In “Love is Not Enough,” David Friedman—known for his work on anarcho-capitalism—presents a defense of private property through the mechanism of love, trade, and force, emphasizing the importance of trade. N. Gregory Mankiw, in his health care policy article for the New York Times, lists peculiarities of healthcare as a good/service that make healthcare difficult to fit under Friedman’s system of trade.
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Friedman argues that private property is not pure selfishness, but rather selfishness in pursuing each individual’s own vision of good. According to Friedman, there are only three ways for others to help achieve an individual’s vision of good, or ends: love, trade, and force. Through love, cooperating individuals make each other’s ends their own, perceive a good/end in the same way, and/or anything people are willing to do for “free.” For things people are not willing to do for “free,” trade, to which Friedman devotes most of his article, helps individuals achieve their ends in return for getting help from others for achieving their own ends. When trade is not used for things people are not willing to do for free, force is used, which is unideal as it forces people work for an end that is not good in their perception. Friedman also addresses concerns of private property. The misallocation of resources, which is an objection to private property, is present in every system, and often bureaucrats in a public-property system make allocation even more inefficient, and unfair, citing Ukraine’s food crisis under Joseph Stalin. To refute public ownership, Friedman argues that there would be less owners if governments owned goods; because governments are fewer than individuals, power is concentrated in the few if a good is owned by governments, making abuse of power easier.
Friedman’s arguments have strengths in the coverage of methods used to achieve ends. Besides love and force, trade encompasses all methods available to persuade others to help achieve an end. Everything is trade, even persuasion. Persuading others to change position, in fact, is still trade; economically speaking, convincing others is simply changing their perception of utility and, consequently, their indifference curves to make trade more desirable to all parties involved. Friedman’s mechanism of trade has its strength in that individuals trying to maximize utility work with each other unknowingly most of the time—harking back to the “invisible hand” concept.
Despite its strengths, in order for Friedman’s definition of trade—parties being better off by seeking ends in return for helping others achieve ends—to work, consumers must have good information in order to determine which goods/services they want relative to other goods. Good information is not always available. Another drawback is that in some products, people do have to have a universal good—rather than their own—in order for that good to function. These same weaknesses happen to be some of the peculiarities in healthcare addressed by Mankiw.
Mankiw argues that healthcare is unlike most goods in that consumers often do not know what they need, because of the inherent nature of illness. This lack of knowledge prevents consumers from actually knowing which healthcare goods/services maximize their utility, and thus puts them on indifference curves that do not necessarily produce the maximum utility they could afford. This peculiarity prevents people from effectively seeking their own best ends, which Friedman argues is a necessary part of trade. Mankiw also points out another peculiarity—because healthcare costs are uncertain, insurance of some form plays a large role. Insurance requires that both healthy and ill people enroll in insurance in order to achieve the best ends for all insured. However, keeping healthy people enrolled would require force—people are bound to not see it in their best interests no matter how persuading—as Obamacare did through mandatory enrollment. If achieving ends through trade requires force in the first place, then it requires force, rather than purely love or trade.
Because healthcare cannot simply operate on love alone—doctors, for example, still need to make a living—trade is the only other acceptable option under Friedman’s mechanism. However, because healthcare, according to Mankiw, fails to satisfy many of the prerequisites needed for trade to happen, force is the only other option. Trade is the best system for most other goods, but when prerequisites for trade are not met—as in the case of healthcare—love and force are the other options. Since love is not an option, force may be a necessary evil in the healthcare market. With its externalities and need for, if not all, people to subscribe to healthcare services for maximum effectiveness—and under trade some people are bound to shun healthcare insurance—force could be the only option to make healthcare tradable in the first place.
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