My BHL post on Ron Paul’s healthcare answer is receiving favourable comment from both Andrew Sullivan and the National Review, and less favourable comment from Matt Yglesias. (CHT Matt Zwolinski.) I posted the following comment at Yglesias’s blog:
This response is pretty drastically missing my point. Suppose there are two possible ways of helping a patient, one much more effective than the other. The better way, A, is forbidden by law; the question is then asked whether the inferior way should be mandated by law. The libertarian (or at least the good libertarian) says: “no, don’t mandate B; instead, stop forbidding A.” That hardly counts as saying the patient should die; on the contrary, the libertarian thinks (rightly or wrongly) that the patient is less likely to die if the government stops forbidding A.
Now what the conservative generally says is “don’t mandate B, but don’t stop forbidding A either.” So I think it would be fair to charge the conservative with being willing to let people die. But that’s just a different position.
Part of the problem here is that non-libertarians tend to treat “let’s do something about X” and “let’s have a government program for X” as equivalent, and so tend to hear anyone who rejects the latter as rejecting the former. By contrast, libertarians generally think of governmental solutions as the least effective ones, and so for them treating “let’s do something about X” as equivalent to “let’s have a government program for X” would be like treating “let’s do something about X” as equivalent to “let’s sacrifice some babies to the moon god in order to address X.”
I haven’t gone over to Yglesias’s blog yet, but I know you’re going to get blasted for not addressing what to do about the hypothetically uninsured patient *right now*.
I can confirm that this did indeed get mentioned — in more or less exactly those words — at least a couple times in the thread.
Of course, the apparent criticism there really is just bizarre. If you’re supposed to answer the question of what happens to the guy right now, while taking the entire political-economic status quo for granted, then the answer to “Who will pay for his care?” is presumably either that he’ll be left to die, or that taxpayers will pick up the tab, depending on where he is hospitalized and on the particulars of his case. But presumably the point of asking the question was supposed to be that you’re interested in the question of who ought to pay for his care, and what might happen if you changed the statist quo in at least some respects?
But if you’re allowed to consider one way in which the statist quo might change (e.g. by zeroing out tax subsidies for care or coverage), then it seems odd to slam someone for saying that what really ought to happen is that the statist quo might change in some other way (e.g. by zeroing out subsidies, monopolies and cartels that ratchet up the costs of medical care). It’s exactly as if some Progressive had answered the same question by talking about single-payer and Roderick started yelling, “Don’t be irrelevant! We don’t have single-payer and the guy is in a coma right now. What are you going to do about that, whiz kid?”
Good show, Roderick!
While Paul’s critics talk about how the crowd shouted, “Yes,” when Blitzer asked if the hypothetical guy should be left to die, Paul distinctly said, “No.” No one talks about that.
I’ve already seen several people say Paul is OK with letting uninsured people die, despite his unambiguous “No.”
And as if simple dishonesty were not enough, some have been bringing up Kent Snyder’s untimely death as some sort of ‘gotcha!’ against Paul.
The Right might invite a more visceral disgust, but I’m not so sure the statist Left isn’t the slimier group. They reek of projection. Their claim that libertarianism is a cover for privilege masking as liberation, is more accurately applied to themselves. Even the most “vulgar” libertarianism would provide a better world for the poor, downtrodden and oppressed than the the infernal machinations of, say, Paul Krugman would achieve. There are probably more good hearted people on the Left than the Right at this point (though this is just a hunch) but at its core Leftism is even more intellectually and ethically bankrupt than the atrocity that is conservatism. The statist left has all the contempt for civil liberties and the lives of foreigners that the right does, it just likes to pretend it doesn’t, and it excuses and promote jackbooted brutality under the guise of fairness and concern for others. This is morally reprehensible. Harumph!!!
Even if the government stops forbidding A, then cases will still arise in which some person cannot afford the much cheaper insurance and/or care. The issue is whether legislation like EMTALA (mandating emergency care) is more or less likely to save the patient’s life than the variable amount of actionable goodwill that surrounds the patient. The latter is necessarily a gamble; the former: not so much. So rather than say “let him die,” the good libertarian says “roll the dice.”
Perhaps, but the libertarian also knows that the odds of the dice roll are very much in favour of the person who cannot afford the cheaper care in a freed market because it is more likely that family/friends/church/mutual aid/etc. would chip in to help [(1) care would be cheaper, (2) others will have more $ in their pocket because of less tax, and (3) others might be more inclined to help since they cannot say "well, my taxes go to aid those types anyhow."]
Given these odds, the libertarian can confidently say there would be more negative effects (unintended consequences, limits on liberty, etc.) to the government mandating emergency care than the odds would warrant.
You’re assuming that the people who cannot afford care actually have family, friends, access to a church or mutual aid. My worry is that the non-EMTALA world frames the solution as “how to best roll the dice,” rather than “how to not gamble.”
