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You seem to believe in a weak central government and strong state governments that try new approaches and get shit done. This is nice, except most libertarians believe in weak governments in all levels of government. No, not a government that works as well, not an efficient government, but a minimal government.

To have a minimum, you have to have a set of constraints. There's no reason those constraints could not lead to "weak governments in all levels of government"

I must be misreading you. I keep finding people making these broad over generalizations about libertarianism. Yes, libertarians are for minimal government, but minimal is a term you can drive a truck through. Simply because one libertarian believes that limited government is minimal, tiered, distributed government and another thinks it means single-layer, centralized government doesn't make one person libertarian and another person not.

The terms you mention are not simplistic, they are broad. There's a big difference. It lets a lot of people have libertarian leanings and prompts the individual to continue the definition process at a personal level, which is exactly what you want in a democracy, right?

>minimal is a term you can drive a truck through

That's why many Libertarians believe in a _Constitutional_ government. I.e. there is absolutely a standard for what size the US federal government should be (and what purposes it should serve). It's the US Constitution.

How much time did you spend in Europe to get the idea that the health care systems are good?

Having lived there for 25+ years and now 10+ in the US I can discern no difference. Both systems are broken with a capital F.

I consider myself a libertarian so I would love to see a simple health care option e.g. provides low level emergency care, low level preventative measures.

So you get a busted bone set, colds/infections treated, child birth and pre/post natal, annual check up etc.

But major stuff is not covered e.g. you have a heart attack you're on your own, you need a lifetime of expensive drugs no chance, hip replacement nope.

The idea being that costs are minimized and a clear directive can be written. Like all things you want better treatment you need to put your hand in your pocket.

Thank you ajmoir. So what do I do? I have diabetes and a couple of heart attacks in my history. I can't get health insurance now or under your system. If I have another my choices are die, go bankrupt, or live in poverty for the rest of my life. Thanks a bunch.

One option is charity. Keep in mind that the government pulls in $1.2 trillion from personal income taxes per year (ironically enough, that's the size of Obama's proposed stimulus package).

Anyway, in a libertarian USA, most if not all of that $1.2 trillion would stay in the hands of the people; that fact, along with a few other libertarian ideals, would mean a more prosperous people.

A more prosperous people, with the knowledge that the government no longer provides inefficient health care to others with their hard-earned money means... you guessed it. Also, a libertarian USA would mean cheaper /everything/ (including health care) because of the Austrian economic, free-market principles.

I truly believe it. I've got some excellent ideas based around for-profit charities. Imagine famous, fancy restaraunts situated in the big cities. The bottom floor sells wonderful food to the celebrities and rich folks. The rest of the building houses and feeds homeless people. Of course, it doesn't even have to be a fancy restaraunt, and it doesn't have to house homeless people.

in a libertarian USA, most if not all of that $1.2 trillion would stay in the hands of the people

Including $11 billion that would otherwise have been spent on tax collection.

http://www.whitehouse.gov/omb/budget/fy2009/treasury.html

But then why is it that Europeans fly to the US for cutting-edge (no pun intended) surgical methods that aren't available here?

Also minimal government is not the same as weak government. A libertarian government wouldn't do much, but the things it would do (such as operating the courts) it would do with absolute authority. What we have now - in most of the Western world - is large, weak governments.

Your discussion of health care systems is simplistic. For example, the US system has a track record of innovation and there are very good reasons that some non-US populations have higher average health that are completely unrelated to health care.

While I'm not a libertarian, libertarians don't encourage small government just to hear themselves speak. If one doesn't err on the side of limiting government, you tend to get one useless bailout bill after another as people with power, but not much more brains than yourself, frantically fling money around trying to solve problems they don't really understand. Unfortunately, it's not play money.

> Your discussion of health care systems is simplistic.

People have written books on the subject. Any internet discussion of it is bound to be "simplistic" to some degree.

Really, though, wheels sums it up best:

http://news.ycombinator.com/item?id=419503

European health care systems are a double edged sword for startup founders. I have lived in several european countries and researched the matter for some others as well because I like to move around. I'll spare you the details because they are mind boggingly complicated.

The issue is that in most countries there is no separate health care system. There is an integrated social security system, including pensions, etc. The problem is that there is a minimum charge that you have to pay irrespective of your actual income.

This "standing charge" varies a lot. It's negligible in the UK ($15 per month) and (I believe) in Ireland. But it's awfully high in most of continental europe ($300 per month). That increases the burn rate for self funded startups by about a third.

