Out of curiosity, how comparable/parallel are the arguments libertarians use to combat the externalities associated with, say, insurance premiums compared to government subsidy?

I'm sharing my risk with drivers who don't wear their seatbelts, sadly. I wouldn't mind seeing policies (or laws) that severely restrict or eliminate coverage altogether for accidents where insureds weren't wearing seatbelts.

I've wondered about one thing with motorcycles: is my interest in not killing somebody worthy of being considered? I.e., if I hit a motorcyclist and he dies because he had no helmet -- perhaps with his brains splattered on my windshield -- I'm going to feel just awful, even if it was the motorcyclist's choice not to wear a helmet, and even if the accident was his fault. Does my interest in not feeling awful count in the equation, or should it?

Presumably, you would take that interest into account when you decide whether or not to wear a helmet. It's not an externality because the person who bears the harm is the same one who makes the decision.

It's not an externality because the person who bears the harm is the same one who makes the decision.

Well, the person who bears the MOST harm is the one who makes the decision. But you can't tell me that I'm not "harmed" when a helmet-less motorcyclist splashes his brains all over my Lexus. There's the gross out factor, and the mess.

But seriously, spilling your brains on an unappreciative public IS an externality of not wearing a helmet. If we're going to ignore that externality, let's do so explicitly.

When it comes to cigarette smoking, the libertarian argument seems to avoid all logic. We are a country that bans all smoking of drugs other than those containing nicotine, yet the typical libertarian will argue there is a right to smoke cigarettes in all places public and private. This would be a valid argument in a nation where pot and crack can be smoked openly, but here in the U.S. it seems a bit illogical. Instead of complaining about the pot smoker who is thrown in jail, they obsess about the cigarette smoker who merely has to smoke outside. NORML contends its members would be glad to accept such restrictions as long as potheads could smoke their drug of choice in private.

When it comes to cigarette smoking, the libertarian argument seems to avoid all logic. We are a country that bans all smoking of drugs other than those containing nicotine, yet the typical libertarian will argue there is a right to smoke cigarettes in all places public and private. This would be a valid argument in a nation where pot and crack can be smoked openly, but here in the U.S. it seems a bit illogical.

Since libertarians oppose the War on Drugs as well as restrictions on smoking, I see no contradiction or "illogic" in our stance. And if we can't get rid of both sets of unjust regulations at once, I don't believe that "logic" requires us to forego getting rid of one unless and until we can also get rid of the other.

Since libertarians oppose the War on Drugs as well as restrictions on smoking, I see no contradiction or "illogic" in our stance. And if we can't get rid of both sets of unjust regulations at once, I don't believe that "logic" requires us to forego getting rid of one unless and until we can also get rid of the other.

I was about to say that. I disagree with it, but I at least understand that the position isn't illogical.

For my part, if forced to try to make the policy "fair" (really, I can't see much difference between tobacco and marijuana smoking) I would choose banning more drugs over legalizing more.

I think it's important to distinguish between the government financing externalities that were the topic of this post and the "nature of the world" externalities that can't really be removed by eliminating a government program. The motorcyclist who won't wear a helmet and runs up huge medical bills on the public tab is one thing, and the motorcyclist who freaks out the driver who hit him is another. Likewise, illegal immigrants on welfare are one type of problem, and illegal immigrants who drive down wages just by showing up to work are another.

I'm definitely in favor of eliminating government programs that are subject to widespread corruption or that create perverse incentives, but that doesn't get rid of all externalities.

<blockquote>
yet the typical libertarian will argue there is a right to smoke cigarettes in all places public and private.
</blockquote>

Will we now

However, if government financing externalities are your true reasons for favoring any given type of regulation, you should at least consider the possibility of getting rid of the externality without restricting freedom.

