Appropriating Hayek


J. Mick Tilford, a professor of health policy and management at the University of Arkansas for Medical Sciences, attempted to enlist F. A. Hayek in his defense of the Obamacare health insurance mandate. In an op-ed published Sunday in the Arkansas Democrat-Gazette Tilford wrote (subscription site):

Even the fervent libertarian Freidrich [sic] Hayek wrote that a system of comprehensive insurance may be necessary.

Hayek wrote “where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance . . . the case for the state’s helping to organize a comprehensive system of social insurance is very strong.”

Here is my letter to the editor in response:

J. Mick Tilford cites free-market Nobel laureate Friedrich Hayek in support of his case for mandatory health insurance (Sunday Perspective). Does that mean Prof. Tilford accepts Hayek’s case for laissez faire in virtually everything else? Perhaps like Hayek, Prof. Tilford overlooks some important matters. For one thing, mandatory health insurance requires coercion. Prof. Tilford wants individuals punished for defying the government’s orders to buy something. Why is this departure from freedom and civility justified by promised—though never delivered—efficiency? Moreover, an insurance mandate will be accompanied by controls on premiums. Obamacare dictates that sick people may not be charged more than well people, despite the fact that the sick need more medical attention than the well do. The history of bureaucratic price controls is a history of shortages, rationing, ever-more-pervasive mandates, and misery. If Hayek didn’t pay enough attention to the consequences of mandatory insurance, that’s no reason for Prof. Tilford not to. Yet Hayek feared for the individual’s freedom once the state intervenes in medicine. “Somebody must always decide whether an additional effort and additional outlay of resources [for medical care] are called for. The real issue is whether the individual concerned is to have a say and be able, by an additional sacrifice, to get more attention or whether his decision is to be made for him by somebody else.” Our already heavily government-managed medical system has too many decisions being made by somebody else. The Obamacare mandate will only push us further down the road to serfdom.



Sheldon Richman is the former editor of The Freeman and, and a contributor to The Concise Encyclopedia of Economics. He is the author of Separating School and State: How to Liberate America's Families.

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