Introduction
I don't like to write this sort of post, and I try to write about the kinds of things I would want to discuss in a free society most of the time: mundane hobbies and day-to-day nonsense. Some anarchists want a perpetual revolution of ongoing struggle, but I prefer to find ways to live free now despite the existence of the State. That said, we are surrounded by a world of political trespass, and I also feel a need to comment on that from time to time.
There is no courage in speaking out against past injustices that have ceased, like denouncing chattel slavery in the Americas today. True courage lies in challenging such injustices while they are happening, and most people accept them as perfectly natural, like the abolitionists who challenged slavery in the 18th and early 19th centuries.
Disclaimer & My Bias
No, I am not a fan of the US healthcare model, but not for the same reasons as most of its opponents. Many anarchists would insist the market itself is a systemic injustice to be denounced and overthrown. I see such arguments as lazy conflation of laissez-faire and government intervention. Case in point: despite often being presented as "free market failure," the medical and insurance industries in the US are quite literally fascist. Despite nominal private ownership and many publicly-traded companies, there are myriad regulations, price controls, legal mandates, and literal state-sponsored cartels.
This present US system also prohibits the two chief hallmarks of free enterprise, namely open pricing and open competition. Corporate consolidation is not a demonstration of some trend toward market monopoly as posited by Marxist analysis, but rather a calculated effort toward regulatory capture and corporate protectionism through government intervention.
Despite this not-at-all-secret historical context and public policy, the common belief is that markets failed, and the solution is a state monopoly. Let me point to the utter debacles of Social Security, medicare, medicaid, Veterans Affairs, Workman's Comp, and every other such scheme for state monopoly care in the US. If it resulted in superior service at small scale, people wouldn't be nearly so leery of widespread versions of such programs. On top of that, we saw what happens when governments demand total medical control over society during the COVID-19 pandemic.
I argue that the US is a mess now because we have this bizarre insurance system that seems to operate a money laundering scheme. Why can I buy a box of band-aids for a few bucks, but a single strip costs a king's ransom on a clinic receipt? This divorce between cost and price is readily apparent, and since the US is proclaimed to be the bastion of free-market capitalism, it is easy for this superficial analysis to lead to an embrace of state socialism.
Americans often choose "medical tourism" to seek lower surgery costs and freedom to try unapproved treatments to escape the US regulatory state and corporate cartels. However, here in northern states, we also see a fair few Canadians hopping south to get prompt treatment instead of waiting months or years for needed procedures thanks to the waste, abuse, shortages and resource misallocation inherent in monopoly.
Oh, Canada
Maybe Americans are just bad at democracy though, and other more enlightened governments are fundamentally better. Never mind the exponential record of government growth since Woodrow Wilson, the US is still just so gosh darn stubbornly independent. Canada in particular is trumpeted as a beacon of virtue in comparison to their narcissistic and selfish southern neighbors. Everyone under the Maple Leaf flag has a right to medical care, and everyone is covered, no questions asked! How could anyone possibly object?
For starters, remember that Canadian trucker protest convoy? It was the epitome of peaceful resistance. Civil disobedience is supposed to be the tool of the disenfranchised and the voice of those the state would silence. The government responded by invoking unprecedented emergency powers and treated the protesters like terrorists.
The point is not that Trudeau is remarkably bad, or that this is somehow an aberration from Canadian kindliness, but that all governments are, by definition, territorial monopolies in violence. Despite the veneer of legitimacy provided by the myth of democracy, governments do not serve the people. There is no representation. There is no agent/principal relationship. It is naked usurpation, and when the tax cattle dare to dissent in a way that actually threatens their system of total authoritarianism, the state will crack down.
This can be hand-waved away by those who believe it's just "a few bad apples." We need new elections, some resignations, and a handful of new legislative acts, and the problem will get solved, right?
The Root Problem
But the problem is not just those few bad apples, or even that bad apples spoil the bushel. State monopoly is never a solution to any societal challenge. The economic calculation problem grows bigger and bigger the more any service is divorced from the market economy of open prices and consumer choice informing everyone of supply and demand. When people are not free to vote with their wallets, there is no signal of demand, and no price structure to allow rational economic calculation.
How many doctors does a community need? Where should hospitals be located? What specialists are required? How much do procedures and supplies cost? Bueaucrats and legislators do not know, and have no sound way to find out. When the state is extorting taxes from the populace and funding a system completely divorced from economic signals, it becomes a matter of posturing and pandering instead of serving the public.
But it goes downhill even from there. Remember when I referred to people being tax cattle for the political class? People serve two main functions for the State: wealth production to be plundered, and votes to maintain the illusion of legitimacy. All government programs are designed to expropriate wealth and buy support. That is the true purpose of welfare programs, universal healthcare, universal basic income, and every other government "service."
So what happens when you are not generating enough wealth for them to extort, and creating a drain on the "social services?"
Culling the Herd
This is likely to get especially contentious here. I am well aware of yellow journalism, a.k.a. "fake news," and I have tried to verify these links from multiple sources that aren't just copies of the same material, and I know foreign reporting is often incomplete at best, so take these links with a grain of salt, but it seems the assertions are verifiable.
Canada's "Medical Assistance in Dying" (MAiD) program started in June of 2016, about 6-1/2 years before this post is being composed. It was accompanied by promises that it would be used only rarely for people suffering terminal illness and eager to escape pain instead of forcing them to suffer under the old anti-suicide laws. The Catholic Church strenuously objected, claiming some wacky slippery slope concerns that no one should need to take seriously.
Said Dr. Bouchard of Calgary, “The downstream effects of ‘death on demand’ in Canada will lead to subtle coercive forces leading people down this road — there will be financial pressures, caregiver burnout, health-care cost implications, which will lead people to feel that this is their only option.”
Except surprise, surprise, it wasn't so crazy after all. Just a few months later in January 2017, the CBC suggested, Medically assisted deaths could save millions in health care spending. Multiple reports indicate suicide is being promoted to the disabled, including a wheelchair-bound paralympian waiting for a stair lift. A woman featured in a pro-euthanasia advertisement wanted to live according to her friends.
Approximately 10,000 people committed "medically-assisted suicide" in Canada in 2021, massively dwarfing the official 4,000 suicides cited in vital statistics. There are deep concerns that people are choosing suicide due to poverty. Next year, Canada proposes expanding "assisted suicide" to the mentally ill, too. How is this compassionate and progressive?
Conclusion
Real progress comes from liberty, not bureaucracy. There is no compassion in monopoly. Consider the Free Market Medical Association, real examples of better medicine like Atlas.MD, and alternative discussions like What's Really Wrong with the Healthcare Industry. Don't be suckered by the false dichotomy presented by party politics. I am personally considering alternatives to insurance like CrowdHealth (not an endorsement or an affiliate link) and direct primary care "concierge" care as better and less expensive options.
I live with chronic illness. It's nowhere near as painful or challenging for me as it is for many, but I can speak from a uniquely relevant perspective here: suicide is not a solution. It certainly looks like the Canadian medical system might be inclined to disagree with me. I am very glad I don't live under that system. There is hope, but not from politics. The State is always a death cult regardless of its flags and mythology.
Update Dec. 13 2022
Facebook deleted a meme I shared on this topic. I think their algorithms decided it was promoting self-harm or destructive behavior. Of course web2.0 social media has terrible service to contest such nonsense. See the image above for others making similar complains.
