The Philosophy of Freedom

by Caleb Nelson

  “No, ma’am. Not by us over here in billing.”

  “I can’t believe you’re saying that she could have kept shelling out $117 per month for another year to your company, and—even though your company is getting reimbursed by Medicare for the exact product and service—likely no one—no one—would have caught it or changed it. Please tell me you are saying something else.”

  “It’s not our policy to do extra work with cross checks. As long as Medicare pays the reimbursement, we consider the account maintained.”

  “Then what has been done with this other money that Mrs. Miller paid directly? Those checks have been cashed. Did you guys think it was a gift?”

  “No, it was credited to her account.”

  “So that means she should be paid up through, what, April?”

  “No, her payment is due for January.”

  “But you just said that the $468 Mrs. Miller sent in was credited to her account, as well as Medicare having paid the adjusted amount. That comes out to eight months of adjusted service cost paid by both Medicare and Mrs. Miller, which should mean that she’s paid up through April.”

  “Let me get you my manager.”

  “Oh, please do.”

  [399]

  Although the issue was “resolved” after another forty-five minutes with the manager, Mrs. Miller being reimbursed for two payments of $117, she apparently was required to have paid the first two payments—set up and installation—for a regular, run-of-the-mill wheeled walker. And why was it so expensive? Because the company that made the walker had a governmental contract (legal monopoly) with Medicare so the customer could not shop around for a better price, a better managed company, or better equipment. Competition was eliminated from the equation. So Chelsea’s client may not have had to pay out of pocket, but her Medicare dollars were being overspent for an overpriced piece of very basic equipment that could have been purchased elsewhere for less than half the cost.

  Now multiply such waste and incompetence by a billion and you see what is going on across the country. This violation of rights leads to unintended consequences, and such waste and price-inflation is ubiquitous across all areas of government spending from education subsidies to the military. Consumers disregard the need to “shop” around for better prices in health care because insurance or the government is footing the bill. They are also forbidden by law to shop for insurance outside of their state. Also, when government is responsible for your health, it necessarily leads to restrictions on your personal life such as “healthy eating” laws.

  [400]

  Overcrowded emergency rooms result from a law requiring hospitals to diagnose and treat anyone within two hundred feet of a hospital, regardless of their ability to pay. Government violations of the rights of consumers, doctors, hospitals, and insurance companies to freely act on their own judgment and contract accordingly stifles productivity, hampers quality, and increases costs of both insurance and care.

  For those who cannot afford to pay for their health care, they are free to rely on private charity, voluntarily given from family, friends, neighbors, strangers, and charitable organizations. Their need, however heartbreaking, does not constitute a valid claim against the lives of others.

  Writer Paul Hsieh called this the “separation of charity and state” which means that the government doesn’t tell us who to be charitable towards; it leaves us free to do so—or not—according to our own judgment. A proper government doesn’t force anyone to support a particular religion. It also doesn’t force anyone to “work in a soup kitchen or donate to the Red Cross. And just as a proper government does not compel a man to support his neighbor’s church, so a proper government does not compel a man to pay his neighbor’s medical bills.”

  [401]

  In Steve Forbes’s book, How Capitalism Will Save Us, he offers a concise view of the issues and solutions he sees regarding the health care system of the United States. He identifies some false claims surrounding this issue that lead to violation of principle. The myth, he says, is that,

  “Today’s out-of-control health-care costs are the consequence of increasingly sophisticated medical technology and growing patient demand, compounded by greed throughout the system. Insurance and pharmaceutical companies, doctors, and hospitals all care more about profits than about patients. The only way to fix these complex problems is through a government-designed system with mandatory health insurance. Otherwise, health-care will become totally unaffordable and beyond the reach of the poor and middle class.”

  [402]

  The reality, Forbes writes, is that today’s health care system shows how government dominance prevents a free-market from working. The individual consumers rarely directly pay for medical care or even insurance. The result of this is that the health care market then tries to meet the needs of big companies rather than individuals. “Policy reforms,” he explains, “allowing customers to take charge of health-care buying decisions would correct this market distortion. Health-care and insurance providers seeking your business would lower prices, provide better service, and become more accountable.”

  [403]

  Further solutions include allowing people to buy health insurance policies across state lines, removing restrictions on health savings accounts, making it easier for small employers to pool together to buy health insurance for their employees, and allowing people and businesses to buy health insurance either with pre-tax dollars or a tax liability deduction for medical expenses.

  We advocate transition to a free market in health care. We must leave insurance companies and hospitals free to innovate competitively for customers. We must leave customers free to contract with them. We must leave patients free to seek and use the treatments and drugs that they judge best for their condition. We must leave taxpayers free from the coercion of government intervention in health care, as well as Medicare and Medicaid. We must leave the doctors free to treat their patients to the best of their ability and judgment.