So long as you are comfortable with your proposals not being taken seriously in the real world, that is a fine idea. But everyone knows there is no significant sentiment for ending all public financing of medical care for the indigent and uninsured. There is not even sentiment for rules such as "if you are injured and were driving a motorcyle without a helmet, or are an illegal immigrant, if you're not insured we will wheel you out of the ER onto the sidewalk." So advocating behavior that leads to minimizing these costs is a practical argument. These arguments are a concrete reference to the high costs of disfavored activity such as illegal immigration.

But sure, if you are a libertarian, it only begs the question of why we should finance such activity in the first place.

"A lot of libertarian position arguments have that sort of college kid who's never had to deal with the real world flavor to them."

Yep. Admittedly more elegant and persuasive than Marxism or Socialism. But just as unlikely triumph over the massive, squishy center of American politics.

Yes, I misunderstood your original point. My answer to the actual point is that I don't think that we have the right to restrict other people's freedom merely because we are grossed out or angered by their conduct. Damaging your lexus is a different issue, but could presumably be dealt with by ordinary tort liability (just as can other damage inflicted on your car by negligent drivers).

Ilya- while Waldensian framed his concern in light terms, it seems like we might want to be open to considering more than just the financial costs of repairing the structural damage caused by foreign brain impact to Waldensian's Toyota. It strikes me (and not my windshield) that the emotional damage caused by killing a cyclist (who would not have died, in the hypothetical situation, if s/he was wearing a helmet) is a cost unaccounted for in your response.

Libertarianism often draws itself towards economists and economical factors, but it seems like a libertarian discussion should also factor in such real emotional damage as blood on one's hands (in a death that could have been easily averted, presumably). I'm guessing that this is Waldenisan's real concern. It is a real concern, in any event.

That's right.
Just let people who can't pay bleed to death.

Or, let people decide who they should help and how much with their own money. You are assuming that no one (yourself included) will help the helmetless motorcycle wreck in the absence of government coercion. I don't know you, so I'll have to assume your low opinion of yourself is justified; but please don't project your lack of charity onto the rest of us, ok?

Explain to me a situation where a nonsmoker would be unable to avoid secondhand smoke. The recent smoking ban in Chicago made me furious because so many people used your argument. The response is this: in free society, no one is exposed to secondhand smoke against his will. If you dislike that smoke is allowed in a certain restaurant, then don't eat there or don't work there. Your preferences do not justify government coercion on private property.

Public transport. Streets. Government buildings. Courthouses. Airports. Etc, ect, ect. I can see your reasoning in instances of private businesses. However, would you at least consent to a ban in places that there exists a legitimate need of use?

Umm..that is "should NOT subsidize..."

...a driver wearing a seatbelt is safer to third parties because s/he is less likely to be thrown from behind the wheel ...If true -- even in a relatively small number of cases -- that would, to me, justify a mandatory seat belt law.

Many of these things come down to matters of degree as well. I'm sure that if the government banned all cars, pedestrians would no longer die in car accidents, this doesn't mean that it is something that should be done.

Or, let people decide who they should help and how much with their own money. You are assuming that no one (yourself included) will help the helmetless motorcycle wreck in the absence of government coercion. I don't know you, so I'll have to assume your low opinion of yourself is justified; but please don't project your lack of charity onto the rest of us, ok?

I don't know you or you outlook on life, obviously. But in general, and in one respect, I can't help projecting that lack of charity.

After spending a number of years closely observing the American public's reaction to, and attitude toward, people with developmental disabilities, I am convinced to a moral certainty that, in the absence of governmental coercion, the developmentally disabled would lead horrifying lives characterized by terrible neglect and even active abuse. Worse than what they face now, I mean.

Just look around. See what major corporations are willing to sponsor on TV. Check out what famous people can say without getting fired. Listen to the XM comedy channel for a day. Then tell me we don't need government watching out for the developmentally disabled.

Or, let people decide who they should help and how much with their own money. You are assuming that no one (yourself included) will help the helmetless motorcycle wreck in the absence of government coercion. I don't know you, so I'll have to assume your low opinion of yourself is justified; but please don't project your lack of charity onto the rest of us, ok?

