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The libertarian tradition
By Abdul Turay
Published Postimees 30 March 2010

“There is nothing nice about the USA. When you go to hospital you have to pay”

So sang legendary Scottish punk band the Exploited in their seminal track “F**k the USA”

Estonian medical practitioners make the same point albeit rather more tactfully.
“In the US people are not even in the health system, it is not working,” Dr Margus Viigimaa, President of the Centre for Cardiology said.

He goes on to explain that when the health system in Estonia was set up in the 90s they borrowed ideas for Sweden and Britain but not from the United States.

The healthcare debate not only show that Estonia is in many ways a better place to live than the United States. It also shows the people who oppose health care reform, American libertarians, are dangerous not just to Americans but to the Estonia nation. To understand why we have to look at how Americans see themselves and their place in the World.

The passage of the health care bill through Congress March 19 represents a triumph for the Obama administration, he is the first president to successfully reform the health care system since Lyndon Johnson in 1965. The bill expands Medicare and Medicaid for the elderly and those on low incomes, provides for reduction in prescription dugs, outlaws insurers refusing cover because of pre-existing conditions and sets up state exchanges where citizens can buy insurance.

However what the bill won't do is the very thing the president set out to achieve, provide universal health care for all Americans.

Because of opposition from the Republican and some Democrats, the final version of the bill - which has in any case been sent back to Congress for fine tuning - is not at all clear cut. It's a thousand pages of compromise and fudge that virtually no-one has read, not least the congressmen who voted on it.

As the Financial Times reported on March 23, about 23 million Americans will still have no health care coverage after the bill becomes law, that is a little better than the supposedly 32 million Americans with no health insurance today but universal health care it is not. The bill also doesn't provide coverage for those people who are in America illegally, some of whom are Estonian.

Most Americans worry constantly about health care. Health cost are ruinously expensive. People routinely go bankrupt because they can't afford their medical costs. Medical bills are the biggest single cause of bankruptcy.

Documentary film-maker Michael Moore in his health care film “Sicko” depicts a scene where a sick women to thrown into the street like garbage by a hospital because she had no money and no health insurance.

If you care to look, you can find videos on the internet about charities operating in the United States where people queue from morning until night to get health care. These charities were originally set up to provide health care in Third World countries.

In Estonia although hospitals and clinics are privately run and privately owned, the principle behind which the health system in Estonia operates is essentially socialist.

Health care is paid for out of a central fund which taxpayers pay into. Anybody can use it more or less for free, even non-citizens who have residency, but only people who are working pay into it.

It's Marxism in the purest sense of the meaning built around a capitalist shell.

“From each according to their ability, to each according to their need,” as Karl Marx wrote.

The system compares favourably to any system in the world.

“The value for money is higher than Europe. It has been officially studied,” said Dr Viigimaa.

“The financial system is quite effective. All General Practitioners are paid the same money for the whole country. People's belief in the state system is quite good. We have in Estonia only one private insurance company,” he said.

Estonia spends between 5.0 to 5.4 per cent of its GDP its on health care cost whereas the United States spend more than three times that amount about 16 per cent, yet Estonia can provide lifetime care for everybody whereas the United States can not.

How is it that an “emerging economy” like Estonia treats its people and even its guests better than the richest, most powerful, country in the World?

The United States has no universal health care because it is not provided for in the constitution.
The United States was not founded as a democracy; democracy was a dirty word in the 18th Century. It was founded as a constitutional republic with rule of law, separation of powers and checks and balances to prevent tyranny or mob-rule/democracy.

When the founding fathers talked about freedom but they meant freedom of individuals from government intervention and government taxes.

Today there is a growing faction of people called libertarians. They believe the constitution should be strictly adhered to. They oppose big government. They argue that universal health means more taxes and more government intervention, in people's life. They believes it means European-style socialism.

To the libertarians the health care reforms are unconstitutional and un-American.

Many people believe Europe adopts ideas from America, but actually in terms of how to run a society the opposite is true. For the past 150 years the United States has moved away from those ideas set out in the constitution and adopted ideas first tried in Europe, especially the U.K.

Had Americans stuck to the principles in the constitution; there would be no public schooling, nor state pensions, nor employment benefits. There would be no social security, no Federal Reserve Bank, no public health insurance of any kind; but black people would still be slaves and women wouldn't still have the vote.

As Gideon Rachman, right-wing, pro-American, columnist writing in the Financial Times puts it: “Healthcare reform has nudged the US a bit closer toward the European ideas of social solidarity- and further away from America's own tradition of rugged individualism”

Libertarians believe that the free market capitalism always provides the best goods and services because competition for customers will force down prices. Usually this is true, but with health care this is simply not the case because health care prices are often perfectly elastic.

If you are the parent of a child with painful leukaemia. And that child is screaming in agony all through the day and all through the night, you would pay any price to get your hands on a drug that would alleviate that pain. You'd borrow from friends, sell your house. You'd rob a bank if you knew how. A drug company with a patent on that drug can charge any price they like. In a system based on the free market is it any wonder that Americans are going bankrupt to pay for health care costs?

There is one other thing that the United States has adopted from Britain and this is where Estonian need to be interested.

In the 1950's Britain handed over the role of global champion of Western values - or global bully depending on your point of view - to the United States

The trouble for those Estonians who are relying on the United States to provide for the nation's security, forever, is as far as libertarians are concerned, this is unconstitutional and un-American also. The founding fathers specifically warned the the young republic about getting involved in foreign entanglements and foreign war, not because they didn't want the country to be strong, but because wars, like healthcare, require more taxes and more government intervention to maintain large standing armies.

In most powerful countries the most right-wing people want their countries to expand their global reach and influence, in the United States right-wing libertarians want to shrink it.

If libertarians are against paying too much tax to defend themselves, how do you think they feel about the paying taxes to defend Estonia?

The danger is not here and now, the current administration is very far from libertarian as the results in the vote show.

But libertarian thinking is a growing force both in American public life and in the Republican party. All Republican congressmen voted against the health care bill and have vowed to keep on fighting. The debate on the health care has also switched many Americans on to understanding what libertarian thinking is all about.

The Libertarians may have lost the vote but they are still fighting for the soul of America.

If in some time in the distant future, libertarianism has taken over, the United States has revert back into isolationism it had before the 1940s and N.A.T.O no longer exists, will people remember it all started with defeat in a domestic bill about healthcare?

In the long term, decision makers in Estonia need to be aware of this strand of the American psyche, and look
to other ways to maintain national security.


Anonymous said…
Ironically, these libertarians also say "don't touch my Medicare or Social Security? by their own definition, it makes them closet socialists i guess.

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