  Review

  Q1: Why is health care not a right?

  Q2: What are some consequences of government involvement in health care beyond the violation of rights?

  Q3: What is the relationship of health care and health insurance to the proper role of government?

  Chapter 19: Principles of War

  “If we desire to secure peace . . . it must be known that we are at all times ready for war.”

  [404]

  - George Washington, 1793

  THE PURPOSE OF WAR

  A proper understanding of war and the foreign policy of a nation can be obtained by reference to the same principles that we’ve discussed and applied for individuals.

  “Rational self-interest holds that every individual ought to live his own life for his own sake, by his own independent effort,” Brook and Epstein write, “—without sacrificing himself to others or others to himself. It holds that the individual’s self-interest is achieved, not by doing whatever he feels like doing, and not by placing his goals in opposition to his neighbors’ freedom, but by living a life of reason, productivity, and trade.”

  [405]

  According to such a view, the greatest threat man faces in the achievement of his values and happiness—and thus the greatest threat to a harmonious and free society—is the initiation of physical force by others. Such violence, theft, or fraud is properly met with retaliatory force.

  Man resorts to governments to keep himself free from the initiation of force so he can pursue his happiness. One of the primary proper roles of government is to protect those living within its borders from foreign aggression, as well as credible foreign threats of aggression.

  An innocent nation does not seek to exist by force at the expense of other nations. When force is initiated against a nation or its citizens by another nation, it must righteously respond with force to neutralize the threat. Anything less is an injustice towards its citizens and a violation of that government’s moral purpose—to protect rights.


  [406]

  Going to war is moral only if it is in response to force, or the credible threat of force. A threat does not consist of perceiving a country’s leadership or citizens as suspicious or shady. A threat would be just that—a state making a verbal threat of violence, and having the capability to act on that threat. Such threats include states giving financial aid to terrorist organizations and calling for the destruction of another country.

  THE MORALITY OF WAR

  “The principle that should guide our foreign policy is the same principle that should guide all governmental action: Our government should protect the individual rights of Americans.”

  [407] - Yaron Brook

  The only moral war is the war of defense, a war that eliminates threats initiated against the lives, liberty, and property of a nation’s citizens.

  To fight and win a morally justified war requires two things:

  Objectively identify the nature of the threat;

  Do whatever is necessary to eliminate the threat with minimum risk to life, liberty, and property on the part of the citizenry. (Note: it is perfectly acceptable to use offensive tactics in a moral war of defense.)

  There are also two types of immoral wars. These wars (and also some tactical actions within a war) are improper and unjust when viewed from the rational self-interest of a nation and its citizens. These are wars of self-sacrifice, or humanitarian wars, and wars of aggression. Both types violate the rights of citizens (especially the soldiers) because they sacrifice the lives and property of individuals for the sake of some “higher” cause, whether it is the suffering of the Bosnians or to satisfy the power-lust of a leader.

  WARS OF AGGRESSION

  “Statism leads to war because that is its nature. It is based on the principle of force, violence, and compulsion.”

  [408] - Ayn Rand

  Such wars are caused by a nation that pursues, through force, its irrational desires against other nations. They should be easy to identify: the German invasion of Poland and France in World War II, the taking of American hostages in Iran in 1979, the launching of rockets into the borders of Israel from its neighboring states and territories.

  In some cases, aggressive nations may be dealt with through less violent means such as sanctions and ultimatums. However, when such means fail, military force is not just the last resort, it becomes the only resort.

  The actions of aggressive nations are reprehensible, and such actions are only encouraged when they not dealt with swiftly. The proper response is with the destruction of the aggressors. History clearly demonstrates the folly in the appeasement of aggressors, which leads to more and greater violence.

  WARS OF SELF-SACRIFICE

  “No government ought to interfere with the internal concerns of another, except for the security of what is due to themselves.”

  [409] - George Washington, 1798

  The popular modern theory of war is known as Just War Theory. It is based upon the self-sacrificial ethics of altruism, and has been taught explicitly to military recruits for many years.

  According to Just War Theory an armed response is only appropriate under the following conditions:

  · An openly declared war;

  · A response to specific aggression against one’s own people or a third party, or for a just cause;

  · It must begin with the right intentions;

  · It must be a last resort after other possibilities for redress have been explored.

  In addition to this, according to Just War Theory, a nation may only wage war while observing that:

  · The means are “proportional,” meaning the level of force is commensurate with the nature of the threat; and

  · “Discrimination” is practiced between combatants and noncombatants.

