New at Reason

Julian Sanchez | December 26, 2005

Matt Welch spins a Christmas tale of how prosperity impedes freedom in the U.S. and France.

Comments

|12.26.05 @ 4:42PM|#

I knew his answer would be interesting since, in addition to being a devout Catholic (he once told me that Christianity has been the "biggest source of freedom in human history"), and a believer of the Gospels as gospel, he's also a professor of Roman history, specializing in the time of Christ.

Matt, I am your father...

|12.26.05 @ 4:56PM|#

Small wonder that American-style economic neo-liberalism is misportrayed here as "savage capitalism"�compared to the affordable cost and superior quality of health care my wife receives when in France, "savage" is an understatement as a description of her experience with American medicine

I mean this in all sincerity, even though it will probably sound like a bitchy snark: I never thought I would see a professional libertarian admit that anything about any socialized medicine program could be superior to America's Best Goddamned Medical System in the Goddamned World.

Thank you, Matt.

|12.26.05 @ 5:51PM|#

It is the best Goddamn System in the Goddamn World. It is also the most expensive system. It is also the most hamstrung, the most mixed, the most inanely semi-free, the most confusing, the most frustrating, the most ridiculously grabbastic, and the most technologically advanced system on the planet. Like I said, it's the best. Therefore we need Hillary to fix it.

|12.26.05 @ 6:08PM|#

"savage" is an understatement as a description of her experience with American medicine?

Let me guess, she had to pay for it herself?

Poor thing...

|12.26.05 @ 6:35PM|#

"... more cost effective, everyone uses and benefits from it, and it delivers a high standard of service."

Like the U.S. Postal Service?
All's good and well in your utopia if all that ailed us were genital warts, broken arms and choking on an occasional flank steak. But we get shit all the time that's real, real, real complicated. And without the free market and the profit motive -- in other words, a system that lets doctors and pill makers get rich -- that real complicated shit just don't get dealt with real good, Merle.

|12.26.05 @ 6:54PM|#

thoreau--I like your analogy comparing hospitals to road workers, but sorry, they're both dependent on money from the state to a large degree. The profit a road company is theoretically capped by the state's supposed reliance on the low-cost qualified bid, meaning that much of the "profit" is really off the books (ie, preference for the next round of contract bids, personal favors for the contractors like express zoning approval for his brother's housing developmewnt, etc). And under our system, hospitals without endowments already rely on Medicaid and public health grants to make budget.

We could argue about the relative values of the statist versus free market system, but any insurance scheme relies on the strength of numbers to achieve savings and cost effectiveness. A rather high percentage, I recall, of your private carrier insurance dollar goes to admin/clerical functions, and smaller carriers spend more than larger ones with more subscribers.

Jamie--the US post office is not supported by taxes. It was set up in 1789, and continued to be, self-sustaining by design. The only thing that pays for it is postage. Don't want to pay for the post office? Use UPS.

And...Merle???

|12.26.05 @ 8:12PM|#

If I ever get the urge to compliment Matt Welch again I'll just send him an e-mail. Christ, how is it that so many freedom-lovin' libertarians get so goddamned bitchy whenever anybody makes a statement that isn't in one-hundred-percent agreement with them?

Jamie, go smoke some pot or something. Strive for mellowness.

|12.26.05 @ 8:15PM|#

Jennifer-

How does "...if private elements are introduced selectively, there's no guarantee that the system will improve" constitute bitching about your statement?

|12.26.05 @ 8:18PM|#

Thoreau, I was speaking of Jamie rather than of you. And I was referring to threads in general, not just this one.

|12.26.05 @ 8:32PM|#

And until [France or the US] experiences some kind of catastrophic collapse��a real one, as opposed to the perennial nonfiction predictions�the forces of statism in both countries will maintain the upper hand.

I have to disagree with this; I think a catastrophic collapse would make people more inclined to embrace the state, purely out of fear.

|12.26.05 @ 8:39PM|#

I think the idea of mandatory health insurance (with the government giving vouchers to indigent individuals) is a worthwhile one and one that a few states should try out. It lets the free market run medicine while making sure that every one has some insurance and that we don't devolve into Haiti medically.

|12.26.05 @ 10:56PM|#

Lest we forget, socialized medicine in its various guises is built on corrupt human relationships: the politicians put a gun to our heads and extort our incomes. Extortion is the relationship between us and our government.

We've all grown up in the pervasive welfare state, where those of us who are politicians take away from the rest of us responsibility for our lives and give it to their bureaucrats. We are losing confidence in our ability to take care of ourselves, our families and our indigent neighbors. We are not encouraged to be free, to practice being free and experience what it is first hand. Freedom is not a panacea to the problems of living and dying. If you are free within then you retain your dignity whether or not you can afford health insurance

As as society we are still barbarians, sophisticated and wealthy barbarians to be sure. But we still resort to force, we still enslave our fellow man. the "free market" is just one tool in the repetoire. If everyone has health insurance without using force, fine. If not, well then we'll have to pass a law mandating it. That's the kind of thinking I see these days.

