What would health care be like in a libertarian society? In a society where the professional class no longer enjoyed the “protections” of government from the cost controlling aspects of a true free market? Where there was free trade in medical drugs? Where most people used computer software to access “Doctor Internet” (a big software program) to find out what was wrong with them? How would they finance needed healthcare? Where could they get the necessary education to allow them to make such medical decisions in the first place? I suggest adding an hour to the day in high school where people could be given the necessary education to understand just what is involved in life and death issues like this.
First the relationship between doctor and patients changes to one of contractor to client. The doctor provides the level of health care services that the client (patient) wants to have. The frequency of office visits and lab tests is decided by the patient, not by the doctor as now. Without prescription laws, the doctor has far less control over the patient’s actions. The patient is the one really making the decisions as to what is to be done. In many cases the patient will likely consult with more than one doctor, getting a “second opinion” on what needs to be done. Price competition will become much more important than it is now.
The patient has likely used Internet sources to learn about whatever ails him, and what to do about it. The patient is far more likely to first use a generic low cost medicine before if needed moving to a more expensive “brand name” medicine. Without prescription laws, or drug laws either, the range of available medications is far larger than what is available now. The patient is only likely to see a doctor professionally if his or her own Internet research has not resolved the issue. The patient will be far more knowledge medically than today’s.
The training of doctors will be much less “generalist” and more “specialized”. The tasks of diagnosis and prescribing of medication will likely for most people something that they do for themselves using advanced Internet resources. The level of medical knowledge will be greater, and most likely will be part of the individual’s education. For these reasons the role of the primary care physician will be more likely something the patient will do for himself or herself. Sometimes with assistance from someone more knowledgeable, but not to the MD level. The “knowledgeable” patient will decide whether or not to consul with someone who is a specialist instead of having to receive authorization from a primary care physician.
Health care will be financed first through individual health savings accounts which draw interest much like an investment account. The second level will be low interest long term loans instead of “insurance” as we know it today. The third (final) stage will be private catastrophic coverage, which will only kick in for major medical issues. Because of this, it will be much lower in cost than present day health insurance is. Since the patient is the “decider” in all this, the patient may make decisions that would be different from those made today. No doubt many people will decide to have a tooth pulled instead of filled, something that our dentists don’t like to do because it is far less profitable long term for them. I expect we’ll have “dentists” who specialize in extraction of teeth at a lower cost than having one fixed. In all of these cases, the patient is the one who makes the decision.
I should note here that the “must treat” laws will be repealed as there is really no justification for the provision of medical services to someone who cannot pay the cost. We don’t ask supermarkets to give away food, we don’t require gas stations to give away their product, so why do we have this requirement for health care? Especially in a society where everyone has access to not only medical drugs, but to all other drugs too. Also, there is no good reason why people can’t pay these sort of costs over a period of time, especially in a society where jobs will be considerably more plentiful than they are now. Too, there will be the “Basic Income” which can be tapped if needed over a period of years to pay for care… People need to be more realistic about such things. There are no immortals among us. We will all die of “something” eventually, regardless of whatever health care resources we have access to. Understanding this fact is in my opinion part and parcel of being a libertarian.
The argument that everyone should be forced to carry health insurance makes no sense if there are no “must treat” laws as we have now. The requirement to carry auto insurance is for liability reasons, which do not apply in the case of health care. No doubt for children we can create some means to see that they get health care. As a general rule, children are cheap to insure in any case. There are also a number of charities that work in this field.