The Libertarian Party and Healthcare, Part 1: Medicare

Given that I announced my candidacy for the 2020 Libertarian Party presidential nomination at the South Carolina Libertarian Party’s 2019 state convention, I did not qualify for that convention’s presidential debate. But I decided to attend it anyway to see the positions that my opponents would be taking. 

Matt Welch, who has long covered L.P. events for Reason magazine and who has long been involved in L.P. activity, moderated the debate. Among the first questions he asked was, “What is your position on Medicare.”

All of the answers involved some sort of healthcare reform. 

When I returned home, I posted a blog on my new campaign website in which I stated how I would have answered that question. My answer would have been: “Repeal it, immediately.”

Soon afterward, Welch and Reason went on the attack. In a Reason article, Welch accused me of just trying to show that I was more libertarian or more “hard core” than the other candidates. It’s an old strategic tool that the reform element in the Libertarian Party have long used to dissuade Libertarians from taking a principled approach to libertarianism. 

The notion is twofold: First, if a Libertarian stands on principle, he is supposedly arrogantly showing that he is superior to Libertarians who advocate reform. Second, reform proposals are considered to be on the “libertarian spectrum” and, therefore, are considered by reform-oriented Libertarians to be just as valid as pure libertarian principles. (See my Substack article “The Falsity and Fallacy of the Libertarian Spectrum Concept.”)

Actually, all I was trying to do was show L.P. members where I stood on this important burning issue of our time. The way I figure it is that L.P. members have a right to know where the candidates stand on all the important issues facing our country so that they can make a well-informed and well-reasoned choice in selecting their presidential nominee.

Moreover, my blog post had nothing to do with expressing some sort of moral superiority by standing in favor of an important libertarian principle. My aim in life is the same as most libertarians: I want to achieve a free society. The only way to do that is by identifying and then removing infringements on liberty. As a socialist program, Medicare is one of the biggest infringements on liberty in our lifetime. 

As I have been emphasizing in my Substack articles, reform is not freedom. Reform is reform. It necessarily entails leaving the welfare-warfare state intact, albeit in a reformed fashion. That’s not freedom, any more than a reform of slavery would have been freedom. And it matters not whether one convinces himself that reform is freedom and on the “libertarian spectrum.” Since reform leaves infringements on liberty in existence, and since such reformed infringements involve a violation of the libertarian non-aggression principle, they cannot legitimately be considered either freedom or libertarian. (See my Substack article, “Slavery Reform vs. Serfdom Reform.”

Immediately after the Welch/Reason attack on me was published, I received a rather excited telephone call from a supporter. He emotionally told me that I needed to delete that blog post from my campaign website immediately. He said that there was no way that I could win the L.P. presidential nomination if I called for the repeal of Medicare. He said that it was vital that I change my position immediately to one that supported health-savings accounts, which is a popular healthcare reform measure within the Libertarian Party and one that necessarily leaves Medicare in existence. 

What my supporter was referring to was the fact that over the years, the Libertarian Party had become predominantly reform-oriented. I myself had noticed this phenomenon when I was speaking at various state L.P. conventions in early 2019, not as a candidate but simply as a speaker. In those talks, I would deliver the principled, uncompromising case for the libertarian philosophy, which, of course, included such things as abolishing Medicare, Social Security, and other socialist programs, legalizing all drugs, opening the borders to the free movements of goods, services, and people, unilateral free trade, ending all foreign interventionism, and dismantling the national-security state governmental structure and restoring a limited-government republic to our land. 

As I traveled from convention to convention giving talks (before I was an announced presidential candidate), I noticed that the eyes of many L.P. members, especially younger ones who had come into the party in the past 25 years, were bulging out of their heads as I was delivering my talk. It finally dawned on me why. They had never heard the principled case for libertarianism. All they had ever heard was the case for reform — things such as school vouchers, health-savings accounts, regulatory reform, selective foreign interventionism, and legalization of marijuana. In their minds “free-market reform measures” were libertarianism and freedom. And now, here was a speaker giving them the genuine case for liberty and libertarianism. Many of them didn’t know what to make of what they were hearing, but I could tell that I was touching some deep chords within some of them.

