Book Reviews

Wanted: A Better Way To Think About Health Care

If social insurance plans had been designed by libertarian-leaning policy mechanics, what might they have produced?

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New Way to Care: Social Protections That Put Families First, by John C. Goodman, Independent Institute, 384 pages, $29.95

In the Depression summer of 1934, President Franklin D. Roosevelt gradually concluded that the country needed a broad-based, government-led program to assure Americans' economic security. He thus created the Committee on Economic Security, led by such long-forgotten policy mechanics as Frances Perkins, Arthur Altmayer, Edwin Witte, and Wilbur J. Cohen.

The Committee begat the Social Security Act of 1935. The legislation's central feature was billed as "social insurance": Workers would make contributions throughout their working lifetimes, the government would invest the funds in special Treasury notes, the earnings would accumulate, and at age 65 or upon disability the workers would begin to draw retirement benefits. What could go wrong?

Thirty years later, big government had advanced far enough in public esteem for presidents John F. Kennedy and Lyndon B. Johnson to expand social insurance to include government-managed health insurance for retired workers (Medicare) and government-paid health care for the poor (Medicaid). The chief policy mechanic for this great leap forward was Cohen, who ended up serving as secretary of health, education, and welfare for the last seven months of Johnson's presidency.

Let's engage in a counterfactual. Suppose those social insurance plans had been designed by libertarian-leaning policy mechanics. What would they have produced?

In New Way to Care, economist John C. Goodman supplies a plausible answer to that question. Goodman reveals the disincentives, inefficiencies, hypocrisies, astronomical unfunded liabilities, and general absurdities in the programs that currently exist. Then he goes beyond that to lay out the policy alternatives that, he argues, would make the American social security, disability, and health care universe effective, consumer-centered, and, above all, pro-liberty.

Goodman has authored at least 26 books on health and welfare policies since 1980. His most influential work was probably Patient Power: Solving America's Health Care Crisis, written with Gerald Musgrave and published in 1992. That 657-page magnum opus reviewed the evolution of health care policies in the U.S. and abroad. It lucidly explained why competitive markets and informed and empowered patients lead to efficient and beneficial outcomes, while turning over patient care to government bureaucracies inevitably leads to inefficient and sometimes calamitous mistreatment.

At that date, this notion was considered borderline preposterous by orthodox health policy wonks, whose differences arose mainly over how and to what extent the government should control health care, who should be made to pay, and what sort of provider organizations and business plans were most desirable. No one has done more than Goodman to force the principles of patient choice and provider competition upon a health policy community that has been uncomfortably resistant at best and relentlessly opposed at worst. Goodman is widely credited as the father of health savings accounts, an idea that Congress enacted in 2003 and now benefits more than 25 million American families.

In his new book, Goodman asks the pointed question: Why is government involved in retirement security, medical care, disability support, and unemployment payments? "For elderly entitlement programs," he writes, "we have made promises to future retirees that far exceed the revenue that will be there to fund them. In fact, the unfunded liability in [federal] elderly entitlement programs alone is about six times the size of the entire economy." What's more, "Even when a social insurance program is reasonably funded, individuals invariably face perverse incentives to behave in ways that undermine the purpose of the program and increase the costs for others."

Goodman goes to considerable lengths to identify those federal programs' defects, few of which were imagined by Wilbur J. Cohen and his colleagues. A six-page appendix concisely explains what socialized medicine actually looks like in practice. One would hope that this recitation would give reasonable people pause. For example, under the much-touted Canadian single-payer system, the care is rationed mainly by waiting. "In 2016," Goodman writes, "Canadians waited an average of 21.2 weeks between referral from a general practitioner to receipt of treatment by a specialist—the longest wait time in over a quarter of a century of such measurements."

Goodman focuses on how to deal with real risks that people face: outliving one's assets, dying and leaving your family without resources, becoming disabled and facing financial ruin, becoming unemployed and finding no market for your skills, or surviving a pandemic. A two-word summary of his solutions would read: "opt out." Goodman wants people to be able to exit dysfunctional systems, both to improve their own circumstances and to give those systems an incentive to improve. More expansively, Goodman wants all of those programs if not totally scrapped then redesigned to maximize choice and responsibility in light of sound economic principles.

