The UK Libertarian

09/12/2009 Chris made the following comments on the NHS should be abolished article. I’m cross posting this reply as its own post. If you would like to leave comments on this article please do so in the NHS should be completely abolished article. You can also read my original objections to the NHS on that page. Anyway here’s the comment and my reply:

1) ’stolen’ implies the taxation is unlawful, when of course it isn’t. If you disagree with the law(s) passed to enforce taxation, please say why.

In my opening post I laid out the libertarian philosophy. Unlike traditional politics libertarian politics holds certain things immoral REGARDLESS of whether some bureaucrats have written it down in a book or not. Most people agree that just because something is a law doesn’t make it automatically okay. For example, slavery was once enforced by law. Libertarians object to taxation because it it the forceful stealing of money, something we do not accept in any other part of our lives.

2) how would you make the NHS more accountable? There may be a website where you can post your views/suggestions.

how would you make the NHS more responsive? I assume this is in relation to things like how quickly ambulances arrive, which are not entirely within the control of the NHS

you say that the NHS is ‘terrible at the job of providing medical care’, I assume in comparison to paying to go private. you acknowledge that this is not an option for everyone, so how could the NHS provide better medical care?

Queues for Food in the old Soviet Union. These kinds of queues are unique to government. When you give things away for free to anybody who asks, there is massive over consumption and things aren't allocated correctly

I wouldn’t make the NHS “more accountable” because I couldn’t. It is impossible. Government agencies are inherently unaccountable because 1) People cannot withdraw their funding voluntarily and 2) the employees from the ground up to the very top dogs don’t have the right incentives to please their customers. In the private sector if you fuck up you lose your customers and you lose money. In the NHS if you fuck up you get a bigger budget the next year.

Same goes for speed of ambulances etc. There are many people  inside the system who want to do a good efficient job but unfortunately, on the average, the incentives are horribly distorted because it is a government agency and therefore everything will be done less efficiently than on a free voluntary market.

I do indeed mean in comparison to private companies. I acknowledge that in our current system not everybody can go private. I want the abolition of the NHS and for every single £pound to be left in the hands of the people to prepare for their own medical care. For those few people who are so poor they cannot afford insurance, I want individuals and local charity to pick up the slack. If anybody doubts that people care about the poor getting sick and worries they would not pay to such charities all I can say is that every single person I’ve ever spoken to about libertarian ideas has brought this issue up first, everybody is concerned about it, so everybody should be willing to help as individuals unless they are hypocrites.

3) I’d agree that NHS provision isn’t the same everywhere, so it will be better in some places than others.

NHS provision will never be properly distributed because it’s funds aren’t properly appropriated. When you run your company through theft, you do not have the correct profit/loss incentives to correctly distribute scarce resources. Remember the shortages and bread lines in the Soviet Union.

4) I did not know that the NHS had to produce innovation, is this a legal requirement? Obviously, innovative use of funds is a good idea. I assume that costs are dependent on outside factors (including those caused by private companies) and I would guess that long waiting lists are caused by poor management of scarce resources.

It does not have a legal or moral obligation to do so. I was simply pointing out that it won’t. It can’t. When taking risks to produce innovations you need the profit/loss incentives of the free market. The UK has been piggy-backing off the medical innovations coming out of America and other countries with freer markets than ours for the last 50 years. And if America totally socialises its system we may be headed into a new medical dark age. I’m sure you can see how this hurts every individual, rich and poor.

And you are absolutely correct about what causes the long waiting lists. The only fallacy is in thinking that government bureaucracies can ever be reformed. The NHS will only continue to grow and become less and less responsive to patients until we finally get rid of it once and for all and transition to a voluntary system of providing healthcare.

5)This works as an argument for helping people with the cost of going private, for people with such rare conditions that only experimental treatments being developed by private companies or overseas have a chance of working. The NHS would argue that they do not have the resources, or it is not their role, to be developing such experimental treatments, or testing them all. Perhaps it should have this role (if it already does, it obviously needs better management/more resources).

I can’t think of anything worse than handing over the role of innovating new medical advances to the UK government. Anything we can do to reducing the size and scope of government is good for the people, anything in the other direction, be it laws, regulations or new departments  will only impoverish the people further.

6) Everyone has bad days and some people will never do their job to the best of their abilities. I agree that the financial imperative is a strong force in society, but the NHS isn’t the reason it exists, so it shouldn’t be blamed.

It is true that everybody has bad days and that some people will never do their job to the best of their abilities. However only in government organisations does this behaviour go unpunished. Because we do not have the option of withholding our tax money to fund this massive organisation they are shielded from the correct profit/loss incentives that the free voluntary market provides. If you go to a private vet and the receptionist is rude or the vet does a bad job of fixing Fidos leg you can stop frequenting the business, therefore those workers have a direct incentive to do a better job or the Vet on the other side of town will scoop up their business. If they piss off enough of their customers with bad service, they will go bankrupt. When the NHS pisses off tons of their customers, they get a bigger budget the next year.

Local GP’s around the country often find it an INCONVENIENCE when they have to take on a new patient. If somebody is unhappy with their service or the wait they have to endure to undergo treatment what choice do they have? The surgery does not care whether you are unsatisfied or if you decide to go private because to them, it doesn’t matter if they get your custom or not.  Again, individuals in the system may care, but on the aggregate, they will care much less than people operating in the free market.

Another way to put it is there are good people, and there are bad people. In the free market, bad people must still provide a good friendly service to some degree or they will be fired or their business will be uncompetitive to those run by good people. In the government sectors good people are not rewarded and bad people are not fired. In fact in politics often the most sneaky, deceptive and manipulative people rise to the top, and this includes organisations like the NHS with its famous “glass ceiling”.

The NHS could be better, should be better, but scrapping it helps noone. Unless you have a vested interest in private healthcare, of course.

Scrapping it would help no one if it was actually “free” but of course it’s not. To fund this behemoth people have to have a sizeable portion of their income extorted through force. Everybody, including the poor (who taxes actually hurt the most) would be better off being allowed to keep that money and redirect it to the healthcare provider OF THEIR CHOICE. In that situation we would see medical costs rapidly declining, innovation rising and quality of service and wait times DRAMATICALLY increasing.