Column by Brian Anderson.
Exclusive to STR
There are two main factors determining our medical treatment: (1) those who are allowed to serve us, and (2) the technological advancements that are created. In a column for The Daily Anarchist, I discuss the former, particularly focusing on the AMA’s state-granted monopoly over the licensure process. A quick excerpt [6] will summarize the stance:
Warning for decades of a surplus of physicians, the AMA is basically letting consumers know that their healthcare bills would be much lower if there were a greater supply doctors to address patient demand. Yet the organization has been successful in avoiding this hazard, with the average doctor now maintaining a patient list of at least 2,000 people.
More than anything else, this barrier to entry keeps prices drastically higher than needed. The government, as we libertarians understand, will never change this, though they’ll certainly complain about the costs to voters. Both political parties have their hands searching through deep pockets in the “health [7]” and “insurance [8]” sectors; legalizing an increase in supply would only make their unethical meanderings difficult.
The often-unmentioned price factor involves the specific technological advancements that are legal to use (in accordance with the Food and Drug Administration’s negative hand [9] in healthcare), but it’s perhaps most important to observe the blueprint filtering which advancements even make it to these clinical trials in the first place.
Case in point—taxpayer-funded scientific research, a huge program operating under the pretense that appropriation committees are better informed than the rest of us can ever be.
Like Murray Rothbard wrote [10] in For a New Liberty:
…the man who puts all the guns and all the decision-making power into the hands of the central government and then says, “Limit yourself”; it is he who is truly the impractical utopian.
Scientific research policies constructed by the government lead to one main consequence: resource misallocation through a distortion of consumer demands. It is not the case that libertarians are unsupportive of scientific research, which, of course, is a prerequisite for any worthwhile product or service; we simply reject the idea that a few unelected—and, quite frankly, unknown—people have enough sophistication and intelligence to direct the flow of others’ finances.
There is no doubt in my mind that most researchers working at places like the Centers for Disease Control and Prevention are brilliant individuals, but the atmosphere in which they work is often skewed by political agendas. Sheldon Richman explains [11] this phenomenon through an example in a different field:
NASA from the beginning has committed itself to manned space missions. These are more expensive than unmanned missions, and much expert opinion, in and out of the government, believe that manned missions are an unnecessary extravagance.
Why does NASA persist in sending people into space? It’s simple and readily acknowledged by NASA people: unmanned missions are boring. No one watches them on television because when you’ve seen one rocket launched, you’ve seen them all. If all the launches are unmanned the public will stop caring about space. And when they stop caring, the congressmen on the budget committees will think that NASA’s money could be spent on things that taxpayers care more about. So an exclusively unmanned space program threatens the existence of the program.
Whereas private firms need to focus their research on products that will eventually be purchased by their customers, the only “customer” in the mind of public research groups is the government with its endless wallet. First the CDC attempted to control tobacco smokers, especially under the organization [12]’s current director. However, like it is with all governments, if you give them an inch, they’ll take your raw milk [13]. And later they’ll take your bacon and eggs [14].
It would certainly seem more significant to use taxpayer money for, say, stem cell research aimed at growing back organs to fill the ever-expanding shortage, but it doesn’t sound as appealing to the government as does a fight against obesity in the United States. After all, obesity won’t cease until people develop better eating habits by choice. Organ shortages—a topic we’ll introduce in a few paragraphs—can be fixed quite easily and objectively, and that would be bad news for those government workers who wish to see their paychecks continue coming in the mail each week.
[Even if these once-private monies are returned to their original owners, stem cell legislation can change year-by-year, so many private investors won’t feel safe risking so much capital for a procedure that may very well be outlawed in the future. It is but another way that governments indirectly affect the great potential for private research.]
Critics may concede to the point that political agendas negatively affect scientific research policies, but they will argue that, without government’s hand in fund appropriation, the research wouldn’t happen at all. This hasn’t been the case in history, though. Even Albert Einstein, while working at a Swiss patent office, conceived the ideas for his Annus Mirabilis papers as an extracurricular activity with little access to the materials usually required for research. More recently, John Kanzius developed a promising radio wave-oriented [15] cancer treatment in the comforts of his own home.
These advancements exist because of the fact that there are fewer free riders when you get into higher positions of academic prestige. For example, Coca-Cola could send me its recipes and every pharmaceutical company in the world could send me its vaccine components, yet I’d still have no idea in the world what to do with them. The only individuals who are able to gain a free ride on these ideas are those who have already spent massive amounts of time researching in their own lives.
Research and innovation may be externalities in a way, but people want to give back to their communities [16] (even if this is a secondary effect). And one of the most important things to note about donations is the organization to which individuals are giving their money, or, I should say, the organization to which individuals are not giving their money.
You can notice that those participating in the Giving Pledge [17] are donating to charity, not government. This alone should stand as a symbol of efficiency. Unfortunately, no matter how much money is donated to non-profit organizations and research facilities, government prohibitions once again subtract from priorities. Since it’s illegal to sell your organs—think back to the oscillating illegality of stem cell research—scientists have no incentive to research alternative transplant surgery techniques.
Alex Tabarrok, research director at the Independent Institute, wrote a Wall Street Journal op-ed piece [18] in early 2010:
Millions of people suffer from kidney disease, but in 2007 there were just 64,606 kidney-transplant operations in the entire world. In the U.S. alone, 83,000 people wait on the official kidney-transplant list. But just 16,500 people received a kidney transplant in 2008, while almost 5,000 died waiting for one. […]
Only one country, Iran, has eliminated the shortage of transplant organs—and only Iran has a working and legal payment system for organ donation.
The concept of scarce resource misallocation is elementary economics. If the government were to enforce legislation prohibiting the sale of televisions while still allowing free television donations, who in their right mind would feel any need to (1) produce televisions and (2) research into related technological advancements, e.g., screens, discs, and cameras? The case of organs is even more personalized as it puts donors at risk for post-operation infections, causing actual deaths each year.
The black market in organ trade is thriving but quite dangerous for donors. There is no legal recourse for willing donors to take if the compensation contract is broken by acceptors. And the black market isn’t all bad, anyway. Last October a man named Levy-Izhak Rosenbaum was arrested for the heinous crime of… brokering the sale of three kidneys, the recipients of which are now “full and healthy lives [19].” This man became a symbol in the eyes of innovative researchers: tread warily when the government can see.
We can do better than to punish men who help the sick regain their existence, and we can do better than to deter real research in favor of unstable despotism called “public policy.”
