurs in medicine and health care in general will revitalize its possibilities for efficiency and innovation—which necessarily include customer service and satisfaction. Assuredly, revitalized consumer watchdog groups and groups of consumers themselves will provide strong checks on any fraudulent practices. Educated opinions spread quickly via the Internet. A just justice system will assist those who might be wronged and enforce judgments for restitution and reparations. Quacks will become an endangered species, only surviving (as they largely do today) on the money of customers who blindly believe in their particular brands of snake oil.
Unregulated insurance companies will charge rates in line with their clients’ levels of risk, and most people will realize that catastrophic health care coverage will be more than adequate to cover their potential health care expenses; the newly low prices of general care and routine visits (and even many surgeries) wouldn’t justify more expensive insurance plans.
Notice that, on account of governmental control and regulation of health insurance, consumers currently try to have their insurance companies pay for every conceivable medical expense. These include things that free market insurance could never insure, that is, things in the realm of personal control, things not accidental. Undoubtedly, the high costs of health care (and the regulations fostering them) promote such irresponsible behavior.
Also, today’s focus is mainly on damage control, or treatment, instead of preventive health care measures and vitality programs. In a free market there will be no financial incentives for these suboptimal practices; they’d be much too costly. People will thus be encouraged to pay more attention to what they put in their mouths and how they treat their bodies. Doctors, imagine having educated and motivated patients! To follow the recommendations of the State-controlled dietary establishment and “The Food Pyramid” is a poor substitute for paying attention to the research and evidence, or at least seeking out reputable people and organizations who do. (In this regard, a book for laypersons that I can recommend as a starting point in evidence-based nutritional understanding is Living the Low Carb Life by Jonny Bowden.)
As for persons burdened with chronic illnesses, even their costs will decrease dramatically, mostly on account of a big rise in the number of health care providers, and therefore treatment options, as well as new business models and technological innovations. Additionally, private charities will spring up in many areas that are now usurped by governmental “benefits,” such as Medicare and Medicaid. Because bad (government) money drives out good (market) money, most indigent persons are currently abandoned in a system of carelessness, callousness, and ineffectiveness. The government’s so-called safety net has many sizable holes in it, and it’s only a couple feet above the ground, which makes for quite hard landings. The moral of this sad story is twofold: Trust a typical politician or policy wonk less than the distance you can throw him or her, and never leave something so valuable as your health (or anything else, for that matter) at the mercy of a committee of bureaucrats and lobbyists.
Now, how about the fate of those relatively high incomes that physicians and other professionals currently receive? Although a free market of health care services will certainly reduce the pay rates of many practices, it will also substantially reduce the costs, in both time and money, of entry and operation of businesses. Therefore, what really matters for professionals in any industry is their standard of living.
Rather than years wasted in the authoritarian grip of regimented higher education and then in stale, red-taped organizations, innovative and smart apprenticeship programs will be the order of the day for practitioners in businesses everywhere. People learn much more by doing things according to their interests than they do by memorizing information, following overbearing orders, working inhuman hours, taking board exams, and defying common sense in the workplace. Not only do these things jeopardize the health of patients, but they also tend to weaken one’s potential for career happiness.
It’s an understatement to say that a truly free market will have greatly beneficial effects on everyone’s living standards, enabling us to buy and enjoy much more with less money. Competition in any industry brings out the best in all aspects of supply and demand of goods and services. This is because productivity and capital are increased, and people are free to do more things with their newly created time and money—which fosters a continuous upward cycle of opportunity. A free market generates an ever larger and more wealthy middle class, which means that luxury item wish lists can be fulfilled by nearly everyone willing to be productive.
The general point of regulation—be it licensure or any other trade barrier, foreign or domestic, such as tariffs, quotas, duties, taxes, restrictions, special privileges, etc.—is that it hurts both buyers and sellers. Neither sellers nor buyers have the right to use laws to benefit their particular interests. That would mean using aggression instead of persuasion, force instead of reason. Such behavior may be fit for other primates, but certainly not us. Yet writing and enforcing unjust laws is definitely the most widely used and most unacknowledged form of violence by our species.
Rather than favoring regulation, people should seek free market methods to distinguish themselves. This mainly boils down to price and quality of product or service. If your prices are relatively low and your quality is high (or sufficient for the job), then you’ve got a winning combination in the eyes of most consumers.