Bloggingheads.tv, One-Handed Applause with Joshua Cohen and Brink Lindsey, 6th October 2009.
Brink Lindsey coined the term ‘liberaltarian’ for a fusion between free market libertarians and liberals (in the American sense for people who would otherwise be known as social democrats). Lindsey works for the Cato Institute and represents the most moderate side of an organisation distinctly inclined towards libertarian-conservative fusionism. ‘Liberaltarianism’ has not really taken off as a major new fusion, but Lindsey has continued his own dialogue with lef-liberal Democrats. In this webcast (can also be downloaded, or played in the browser, in wmv audio-visual, or mp3 and mp4 audio formats, I recommend the wmv option), Cohen and Brink chat about health reform and the overall progress of Obama;s presidency.
As they point out, the two biggest influences on libertarian thought, Milton Friedman and Friedrich Hayek, both supported forms of universal health coverage. Brink builds on this in supporting universal health coverage, but with competition between providers and a removal of current barriers to health markets. As he points out, there are various forms of interventionism in the health market, particularly tax deductions for employer provided insurance. This creates at least two major problems: lack of interest in cost control, difficulties in transferring health coverage when changing jobs. Cost control is not necessarily about restricting access to health care, it is about recognising that health care will be better distributed if users are aware of cost comparisons, and are not inclined to waste money on ineffective health care.
Cohen’s ideal option is ‘single payer’, i.e. universal health care from general taxation. They do reach a lot of agreements on possible health care solutions if ‘single payer’ is not a likely option. Singapore is discussed most, that is minimal government health care supplement by compulsory contributions to personal health savings accounts. Lindsey is very critical of current health care in the US, quite rightly as this strange mix of government provision (Medicare and Medicaid) and heavily regulated private insurance markets, does not satisfy free market or social justice criteria.
The major advantage he sees in the current US system is that most medical innovation comes from the US, which he links with the unwillingness of government controlled systems to pay for innovative drugs and technologies. His major concern, quite rightly, is to make sure universal coverage is designed to create competition between providers with regard to both cost and innovation.
Cohen and Lindsey finish with a discussion of the Obama presidency. They agree that Obama is not a transformational left wing president, and remind viewers that he ran as a more centrist candidate than Hillary Clinton. They also agree that he is politically skilled but has not been very successful at getting many policies through so far, and that it is too soon to judge the presidency.