You are posing a situation (EMTALA) where no one cares whether or not a given stranger lives or dies to the point where they want to contribute their time and effort to help that person; the solution is that people must be made to help, no matter the circumstances. I suppose you have to assume that this is the right thing to do, that some organization is allowed to make these kinds of decisions, that whatever organization is going to be genuinely concerned with the situation so that they are incentivized to find the best solution for loners. I guess you must also assume that people should be penalized for not helping (not providing money, not providing their medical expertise, etc.).
Are doctors and nurses “made to help” by their hospital’s administration — as if by force? Or do they choose to work for an organization that’s aligned with EMTALA?
I see where you’re coming from and I think that your concern is a valid one.
It seems to me that the difference between us is that I think that there are enough caring people, like you and I, who would chip in to help the dying person (or that various charitable organizations would arise to deal with such situations, or that hospitals and doctors would help such people pro bono, etc.) whereas you are so confident in such good will.
As a former social democrat/’leftist’ with many friends still in that camp, I think that that difference noted above is fundamental to many libertarian/leftist disagreements with respect to social policy.
q>Are doctors and nurses “made to help” by their hospital’s administration — as if by force?
No. Are hospital administrations made to require the help? If they are, I think they have been wronged, but they do not wrong physicians by complying.
Roderick writes about a weak consequentialist filter: a criterion for justifiable “aggression” in cases where its absence would generate severely worse harm. The hospital administration is barely scratched in comparison to the patient you would allow to die at the hospital’s doorstep.
Actually, I wouldn’t let that patient die; that’s the hospital’s job.
Joking aside, I’d give him some money, assuming he isn’t me (so if I had the money). Do you think we need to be prepared for the eventuality that there will be a dying man and no one wishes to hear his plight?
The beauty of hypotheticals is that ones’ principles are put the test. If the question is whether or not I’m justified in applying the libertarian criterion for proper care and noting where it falls short, then I question your criterion for measuring the soundness and validity of a political philosophy. Specifically: why would you disallow realistic hypotheticals to hold weight?
The truth is that even good libertarians are exposed as cold-blooded on this issue — not, by any means, in general. If you doubt this assessment, then take a gander at this way of handling the problem.
So, there it is: the academic version of Let ‘em die.
Do you folks really want to bite that bullet? And how exactly is this position consistent with the bleeding heart aspect of Bleeding Heart Libertarianism?
I didn’t know that that’s what I was doing.
How so? If someone feels confident that it won’t be an issue, that doesn’t mean they are cold-blooded; they could be mistaken, but saying they are cold-blooded means you are presupposing the incorrectness of their views. I think the presupposition will stand as just that until you have a convincing argument.
With the paragraph you quoted from Caplan: It is perfectly reasonable for an individual to not take responsibilty for another’s mistakes. What makes this situation bad is the intensity of the cost for the mistake made by one who finds oneself without insurance and without money. I can still see someone deciding to not help everyone who runs into this problem. I don’t think their lack of helping in remote instances, for example, makes them cold-blooded.
… Then someone must be assuming a libertarian Utopia.
Maybe a voluntarist utopia.
Speaking honestly for myself, though, I already don’t care when someone dies from lack of coverage. I think it’s unfortunate but it’s not really important to me.
Within the context of Bleeding Heart Libertarianism — insofar as it claims to reconcile Rawls and Hayek or Rothbard — the original position overrides your personal position. You’re just as likely yourself as you are the young man that dies.
MBH,
Libertarians are of the opinion that individual person have a right not to contribute, democrats* are of the opinion that the population as a whole has a right not to contribute. Why are libertarians more cold-blooded than democrats on this issue?
*By ‘democrats’ I mean people who are in favor of democratic government.
A right not to contribute isn’t the issue. The issue — in Lockean terms — is whether or not one would be taking more than a good draught by not contributing. Or is one disallowing the river to replenish?
So how does that relate to libertarians’ cold-bloodedness?
Libertarians tend to look at treatment as analogous to private rivalrous property (scarcity is necessary/reality). Progressives tend to look at treatment as analogous to a public non-rivalrous good (scarcity is manufactured/artificial).
To automatically rule out the latter is, I say, cold-blooded.
What do you mean by “analogous to”? Do you mean anything else than “libertarians think treatment is a rivalrous good, while progressives think it is a non-rivalrous good”? If so, what?
If “libertarians think treatment is a rivalrous good, while progressives think it is a non-rivalrous good” is indeed what you mean, why does that make libertarians cold-blooded? How do you come by the idea that progressives think treatment is a non-rivalrous good? Isn’t it obvious that it’s a rivalrous good?