There are some complications. One can imagine the better students of a yearlong college course taught by Goodman using this book as a financial planning handbook. But most people are likely to have a hard time working their way through some of Goodman's solutions. And it's hard to imagine some of them, however defensible they may be in an economics seminar, becoming viable policy alternatives in Congress.

Take opting out from the Social Security program. Goodman suggests that the government give a young worker the opportunity to make a one-time lump sum payment in lieu of ever paying payroll taxes or accepting any benefits. Then he could use 4 percent of his untaxed wage income to make investments that would produce larger benefits than what he forswore over his expected lifetime.

Or: A worker who has vested Social Security benefits could take an early buyout, in an amount determined by life expectancy and a government discount rate. He could then take the cash and put it to work at what he expects to be a more advantageous rate.

A young Milton Friedman might have jumped at those offers, but one may fairly suspect that many young people today will not, unless they have an appreciable amount of assets to begin with.

Another economically but not politically defensible idea is for the government to allow health insurers "to sell insurance that substantially restricts largely futile end-of-life care." This would offload to insurers the practice of the U.K.'s National Institute for Clinical Effectiveness (NICE)—that is, expertly establishing a cost-benefit tipping point beyond which the National Health Service won't pay for any more care. Just imagine an insurance salesman trying to make a pitch for such a policy.

These may not be plausible as political proposals, but they are worthwhile as thought experiments. And Goodman produces dozens of less sweeping reforms that would expand personal responsibility and allow more choices. Many of these are, or should be, within the realm of practicality.

Goodman defends several program changes made under the last administration. Chances are that President Donald Trump had little awareness of what his appointees were actually doing, but Goodman rightly credits the Department of Health and Human Services (HHS) and its Centers for Medicare & Medicaid Services director, Seema Verma. She found ways, without legislation, to expand virtual health care technology in a pandemic, pay doctors for "virtual check-ins," create "right to try" treatment options, protect emergency use of health savings accounts, expand opportunities to buy lower-cost short-term insurance coverage, and increase medical price transparency.

Unsurprisingly, The Washington Post reported in February that President Joe Biden's HHS appointees "are preparing dozens of regulatory actions to roll back much of the previous administration's legacy. That legacy, largely loathed by liberals, emphasized personal responsibility over government assistance and individual freedom over consumer protections.

As in Patient Power, Goodman looks for creative market-oriented practices abroad, even when they occur within an otherwise unappealing political context. Chilean dictator Augusto Pinochet, for example, replaced his country's collapsed social security system with one based on worker-owned accounts. These became popular precisely because employees, not the corrupt government, owned them. (Chile also created a private disability insurance program, in which "Workers make additional contributions to their retirement accounts to cover the contingency of disability, and they pay fees for group disability coverage for any portion of their wages that can't be replaced from their own accounts.")

Similarly, while Singapore is an illiberal society in several notable ways, it has adopted what Goodman calls "the most successful social security system in the world." There, he explains, "people are required to save a substantial part of their income to meet basic needs." Unfortunately, Goodman devotes only three paragraphs to the Central Provident Fund's successes.

New Way to Care is enormously valuable for anyone engaged in the debates over the future of retirement, disability, unemployment, and health care policies. Life would be better for all Americans if John Goodman and other market-oriented health policy practitioners could achieve majority support.

NEXT: New York and Michigan Will Force 2-Year-Olds To Wear Masks at Camp

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  1. Without financial consequences for individuals who make poor market decisions, in a socialized system, costs will continue to increase significantly.
    Keep up with the Joneses even if it is the Joneses in your mobile home park or apartment complex.

  2. New Way to Care is enormously valuable for anyone engaged in the debates over the future of retirement, disability, unemployment, and health care policies. Life would be better for all Americans if John Goodman and other market-oriented health policy practitioners could achieve majority support.
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  3. For elderly entitlement programs,” he writes, “we have made promises to future retirees that far exceed the revenue that will be there to fund them.

    It’s the same problem with healthcare – medicine can do wonderful things now, but it’s expensive and who’s going to pay for it? This past Easter I went over to my brother’s for Easter dinner, my oldest brother had come up from Florida with his wife and my oldest sister had come down from Ohio with her husband. As we sat around talking, I realized we’re all getting old because all the talk was about their latest surgeries. My brother, who just turned 67, is limping around with a cane, he’s waiting to get scheduled for knee replacement surgery after having back surgery for a pinched nerve. My sister, who’s 69, has had both of her knees replaced. Her husband, 71, has had a hip replaced. My oldest brother, 73, has had a shoulder replaced and his wife, 68, has had a knee replaced. My other brother-in-law was there, too, he’s 71 and has had triple heart bypass surgery.

