Philosopher Rod Long’s gotten a lot of attention for his recent post on Bleeding Heart Libertarians, and it’s easy to see why.  Rod leads with Wolf Blitzer’s “gotcha” for Ron Paul:

Wolf Blitzer: You’re a physician, Ron
Paul, so you’re a doctor. You know something about this subject. Let me
ask you this hypothetical question.

A healthy 30-year-old young man has a good job, makes a good living,
but decides: “You know what? I’m not going to spend $200 or $300 a
month for health insurance because I’m healthy, I don’t need it.” But
something terrible happens, all of a sudden he needs it. Who’s going to
pay if he goes into a coma, for example? Who pays for that?

Ron Paul has a three-part answer: (1) The young man should have been more responsible, and strangers shouldn’t be forced to bail him out; (2) private charity will help; and (3) regulation makes health insurance needlessly expensive.  Rod argues that this is a philosophical and rhetorical mess:

This is the kind of question that libertarians usually give stupid
answers to. Their first impulse is to stress that no one has the right
to force other people to pay her medical bills – which is true enough,
but a weird place to start. This answer in effect treats the free
market as the present system minus welfare, and so takes for granted
that the problem described is likely in a free market. It also casts
the sick person as a threat to others’ liberty rather than as a person
who can be better helped by libertarian methods than by statist ones.
If someone is looking to smear libertarians as people who want to let
sick people die, this hands them the opportunity on a platter.

So what should libertarians say?  Rod’s approach:

The right way to answer a question like Blitzer’s is to proceed in precisely the opposite order. Start by asking what causes people like the hypothetical patient to be in the plight they’re in. In other words, lead with stage three. Why didn’t the patient buy insurance? Because the price was too high. Why is it so high? Talk about the specific ways in which corporatist policies drive up medical costs (and disempower the poor in other ways too).

Then, if you still have time, proceed to stage two. If someone
doesn’t have insurance and needs care, what’s the most efficient way to
get it to them? Talk about how charity and mutual aid are more
efficient than government welfare, and how we therefore need to shift
the venue of assistance from the latter to the former.

And then you can finish by pointing out that peaceful, voluntary
solutions are not only pragmatically but morally superior to coercive

Rod’s advise is at once wise and dissatisfying.  If we can honestly say that laissez-faire will rapidly and decisively solve a problem, Rod’s exactly correct.  Unfortunately, the real world is often a lot messier in two important ways:

1. Free markets do lead to higher economic growth, but this is a very gradual process.  

2. No matter how rich a society gets, irresponsible behavior will continue to have bad consequences.

Consider Blitzer’s example.  I’m willing to believe that under laissez-faire, health insurance would cost half as much.  But if a healthy young man with a good job is unwilling to pay $200 or $300 for health insurance, he could easily continue to say no after free competition drives the price down to $100 or $150.  And then the question returns: What do “we as a society” do if the uninsured man goes into a coma? 

The libertarian can respond, “Voluntary charity will take care of him.”  But ask yourself: How rich and generous will donors have to be before philanthropy can feed every hungry child on earth?  Until we get there, libertarians should just bite the bullet and say, “Healthy young men with a good jobs should do the responsible thing and buy health insurance – and it’s perfectly reasonable not to bail them out if they don’t.”

Furthermore, there are many problems that laissez-faire won’t much improve.  Take alcoholism.  Yea, you could claim that bad government policies drive people to drink.  But that’s far from clear.  And don’t liquor taxes make people drink less?  The hard fact is that free people make lots of bad choices.  Libertarians should accept this fact – not pretend that government policies are the “root cause” of bad choices.   

When you really think about it, Blitzer’s “gotcha” for Ron Paul was actually a “softball.”  Blitzer could have asked Paul about an unhealthy man.  Or a man without a job.  Or a child.  Or an orphan. 

I wish Rod’s Three-Step Program had credible solutions for all these cases.  But it doesn’t.  Free markets quickly make life better in some ways, and gradually make life better in almost all ways.  But critics of libertarianism will never run out of empirically plausible “hard cases.”  When faced with these hard cases, the best response we’ll ever have is, “Charity can probably provide for the deserving poor.  Everyone else should live with the consequences of their actions – and stop blaming total strangers for failing to help them.”