Achieving Healthcare Abundance

Noting that the field of Republican presidential candidates is fixated on “repealing and replacing ObamaCare,” Forbes’ David Whelan asks, “but with what?” Whelan raises the example of the micro-nation Singapore, which has removed the state from “delivering or financing health care.”

The mere fact that the state is not directly involved in the delivery or finance or these services, though, may be misleading. If the United States were to adopt such a system, there would nevertheless remain innumerable instances of state involvement standing in the way of the kind of abundance that would mean coverage for the indigent — a segment of the population that politicians love to pander to, but never seem to deliver for.

Much of standard anarchist economics — if indeed there is such a thing — falls under broad heading of what is often called “post-scarcity” economic theory. Social anarchist Murray Bookchin famously suggested the notion of a post-scarcity world in 1971, writing that the “technological revolution, culminating in cybernation, has created the objective, quantitative basis for a world without class rule, exploitation, toil or material want (emphasis added).”

And while much of the conventionally libertarian (in the American sense of that word) side of anarchism has been skeptical of the post-scarcity idea generally, there is reason to believe that many of the scarcities we endure today are the proximate result of state intervention. Discussion of the ideological framework created by a hypothesized post-scarcity world often raises charges of utopianism.

Caricatures of the argument that much of today’s scarcity is state-created make it easy to be suspicious, painting an idyllic picture of a Garden of Eden somewhere in the future. Those caricatures, however, are not representative of what market anarchists’ critiques of the state capitalist system envision for economic life without the state.

Market anarchists argue that the aggregate effect of the state’s manifold laws and regulations is to bring about an environment within which obtaining or furnishing the necessaries of daily life is needlessly difficult and costly. The difficulties that the state builds up in the economy serve to generate opportunities for the economic elite to exact tributes or rents.

Once you begin to look for them, examples abound. Health care costs are just such an example, embedded by a host of rents that inflate the price we pay far beyond what a genuine free market would allow.

The United States’ Byzantine regulatory scheme is, to begin with, a successful impediment to forms of bottom-up competition that would subvert the market dominance that the giant insurance companies enjoy today. As the groundbreaking work of Kevin A. Carson and others demonstrates, various forms of mutual aid and contract practice once prevailed before today’s model of corporate health care insurance became the predominant one.

Arbitrary regulations on, for instance, capitalization and the kinds of packages that can be offered — supposedly designed to protect consumers — function to demolish competition’s downward pressure on price. These rules insulate huge, inefficient bureaucracies from what would otherwise be a constant need to respond to market incentives.

What’s more, intellectual property protections, monopoly privileges that actually stifle innovation, enable high tech and drug companies to charge exorbitant prices for their products. Intellectual property laws are perhaps the ultimate affront to genuine free markets, operating to give certain privileged groups the right to control what others do with their resources.

Patents on prescription drugs and cutting edge technologies forbid competitors from supplying these goods and attempting to improve on them. Coupled with the regulatory barriers to entry already noted, corporate plutocrats have an ironclad command over the market, far removed from the forces of unbridled free exchange.

Markets freed from the special advantages currently granted to elites are the most practical way to approach anything like “universal coverage.” The interests of the state and those of capital are conspicuously aligned, working in concert to preclude free markets and extort consumers.

Those who sincerely care about the vast numbers of uninsured ought to reexamine the statist propaganda parroted by both halves of the political class. They will very quickly find that the state is the enemy of abundance for (and the well-being of) the masses.

Anarchy and Democracy
Fighting Fascism
Markets Not Capitalism
The Anatomy of Escape
Organization Theory