If it’s the case that scarcity in treatment is manufactured, and the libertarian position insists on treatment as scarce, then it’s a frozen situation-independent approach to health care.
They tend to believe in universal health care. If treatment is a non-rivalrous good, then universal health care is justified — both morally and economically.
Just as it’s obvious that state-corporatism is the state of nature.
I don’t consider myself a BHL.
Well, how is justice sensible in the absence of the original position or something like it? What does it mean to talk about “justice” if it derives solely from one’s own preferences?
Progressives are willing to imprison and murder people who are not willing to submit to taxes in order to pay for healthcare. That seems rather cold-blooded to me.
Some progressives. Just as some libertarians endorse passive aggression as reasonable.
If there are progressives who oppose taxation, I’d be very surprised, but I suppose it’s possible. Of course progressives who oppose taxation while supporting a single-payer healthcare system, or the worst-of-all-worlds that was Obama’s reform for that matter, do not exist.
I recall that your notion of “passive aggression” includes “free speech” among other things.
And your notion of “free speech” places deep-traction-gaining world-wide Nazi propaganda on even footing with criticisms of an illegal war. Again, at some point, the weak consequentialist filter comes into play. Some “aggression” that prevents infinitely more severe aggression can be justified. To rule that out is… startling.
Progressivism just is a long list of justifications for aggression, so someone’s in trouble if we do away with free speech.
That aside, the war was waged by the institution that decides what is and is not legal*, so if any criticism of it was justified it was not because the war was illegal. In any case, I’m sure that what you mean by “Nazi propaganda” includes things I agree with (such as the idea that self-defense or even preventive violence against politicians and their enforcement agents is morally justified, that dodging taxes is at the very least morally permissible, that laws and regulations are morally irrelevant in and of themselves, etc.), so I’m not particularly moved by your appeal. And I’m sure what you mean by “aggression” includes things like disobeying Obama, saying mean things about politicians, and not paying your taxes, etc.. Since I simply don’t agree that disobeying Obama, saying mean things about politicians, or dodging taxes constitute aggression, even if I agreed that speech exhorting or justifying aggression should be prevented or punished at gunpoint, I’d still find these appeals unpersuasive.
*Unless you’re a complete legal nihilist like me, but that doesn’t help, because as I see it, any action one successfully carries out without being punished is legal, and any action one is prevented from carrying out or is punished or made to “pay” for is illegal, regardless of who does the prevention/punishment.
I’m not saying do away with free speech. I’m saying that deep-traction-gaining world-wide Nazi propaganda does not count as free speech.
As I understood Roderick’s BHL post, he was pointing out that Wolf Blitzer asked a loaded question: the libertarian is prompted to apply his principles to a problem created by those who’ve continually broken those same principles. If the application of libertarian principles leads to an intuitively absurd/abhorrent solution, libertarianism is deemed untenable. Roderick suggests that the libertarian should “avoid” answering the question by explaining why it is so unreasonable.
This reminds me of a phenomenal article entitled “Demunicipalize the Garbage Service“, by E.W. Dykes. The title is what Dykes would have likely replied if asked the same question as Ron Paul.
And your notion of “free speech” places deep-traction-gaining world-wide Nazi propaganda on even footing with criticisms of an illegal war. Again, at some point, the weak consequentialist filter comes into play. Some “aggression” that prevents infinitely more severe aggression can be justified. To rule that out is… startling.
Do you believe Nietzsche and the Bible should also be banned because people have used these to justify severe aggression in the past?
Nietzsche and the Bible have been/are misinterpreted to justify aggression. Nazi propaganda actually attempts to justify aggression. Big difference.
They have both been (and still often are) correctly interpreted to justify aggression, as well.
On a mighty superficial reading, sure. But then I’d wonder about how you’re using ‘correctly’.
“Correctly” simply meaning that the text implies certain sorts of violent acts are justifiable (or even praiseworthy). In the case of the Bible correct interpretations run both ways, since the book is, among other things, an argument with itself (especially in the OT).
I argue here that the NT is implicit within the OT. The tensions are merely superficial.
MBH
1. Who gets to determine the correct reading?
2. Do you believe objectively correct readings are possible?
3. If a large number of people have an incorrect reading and commit violence, then should the text be banned?
4. If the agency that controls free speech gets something wrong, what protections are there for the people who are wrongly prosecuted by the agency?
5. Why not make the acts of violence illegal rather than control free speech?
Whoever has it correct.
No. Intersubjectively universal? Yes.
No.
No agency controls free speech. Some agency handles that which poses as, but is not, free speech.
See the answer to 4.
Of course Blitzer’s question was loaded. It presumes some sort of omnipotence on the part of the libertarian to intervene in all such tragic cases with a happy ending. All while ignoring the reality that coverage under UHC allows death from delay of treatment or approved withholding of treatment.