The Republican-Lite Positions of the Libertarian Party: Medicare

The two crown jewels of American welfare-state socialism are Social Security and Medicare. They are also the two largest expenditures in the federal budget, a budget so big that it has led to more than $36 trillion in debt now hanging over American taxpayers, not to mention the decade-over-decade debasement in the value of the dollar.

Unfortunately, support for these two massive socialist programs is a defining feature of the overall message that has come to define the Libertarian Party and its presidential campaigns. That includes the 2024 L.P. presidential campaign of Chase Oliver, who favored some sort of healthcare reform plan, such as health-savings accounts or some reform called “direct medical care.” The operative word, of course, is reform. Reform, reform, reform.

My 2020 L.P. presidential campaign

At the 2019 Libertarian Party convention in South Carolina, I announced my candidacy for the 2020 L.P. presidential nomination. Since I had not announced my candidacy prior to the convention, I was not qualified to participate in the presidential debate that was held at the convention.

Nonetheless, I attended the debate as a spectator. The moderator of the debate was Matt Welch, editor at large of Reason magazine. Among the first questions Welch asked was: What would you do with Medicare? No candidate advocated the immediate repeal of this socialist program. The answers entailed some sort of healthcare reform that left Medicare intact and that purported to improve or alleviate America’s healthcare crisis.

That was not how I would have answered the question. Upon returning home, I published a piece on my campaign website stating that my answer would have been: immediately abolish Medicare, and I explained the reasons for my answer.

It did not take Welch and Reason long to go on the attack against me. Reason quickly published a piece by Welch taking me to task with what has become a common attack against libertarians who advocate a principled, uncompromising approach toward libertarianism. He asserted that I was just trying to show that I was more libertarian than the other presidential candidates. Another popular form of attack along these lines is asserting that someone is simply trying to show that he is more “principled” than other libertarians.

There was one big problem, however, with Welch’s and Reason’s assertion. It wasn’t true. I wasn’t trying to show that I was more libertarian than anyone. After all, how does one really decide whether someone is more libertarian than another person? Is a person who hews strictly to libertarianism but favor drug laws more libertarian or more principled than a person who hews to 70 percent libertarian positions but opposes drug laws? It has always been a ridiculous attack.

I simply felt it was important for L.P. members to know where I stood on a critically important issue facing our nation, not to mention a critically important issue within the libertarian philosophy. After all, Medicare, like Social Security, is based on the initiation of force — i.e., taxation, which constitutes a direct violation of the core principle of the libertarian philosophy — the non-aggression principle. It is also a socialist program in that it is based on the forcible taking of money from one group in society in order to give the money to another group. Socialism is, needless to say, antithetical to libertarianism. Therefore, there is no possibility whatsoever that Medicare or any other socialist program fits within the libertarian paradigm. (See my Substack article “The Republican-Lite Positions of the Libertarian Party: Social Security.”)

Supporting socialism while decrying socialism

Yet, there it is. Support for Medicare, just like support for Social Security, has become a central feature of the standard message that has come to define the Libertarian Party and its presidential campaigns.

In fact, the permanence of these two socialist programs within America’s political and economic system has come to be an accepted fact within the overall libertarian movement itself. For example, in the December 2024 “Abolish Everything” issue of Reason, the magazine called for the abolition of Obamacare but not Medicare. Yet, Obamacare was, of course, a reform of the healthcare crisis produced by Medicare. Abolish Obamacare and you still have the healthcare crisis produced by Medicare that Obamacare was designed to resolve.

To further buttress my point of how support for Medicare has become a fortified position within the Libertarian Party, soon after I published my response to Matt Welch’s question about Medicare on my campaign website in the 2020 L.P. presidential race, I received a frantic telephone call from one of my biggest L.P. supporters. He had just read Welch’s attack on me in Reason and exclaimed, “You have to remove that article from your website immediately.” When I asked him why, he responded, “Because you can’t win the L.P. presidential nomination calling for the repeal of Medicare. Support for this program is too deeply embedded within the L.P. You probably have already doomed your chances but removing it now might still leave you a chance.” He also made it clear that he himself embraced the standard rationale for opposing immediate repeal of this socialist program — that there would be people dying in the streets if Medicare was suddenly terminated. Needless to say, I left my article posted as is.

Of course, he was right about one thing — I did fail to win the 2020 L.P. presidential nomination, but I suspect it had more to do with just calling for the immediate repeal of Medicare (and Social Security). But four years later, nothing had changed with respect to the overall message of the Libertarian Party and its presidential campaigns. At one presidential debate at a state convention, when I stated that we should immediately repeal Medicare, one of my opponents called it a “crappy” solution. None of the other presidential candidates on stage disagreed with him.