Thus, my supporter who telephoned me beseeching me to delete that abolish-Medicare article from my campaign website was not off-base from his own particular perspective. In his mind, health-savings accounts were libertarian. Therefore, given a choice between health-savings accounts and abolishing a popular socialist program such as Medicare, for him it was a no-brainer. As far as he was concerned, given the predominant reform-oriented mindset within the L.P., it would be politically smart to support health-savings accounts and abandon my position in favor of repealing Medicare.

Needless to say, I kept the article on my campaign website and, in fact, continued calling for the repeal of Medicare through the rest of the campaign.

A few months after the Welch/Reason attack on me, I had an interesting and revealing experience with respect to healthcare. I was attending another state convention, where there was to be a presidential debate. This time, I was going to be participating in the debate. Of course, I planned to make the principled, uncompromising case for liberty, including calling for the abolition of Medicare. In fact, my campaign motto was “A Campaign of Principle for the Party of Principle.”

In the hour before the debate, a Libertarian healthcare expert was giving a talk on healthcare. The speaker began his talk with words to the following effect: “We all know what the genuine libertarian position is on healthcare. It’s a total separation of healthcare and the state.” 

I thought to myself, “Wow! This is fantastic because that was the position I, of course, would be taking in the debate.”

And then came the but. “But we all know that voters are not ready for that. Therefore, we have to take the position they are ready for, which is health-saving accounts.” Of course, in his mind, health-savings accounts were a healthcare reform measure that fell within the “libertarian spectrum” and, therefore, were considered a legitimate position for Libertarians to take.

I thought to myself, “Oh, no. Here this guy has a chance to spend a full hour educating Libertarians on how to advance the genuine Libertarian position on healthcare — the total separation of healthcare and the state — and he instead resigns himself to presenting what is actually the Republican/conservative reform position on healthcare.”

And how does he know what voters are ready for? If many of us Libertarians are ready for genuine healthcare freedom, why wouldn’t there be other Americans who are ready for it? The way I figure it is that if we can see the virtues of freedom, so can others. But to do so, they have to hear the case for liberty, not the case for reform.

America once had the finest healthcare system in history. Hardly anyone had major-medical insurance because they didn’t need it. Prices were low and stable. Going to the doctor was like going to the grocery store. Doctors loved what they did in life. Healthcare innovations were soaring. In my hometown of Laredo, Texas, which was the poorest city in the United States, doctors and the local Catholic hospital, Mercy Hospital, provided free medicare care to the poor. 

And then came Medicare and Medicaid, two socialist programs whose concept, like Social Security, had originated among socialists in Germany and was imported into the United States. That’s what ended up destroying the finest healthcare system in history. Healthcare prices began soaring. Doctors began hating their profession and began retiring early. America’s healthcare crisis became a permanent feature of American life. 

Meanwhile, in the hope of pleasing voters, Republicans, who had initially opposed Medicare, threw in the towel, accepted Medicare, and embraced reform, in the form of health-savings accounts. Disgruntled Republicans who left the GOP and came into the Libertarian Party convinced many L.P. members that health-savings accounts were a “free-market” libertarian healthcare reform.

For their part, Democrats also advocated reform. That’s what Obamacare was all about. With the failure of that reform to fix America’s healthcare crisis, Democrats began pushing for a full-fledged socialist healthcare system, like the one that exists in Cuba, which many Democrats extol.

But there is actually only one solution to America’s ongoing, never-ending healthcare crisis. It lies not with reform but rather with the repeal of Medicare and Medicaid and, ultimately, with the total separation of healthcare and the state. Restoring the Libertarian Party to its role as the “Party of Principle” in the political arena is the way to lead America out of the healthcare morass into which both Republicans and Democrats have plunged our nation.

NEXT: The Libertarian Party and Healthcare, Part 2: Covid.