    Look, the six million dollar man used to be fiction, it’s now a very real possibility that if you’re having hips and knees and shoulders replaced, hearts repaired, stem cell treatments for chronic conditions and cancer, artificial organs installed as yours fail, you could very nearly be a six-million dollar man. And for what? Look, goddammit, you’re getting old, your body is starting to fall apart. Sure, it’s nice that we can fix up the ravages of age, but it’s a luxury, not a necessity.

    Something’s got to give with this entitlement mentality, that somehow we have an obligation to extend and improve life regardless of the cost, that it’s immoral to allow people to die just because they can’t afford the medical treatment to keep them alive. The cold, hard reality is that we simply can’t afford to create 100 million 6 million dollar men. Sad, but it’s the truth.

    1. I propose you set an example and not have any surgical procedures.

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    2. I’m 73 years old, I retired from 30 years of registered nursing and I have a metal hip. The health care your family, myself and many others have been getting maintain the value of our daily life . Any of us could die tomorrow by events other than our physical ailments and disabilities. Latest health care gives us ability to live each day with fewer physical challenges. Sometimes our health care simply controls chronic illness, sometimes progress after trauma is less than we hoped for. But having mobility with our manufactured body parts makes every a day better than being a burden.

    3. Except the 6 million dollar man was better, faster & stronger. These things are just keeping us going.

  4. Before the “New Deal”
    USA citizens call on their local doctor who shows up at your house for the price of a pizza.

    Wilson and FDR
    1913 (D-Legislation): Put government in control of all money with the Federal Reserve Act. Excuse? 1-Single NYC bank failure.
    1929: Enter the Great Depression ( i.e. Federal Reserve Act makes ALL U.S. Banks fail )
    1935 (D-Legislation): Put government in control of all people’s retirement and healthcare.

    Un-affordable Healthcare crisis and SS going bankrupt.

    Recently:
    #1: Put the federal government in charge of housing mortgages.
    #2: Enter the Great Recession and collapsing housing market.

    Federal government has no Constitutional Authority for any of this. They are breaking the USA and its definition the U.S. Constitution.

    1. The primary care physician who treats you with tonics and advice is still about the price of a pizza. (At Medicaid and BCBS discount rates.)

      A key way that Europe spends half of what we do is that they have many fewer specialists.

  5. The following paragraph is dangerous.
    *****
    “A worker who has vested Social Security benefits could take an early buyout, in an amount determined by life expectancy and a government discount rate. He could then take the cash and put it to work at what he expects to be a more advantageous rate.”
    *****
    Very few have the knowledge o make alternative investment choices.

    1. Then don’t do that.

    2. 401(k)s already deal with this fairly well by offering age-targeted retirement funds. You tell them how old you are and they choose an appropriate mix of investments. Then they balance the investment mix as you grow older.

      1. Yeah, and then have some fund manager take 1% of your money in order to try to mimic the performance of an index. Man, capitalism sure does have a lot of grifters in it.

        1. They are actually performing work. And it is an at-will relationship. Don’t like the fund manager? Get another one. Without having to move to a new country.

        2. Don’t buy funds. A balanced portfolio of individual stocks does much better.

          Also never buy annuities.

        3. That’s not actually how 401k’s work.

        4. At least it avoids the capital gains taxes… the real grift, much worse than 1%.

      2. The 401k model is reasonable, but mine for example has a board that limits investments to selected alternatives that have met certain requirements. Usually selecting investments based on the amount of management fees and the quality of the investments. Would a libertarian approach accept a compromise that has people self direct their retirement funds, but limit that to approved investments? I think this would be reasonable but I am not a libertarian.

        1. In terms of moving from social security? Sure. Don’t let the perfect be the enemy of the good.

          But the end-goal is maximizing individual liberty. Our end goal would be to allow you the freedom to *choose* – and if you chose a limited fund, fine. If you don’t – fine.

          Just don’t expect us to come by and pick up the pieces.

          However, people *aren’t* dumb and best practices will percolate through society and suitable and safe investment forms will rise to the top.

        2. Cant you cash in those funds and put it into an IRA you manage?

          If you roll over there should be no axes.