With their allegiance to Medicare and Social Security, how does the L.P. and its presidential candidates make a moral or economic case against the welfare state itself or, for that matter, against socialism in general? Oh sure, Libertarians decry some welfare-state programs like food stamps just as they publish articles and deliver speeches decrying the evils of socialism in general. But how credible are such critiques when Libertarians are, at the same time, supporting the crown jewels of American socialism, Social Security and Medicare? Moreover, in a future article, we’ll see that the pro-socialist problem within the Libertarian Party and the libertarian movement is even more aggravated when it comes to the subject of public (i.e., government) schooling.

Healthcare before and after Medicare

I grew up in the 1950s, before Medicare and Medicaid were enacted. Hardly anyone had major-medical insurance because they didn’t need it. Healthcare costs were low and stable. Going to the doctor was like going to the grocery store. People could easily afford healthcare expenses.

Then President Lyndon Johnson’s regime, emulating LBJ’s hero President Franklin Roosevelt, who had converted America into a welfare state in the 1930s, enacted Medicare and Medicaid in the 1960s. That’s what caused healthcare costs to begin soaring. That’s what gave us our ongoing, never-ending, perpetual healthcare crisis. Medicare and Medicaid are the cancer on the body politic that is contributing to the destruction of our nation.

What Libertarian healthcare reformers fail to realize or acknowledge is that as long as Medicare and Medicaid remain in existence, there will always be an ongoing, never-ending, perpetual, and growing healthcare crisis, no matter what healthcare reform is adopted. There is one — and only one — solution to America’s healthcare crisis: repeal Medicare and Medicaid and do it immediately and without any hesitation. After all, isn’t that what doctors try to do with cancer?

What about the poor?

What about the poor and needy? My hometown of Laredo, Texas, was the poorest city in the United States in the 1950s and 1960s. Every day, doctors’ offices were filled with patients, many of whom couldn’t afford to pay. Doctors never turned away anyone. They felt it was their ethical duty to help out others in need. Nonetheless, doctors were the second-wealthiest people in town, second only to the oil people. Helping the poor and needy on a purely voluntary principle was also true for the only hospital in Laredo — Mercy Hospital, which depended on donations. That’s what genuine charity is all about. Genuine charity comes out of the willing heart of the individual, not the coercive apparatus of the IRS and the welfare-state bureaucracy.

Consider the dental profession. There is no governmental welfare program for dental care, including for seniors and the poor. Yet, countless dentists across the land quietly, without any fanfare, provide free dental care to needy people. Notice also that there is no ongoing, never-ending, perpetual dental crisis, which there would be if there was dental welfare program established comparable to Medicare and Medicaid.

Sudden repeal brings vitality, not chaos

In the 1930s, the Roosevelt regime enacted the National Industrial Recovery Act, which cartelized American business and industry. It was a program straight out of the playbook of the fascist dictator of Italy, Benito Mussolini. It was soon proving to be an economic disaster. Advocates maintained, however, that since it had become an integral part of the American system, there would be chaos if it were to be suddenly and immediately repealed. The only thing to do, they said, would be to “phase out” the program over a long period of time. One day, the U.S. Supreme Court declared the program unconstitutional, effectively “pushing the button” that brought a sudden and immediate end to the program. Not only was there no chaos, the sudden and immediate end to FDR’s fascist program immediately produced an economic revival.

Americans lived without Medicare and Medicaid (and Social Security) and other welfare-state programs for more than 100 years. The result was the most prosperous and the most charitable nation in history. To get our nation back on the right track, Americans of today need to capture the faith in freedom, free markets, and voluntary charity that characterized our American ancestors.

Leading the charge toward freedom

It goes without saying that support for Medicare (and Social Security) are major positions of the Republican Party. For that matter, the Democratic Party too. The fact that the Libertarian Party has also come to embrace these two socialist programs helps to explain why many L.P. members, including within the right-wing element that currently controls and dominates the party, had no reservations whatsoever with making Robert F. Kennedy, Jr., a died-in-the wool welfare-statist who praises communist Cuba’s socialist healthcare program, the 2024 L.P. presidential candidate.

But Medicare and Social Security and all other socialist programs have no place whatsoever in the Libertarian Party, a political party that purports to strive for “freedom.” A necessary prerequisite to living in a genuinely free society is the repeal of Medicare, Medicaid, Social Security, and all other socialist programs. No one who lives under socialism can ever be considered free, no matter how much people might convince themselves that they can find freedom under socialism.

The Libertarian Party and its presidential candidates and, for that matter, all members of the Libertarian Party, should be leading the charge in the restoration of faith in freedom, free markets, and voluntary charity. It cannot do that so long as the L.P. and its presidential candidates remain wedded to Medicare, Medicaid, Social Security, and other socialist programs. It can only do that by unequivocally advocating the immediate repeal of all socialist programs in America, especially the crown jewels of American socialism that are helping to bankrupt our nation — Medicare and Social Security.