Freeing the green in all of us

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There seems to be at the moment fad for prefixing the word libertarian with a politically descriptive term and proclaiming that the latter justifies the first somehow and that they are mutually beneficial.

A recent example I came across was "On Being a Green Libertarian" in the latest copy of The Individual, a publication by the Society for Individual Freedom. The author of the article argues that his green beliefs can in fact be joined with libertarian ideology, creating an effective process for environmental protection. He correctly identifies the key tenets of libertarianism, as well as the irrational behaviour of most of the environmental movement in their clamouring for more legislation to enforce their arguments. But fails to expand on how the two ideologies can be married together successfully.

Most libertarians would suggest pricing, property rights and the common law as the answer. For example, if someone suffers from the ill effects of pollution then they can seek compensation through the courts. The person who pollutes will then be forced to price that compensation into their product before selling it on the open market. The negative environmental externalities would be internalized in the price, and people would then be free to buy their electricity (for instance) as they saw fit.  People would base their spending decisions on their own personally ranked concerns,  be they environmental, price or otherwise. The cost of developing nuclear power stations, tidal barrages etc would all be laid out in the prices offered to consumers, leaving them free – but not coercing them – to allow their beliefs to come into play. But power generators would indeed be reacting to the greatest demand, and how best to turn a profit – the free market at work.

In an ideal world it would be up to the 'greens' to argue, with well founded ideas, the best way forward and not seek to impose their ideology upon others through purely legislative means. They would change people's views so that they would then demand greener products from greener manufacturers.

Let the people decide how green they wish to be. They'll be libertarians...but with a hint of green.

Medical tourism drives healthcare innovation

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There is a new survey out there from the always-interesting National Center for Policy Analysis It covers the rapidly growing global market for medical tourism. We have already blogged about it here . But it is now becoming clearer what lies behind the success of the global high performance hospitals.

The market leader is Bumrungrad International Hospital in Bangkok, which served a stunning 1.2 million customers from 190 countries last year. It is American-managed and creates returns of 20-25 percent each year. Many other hospitals are managed, owned or affiliated with prestigious American hospitals:

• Cleveland Clinic in Ohio has satellites in Vienna, Canada and Abu Dhabi.
• The Indian hospital chain Wockhardt is linked to Harvard Medical School.
• Johns Hopkins has an affiliate in Panama and in Singapore.
• Dallas International Hospital operates hospitals in Mexico.

All these hospitals are escaping micromanagement by third parties – or otherwise highly regulated markets – at home. And that's how they achieve such competitive pricing. It is not simply a question of lower wages for doctors and lower overheads for hospitals. It is the absence of third party bureaucracies (which do so much to drive healthcare inflation) which allows these hospitals to provide such high-quality, low-cost services.

These hospitals are free-market laboratories serving cash-paying patients. That gives them the edge of performing at the frontier of medical and managerial innovation. Bill Gates just purchased the supreme management software, Global Care Solutions, from Bumrungrad hospital in order to market it worldwide. We should expect more innovation being created overseas and then re-imported to strangulated hospitals in the US and Europe.

Child emission reduction

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There may well come a time in the future when parents who choose to have children become stigmatised. Imagine the scene at an "Islington" dinner party some years from now when someone around the table mentions that their partner is pregnant. Cutlery is dropped onto plates heaving under the weight of the locally grown organic vegetables and the person is admonished for being "selfish beyond comprehension". How dare they not think of the global impact of that child. Some though are already thinking along these lines and are sterilising themselves against the possibility of lumping the world with what could be a climate tipping pile of carbon emissions, otherwise known as a child.

The right over one's womb is of course beyond question, and I do not, in any way, suggest that it should be taken from them. It is the fact that the rest of the rational population will ultimately need protecting against possible demands for legislation to be passed. We are probably not far from a world where we have to undertake "carbon awareness training" if we wish to reproduce and how to offset the carbon of the child we bring into the world. Currently many of us would laugh at such a suggestion, but I suspect if you raised that idea in environmentalist circles they would all think it brilliant and seek to implement it.

Caring for the planet through this course of action (self-sterlisation) raises a valid question though: How to reduce the carbon footprint further so as to alleviate the level of one's guilt to zero? There is a course of action that I could suggest that these people take, but I don’t think they’d like the consequences.

A safer high

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A rational approach to the hardcore heroin addicts is proving somewhat successful. A pilot scheme that has been running for the past two years has seen drug use and drug related crime fall among those undergoing treatment. The treatment involves two thirds of patients taking methadone (half orally, half injecting) and the remaining third injecting diamorphine (pure heroin) all under the watchful gaze of nurses, doctors and counsellors. This amassed support has helped many users back to a more stable life and a way of coping with their addiction.

This clinical version of supplying legalized heroin has cut the amount of crime normally associated with addicts. As Professor John Strang, of the National Addiction Centre, pointed out, about 40 percent of users had "quit their involvement with the street scene completely. Of those who have continued, which obviously is a disappointment, it goes down from every day to about four days per month.” Whilst it hasn’t totally cut crime, it has reduced it significantly and this is just as important for both users and society in general. This isn’t a cheap process; the treatment costs around £9,000 to £15,000 per patient but this is more than borne out by the reduced costs in policing and prosecuting their crimes.

