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This is a perfect example. Healthcare by charity, only by charity.

I’m liberal/libertarian in the sense that I want personal liberty maximized. At the same time, I do not think most of these liberties make much sense without education or health. I simply do not believe there is no way to provide provisions for health, education, a social safety net and other forms of welfare without the usual government inefficiencies.

Instead, I think in some ways, government can do better than private-sector charities. Consider healthcare – a Bismarckian system of social insurance allow risk-pooling, while allowing for a high level of private players. By its design, it covers the very poor – those who otherwise cannot afford the security of healthcare.

Sure, there can be charity hospitals, but the flaw of philanthrophy is that it isn’t the most efficient way of distributing aid – hospitals in New York City and Los Angeles probably would get by, hospitals in Detroit and other likewise areas would face a tougher time. And private insurance doesn’t cut it either – profit motivation doesn’t seem to be very compatible with health risk pooling. Those who need it most can’t get insurance, those who have it find claiming notoriously difficult, and the healthiest tend not to buy insurance. Pretty bad risk pooling there.

Sure, there are trade offs. I call it the unholy trinity of healthcare: accessibility, high quality (low waiting time and all that), and low cost – choose any two. Just that with entirely private healthcare provision, you get high quality. That’s all. The healthcare market just doesn’t work the same as other markets (consider this: if you had cancer, would you pick cheap, run-of-the-mill treatments or the best available? The latter, right? Well, the best available never reaches “mass production” – it rarely becomes affordable).


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