My argument then, and still today, is that affordability is a subjective standard, best served by unleashing the free enterprise system.
On reflection, I must say that there is one big problem with free enterprise. It can best be described as REALLY free enterprise.
REALLY free enterprise, like basic free enterprise, begins with the idea of human liberty; nothing more nor less that human beings pursuing their own happiness by making their own decisions.
But REALLY free enterprise includes the freedom to act in concert with other people. Thus associations, corporations, partnerships, unions, churches, clubs, political parties – you name it – every manner of combining the efforts of more than one person, involves free people freely associating to pursue happiness together.
And the problem is that the freedom to associate often gets in the way of individual freedom.
I remember the phenomenon very well from my days spent launching the Thomas Cooley Law School. The American Bar Association is a fine organization, completely voluntary, which lawyers all across the county join for the purpose of improving their profession.
But the common economic interest of lawyers often tempts them to close the front door of their profession. It’s a common practice in all trades and occupations. Licensure statutes are always popular with licensees, whether plumbers, builders, barbers or nurses. The theme is “you don’t get to do it unless you are one of us.”
In business, many people seek to “corner the market.” It’s call having a monopoly. It’s a natural selfish instinct.
In the final analysis, the ultimate monopoly is the exclusive use of force to accomplish things. It’s called sovereignty; people power; the power of government.
Historically, logically and necessarily, under the common law, it is a proper function of government to regulate monopolies.
Now, here is where it gets sticky. Under the Constitution of the United States of America, we are a federal nation; that is to say’ the power of government, the right to use force to accomplish things, is divided between the States and the national government.
That division can be stated very simply: the national (we call it the ‘federal’) government gets to use force to do all those things, and ONLY those things specified in the national Constitution. The States get to use force to do everything else.
That is what the Tenth Amendment to the U. S. Constitution, the last Right of the Bill of Rights, tells us. Whatever power has not been expressly given to the national government stays in the States or the people themselves.
Health care basically consists of two things; knowing what to do and doing it. Diagnosis and prescription. Knowledge and service. Heads, hands, and hearts. Making it affordable in a free country requires removing every unnecessary obstacle to the recruitment, training and authorization of health care professionals.
And it requires reducing the responsibility for health care to the lowest common denominator. The cheapest health care is that which is self administered: diet, exercise, rest. Learning how to take care of yourself. Knowing when you are sick and what to do about it.
The next cheapest source of health care is your family. The folks who love you. The people who live under the same roof that you do. Right after that comes the guy next door. The folks in the neighborhood. Your town. Your city. Your State.
The most expensive health care is that which is farthest away. Like the brain surgeon in Switzerland. Or the bureaucrat in Washington, D. C.