A Libertarian Case for “Free” Health Care?

Last month author, columnist, and intellectual-at-large Christopher Hitchens spoke about George Orwell and Hitchens’ new book, Why Orwell Matters, with Russ Roberts of the Library of Economics and Liberty. (A link to the audio recording of the interview is in the footnotes. [1]) It is always a pleasure to listen to Hitchens even though, perhaps especially, when I disagree with him. This interview is no different and I would like to draw attention to one argument Hitchens offered regarding the issue of health care insurance since I have not heard it from anyone else of late.

Long time member of the left, one might expect from Hitchens one of the typical arguments for “free” health care for all. Seemingly, he offers something different. Is he even more inclined today “to stress those issues of individual liberty,” as he said several years ago in a Reason interview? [2] Paraphrasing, Hitchens said: if you offered people health care and freed them from the burden of worrying, “if I lose my job and fall ill, I’ll be doomed,” you will be making them more free. It appears an interesting and novel argument in favor of the proposed “health care reform.” Amongst the many arguments offered in favor of the proposal in recent months this is interesting insofar as it appears to have a legitimate philosophical base. Who doesn’t want freedom? Freedom is great! America is founded on the notion of freedom, we should make people free!

We must first, though, define freedom before we can know whether or not we possess it. In this task I turn to the great author and scholar C.S. Lewis, whose indispensable book Studies in Words will assist us. The modern English free like the Ancient Greek eleutherios and Latin liber originally carried connotations of both autonomy and legal status. The words also contain both ethical and social connotations: that a man is both free insofar as he is not a slave and free insofar as he acts as befits one who is free (as slaves were thought inherently to be nosy, ungenerous, carry grudges, et cetera.) Additionally, the English free grew to be used in the sense of “enjoying the freedom of a city” and by extension, being a citizen of that city and enjoying the commensurate rights, namely the right to vote. With those notions in mind, we may examine the cultural meaning of free. Chief amongst these distinctions is there are certain occupations that befit the free man because he undertakes them for their own sake and not for utility. Even commercial work does not make one free in this sense, since it is done to contribute to some other end. Lewis adds, “Only he who is neither legally enslaved to a master nor economically enslaved by the struggle for subsistence, is likely to have, or to have the leisure for using, a piano or a library.” I believe this definition is most similar to what Hitchens means by “freedom.” If only we could free people of the fear they might not be able to support themselves, they will be able to do their jobs better, more joyfully, et cetera. These are variants of what I call “Star Trek Syndrome,” which is the supposition that if we removed from man his need to support himself, he would be free to devote his time to some worthy pursuit. Yet Hitchens’ idea still sounds credible, as no man living with the anguish of uncertainty can be happy.

Alas, there exist two flaws in this argument. The first is this: it assumes the government is a “rights bursar,” that it exists to (or even simply, may) create and grant freedom. This is an incorrect assumption, as our society, unlike those that heretofore defined free, is one founded upon the principle of natural rights. In a society in which social mobility is impossible, where one is either citizen or slave or lord or serf, where there is neither legal ability nor practical chance for improvement, freedom is essentially inherited. The connotations and prejudices contained in the ancient definitions are foreign to our definition of liberty. In our society, freedom is simply the ability to act uncoerced by force and it is considered distinct from prosperity or happiness. Our government exists but for one purpose, to guarantee our natural rights to life, liberty, and the pursuit of happiness. The government does not exist to invent additional rights and to grant them to the people, nor can it do these things. The Declaration of Independence and The Constitution of the United States of America contain acknowledgments that men are inherently, i.e. already, free. In the definitive biography of our third President, Dumas Malone summarized the Jeffersonian outlook:

Like so many of his ‘enlightened’ contemporaries, Jefferson believed that men had originally been in a state of nature; that they had then been free to order their own actions and to dispose of their own persons and property as they saw fit; that government was instituted among them in the first place by consent.” [3]

Thus the government’s purpose is to safeguard those freedoms, neither to add to nor subtract from them. This concept of natural rights represents a fundamentally different worldview from both its predecessors and successors.