The government has taken a very practical approach to the problem and has seen that 'legalizing' drugs can be done in a safe way and has many benefits, not just to the user but to society. Perhaps they could extend this to other drugs and remove them from the streets so as to be in direct competition with the current sellers. In future the government could pay for the treatment of those that become heavily addicted, or indeed suffer a bad reaction to the drug of their choice, through taxing the sale of drugs. Not only would drug legalization reduce crime overall but it would also mean that a large swathe of our society need never be in contact with the criminal element. 

Government (and people) getting a bit larger

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The Daily Telegraph has reported a story about a Welsh couple prevented from moving to New Zealand because each was considered vastly overweight and therefore a likely strain on health services. Mr Trezise had secured a highly skilled job for Telecom, but had to go on a crash diet in order to enter the country. His wife, unable to lose the extra pounds, has still not joined him.

Now, arguments have arisen that this is discrimination and stigmatization, but aren't these the kind of problems a nation faces when the government decides to provide health care? Private health companies won’t allow you to buy a policy with a serious pre-existing health problem, and when services like health become nationalized it makes sense that unhealthy people would then be banned from the nation providing the service.

Once the government becomes the health insurer, translating health policy into immigration policy isn’t that drastic of a step, neither is drinking policy or smoking policy – both of which we've seen in the UK. Once the government gains one power, it can expand its purview into all manner of life activities, all justified under keeping you healthy and safe. Start to scale back those powers (less socialized healthcare, for example) and the state has fewer justifications for control. Funny how that works.

Convenience medicine triggers competition

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People working in the healthcare industry are beginning to understand that customer convenience, the top concern in other industries, should have its place in healthcare too. The reason for this is often overlooked. It’s driven by demographics. With ever-growing workforce participation in developed countries, time is becoming more precious – and so looking after your health is squeezed among other chores. That’s the principal reason why waiting lists for medical treatments are a medieval plague and absolutely counterproductive.

This is where Convenience Medicine kicks in. It’s also the story behind Wal-Mart's recent heavy engagement in healthcare. The world champion of retailers has prodded others to offer most common drugs so cheap that even the Medicare Pharmaceutical Benefit Scheme – introduced at huge cost by George W. Bush – is already looking rather obsolete. But it’s not only cheap drugs. Convenience care also offers a different approach to patients. Surveys show an extremely high rate of patient satisfaction with convenient care clinics.

Convenience care clinics provide reliable, immediate, low-cost healthcare to the general public, many of whom do not have access to traditional healthcare. With over 500 active clinics in the United States (projected to grow to 700 by the end of 2007), these clinics complement traditional medical services providers.

With the healthcare industry employing the biggest workforce in many countries and eating up increasingly vast chunks of government budgets, it is unsurprising that market forces are finally getting loose. It always struck me as hypocritical that those who insisted that healthcare was "morally different" were often the same people who shrugged off the industry's deplorable record of customer relations.

Free trade in healthcare

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One of the biggest problems facing the US health system is that care simply costs more in America that almost anywhere else in the world. The high costs have a number of factors, but one of the largest is the amount of regulation and intervention by American governments and insurance companies. The National Center for Policy Analysis has just issued a report highlighting a response to these extremely high prices and a new trend in globalization: medical tourism. For years wealthy individuals from all over the world have been travelling to America for high quality care. Now, many medical tourists from America are travelling to Latin America or Southern Asia to receive nearly the same quality care but at affordable prices.

Obvious concerns arise about this practice, mainly over the quality of care. However, many of these nations are not that far behind the western world and the numbers of patients seeking this care continues to rise, evidence of the care they received. In addition to this new kind of travel, other medical services, like the analysis of lab results, can be done outside of the country to further utilize non-American expertise. We shall have to wait and see what changes like these do to the health industry, but here a free trade in healthcare might be just what’s needed to end the 'crisis'. Individuals can travel to wherever they can afford the care, and the professional health industry will thrive in less advantaged nations, aiding growth. Now, please, just don’t regulate it.

Deregulate the Drinking Culture

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In the past decade, the UK has seen an increase in alcohol related deaths. This has been accompanied by an increase in government regulation to try and combat the problem. The Health Alcohol Alliance recently called for even more regulation specific to fighting alcohol abuse and disease among youths. As well as regulation on advertisements, they want taxes on alcohol increased. Britain already has the second highest alcohol tax in Europe and many government programmes and regulations, and yet the Alliance thinks more of the same will do the trick.

Increased control isn’t the way to solve the problem. Countries with a less restrictive attitude toward alcohol don’t have the same problems of youth abuse. In many European countries, children grow up with alcohol as an accepted part of daily life, rather than a forbidden novelty, so when they reach adulthood the desire to overindulge is much less. In more temperate cultures like Britain and America, when young people begin to drink they often do so to excess because alcohol is a new and exciting novelty. This problem is even worse in America, where the drinking age is 21, and high school and college students drink heavily as soon as they gain access to alcohol. In terms of safety this is even worse. The young are more likely to try and drive themselves home if they are drunk and their drinking is forbidden, rather than calling a parent or taking public transport.

Obviously, the regulation hasn’t been working and the Alliance must find new ways of combating the problem, not just increasing the old, ineffective ones. The answer to our alcohol problem is less regulation, not more, to create a climate and a culture that doesn’t need to abuse alcohol to the same degree.