I don't believe that greedy libertarians should be able to get away without contributing anything to the care of people who are injured.

I think that hospitals and doctors who care for people without means should be compensated by society. The full burden of such care should not fall on their shoulders alone.

Lets get down to it.

Libertarinism = selfishness.

End of story. What if the charity you assume to exist is not at hand?

You let the person bleed to death, all so you can satisfy your stupid ideological needs.

There is another group that was willing to let people die in order to satisfy strange ideological fixations. They were called communists.

Communists and libertarians have a lot in common. They are both a threat to civilization. Happily, in present times, they are both properly marginalized threats.

Liberals usually defend smoking bans partly as a workplace safety argument, based on the notion that employer and employee do not bargain in the market as equals: employers can replace a worker (even an injured or dead one) more easily than a worker can find a new job. Because of this inequality, workers should (or so the argument goes) be protected from harmful conditions that employers could impose upon them as conditions of employment.

For instance, a worker might agree to work on unsafe machinery, if he had no other available employment and needed to feed his children. The employer's only risk is losing an employee and a little bit of reputation, while the worker risks losing his hand or his life (and thus, also, his ability to feed his children). Workplace safety regulations exist to prevent employers from imposing harmful working conditions.

But workplace safety regulations have another feature as well: they protect employers from legal claims by injured employees, by allowing employers to demonstrate compliance with the regulation. If you cut your hand off with an OSHA-compliant bandsaw, you can collect workman's comp -- but if you sue your employer, claiming the bandsaw was in fact unsafe, he can just point out that it was completely compliant with both industry standards and the law.

Enter the smoking question. Most advocates of smoking bans are acting chiefly out of aesthetics: they don't like the smell of smoke and would like to enjoy various public accommodations without it. But they additionally cast the argument in terms of workplace safety: employers should not be allowed to subject their employees to known carcinogens as a condition of employment.

It's not unreasonable, if you accept the market-inequality basis of liberal advocacy for these sort of laws anyway. But it's interesting to note that smoking bans lack the second prong of other workplace-safety laws. They don't offer very much to employers in the way of protection.

I think that hospitals and doctors who care for people without means should be compensated by society. The full burden of such care should not fall on their shoulders alone.

Mr. Liberal's argument is so persuasive that I suggest we incorporate it to other fields:

I think that taxi drivers and bus drivers who drive people without means should be compensated by society. The full burden of such care should not fall on their shoulders alone.

What, precisely, is the difference? Oh yeah, those taxi drivers are selfish!

In any event, what, precisely, gives doctors the right to demand payment from me when they cannot obtain it from the person they contracted with?

Thank you Mr. Liberal for confirming my prejudices regarding liberalism and self-righteousness: everyone who doesn't agree with Mr. Liberal simply isn't as morally good a person! "I am so good, I am so good." Wonderful.

The usual stereotype of the self-righteous is some Southern Christian minister. They can't hold a candle in this department to many on the left.

You let the person bleed to death, all so you can satisfy your stupid ideological needs.

There is another group that was willing to let people die in order to satisfy strange ideological fixations. They were called communists.


Yes, and communists used the state apparatus to kill and enslave, while supporters of the libertarian position only argue for the right to be left alone.
The problem with most liberals is there their inability to distinguish between passive action by the state and the unavoidable though not necessarily natural consequences of no state action.
Killing under communism was not due to inaction on the part of the state but due to abuse of the state. Socialists always attempt to blur the distinction between action and inaction, so they can win the argument by endorsing the more "respectable" statist position.

Wasn't London in the Victorian era a good example of a libertarian paradise? Shall we go for a metaphorical stroll through the tenements? See the children begging and old people dying? What a great time that was! How come all those rich aristocrats didn't give to charity??!

Personally I'm not willing to watch people starve on the street no matter how much they "deserve" it because they didn't work hard enough or didn't save money. If you are, more power to you. Get the votes and we'll try it!

Wouldn't 18th century America be a much better analogy (i.e., move out of the slums of London, into the slum of New York on the way to making a better life for yourself.)

