LR08: Healthcare


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Liberty Revealed Episode 08 Show Summary

This episode addresses our system of healthcare and explains how it can be improved.

Listen to Liberty Revealed Episode 08


Liberty Revealed Episode 08 Show Notes

Welcome back to Liberty Revealed. I’m your host, Mike Mahony, and today I want to discuss an issue we’ve heard a lot about since Obamacare was put into effect–healthcare. To many, health insurance is a right. I do not agree with that statement even a little bit. I want to explain to you how the healthcare industry could be profitable and yet costs for that healthcare could be reduced. The answer is actually simple.

Libertarians believe that healthcare prices would decrease and quality and availability of healthcare would increase if providers were freed from government meddling and control. By removing government interference and enabling the free market to work, healthcare prices would come down and the quality of healthcare would increase. Currently, our government controls healthcare in many ways:

  • Government and a handful of insurance companies have a virtual monopoly as payers. Because of this, they make most of the decisions about what kinds of healthcare are available.
  • Government regulates where, when, and who may open new healthcare facilities.
  • Government agencies greatly slow development of and access to new medicines, devices, and technologies that may improve quality of care and reduce the cost of care.

Currently, the healthcare industry is virtually monopolized by the government and a handful of insurance companies. They hold the checkbook and wield it for their own benefit. They do not care about the consumer at all, they only care about maximizing the profits they make.

Each year, the government sets prices that they will pay providers including doctors and hospitals. Each year, these payments increase at less than the cost of inflation, while the cost of providing medical care increases by a far greater amount. This has unpleasant consequences for everyone. Providers are incentivized to do what is quick and cheap, not what is in the best interest of a particular patient. Doctors are forced to reduce the time they spend with patients, and this reduces quality of care. Hospitals are discouraged from upgrading facilities, and this reduces the quality of care. Worse yet, insurance companies often set their payments according to the government’s prices. This regular ratcheting down on payments to providers, while actual costs to provide care increases, makes providers less able to provide high-quality healthcare.

The government also regulates where medical facilities can be built, who can build them, and when. The process for applying for permission to build facilities is very costly and very slow, thus it favors the biggest corporations and prevents smaller organizations from opening new facilities that could serve patients. This greatly limits patients’ access to medical care and increases costs compared to a system where government permission was not required.

Institutions such as the Food and Drug Administration also limit cost-effective access to quality care. The approval processes for new drugs and technology is lengthy and expensive. Because of this, the process favors the biggest companies with the most lawyers. There are many stories of patients dying while waiting for approval of a new device or medicine. Instead, Libertarians call for free-market testing which will be inherently incentivized to be efficient and fair in their processes. Additionally, Libertarians believe in the “Right to Try”, especially in situations with a terminal diagnosis. The government must not be permitted to deny patients access to new medical advances.

Tort reform would also greatly reduce the cost of health care. The current tort system raises the cost of care by encouraging unnecessary testing and procedures which increase the cost of medical care by forcing medical teams to devote significant time and resources to preventing or defending against unwarranted legal actions. When legitimate claims arise, they should be taken seriously and resolved fairly through the courts. However, frivolous and fraudulent claims should not be tolerated, as our current system does. These disparage our healthcare providers and the quality of medical care they can provide and that we can receive. Libertarians oppose fraud in all forms.

In short, Libertarians believe that each person has the right to make their own medical decisions. Libertarians support removing government meddling from healthcare. We think this and tort reform are the best ways to improve the quality of healthcare, increase access to healthcare, and decrease the prices of healthcare in our country.

Now that I’ve explained how I think healthcare should operate, allow me to address the details and some objections I’ve heard.

I believe that if you need an MRI you should have the ability to look up a list of MRI providers and pick the one that gives you the best value. You should be able to see ratings and pricing for each provider which will enable you to make an informed decision as to which provider you want to engage with.

I’ve heard the objection that a free market healthcare system won’t work because of emergencies. First, I currently have a Direct Primary Care physician. I pay him a monthly subscription fee to use his services. He is available by phone and text at all times. If I have an emergency like a major cut or a broken bone, he will meet me at his office and take care of it. That won’t eliminate the need for the emergency room though. For those situations, each person would need catastrophic insurance that covered the big things. The price for this insurance would be cheap because it would only be used for major emergencies. The fact that the providers would be keeping prices competitive would also help keep the cost of the catastrophic insurance low.

The free market approach works for things like this because they create competition. It is important to note that insisting something be paid for by someone else never works. It is a recipe for disaster. It changes our  behavior and we no longer look for the best prices. It is not in the best interest of hospitals and doctors to do things cheaply. They want to keep prices high so they make the most money. It is up to the consumers to force the prices lower by exercising their right to choose.

One way to see the truth that a free market healthcare system will work is to look at the real data. Today, 7 in 8 health care dollars are paid by Medicare, Medicaid or private insurance companies. Because there\'s no real health care market, costs rose 467 percent over the last three decades. By contrast, prices fell in the few medical areas not covered by insurance, like plastic surgery and LASIK eye care. Patients shop around, forcing health providers to compete.

The National Center for Policy Analysis found that from 1999 to 2011 the price of traditional LASIK  eye surgery dropped from over $2,100 to about $1,700.

These are numbers you cannot really argue with. Competition creates better pricing for consumers. This is a basic concept that most understand, but resist applying to healthcare for some reason.

What is stopping this type of system from taking hold? A true free market in health care provides patients with medical options that they can assess with their primary care physicians to maximize their own health outcomes with the least amount of risk. To do this, Republicans and Democrats must confront powerful special interests who are now calling the shots and who would be financial losers from genuine changes.

What are your own thoughts about free market healthcare? Do you see problems? Please send your comments to or leave your feedback at

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