Over at the LPUK blog, Guthrum (who I think is LPUK Head of Policy, though I’m not 100% on that LPUK Party Chairman) writes that:
One of the greatest problems that a Libertarian has is trying to convey the message that Libertarians would not close all of the hospitals in the country, and the dead, dying and ill would be lying in hedgerows and/or the work house.
But the argument that follows does nothing to deflect that criticism. Now, it may well not be LPUK policy to stop funding hospitals etc, but I think that a reasonable reading of libertarian political philosophy would mean that at least some dead, dieing and ill would be denied treatment. I take it that Guthrum is arguing (or trying to argue) that libertarianism as an ideology need not lead to the bad situation he outlines, not that he’s making a point merely about LPUK party policy (or else all he’d have to do is link to a policy document).
Anyway, libertarians believe that any State significantly larger than Nozick’s minimal State is unjust. The State should provide police, military, courts, enforce contracts and so forth, and nothing else. Or rather, the State is not justified in using coercive taxation to fund anything else it wants to do. Now, hospitals pretty clearly come in the “anything else” bracket, so the libertarian line ought to be that that hospitals cannot be funded out of coercive taxation. Any funding of hospitals must be on a purely voluntary basis.
In this hypothetical libertarian world, it is plausible that at least some people would lack health insurance. Perhaps they do not have enough money for it, and perhaps their employer won’t provide it because they are unskilled, and hence easily replaceable. I don’t think that that’s an implausible picture – there are plenty of unskilled, easily replaceable workers in this non-libertarian world!
Well, these people would be beholden on private charity. Medical treatment costs money, and if it’s not going to come from the State, it’s got to come from private individuals (of course, the money the State raises in taxes was once the property* of private individuals – I do not intend to gloss over than fact). If there’s no private charity in your area, you won’t get treatment if you lack insurance etc. If there’s insufficient private charity, hospitals will have to close.
Guthrum’s argument against the view that libertarians would close all of the hospitals in the country, and the dead, dying and ill would be lying in hedgerows and/or the work house is along the lines of “well, the NHS is crap anyway”. Maybe so. But that isn’t an argument for either:
a) libertarian ideology would not lead to some poor people etc not getting medical treatment, when they would under the NHS
b) libertarian ideology would lead to some poor people etc not getting medical treatment, when they would under the NHS, but that doesn’t matter (perhaps for reasons of justice). This is what I think Nozick would say.
But Guthrum’s argument doesn’t get him to either (a) or (b) and it is those that he needs. Guthrum is thus right to suggest that:
One of the greatest problems that a Libertarian has is trying to convey the message that Libertarians would not close all of the hospitals in the country, and the dead, dying and ill would be lying in hedgerows and/or the work house.
It is a great problem, because libertarians don’t have an ethically palatable answer to that problem, and it’s right that non-libertarians find the libertarian position distasteful at best.
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* I use “property” in a non-moralised sense – I do not imply, nor do I believe, that it is wrong for the State to tax redistributively.