Political freedom will not happen until most of us are free inside. Until each of us is willing to die before we make one other person an unwilling means to our ends.

|12.26.05 @ 11:19PM|#

Health insurance is a misnomer, I've looked for it and found it doesn't exist. I'd wager actual insurance would be much cheaper than the current maintenance set ups. I don't need covered oil changes just the pretzeled rear quarter and paint, thanks.

|12.26.05 @ 11:27PM|#

I would invite anyone who wonders about socialized medicine or government run health care to ask a member of the military what it is like trying to get treatment for non-life threatining illnesses. Or ask a veteran about getting treated at a VA hospital for other than a service connected injury or condition. Speaking for only myself, I personally cannot give a very high recomendation.

|12.27.05 @ 1:10AM|#

Nice article. It could be summed up in the saying, "good is the enemy of excellent."

I would liked to have seen a link attached to " a multi-decade economic crisis," giving some stats. It's conventional wisdom about old europe's economic condition, but conventional wisdom is always suspect; I don't doubt you, but I'd still like to see some evidence of over ten years of "crisis", which of course many would define differently. Are there masses of people starving in the street? Inflation outstripping income by how much? 20% unemployment? For more than 10 straight years?

Matt Welch|12.27.05 @ 3:16AM|#

Let me guess, she had to pay for it herself?

Poor thing...

Remember, when you assume, you make an "ass" out of "u" and "me".... No, my biggest complaint isn't the cost -- though that's a pretty big comparative issue (and yes, you *do* have to provide out-of-pocket money in France) -- nor is it the substantial comparative delay in getting to see the doctor you need. It was the mis/non-diagnosis of an alarming condition that required surgery three months later.

And just to be clear, I don't think the French health care system would work in the United States, and I don't want it to be copied. But I do find it hilarious when Americans who've never been there lecture me on how awful it is. A lot like our fancy Military Industrial Complex, sometimes statism produces tangible results.

|12.27.05 @ 8:47AM|#

I would invite anyone who wonders about socialized medicine or government run health care to ask a member of the military what it is like trying to get treatment for non-life threatining illnesses.

I grew up as a military dependent, getting my healthcare primarily from the Army, aside from those periods when my father was between assignments, until I was 16 or so. (This would have been 1969-1985.) We never had problems getting treatment for, well, anything. I can't speak to whether or how it has changed now, but care during my childhood was uniformly excellent.

|12.27.05 @ 9:25AM|#

I'm just saying that corporatized medicine sucks, too.

That's it, hand in your decoder ring.

|12.27.05 @ 9:26AM|#

That's it, hand in your decoder ring.

Fine, take your stupid ring back. It made my fingers look fat, anyway.

|12.27.05 @ 9:34AM|#

We are not encouraged to be free, to practice being free and experience what it is first hand. Freedom is not a panacea to the problems of living and dying. If you are free within then you retain your dignity whether or not you can afford health insurance

On the other hand, when I had my second kidney stone (as an uninsured grad student), I had oodles of freedom but no dignity at all, as I thrashed about in the emergency room screaming shrill screams of pain and vomiting all over the damned place.

|12.27.05 @ 9:45AM|#

Jennifer,

You are obviously not free within. If you had the noumisma of freedom in your soul, you would have been serene throughout your kidney stone ordeal.

Matt Welch|12.27.05 @ 9:56AM|#

crimethink -- No, I'm just talking about what I found most "savage."

My overall experience has led me to avoid all contact with U.S. health care except for something that can't wait until Christmas, because of costs, utter lack of concern or even knowledge on the part of the care-provider about how much any given procedure costs, waiting times, and basic quality. Also, I had a devil of a time getting insurance for several years, despite being a healthy chap, and this made me cranky.

With the exception of the quality of the highest-degree-of-difficulty procedures -- and that's an important exception, just one that probably won't affect me for a few decades yet -- as a consumer, I'll take the French system (the one that's provided in France, I mean) any day of the week. If I was rich, I might not feel that way, but I'm not, so I don't.

|12.27.05 @ 9:57AM|#

Jennifer,

I see what you're saying. Maybe self respect describes better what I'm trying to say. Dignity is often associated with composure and as you said when the pain became unbearable you lost it. I still like dignity though.

|12.27.05 @ 10:09AM|#

I see what you're saying. Maybe self respect describes better what I'm trying to say. Dignity is often associated with composure and as you said when the pain became unbearable you lost it.

Even so, how much self-respect can you have when you're terrified you'll soon die at the age of only twenty-seven, and the pain is so bad that you reach a nearly Zen-like state of nothingness? At the height of the pain, I doubt I could have told you my own name, let alone worry about luxuries like propriety and self-respect.

Oh, and remember when I said I was throwing up all over the place? They still gave me painkillers in pill form. Which is why I had to make a second emergency-room visit less than twelve hours after my first one.

But to give credit where it is due: they never actually came right out and said "Your life is worthless to us."

|12.27.05 @ 10:28AM|#

"Hundreds of millions of people around the world have just finished celebrating and propagating a story described by even some of its biggest fans as revisionist history written by the victors."

