Saturday, November 30, 2013

Libertarian Health Care

Last night an anonymous commenter added this to my post on Julia Ioffe's whooping cough:
To call for someone else to take drugs so that you do not get sick, is frankly ridiculous. You are responsible for your health or lack of it, not some new born child. I empathize with your health challenge. I trust you will recover in time, however, do you really think that all children in the world should be injected with drugs at birth because you have a cough?
Perhaps this person was merely grouchy after eating too much stuffing in the company of annoying relatives, but taken seriously this shows exactly what is wrong with libertarianism and the attitudes behind it.

First, there is the fantasy that you, and you alone, could somehow keep yourself well by your own efforts. Infectious disease mocks this notion. The way epidemics work is that by spreading to more and more people they build up to an enormously powerful wave that simply sweeps away the immune systems of individuals unlucky enough to get in their way. What did any of the 20 million people killed by influenza in 1918 do wrong? If you are stranded in the midst of a serious outbreak of bubonic plague there is pretty much nothing that you, by yourself, can do about it. Chance will determine whether you live or die. Yet European governments managed to defeat plague in the 18th century without having any idea what caused it, by imposing draconian quarantines on any city where the plague broke out. These measures were unfair; in fact they simply ignored notions of individual responsibility. Yet they removed from Europe one of the great scourges of the age.

Cholera and typhoid fever were defeated in Europe and North America by public water systems and intrusive inspections of restaurants and food wholesalers. Tens of thousands of babies were saved from blindness by requiring that their eyes be treated against venereal disease, ignoring the cries of outrage from parents who insisted that there was no chance of their having such horrid conditions.

Public health is one of the things that only governments can do, and only by trampling on the individual "rights" of citizens. It takes a government with a hardened heart toward its people's fears to bring dangerous diseases under control. What is bringing whooping (and the measles, mumps, and other diseases) back is that our governments have gone soft. Without the prod of the great fear these diseases used to cause, they have decided to be gentle with people who don't want to take any risk for the public good, or who just feel "uncomfortable" about vaccinations. And now we are suffering for it.

Yes, I do think that all the children in the world should be injected with drugs to keep other people from getting sick. It is the only way to keep us well. And I think that to make our world better governments should force people to do thousands of other things, from paying taxes to educating their children to replacing old, polluting lawn mowers. Asking people to please take responsibility for their own health care is a joke, just like asking people to please take responsibility for their own streets, sewers, clean air, electrical grids, school systems, police forces, and a million other things. We can only survive by working together.


Thomas said...

A libertarian response would be that a school, store, restaurant, transportation, or any other place could require a signed affidavit attesting to your vaccination or deny you entry/service.

And if you lied, you'd be liable to lawsuits.

But that's really just a legal nightmare, which is a common result when you take most libertarianism seriously.

John said...

But who would willingly quarantine himself in a city full of plague?

Plus the way vaccinations work is that when 90% of the people do something, there is a health effect that is many times greater than if just 70% of the people do it.