Oh please yes, where a quarter of the population were chattel slaves. A much better example!

I really look forward to the accident scene in Ilya's libertarian paradise, where competing ambulance services show up and rifle through the victims' wallets to decide who they will help instead attending to the most seriously injured first.

You know fire services used to be privatized until people figured out that if your neighbor's house was burning and they hadn't bothered to pay for private fire protection suddenly the externality of them taking the calculated risk was your problem.

Also how come no one ever wants to answer my questions about how sewer, water, electrical transmission, and other basic services are going to be handled in a libertarian paradise?

Good post.

So should be we conclude that all liberals are selfish jerks who would rather shirk their personal responsibility to the poor in favor of letting a cold, faceless bureaucracy deal with it?

You forgot the most important aspect: a cold, faceless bureaucracy largely financed by someone else. There's crude selfishness inherent in soak-the-rich tax policies, government-funded thing-that-I-want (higher education, healthcare, whatever), and all manner of other liberal programs.

Victorian London:

a) no or few regulations on businesses for worker safety

b) few taxes

c) drugs (opium, etc.) and prostitution were legal

d) very little help provided to the poor or unemployed by the State -- workhouses being the ending for the destitute

http://www.victorianweb.org/history/sochistov.html

I would just like to point out that not all libertarians are against regulation. I (and Hayek for example) believe there is a role for government regulation in the libertarian perspective. The question for people like us is more in the methods and reasoning behind the implementation. Specifically regulatory laws should be applied with the rule of law where the laws are applied to everyone (and not against or for specific segments of the population), be advertised to the population so they can negotiate the laws, and not be changed after the fact, among other things.

The libertarians who want to privatize everything often make great arguments and I pay attention but I still believe in a role for government and regulation. In my opinion this separates a libertarian from an anarchist.

Equate liberatianism with poverty.

Well, libertarians don't have a good answer to how poverty is going to be dealt with. Obviously, there won't be any poor people is a ridiculous assertion to make and makes libertarians look just as ridiculously utopian as your most hardcore Marxist. Charity will take care of them is just as ridiculous (government got into the business of taking care of poor people because the traditional charitable institutions just couldn't handle it at an acceptable level anymore). So apparently, the libertarian answer is, "let them starve in the street or reintroduce workhouses and debtors' prisons", although you will rarely get them to admit that.

After a night's sleep and a morning's work, I'm prepared to declare that seatbelt use is substantially on the "none of the government's business" side of the line. The increased risk is virtually entirely on the non-seatbelt-wearing occupants of the car, and therefore their business. If you blow a tire and the car swerves so badly that you will lose your grip on the wheel, you'll lose it with or without a seatbelt on. Maybe when front seats were smooth benches, there would have been an outside chance that the seatbelt makes the difference between holding on or sliding away, so that there's some even smaller chance that it would make the difference between whether you swerve into another vehicle, but not with modern bucket seats. A major accident will result in a major traffic jam with or without seatbelts, and if you are more than a few car lengths back in the jam you will not have to see anything you don't go out of your way to see. EMTs see injured bodies—that's what they signed on for.

Thus, even if researchers have done multiple regressions that demonstrate the effect of seat belt laws in reducing highway fatalities, it is of little relevance. And any such demonstration does require careful data analysis because there are other factors: modern cars handle and brake much better, modern roads are safer, and drunk driving is taken much more seriously than once was the case. Furthermore, while increased seatbelt USE may decrease fatalities, that doesn't mean seatbelt LAWS do. Social norms may be sufficient to induce responsible drivers to buckle up without coercion, while irresponsible individuals flout the law anyway.

