Hayek on healthcare

All this discussion of Hayek reminded me of Mark Thompson’s post on the subject from waybackwhen.  Here’s a quotation of Hayek’s he pulled from Serfdom:

“Nor is there any reason why the state should not assist the individuals in providing for those common hazards of life against which, because of their uncertainty, few individuals can make adequate provision. Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance – where, in short, we deal with genuinely insurable risks – the case for the state’s helping to organize a comprehensive system of social insurance is very strong… Wherever communal action can mitigate disasters against which the individual can neither attempt to guard himself nor make the provision for the consequences, such communal action should undoubtedly be taken,” – The Road To Serfdom (Chapter 9).

Thompson wrote at the time:

This is why, for all the bluster about “death panels,” and health care reform being an irreversible step on the road to socialism, it is the Randian vision of the world that animating the Right’s position on reform at the expense of the far more rigorous, thoughtful, and classically liberal vision of Hayek.  Were the influence of these visions reversed, we would have a situation where the Right would actually make a good-faith negotiating partner on the issue of health care reform rather than leaving it up to liberals to negotiate reform with spineless and philosophically unmoored centrists. 

The above-referenced quote does not in the least imply that any system of social insurance is acceptable or will work.  An individual-based system supported by tax credits or vouchers? Sure.  A system of nationalized re-insurance?  Quite possibly. Single-payer insurance?  Maybe.  But a byzantine system of employer and individual mandates, public options, increased regulation, etc.?  Absolutely not. 

Yet because the Right is so much more infatuated with the Randian vision rather than the Hayekian vision (even as it so often claims devotion to Hayek), leaving unmoored centrists as the gatekeepers, the reform we will get will be the latter.  This, I would submit, is the worst of all worlds from the supposedly free market perspective held by the movement Right – the reinforcement of existing flaws and regulatory regimes; increased opportunities for regulatory capture; large increases in overall government expenditures and an ever-larger national debt; and only marginal improvements in the delivery of health care to the currently uninsured (at a cost that many of them may be unable to afford).

I agree with many of Mark’s criticisms of the healthcare package we ended up getting, and I think the general mediocrity of the bill was largely due to the coalition of opportunistic centrists on both sides of the aisle that held up more meaningful reforms, but I eventually took a much more positive view of the final bill than Mark did. The alternative, I concluded, was worse. Mark disagreed. We both preferred the excellent Wyden/Bennett bill, but that was, apparently, never in the cards. It was bipartisan, but also pretty radical. C’est la vie.

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6 replies
  1. 1
    mistermix says:

    I read Hayek a long time ago and remember a pretty generic classical liberal. I’m to lazy to re-read, so appreciate your posts, because I was wondering whether I had totally misread or misremembered his work.

  2. 2
    Gus diZerega says:

    Hayek’s name has been captured by right wing ideologues who never read him and likely couldn’t understand him if they did. He would be regarded as a “socialist” by many of the idiots who invoke his name if they knew what policies he actually advocated.

  3. 3
    pragmatism says:

    ha! this just made my austrian school worshipping friend’s head explode. of course, he thinks that all there is to the austrian school is FREE MARKETS.

  4. 4

    Just curious, without bothering with waybackwhen (does it even still exist?), does Thompson object to any of his list specifically – “employer and individual mandates, public options, increased regulation, etc.” – or is it just that he thinks the system byzantine? And if the latter, why does he hate Orthodox Christians?

    Also what’s with the “unmoored centrist” digs? Does everybody need a strict ideology? Your own “coalition of opportunistic centrists on both sides of the aisle” sounds like the definition of politics to me.

  5. 5
    Zifnab says:

    @mistermix: No. He was coming out of the Great Depression and generally cautioning of too much government control over industry. But he wasn’t some wild-eyed Bircher.

    More of a latter day George Will.

  6. 6
    ThatLeftTurnInABQ says:

    Face it – these dead and gone* philosophers of the right, their names are being used as little more than fodder for magical incantations, not as a mine for useful ideas. “AynRand Hayek” instead of “Avada Kedavra” – what difference does it make if all you want to do with it is to kill your enemies? It’s just a bunch of foreign sounding syllables with malign intent lying behind the invocation of the names.

    *The dead and gone part is handy because you wouldn’t want the actual living person to be around just in case they might object to the uses to which their name is being put.

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