"Revisionist History" is defined as history that revises a previous, widely held historical narrative. There was no previous narrative of Jesus' birth that the story of the adoration replaced.

"Revisionist History" is not defined as "dishonest history." When historians got around to pointing out that Columbus didn't actually discover America, that was revisionist history. The term gets thrown around as an insult, as if revising history is always an act of imposing a dishonest spin on the objective facts, but it is a lot more common for revisionism to wipe away a dishonest spin.

|12.27.05 @ 10:49AM|#

Other ways wealthy societies shoot themselves in the collective foot is by funding police and prisons.

Matt Welch|12.27.05 @ 11:18AM|#

Joe -- Actually, Reason had a helluva Revisionist History issue 30 years ago, whose main feature (though by no means it's only one worth reading) was a full-throated defense of Tokyo Rose....

|12.27.05 @ 11:34AM|#

Jennifer,

yep the fear of death can definitely mess with your feeling of self respect, especially if you haven't faced the issue of your own death. But do you think mandated health insurance, socialized medicine, or the free market will save you from what will surely happen to you, to each of us, sooner or later?

I known many people who lived with chronic pain, some who were dying. Some chose to bear it, dare I say, with dignity and were grateful for the help they got. Others were bitter and angry and made a hell for those who were trying to see them through their suffering.

I'm not making light of what you say. I want to live too. I don't want to die, I don't want to be in pain. But the fact is I'm gonna die and it maybe very painful. And I want to face that fact. I don't want to run from it. I've experienced chronic pain and debiltation in my life. At first I wallowed in self pity because I was relatively young and very healthy and active. But I couldn't stand being that way. So I stopped feeling sorry for myself and focused on living and accepting my problem. 13 years later I'm happier, but my problem is worse. But it's my problem and my responsibility not govt's, not the hosiptal or the doctors or the health insurance people. And fortunately I've been able to self medicate and take care of myself and I think I accept my own death more now. It's not as scarry. So I'm freer within than I was 13 years ago.

|12.27.05 @ 11:50AM|#

Art, the fact of my eventual death is a given, as it is for all of us. My complaint is that I came very close to dying in the prime of life, from a condition that, while painful, is not fatal for people who have access to modern medical care. (The stone I had was small enough to pass on its own; problem is, to pass even a tiny kidney stone you need water going through your kidneys, and I was unable to drink water and keep it down because of my inability to keep anything in my stomach for more than three seconds.) I very nearly DID die, from a condition that shouldn't be fatal under normal circumstances here in the US.

THAT is the basis of my complaint.

|12.27.05 @ 12:17PM|#

Tokyo Rose. That's just *^%$#&in' lovely.

With friends like these...

;-)

|12.27.05 @ 12:44PM|#

"Joe -- Actually, Reason had a helluva Revisionist History issue 30 years ago, whose main feature (though by no means it's only one worth reading) was a full-throated defense of Tokyo Rose...."

Hey, I remember reading that! I think I still have a copy of it put away, if the bugs haven't eaten it.

Matt Welch|12.27.05 @ 1:04PM|#

joe -- If it eases your mind, the defense wasn't of her actions, but rather of her *defense* against a hysterical (though partially successful) prosecution. Terrific stuff.

|12.27.05 @ 2:12PM|#

It is probably a mistake to take the health care systems as they are as the basis for which is superior because there are built in dependencies.

It is hard to say that the French model is superior when it depends on the US system for 75% of new drugs and procedures. That is the figure coming from Cato, anyway. Not US companies, but US consumers pay for 75% of global R&D. With that kind of subsidy, the universal access systems should be doing a hell of a lot better than they are.

I would also say that it may be that there are some people arguing that the US system is better in every imaginable case, but that is really an extreme position that I can't recall ever having seen staked out. Usually, the argument is about overall utility and not every specific case. Certainly, the system that guarantees access to all plentiful procedures and medicines should be better in the dimension of granting access to plentiful procedures and medicines.

|12.27.05 @ 2:19PM|#

"French farming yields the most delicious food and wine on the planet; its health care system (in sharp contrast to the UK's) is a glittering advertisement for socialized medicine; and its public sector is the G8's most productive."

Cuba makes good cigars, too. The argument has to be that state direction makes unintelligent sacrifices to have certain good things, not that no state can ever do any specific thing right.

|12.27.05 @ 4:40PM|#

Jason, thank you. I couldn't have put that any more succintly and reasonably.

David Nieporent|12.28.05 @ 3:29AM|#

Jamie--the US post office is not supported by taxes. It was set up in 1789, and continued to be, self-sustaining by design. The only thing that pays for it is postage. Don't want to pay for the post office? Use UPS.

Aside from the fact that the US post office routinely runs a deficit, it is supported by massive government subsidies (its operations, unlike those of UPS, FedEx, et al, are tax free), and more importantly, enjoys a huge government gift: it is illegal to compete with the Post Office.

You may not send a non-urgent letter via UPS, unless you pay both UPS _and_ the Post Office for the privilege.