          1. No, you can’t roll over a 401(k) until you’re no longer an employee.

        3. That approach is legal, and some companies allow it. Unfortunately too many companies are too paternalistic and are afraid some employees will make very bad investments, so don’t provide a self-directed option.

    3. Very few? God I hate authoritarian retards like you, “we must force the sheep, for they are too dumb.” Fuck off slaver.

    4. “The following paragraph is dangerous…”

      You’re full of shit.

    5. Are Treasury Bonds a sound investment? If not, why is it that SS can’t be invested in the S&P instead?

      1. SS does not exist to be invested. It is a ponzi scheme. Last time I checked, 2035 is the year that more money will go out then comes in and then the trouble will be noticed.

        1. And the SS lockbox is full of IOUs.

        2. The op seemed to be trying to argue that individuals wouldn’t be able to make better investments in relation to “…the government would invest the funds in special Treasury notes”. I was trying to, probably not very well, point out that SS is already not very well invested.

          And yes, it is most definitely a Ponzi scheme.

      2. There’s no money in social security to invest.

        Its paid into the General Fund, where tax money is siphoned off to pay current recipients. There isn’t a pot of money to invest.

        And treasury bonds are a sound investment as long as a) you want jack shit for a return and b) actually trust the government won’t inflate your savings away – which seems to be the route the government is going. Just print more money, honey.

    6. Well, turns out that simply leaving the money in a saving’s account for 40 years would have been a better investment than the one the government chose for you.

      And its not like its hard to learn how to invest for retirement. You’re not playing the stock market day trading here.

      But no one is ever *taught* this shit because . . . the government will take care of it and anyway, that little bit of extra money you had? They took it for social security payments to the old people of today.

      1. SS isn’t an investment, and was never intended to be one. It’s always been an insurance policy. A very bad insurance policy.

    7. If that statement is dangerous – then you simply don’t trust people to manage any aspect of their own lives.

      And if you don’t – why are you here? We’re supposed to be libertarians.

      1. It’s fine to have non-libertarians here. It’s educational to see how others think. Try reading the NYT editorial page, and especially the commenters, on a regular basis. It’s educational and distressing.

  6. Unsurprisingly, The Washington Post reported in February that President Joe Biden’s HHS appointees “are preparing dozens of regulatory actions to roll back much of the previous administration’s legacy. That legacy, largely loathed by liberals, emphasized personal responsibility over government assistance and individual freedom over consumer protections.

    Reason staffers deserve thanks for their help in getting rid of the “previous administration” and its legacy of personal responsibility and individual freedom.

    1. Hey, no more mean tweets and a return to normal levels of awfulness!

    2. Look, libertarians loved the previous status quo and haven’t been spending the last 50 years trying to, in any way, upend it in order to affect change.

  7. “If social insurance plans had been designed by libertarian-leaning policy mechanics, what might they have produced?”

    It would have produced something less effective and less pro-freedom than a free market would have produced !

  8. Libritarians don’t design social systems we let people determine the best way to serve one another.

  9. Te article states “Canadians waited an average of 21.2 weeks between referral from a general practitioner to receipt of treatment by a specialist”
    This is definitely a supply problem

  10. The article suggests a very bad idea for most workers: “A worker who has vested Social Security benefits could take an early buyout, “

  11. I think some “workers” took early buyouts last year and aren’t returning.

  12. Interesting…Colorado recently passed a law for pay equity and so companies with at least 1 employee in the state have to post salary ranges. Consequence…companies with no Colorado presence or employees are specifically not hiring people in Colorado for remote work.

    Thanks government!

  13. So, turns out Cyber Ninjas and Trump were spreading uninformed FUD about the Maricopa County election audit.

    Why is the audit firm leaking “problems” before the audit is concluded, anyway? It’s like they aren’t professionals, but just on a fishing expedition for anything that can stir up the stolen election believers:

    https://www.businessinsider.com/arizona-recount-auditors-find-files-trump-claimed-destroyed-2021-5

    “Just want to underscore that AZ Senate’s @ArizonaAudit account accused Maricopa County of deleting files- which would be a crime- then a day after our technical letter explained they were just looking in the wrong place,” the tweet said. “All of a sudden ‘auditors’ have recovered the files.”

    1. Why did the Democrats say that we need to replace all the voting machines because the Republicans might have hacked them when previously they said they were totally secure and couldn’t be?

