A free-market economy tends to correct itself, while government regulations usually accumulate and increase deviations. Medicare is a perfect example of an anti-market policy. Liberal theory seeks to correct marginal injustices, where the cost of correction is small compared to benefits. In liberal terms, medical care could properly be extended to those who absolutely cannot buy it for themselves, and the care would be kept to a basic minimum. Instead, medicare long ago evolved from insurance into redistribution: providing for patients with existing conditions is not insurance.

Medicare artificially increases the number of retirees and thus the ratio of retirees to working-age people. Just as working adults struggle to support the retirees, better healthcare continuously increases their age and further tilts the ratio. The older the retirees, the more expensive healthcare they need. Accordingly, they consume even more medical resources than their already high ratio of the population suggests. Most healthcare costs are incurred within the last six months of a person’s life. A person is perfectly entitled to struggle to extend his life for a few days with private resources, but society has zero interest in prolonging his life a little bit at tremendous cost.

Just as retirees become the biggest indirect buyer of health services, drug companies concentrate R&D resources on drugs for old age instead of combating the illnesses typical for working-age people. It is not uncommon for an insurance company to spend more on keeping a retiree alive for a few additional months than was spent on him during all his years of work. Faced with increasing health-care costs, working adults can afford still fewer children, and the population grows increasingly old. The society changes its voting patterns. Politicians become responsive to non-productive but voting retirees rather than busy working adults. Subsidies to retirees increase further. Democratic politicians with a four- or five-year perspective cannot change the dead-end medicare system: economic interests and the country’s survival take a remote second place after election results, which are heavily influenced by retirees.

It is one thing to kill one’s retirees as the Eskimos allegedly did, and another thing to subsidize them with all your resources. If people want to live longer, they must save sufficient funds, raise children to support them in their old age, and choose the least expensive health care. The right to live longer, just like the right to live better, or to eat, or just about any other right, is contingent on the person’s ability to pay for it. When a state embarks on the dubious path of subsidizing or redistributing healthcare, it will end up providing free food.

dubious ethics of state healthcare