  [410]

  “A soldier must take careful aim at his military target and away from nonmilitary targets,” writes Michael Walzer in Just and Unjust Wars,

  “He can only shoot if he has a reasonably clear shot; he can only attack if a direct attack is possible . . . he cannot kill civilians simply because he finds them between himself and his enemies.

  “Simply not to intend the deaths of civilians is too easy . . . . What we look for . . . is some sign of a positive commitment to save civilian lives . . . if saving civilian lives means risking soldiers’ lives the risk must be accepted.”

  [411]

  Such rules of engagement are the sort under which U.S. soldiers are fighting and dying overseas. It is such rules that led the team of SEALs in Operation Red Wings in 2005 to release the civilian goat herders who had discovered them. Releasing them compromised their mission and position to militants in the area and resulted in the deaths of nineteen American troops.

  Many of the altruistic notions of Just War Theory were first described by early Christians such as Augustine, for whom, “killing to defend oneself alone was not enjoined: It is better to suffer harm than to inflict it. But the obligation of charity obliges one to move in another direction: To save the lives of others, it may be necessary to imperil and even take the lives of their tormentors.”

  [412] This means that it is immoral to defend your own life, but in order to defend others it is sometimes required to risk your own life as well as those of the aggressors.

  Such a theory denies the morality and necessity of a self-interested approach to war, considering that a reference to self-interest makes “most attempts at moral analysis irrelevant.”

  [413] (“Moral,” in this case, means the collectivist ethic of altruism.) In Just War Against Terror, scholar Jean Elshtain uses Augustine as a moral authority for such a self-sacrificial theory. Augustine, she says, argues “that it is better for the Christian as an individual to suffer harm rather than commit it.” Augustine asks, “But is the morally responsible person also . . . permitted to make for other innocent persons a commitment to non-self-defense? . . . the answer is no.”

  [414] Thus, if only you are attacked, it is immoral to defend yourself. If your neighbor is attacked you are obligated to defend him. It is not a matter of defending innocence against evil, or peace against aggression, in Augustine’s view. His standard used to judge the use of force is that it must not be a self-interested act of defense, but a selfless service to others.

  Consider the Just War requirement that a nation may only go to war for a “just cause.” What constitutes a “just” cause? The only “just” causes endorsed by Just War advocates have been humanitarian crises in which a foreign people are suffering under oppression or genocide. Sacrificing American soldiers to “peace-keeping” missions and humanitarian conflicts, in which no American rights are threatened, is considered morally mandatory in Just War.

  What about the theory’s claims that self-defense is an appropriate reason to enter into military conflict? The problem is that it means no such thing when rendered impotent by chaining a response to being a “last resort” and to means that are “proportional.” Elshtain clarifies that, “For just warriors, both aims and means are limited, even if one has been grievously harmed.”

  [415] Why? Because your sacrifice is good.

  When should military action be considered when it is supposed to be viewed as a “last resort”? When a new Iranian regime held fifty-two Americans hostage for four hundred and forty-four days? “Did it rise to the level of a direct attack sufficient to place us at the point of ‘last resort’ with Iran and other nations that sponsor Islamic terrorism?” Brook and Epstein ask,

  “Not according to Jimmy Carter. What about after two hundred and forty-three marines were killed in Lebanon in 1983? Not according to Ronald Reagan. Or after Khomeini’s fatwa offered terrorists a bounty to destroy writer Salman Rushdie and his American publisher for expressing an ‘un-Islamic’ viewpoint in 1989? Not according to George Bush, Sr. Or after the first World Trade Center bombing in 1993? Not according to Bill Clinton. The pattern is telling.”

  [416]

  What about the guideline that military action
may only be used with “right intentions”? In this case, “right” means “altruistic.” A nation which goes to war for the welfare of its own citizens is held suspect. A nation fighting for another nation’s citizens is held as acceptable. Such a view can be seen in “Operation Iraqi Freedom,” which was not called “Operation American Defense.” Emphasis was placed on freeing the Iraqis from a dictator, bringing them “democracy,” and loading them with food and collectively owned oil. The standard used for determining the success of such an operation was not whether Americans were safer, but, as Elshtain observed, the fact that “schools are opening [in Iraq], women are returning to work, movie theaters are filled to capacity, and people can once again listen to music and dance at weddings.”

  [417]

  Under Just War standards, there is no such thing as an enemy nation. As of this writing, the U.S. has not officially declared war against another nation since World War II—not against North Korea or Vietnam or Iraq or Afghanistan. Now we have a never-ending War on Terror where we wage war only against enemy combatants, not against the states that sponsor them, and in some unfortunate cases, it is the U.S. that is arming its own future enemies.