  14. Why isn’t the supply of medical addressed. Numbers of doctors and hospitals are limited. It really does not take too much intelligence to be a pediatrician or family practice doctor. Increase the number of doctors and let them compete on price. The number of intelligent Asians who don’t get into medical school( victims of bad personalities) is large and could add to the number of specialists to add competition there as well. But the residency spots are limited by the government.

    When Hahnemann went bankrupt lst year, they sold their residency spots to other programs at a large profit.
    I could go on….

    1. The vast majority of doctors do not want to compete on price. Most have no idea about the business end of things. That is why they sign up as employees or partners in large groups.

      It is not what they signed up for.

      Not only that but the majority of health care costs have little to do with physician charges.

    2. Every American who graduates medical school can get a residency slot. There is a surplus of those and the hospital can fill the rest with foreign grads who qualify. Many of those are on J-1 visas and very difficult to stay here if they want to.

      If you think it does not take much intelligence to be a pediatrician – you try.

      1. If he tried, the government would throw him in jail for not getting their special permission slip.

  15. Libertarians don’t need to design health care plans.
    Health care is a service. Companies who can provide that service at a reasonable price will grow. Companies who let their costs spiral out of control will have to charge too much and go broke. Social insurance and government intervention pretty much guarantee the costs will go ever higher and consumers will end up with less health care at higher costs (even if they only pay it indirectly through taxes and insurance via their employers.)

    Trust freedom and self-interest.

    1. Why do you think those welfare programs were put into place to start with? Not the ideological/bs reasons. The pure self-interest reasons where people back then saw an existing state of affairs run by the market and a proposed state of affairs with govt intervention. And they chose the govt intervention.

      1. Because health care providers wanted to drive out competition and politicians love Power and spending Other People’s Money.

  16. The real problem we face is a moral issue of how much healthcare we provide to people. It is easy to short poor people at a young age thus shortening their lives and avoiding the issue of end of life care. But it is hard when we talk of middle class and affluent people. These people have had good healthcare throughout life and this in turn extends their life and bring on more expensive end of life care.

    We need to be able to speak to these people, point out the advantages they have had and then tell them that we will care for them at the end of their lives but not without limits. Don’t misunderstand this, I would certainly provide basic health care to older people, but I would limit heroic measures. What is the point of a 5 year cancer survival rate, if you unlikely to live 5 years anyway?

    1. “Don’t misunderstand this, I would certainly provide basic health care to older people, but I would limit heroic measures.”

      Oh would you? And how would you explain this to your patient and her family?

      You must be very good at this to predict a five year mortality and the financial cost/benefit of five more years of life.

      End of life decisions happen every day. They are not based on anything you discussed.

      So when the pain clutches your chest at age 70, or that of your wife or mother, at 2:00 am. Do us all a financial favor and stay home.

      1. “Oh would you? And how would you explain this to your patient and her family?”

        The same way I had the doctor and the insurance explain to me that a surgery my son needed was not covered, they just did it. The fact is that insurance companies tell people all the time that something is not covered. Just like my dental insurance which will clean my teeth and fill cavities but not cover crowns.

        So it simple the patient and family are told we don’t cover surgeries, chemotherapy, radiation, ect. for patients above the age of ? because the long term survival data suggests it is of limited value.

        1. Except that an insurance company exec has a bottom line to protect – so he’s gonna be rock hard about where the limits are.

          A politician is deciding where the limits are in government provided health care – and his only bottom line is ‘get elected again’.

          So you’ll see costs spiral out of control because no politician will say ‘enough, we’re not paying for this’. Because as far as he’s concerned – its other people’s money anyway.

    2. ^^paraphrased summary: You don’t own you — [WE] own you!!!!

    3. ” I would certainly provide basic health care to older people, but I would limit heroic measures.” Feel free.

  17. On another point, a significant portion of Medicaid goes to taking care of the very old and those with dementia. I think it unlikely we will be turning these patient out onto the streets.

    1. In at least one instance, and old man with dementia got sent to a government funded residence.

      1. No he was sent to Mara Logo and the government only needs pay for his protection there. Something like $390/night lodging for the secret service agents.

    2. Again, with the if the government doesn’t do it no one will. I want to help old people, don’t you? We can get together with all our like-minded friends and help all the old people all we want without getting the guns of the State Apparatus, the force and fraud and waste of corrupt politicians and bureaucrats involved.