Paternalism breeds more paternalism. At one time it was a joke to suggest that before long the government would be outlawing fatty foods, but who's laughing now? If failing to buckle up marginally decreases the likelihood of surviving the next year, what about Sunday driving? What about unnecessary trips to the mall? What about driving from Pittsburgh to Chicago to visit family instead of flying? There you are increasing the risk both to yourself and others (by increasing traffic). Shall we have government second-guessing us every time we get in the car? What about the campers who get caught in snowstorms, the hikers lost in the woods, rock climbers who fall, and in each case impose on the efforts of law enforcement and rescue personnel as well as harming themselves through unnecessary activities? What about downhill skiing? What about motorcycle riding, with or without a helmet?

By the way, people can be charged for emergency room use. If your insurance company won't pay because you didn't buckle up, that's a non-paternalistic inducement. If you don't meet your financial obligation to pay for services made necessary by your failure to take reasonable precautions to avoid that emergency room trip, you could have your driver's license suspended until you do. All non-paternalistic.

But if we can't draw the line at requiring seatbelts, I don't see where to draw it. You don't have to be very libertarian to place a high priority on making you own choices and taking your own risks.

you could have your driver's license suspended until you do.

In libertarianland, where all roads are private, what possible business would the government have in issuing driver's licenses. The whole country would be like Illinois, where driver's licenses would be issued based on ability to pay (but unlike Illinois, people--especially the Governor--wouldn't go to jail for this novel, market-driven concept), because obviously the more you can afford, the better driver you are.

Getting back to the externality argument, I think one can be a libertarian and still have a coherent answer to such things. I also think that (in my experience anyway) most actual libertarians don't, but that's a different issue. The coherent answer is that the real world is not, and won't be, a perfect theoretical market. Lack of information, primitive technology for delivering a product or service (see cable TV) etc. create large and small imperfections (market failures) that can only be addressed by some sort of collective action.

This is what a lot of libertarians either don't get, or don't want to deal with because it mucks up their simple arguments. To take the cable TV example, how exactly would one propose to offer robust competition in that market? The cable company owns the physical infrastructure -- and should, since they built it. Do you force them to allow others to transmit over their wires? That doesn't scream property rights to me. Maybe you deregulate cable TV in a similar fashion to the power grid, where the monopoly company merely owns the wires, and must sell access to any broadcaster willing to buy it. But then there's still a monopoly involved. Or, of course, you could have multiple cable companies building multiple physical networks (if they can get real estate owners to agree to all those trenches)

Anyway, you get the point. There's almost always room for improvement, but not everything can be rationally privatized, and there is a legitimate (limited) role for a representative government to regulate those markets where the "reality on the ground" produces a suboptimal outcome.

Stacy strikes me as a reasonable person.

We can all agree on limited government, even while disagreeing on the details.

Pretty much all liberals I know of do want limits on government power. The limits they like are very different from libertarian limits, which are simply a function of a skewed logic based on bizarre starting assumptions, are excessively ideological and extremely impractical.

The truth is that every human activity has externalities. In some cases these are slight, though I begrudge even the precious oxygen some Internet trolls suck up. In other cases they are extreme, as when a drunk driver hits another car head on and kills a young family.

So unless one is willing to discard liberty entirely, it is not sufficient to say "identifiable externality, ergo, license for unlimited state regulation." But, likewise, unless one is willing to discard every other consideration than liberty, it is not sufficient to say "world will not immediately end, ergo, license for unlimited personal behavior."

In other words, little is gained by drinking the ideological Kool-Aid at any extreme of the political world. There will always be tradeoffs, and someone's ox will always be gored. The best we can to is to approach the minimum possible level of goring, hopefully along a path where the goring is spread equitably. (Insert predictable puns on Gore here.)

I think the present balance is too illiberal (in the classical sense) in economic and regulatory matters, but perhaps a touch too liberal regarding cultural mores. To pick a Google-friendly example, I haven't yet come up with a way that Britney Spears could have been shut down before the present train wreck, or at least a way that wouldn't constitute a cure worse than the disease, but I have no doubts a culture that sustains her celebrity status is diseased. And a diseased culture does pose externalities, even if they are less tangible than becoming a drunk driver's hood ornament.

frankcross, you're not entitled to make up what I said. I did not offer made-up facts. I said such regressions are irrelevant. What you are talking about is a small reduction in an already tiny probability that on any day or in any year my death will be caused by failing to buckle up. That's my choice.

