TANSTAAFHC

Tibor R. Machan

TANSTAAFL is an acronym for "There Ain't No Such Thing As A Free Lunch," popularized, according to Wikipedia, "by science fiction writer Robert A. Heinlein." But the saying caught on mostly with classical liberals and libertarians who have a philosophical commitment to tell the truth about public policy matters. The current version should, however, be changed to TANSTAAFHC, meaning "There Ain't no Such Thing As Free Health Care" despite what Obama Care champions pretend.

Consider Sarah Lyall, who wrote--in her essay pushing to something like the UK's National Health Service here in the USA, titled "An Expat Goes for a checkup, Here and Abroad," published in The New York Times on August 16th--that "Certainly, as someone who in the 1980s paid $333 to have an emergency room doctor at Georgetown University Hospital remove a piece of toilet paper from my ear after I had unsuccessfully tried to use it as an earplug, I applaud a system that is free."

Never mind about the stupidity of stuffing one's ear with toilet paper--whatever turns you on, I say. But why should anyone other than Ms. Lyall be paying for the removal of it? Because, let's face it, there really is no such thing as free health care. Doctors want to be paid, as do nurses, medical labs, the clerk in the various facilities, the drug manufacturers, as do all others working in the health care industry. (I am also pretty sure that Ms. Lyall wants to be paid for her work that produced the essay about the wonderful free system in the UK which, of course, is anything but free.) Someone must pay for it all.

But of course Ms. Lyall isn't alone in advocating the "free" system--moreover, to her credit, when I contacted her by e-mail she answered that "You're absolutely right that the NHS isn't free, but is paid for by the taxpayer, and I should have explicitly said that in my article. But by that measure, I do indeed help pay for it: I pay British (and US, too, alas) taxes." In its coverage of the debate, which has featured some people on both sides of the Atlantic, UK produced magazine, THE WEEK, in a short piece published August 22, 2009, and titled "Knocking the NHS," also referred to the NHS as providing "free health care," which it clearly is not. It's no more free than are freeways in the USA. But because many people do share the primitive magical belief that the name one gives to something influences its nature, politicians who favor socialized medicine--meaning medical care that is provided at the expense of taxpayers many of whom would rather take part one that involves no government and involuntary wealth redistribution at all--as well as all their academic and journalistic cheerleaders keep calling government mandated and taxpayer funded health care "free."

But saying something is "free" will not make it so. Among the few free goods and provisions in the world health care is certainly not one. Perhaps the heat from the sun, when the clouds are hiding, is free. Maybe so is motherly love, at least to a baby. But because life requires support from hard-to-come-by materials, the work needed to discover and deliver those materials must be paid for by someone. And the case recounted by Ms. Lyall indicates pretty directly why collectivizing the provision of health care services is unjust--after all, all those folks who take better care of themselves than to stick toilet paper into their ear should not have to foot the bill for those who do and then must be provided with medical services to rectify their imprudence.

It is interesting, by the way, that just at this time it has stopped being politically incorrect, even illegal, to discriminate against people who neglect their health. It is beginning to be OK to refuse to hire smokers and obese people because their condition, often brought on by themselves, imposes costs on employers. (It used to be considered unjust discrimination to refuse to hire the obese among us, not so long ago, actually.) That there are inconsistencies lurking here seems to have escaped many public commentators, including ones who were avid supporters of certain provisions of the Americans with Disabilities Act that made it illegal to discriminate against, well, obese people, at least in enough cases to have a chilling effect on those who would refuse to hire them. (www.ada.gov/archive/mythfact.htm)

The most important flaw in both the UK's NHS and similar systems around the globe, as well as the comparable proposals coming from the Obama administration, is that they treat all of us as if we were members of a voluntary group the membership of which has accepted the obligation to care for all. But the USA or UK is not such a club. They are countries where people are supposed to have the liberty to either sign up or refuse to sign up for systems of wealth redistribution, including health insurance.

Krugmania Revisited

Tibor R. Machan

Princeton University Nobel Laureate economist and regular pundit
at The New York Times, along with many other contemporary defenders of
mercantilism--the idea that the state is the most suitable agent for
making economic decisions in society--is fundamentally opposed to a
principled public policy that rests on the renunciation of coercion among
human beings. Indeed he repeatedly ridicules those who do renounce
coercion. He considers them ideologues, people wedded to a mindless dogma.

At first inspection Krugman`s fierce opposition to principled free
market public policies may appear sound. He makes such thinking appear to
be mindless, dogmatic, unchecked by experience or history, merely a matter
of churning out some slogans. Yet, Krugman is on remarkably weak footing
in his stance. This is because principled thinking about public and
indeed any policies is the hallmark of intelligent and civilized human
approaches to problem solving--from engineering, farming, psychiatry, all
the way to epistemology (the theory of knowledge), ethics or politics. The
scientific method, for example, deploys principled thinking in
distinguishing between sound and pseudo-science. In law it is also
remarkable how procedures depend upon principled thinking, due process!

But to illustrate the pervasiveness and significance of
principled thinking, consider the nearly universal opposition to rape by
decent people. This opposition rests squarely on the principle that sex
with anyone must be voluntary, uncoerced (thus those unable to give
consent must not be sexually approached). There is no exception to this
idea, however tempting it may be to breach it. The fiercest commitment is
required of all, a commitment that according to Krugmania amounts to
ideology. By his view of what kind of thinking must go into the forging
of policies, public or private, in human affairs, each case of rape would
need to be considered individually, divorced from any
fundamental--opposition to rape on principle!

Those whom Krugman ridicules for holding to principles thinking in
public policy decisions, especially pertaining to economic affairs, hold
that the principle of voluntariness also applies to economic relations
among people, not just to sexual ones. This approach is, indeed, not
different from the common sense idea that under no circumstances is it
permissible to use people and what belongs to them without their consent.
This is what free market economics stresses, ultimately. And this is what
Professor Krugman considers infantile, ideological.

Now ideological thinking is often denounced without really
understanding it at all. In some cases there is nothing at all wrong with
using a well examined ideology to guide one in making decisions, including
in public policies. It merely means that there are general ideas that
apply and not every single action one takes has to be treated as a brand
new one. In other contexts ideological thinking amounts to something
insidious. This is when someone desires to do something and invents a set
of phony ideas to justify it, post facto. This is the kind of ideological
thinking that most serious scholars and researchers consider fallacious,
objectionable.

For Professor Krugman, however, all principled thinking amounts to
ideology. This spares him the trouble of having to actually examine the
principles being deployed--they can just be dismissed out of hand, never
mind any arguments in support of this dismissal. Yet, as already noted, a
great deal of the thinking done by human beings--be this thinking what
guides one`s driving or cooking or child raising--involves using
principles that have been tested and found sound and useful.

That, in fact, is what prompts many people to oppose not government
per se but the use of government`s major tool, namely, coercive force, as
the economy is dealt with. Governments use force because their role, as
the American Founders made clear, is to secure the rights of all citizens.
That is why governments exist, not for all the reasons so many statists,
mercantilists--in short, meddlers in human affairs--keep brining up.
This, at least, is the idea behind preferring public policies that follow
free market principles rather than interventionist ones. And it will not
due, however much Professor Krugman keeps repeating the idea, to dismiss
such thinking as some kind of blind fundamentalism.