  18. If social insurance plans had been designed by libertarian-leaning policy mechanics, what might they have produced?

    They wouldn’t have been designed by libertarians in the first place – because we’re smart enough to know we can’t do the job properly.

    Which is why the ones that exist are so bad. It takes someone with a lot of hubris and, frankly, a bit of sociopathy, to sit down and say ‘I can do society better than all the other people in society and I’m willing to kill them to prove it’.

    1. Imagine what society would be like if all the horrible ‘social insurance’ programs didn’t exist and people could have gotten on with taking care of themselves.

      Like social security.

  19. The entire commentary and article seem to be based on the notion that a libertarian reform/overall of this stuff must first require that everyone read a book.

    I’m pretty sure HSA’s did not happen because some tipping point of people read a book. 30 seconds is what you’ve got to summarize your idea.

  20. People are the primary infrastructure of any economy.

    Sick people are the same as bad water, roads or power distribution.

    We know what that’s like in third world economies.

    1. Your bad assumption here is that government should be paying for infrastructure.

      1. My understanding is that government is responsible to coordinate and enforce the will of the people through laws and regulations that support the constitution.

        The government works with other governments to coordinate the protection and defence of our interests.

        To do all this, basic infrastructure must be in good working order all across the country.

        Can you describe a better way to ensure everyone is protected by the constitution?

  21. Social security was never meant as anything other than a way to collect more taxes from workers

    It was a ponazi scheme as a way to give the government more money.

    1. If you look at the economy of the time, it was created to ‘tempt’ older workers to retire so younger workers could have their jobs.
      Large numbers of unemployed young men have frightened politicians since the French revolution.

    2. Nonsense. It was seen as a way to resolve the final issues of the gold standard and the Depression.

      In the early years (hoover era basically), the economic impact was almost entirely on working-age and younger. Older Americans who had been saving (in banks) for decades were almost immune from that – except that whenever they themselves became fearful of something vague, they would start a local run on the banks thus starting another local collapse of the local economy.

      That did all end with the nationwide bank holiday and revaluation of gold-dollar link. That particular effect – both short-term and going forward – was mostly negative for the elderly but positive for everyone else. So SS was seen as a way to re-balance that.

      Mistakenly of course since the effect of SS is to – once again – screw the working age and younger while insuring the elderly against all economic conditions faced by everyone else. Economics is like that. It deals with scarcity and conflicting values and those aren’t necessarily resolved by agreement or contract.

  22. If social insurance plans had been designed by libertarian-leaning policy mechanics, what might they have produced?

    Now do If concentration camps had been designed by libertarian-leaning policy mechanics, what might they have produced?. /sarc

    Also makes you wonder what “libertarian-leaning policy mechanics” do in their spare time after they are through with redesigning society. Do they enjoy a good game of golf? Ballroom dancing?

  23. Look, the six million dollar man used to be fiction, it’s now a very real possibility that if you’re having hips and knees and shoulders replaced, hearts repaired, stem cell treatments for chronic conditions and cancer, artificial organs installed as yours fail, you could very nearly be a six-million dollar man. And for what? Look, goddammit, you’re getting old, your body is starting to fall apart. Sure, it’s nice that we can fix up the ravages of age, but it’s a luxury, not a necessity.

    Something’s got to give with this entitlement mentality, that somehow we have an obligation to extend and improve life regardless of the cost, that it’s immoral to allow people to die just because they can’t afford the medical treatment to keep them
    https://wapexclusive.com ,alive. The cold, hard reality is that we simply can’t afford to create 100 million 6 million dollar men. Sad, but it’s the truth.

  24. “Goodman defends several program changes made under the last administration. Chances are that President Donald Trump had little awareness of what his appointees were actually doing…”

    Since when are libertarians in favor of the Philosopher-President who makes all the decisions, anyway?

    “That legacy, largely loathed by liberals, emphasized personal responsibility over government assistance and individual freedom over consumer protections.”

    And this is what pisses me off to no end about my fellow libertarians. Trump was certainly not one of us, but he implemented a lot of things libertarians have wanted for ages, yet the Reason staff gave him absolutely no credit for that. For his whole term, they fixated on his immigration policies, as if *that* was the overriding libertarian litmus test.

    1. Apologies, that should be “some of my fellow libertarians.”

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