Medicare/Medicaid: Immoral in Theory, Impossible in Practice

Dr. Hurd: I really enjoy reading your thoughts and comments. A question please? What would you advocate to do to get the government out of health care? I agree with you that Medicare and Medicaid as well as the restrictions the government places on private health care should be ended, but how do you do that when so many people rely on say Medicare or Medicaid for their health care needs?


Dr. Hurd’s reply: Medicare and Medicaid represent promises that the federal government never had a right to make. They were wrong in theory and inevitably led to bankruptcy and unaffordability in practice. Everything that liberals claim to be true of capitalism and business is actually true of government monstrosities such as Medicare, Medicaid and Social Security. It’s true that the vast majority of people support these programs. You won’t find a presidential candidate (other than possibly Ron Paul) who questions their validity. People are either too naive and foolish, or too intellectually dishonest and evasive, to grasp that entitlement programs are wrong in principle.

Why are they wrong in principle? Because they represent force. Ironically, most Americans would not support a program forcing everyone to have their cars paid for by the government. Most people would resent having to pay for their neighbors’ cars, even if it meant a “free” car of their own. They would say, “I work hard and pay into the AutoCare fund. I pay my taxes. But two of my neighbors don’t work, and a third one pays very little in taxes. Yet we’re all entitled to the same barely adequate car. Not fair!” Government AutoCare would never fly, and even if it did, nobody would be surprised when it went bankrupt. Yet medical care operates on a different plane entirely. It’s not called the “third rail” of American politics for nothing. To question the viability of Medicare is to question the desire everyone has to be as healthy as possible, for as long as possible. They haven’t “unbundled” the issue of health from the morality of force and the inevitable bankruptcy created by something-for-nothing schemes. They totally get it when it comes to automobiles and other commodities or products, but they somehow expect the laws of morality, economics and human behavior to be completely suspended when it comes to medical care. Go figure.

Even the premise of your well intentioned question falls into this trap. If you’re a fan of my articles, I doubt very much that you’re anything close to a liberal, Democrat or socialist, or some Mitt Romney or Newt Gingrich faux capitalist. However, your question implies the very thing these people state openly, every day: How are people supposed to survive without these programs? This is kind of like saying, “I know bank robbery is wrong. But how are people supposed to survive once they come to depend on it?” The efficiency of government at delivering something for nothing — or fostering the delusion that this is what they’re doing — does not prove that they have, in fact, been doing this. In reality, a free market would provide people with far better choices and far better quality of care overall than the mediocrity and growing bankruptcy/eventual collapse of government entitlement programs. True, some would have to rely on voluntary charity. But there’s nothing immoral about voluntary charity, and there’s nothing immoral about requiring people in need to depend on it. What’s immoral is forcing people to participate in a program that most would not need on a free market.

The truth really does set us free. Once people realize and face the truth, that entitlement programs are wrong in the first place and therefore will never work, then the sooner politicians can get about the business of transitioning to a free market. I never thought it was right or necessary for government to pull the plug on entitlement programs overnight. I do still think, and indeed know, that it’s up to government officials and leaders to tell us, “This was always wrong, it’s wrong now and therefore will never work. Let’s start building a free market.” No such thing is imminent, and as a result it will also simply have to play out in the context of government bankruptcy (already here) and resulting economic calamity (devaluation of the currency, and much else). I can’t tell you what that will look like, but I am absolutely certain it will be less pretty — for everyone, including the poor by the way — than the privatizing of Medicare and other entitlements would ever have been.

In the end, reality will take care of privatization if the politicians won’t. But it’s important to understand that the question, “What are the dependent to do?” is part of the problem. The implication is that it’s government’s responsibility to ensure that everyone has everything he or she needs in life. This is wrong, because it’s the same as saying that, “You’re entitled to a living, and if you cannot or will not provide that for yourself, others will be forced to provide it for you.” I see nothing in the Constitution promising this, and more importantly there’s nothing in the nature of reality to enable it (nor morality to require it).

People will just have to learn the hard way. For an illustration, read the latest headlines.