Atlas Shirked

So Wonks Anonymous has been hearing the libertarian "free market medicine" argument a bit of late and it is not increasing his estimation of the intellectual honesty and moral character of Libertarians.

These are the lawyers, stockbrokers and commodities traders who find it exquisitely unfair that someone with more than $250 K annual income should pay more income taxes while a laborer with less than $20 K should pay only payroll tax and sales taxes and so on. They think that people should pay for their health care just like unfortunate, over taxed rich folks pay for their Hummers and BMWs. I quote:
Note: your grocer doesn't charge you based on your income—rather what the market dictates. Why should health services be different?
I note further that your grocer does not give you food for free.

Well, medicine does not work that way in the US. There is a law called the Emergency Medical Treatment and Active Labor Act which makes it illegal for hospital emergency rooms to turn away anyone who has a life threatening medical condition or who is about to deliver a baby. The law was passed in the 1980's because some hospitals were turning people away who they thought could not pay, with messy and inconvenient consequences.

No other business or profession in this country is obligated to provide services regardless of the ability to pay with no guarantee of public reimbursement.

And no libertarian I have ever heard, not even the most outrageous free market punk, has ever advocated the repeal of EMTALA or taken the free market medicine idea to its logical conclusion.

Imagine Market Street in San Francisco. A Market street populated not only by the usual drooling drinks and quivering crackheads but also by an assortment of cancer patients, active tuberculosis cases and other people dying of various infectious and non infectious diseases.

Because if people can't pay for medical care it is certainly not fair to force doctors and hospitals to provide this care for free - that is even more outrageous than a paltry increase in the marginal tax rate for stockbrokers - and if we don't force doctors and hospitals to provide this care many sick people will wind up on the street. That is why they passed the law in the first place.

To which you might say that doctors and hospitals are in the business of helping people and should be willing to work for free. And you are in the business of making shady business deals or amassing money or trading pieces of paper and therefore deserve to be handsomely rewarded with every single penny that you wring out of the market?
Because why? Because money is clearly more important to you than anything else in life?
You have a great unmet need and society should organize itself around making sure that you get more?

Does the idea of people dying on the streets make you feel a little queasy? Well you can't make a free market revolution without making some tough choices.


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