The reason why it's so high in some countries is that you don't get to choose what kind of risks you want covered. The assumption is that you pay for the older generation so that the next generation pays for you.

It's one size fits all, decoupled from individual choices. You must pay into the retirement system even if you decide (as I have) that you are never going to stop working unless you're unable to (which should be covered by a basic disability insurance which is much cheaper)

As a result, many people (including myself at this moment) have no health coverage at all. Either because they cannot afford it or because the rules are so complicated, inconsistent and inflexible that people with unusual CVs slip through the net.

> This "standing charge" varies a lot. It's negligible in the UK ($15 per month)

Do you have a reference for the "standing charge" in the UK? I've never heard of it.

Yes as I said in the other post, the self employed pay class 2 and class 4 NI contributions: http://www.hmrc.gov.uk/nic/background-nic.htm

The rates are here: http://www.hmrc.gov.uk/rates/nic.htm

If you earn below 5715 per year you only pay class 2 NI contributions, which is 2.4 pounds per week.

[edit] I forgot to mention that you can apply to be exempted from class 2 NI altogether. I didn't do that because 2.4 pounds per week seemed already very low to me.

My understanding is that income tax as well as NIC contributions go towards funding the NHS. Anyone is eligible for NHS treatment, even foreigners, so it seems inaccurate to say that your contribution to the NIC is what pays for your health care.

I didn't say that and I really don't know how much of the NHS is being paid for by NI contributions.

The point is that in the UK you pay according to your actual profit wheras in other european countries you pay a lot starting on the day you register your business.

I believe he's referring to National Insurance. But as far as I remember NI is the government pension scheme and not related to health insurance.

I can't remember if I had to show my NI card when going to the doctor when I was at university there.

Later on when I was working I normally paid for my own private doctors, due to my experience with the horrible NHS system during my student days.

http://en.wikipedia.org/wiki/National_Insurance#Class_2 ?

Standing charge in the UK? Not sure where you get that idea - treatment with the National Health Service is free.

The self employed pay 2.4 pounds per week class 2 NI contributions + 8% class 4 NI contributions for earnings between 5700 and 43875 a year. So if you don't make a profit you pay 2.4 pounds pw which is around $15 per month.

You seem to be getting caught up in the most extreme version of libertarianism.

Consider this: If more big problems were solved in various ways at the state level, there would be COMPETITION and government might be BIGGER in some areas and SMALLER in others.

My guess is that in many cases it would be smaller if there were more competition between regulatory ideas/approaches, but this is probably not going to be the case in every area.

Libertarians don't believe in small government at all cost, only that government should be put under competitive pressure so that it's as minimal and efficient as possible, and so that there are not perverse incentives and special interest entrenchment created.

I don't think "weak" and "minimal" should be used interchangeably. MY personal beliefs, which I generally describe as libertarian (though I admittedly don't know, understand, or agree with ALL beliefs that may be called libertarian), are that a government should be very strong and able to do WHAT IT NEEDS TO DO. I use the term libertarian simply to mean prioritizing personal liberty. A government should be able to protect your liberties, and should perform that task above any other. Libertarians in the US surely all agree that the FEDERAL government should be small, and most probably believe the State government should stay out of your lives as much as possible as well. However, I think most would agree that the more local the government, the more of a true voice the individual has, so regulations/taxes/etc. are more acceptable at more local levels of government. For example, speaking only for myself, I have a problem with federally funded, regulated, and mandated public schools, but I DO NOT have a problem with a local tax to fund local schools being on a local ballot. Depending on where the funds would be used, the perceived necessity of the funds, and perhaps my own financial status, I would choose whether to vote for the tax, and would have no problem with the tax being passed if the locals voted for it.

>As an example, take the health care debate. Compared to some european countries with good healthcare systems, the US spends substantially more (~15% vs ~9% of GDP) covers substantially fewer people (the millions without coverage) and the overall health of the population is poorer. By nearly all objective measures, a good public system is much better than an all-private system and yet, we know this is not compatible with libertarian ideology - you will have to search far and wide to find a libertarian group that supports a public healthcare system.

I haven't been feeling my best lately.[1] I apologize for not supporting my argument, but I believe Chile has a reasonably good healthcare system, where the rich go to the private system and the rest go to the public system.

[1] I just moved to the US from Chile.