A second flaw is this: who would provide these rights? If, as we have said, a man is born free, then he inherently has a right to his life and thus must be left free to use his mind to decide how best to support himself. The concept of making a man more free by alleviating him of the necessity of supporting himself is in contradiction with the above principle. In creating a legal responsibility for supporting a man, you in fact diminish everyone’s rights, enserfing both the poorer and richer parties to a distributive entity. The only way to “free” one group of people from the “burden” of supporting themselves is to have another group of people support them. The underlying assumption here is that it is not my job to support myself, but someone else’s, i.e. that I am entitled to my own freedom at the expense of someone else’s. Here we must differentiate between two concepts, freedom and prosperity. In the ancient definitions, the prosperous man is free. In our era, the free man is able to become prosperous. To impose the older definition on our society would be to mandate an average level of prosperity, i.e. the more prosperous must be brought down to average to raise those below average to the same point, that way everyone can be said to be prosperous, and thus free. The root of this conclusion is an egalitarian assumption: that equal opportunity must result in equal outcome. If we are all equal in ability, this argument goes, then it must be an unjust system or society that represses some. Without commenting on the truthfulness of this claim, I will say only that it is a concept alien to our foundational laws. It is an extra-legal belief which, of course, your are free to adopt and live by, but not free to impose on others.

If we exercise our memories (or hit the history books) we will recall this view is not new. Proposals for “additional” rights have been made before by many 20th century Progressives. In his 28th Fireside Chat on January 11, 1944 President Franklin Delano Roosevelt said, “Necessitous men are not free men." Clearly we see the old arguments and the new are one and the same. From the same speech: [4]

In our day these economic truths have become accepted as self-evident. We have accepted, so to speak, a second Bill of Rights under which a new basis of security and prosperity can be established for all-- regardless of station, or race or creed.

Among these are:

The right to a useful and remunerative job in the industries, or shops or farms or mines of the nation;

The right to earn enough to provide adequate food and clothing and recreation;

The right of farmers to raise and sell their products at a return which will give them and their families a decent living;

The right of every business man, large and small, to trade in an atmosphere of freedom from unfair competition and domination by monopolies at home or abroad;

The right of every family to a decent home;

The right to adequate medical care and the opportunity to achieve and enjoy good health;

The right to adequate protection from the economic fears of old age, and sickness, and accident and unemployment;

And finally, the right to a good education.

All of these rights spell security.

Aside from the problem of the authority by which those rights would be precisely (i.e. actually and usefully) defined and administered and the myriad problems of implementing them, author and philosopher Ayn Rand succinctly addressed the fundamental problem of these supposed rights in her 1963 essay, Man’s Rights, asking: “at whose expense?” [5] Is a nation in which some men work to provide these “rights” for others more or less free than one in which each works to support himself? Rand added, “A right does not include the material implementation of that right by other men; it includes only the freedom to earn that implementation by one’s own effort.” [5] One is free to pursue happiness, one is not owed happiness itself. In a time of great crisis, FDR asked Americans to sacrifice liberty for security. Americans have, at various points over the past 60 years taken that offer from various people, parties, presidents, congresses, et cetera. We accepted Social Security, which is now bankrupt. We accepted Medicare, which is now bankrupt. We accepted a government monopoly on education and national education standards, and school systems are in shambles. We incentivized home ownership and regulated our economy with disastrous consequences. All of these programs were supposed to make some people, the unfortunates, more free. All of these programs and more will have to be supported at the expense of some: are they more free or less free?

Today, amidst another crisis gladly not as great, our current president asks the same. Perhaps more of the poison is the cure? Yet FDR’s “rights” have indeed secured something: a government continually growing in size and power. Let us return to the understanding that freedom is the right to life, liberty, an the pursuit of happiness. Admittedly, these rights do not spell security. They spell liberty, which cannot be invented, bought, and doled out, only recognized, fought for, and preserved. What man, then, shall we call free? He, “whose life is lived for his own sake not for that of others.” [6]

[1] http://www.econtalk.org/archives/2009/08/hitchens_on_orw.html
[2] http://www.reason.com/news/show/28208.html
[3] Malone, Dumas. Jefferson the Virginian. Little, Brown and Company. Boston. 1948. p. 175
[4] http://www.presidency.ucsb.edu/ws/index.php?pid=16518
[5] Rand, Ayn. Man’s Rights. Signet. New York New York. 1961 (p. 113)
[6] Aristotle. Metaphysics 982b

Lewis, C.S. Studies in Words. Cambridge University Press. Cambridge, UK. 1960 (Ch. 5: “Free”)