To J. F. Thomas: I'm talking incrementally, from approximately where we are. Of course the situation is different if roads are private. For the time being, I'm willing to focus on getting rid of some of the more presumptuous intrusions and holding the line against more.

(from Kent G. Budge) "a diseased culture does pose externalities"

But I suspect you would concur in my skepticism about the likelihood of our political class effectively diagnosing and applying therapy for a diseased culture.

(from Mr. Liberal) "All we need is democracy."

Hitler was elected, as I recall. But anyway, I take it you're willing to erase the Bill of Rights, then? Who needs it? Government is constrained by democracy.


"collectively consent to, either through action or inaction."

Am I the only one to whom that sounds like one hellova can of worms?

If you don't have the money in your blood soaked wallet at the time of the accident, there are plenty of pretty simple solutions (installment plans, credit cards, wage garnishment if need be).

By the way, people can be charged for emergency room use. If your insurance company won't pay because you didn't buckle up, that's a non-paternalistic inducement. If you don't meet your financial obligation to pay for services made necessary by your failure to take reasonable precautions to avoid that emergency room trip, you could have your driver's license suspended until you do.

I don't know what fantasy world you guys are living in but in this world, the vast majority of the poor are completely judgment-proof with respect to the average cost of an E.R. trauma visit which can easily be hundreds of thousands of dollars. Let's be extra-generous and say $100k (it wasn't a bad accident) and let's further assume that the injured was in the bottom half of the income scale (median US income $24k). Given that interest is accruing on his $100k debt at a rate of 5% (somebody made a mistake and typed '5' instead of '15' or some other absurd rate) it's quite clear he will never pay off this debt. Hospitals don't even bother not because they don't want the money but because you can't squeeze blood from a turnip.

I am pretty sure J.F. Thomas was referring to George Mason University.

Indeed I was. It is rather presumptious to call the University of Chicago, even its economics department, libertarian.

There was a time when poor people were treated charitably, but government intervention changed all that.

And when exactly was that time?

[I'll fill in briefly for "Dco W", since we agree on all points]

"And when exactly was that time?"

Before the massive government intervention in the provision of medical care. Sorry, I'm not a history book.

At any rate, here's what we're down to. Everyone can be force to buckle up because of the marginal increment in medical costs run up by those who don't, and don't have insurance, and can't pay up. There is no end to that logic. Anyone who drives, say, 10% more miles than necessary increases his or her risk of injury by 10%. People who like to drive cross-county to see the sights are incurring, as a group, increased medical costs, and if they can't pay they are imposing on others. Camping, rock climbing, skiing, eating fatty foods, riding horses. And recent government moves on fatty foods indicate clearly that the logic will be followed up.

It's got to be possible for individuals to make their own choices on risk and responsibility.

There is another group that was willing to let people die in order to satisfy strange ideological fixations. They were called communists.

Communists did not "let people die." They killed them. Big difference.

Or, let people decide who they should help and how much with their own money. You are assuming that no one (yourself included) will help the helmetless motorcycle wreck in the absence of government coercion. I don't know you, so I'll have to assume your low opinion of yourself is justified; but please don't project your lack of charity onto the rest of us, ok?

I don't believe that greedy libertarians should be able to get away without contributing anything to the care of people who are injured.

What if "greedy [sic -- that word doesn't mean what you think it means] libertarians" think that a child starving in the Sudan is a more worthy recipient of his money than some guy who was so reckless that he didn't wear a helmet?

Communists did not "let people die." They killed them. Big difference.

Really? Explain that to the dead person.

Doing nothing as individual is run over by a train, where you knew of the danger and could easily have prevented the accident, but were too busy sipping your tea, is just as evil as murder.

Its not a big difference.

Libertarians who would passively do nothing while other die on a massive scale, (admittedly, a minority of libertarians) are just as evil as the worst mass murderers.

In fact, the only explanation for such behavior is sociopathy.

And, in fact, sociopathy is strongly associated with murder. It is not that far from indifference towards others to killing them for amusement. If you do not care about others, why not kill them for amusement, just as long as you can get away with it? That is the logic of a sociopath.

Most communists would not agree with and were powerless to stop the mass killing perpetuated by a few sociopaths in leadership positions. Their adherence to communism is based on confusion concerning its likely consequences. Likewise, most libertarians have probably adopted the ideology out of a similar confusion. But the more sophisticated libertarians, those that have adopted libertarianism because it, of all political philosophies, best tolerates their indifference and exploitation of others, are pure evil.

Here is a thought experiment.

If you were a sociopath, what would be your preferred political philosophy?

Well, you might like communism or any system of dictatorship, as long as you had the power. If you were able to use, torture, and murder people without consequence, that would be ideal.

But, what if you are not in a position of power? What then would be your favored political philosophy?

Either anarchy or libertarianism, of course. These both minimize accountability for individuals who use and abuse others in economically desperate situations.

Which would be among your least preferred political philosophies? Both true conservativism and liberalism, because both will hold you more accountable when you use and abuse others.

Sociopaths interested in political philosophy would naturally gravitate towards libertarianism. Those lacking in empathy for others, but not reaching the level of sociopathy would naturally gravitate towards libertarianism.

"the vast majority of the poor are completely judgment-proof with respect to the average cost of an E.R. trauma visit which can easily be hundreds of thousands of dollars."

The it would behoove them to get insurance, or not drive. Come to think of it, you can't drive without insurance anyway, can you?

A poor man has no incentive to get health insurance because it's free to him anyway! It's not worth the hospital's legal and administrative costs to squeeze what measly cash they have. Even if they could, he'd just declare bankruptcy. The man just cannot possibly pay and, insofar as the hospital is required by law to provide him with services that he can't pay for, they have to eat the costs.

A lot of libertarian position arguments have that sort of college kid who's never had to deal with the real world flavor to them.

When I was in college, I was vaguely conservative.

Out in the real world, I saw the waste and pain and outright carnage caused by the "realistic" solution proposed by people like Jake and "Mr. Liberal" and learned that freedom does work and their precious, compassionate, caring, helpful government simply does not.

There, got that off my chest.

All fair points. However, you assume that someone in the both 1/4 today, will still be in the bottom 1/4 in 10, 20, 30 years. I'm pretty sure that this is a mistaken assumption. Granted, there is a segment that are poor and will be poor their entire lives, but I'm pretty sure that is the exception, rather than the rule.

Considering that the debt will double every 10 years, our theoretical victim is going to have to rise pretty damn fast to be able to pay it. Remember, I'm assuming that our victim is able to finance at 5% - a rate that most home-buyers would be lucky to get! Use a more realistic number like 13% and the debt doubles in less than 6 years. Compound interest is indeed the most powerful force in the universe.

But yes, certain folks will be judgment proof, but interest rates can take this into account.

Raise the interest rate and more people will default and declare bankruptcy -- more than half the bankruptcies in the US result from medical issues. Sorry, you just made the problem worse, not better.

However, if everyone is paying for the amount they recieve, the costs will go down somewhat

Still can't get blood from a turnip.

Considering that the debt will double every 10 years, our theoretical victim is going to have to rise pretty damn fast to be able to pay it. Remember, I'm assuming that our victim is able to finance at 5% - a rate that most home-buyers would be lucky to get! Use a more realistic number like 13% and the debt doubles in less than 6 years. Compound interest is indeed the most powerful force in the universe.

You don't think the victim's salary will rise with the rate of interest? Why not?

If bankruptcy is your concern, give medical creditors ultra-super-duper priority. That at least partially addresses your concern.

You can't squeeze blood from a turnip. But reciting an old cliche isn't really a convincing argument. A stitch in time saves nine. An ounce of prevent equals a pound of cure. Don't tase me bro! Where's the beef?