Critics of libertarianism often resort to absolutist arguments, such as “without government regulations and oversight, people will die because crooks, quacks, and charlatans will be free to kill them.” I usually dismiss these protestations as a variant of Washington Monument Syndrome, wherein anti-liberty types cherry-pick the oversight they expect most people support while ignoring the (far more prevalent) restrictions that are there to benefit the well-connected rather than the public. Requiring a couple thousand hours of cosmetology training to braid hair is one of countless examples.
But, it behooves libertarians to also explain how, in our vision of society, such quackery would be addressed, even if we don’t expect things to get anywhere close to that vision (that’s the other absolutism we face: “in your world, this bad thing would happen” straw men that the utter improbability that “our world” would appear in a week or a month or a decade).
In the past, I’ve discussed, in general terms, the “A-to-B” question, which is about how we transition from our current over-regulated state of things, where John Q. Public presumes that government has vetted the goods and services he seeks, to the libertarian state, where such vetting happens through private-sector and market mechanisms.
Fortunately for illustrating our cause, the latter already exists to a degree.
Ever buy something you plug into a wall? Look at the plastic case of that something and you’ll see “UL Listed.” That something has been certified by Underwriters Laboratories, a private organization that provides safety standards.
And, almost certainly, you’ve bought something vetted by the United States Pharmacopoeia (USP).
There are many more such private testing, certification, and standards-setting organizations, and companies benefit in many ways from utilizing them and/or employing their standards. It doesn’t take much in the way of due diligence on a consumer’s part to look for a UL logo on a clock radio or appliance. And, if an organization doesn’t establish or maintain high standards, others can come along and displace it by offering ‘better.’ That doesn’t happen with government – government doesn’t suffer when it gets things wrong.
Such “third party certification” can be applied to the sorts of licensing activities that many people want to continue, including the practice of medicine. As presented by the fine folks at Cato, it’s quite conceivable to swap out a government licensing scheme for an accreditation scheme offered by the private sector. It’s a pro-liberty step away from current direct licensure, where the government would recognize specific private sector entities, whether they be organizations a la UL or USP or universities, that could confer certification/accreditation outside the monopoly of government licensure. There’d be far more room for “innovative educational and certification programs, nontraditional career paths, incremental expansion of clinician skills and scopes of practice, and the creation of new categories of health care professionals. The result would be better career opportunities for clinicians and greater access to care for patients.”
And, of great import to the challenges lobbed at libertarians, it would address the quackery concerns. Obviously, quackery exists even under government’s supposedly watchful and benevolent eye, and no one should ever assume or assert that there’s a way to wholly eliminate it (although many lazy anti-liberty arguers do). But, a third party certification system would work as well, if not better, simply because there’ll be positive market pressures at play instead of an unaccountable and often inscrutable bureaucracy.
A true libertarian would call this a transitional stage, with the optimal end stage being third party certifications that relied entirely on market forces for their continued existence, rather than a government blessing. This end stage would also require certain behavior modifications from the populace, as in “I’m not going to blindly assume the government’s got it right, but instead I will pay attention to the certifier and its reputation.” We’ve got a fair bit of that even today, but let’s be real: we’re not getting to that point in your or my lifetime.
This is the other aspect of the A-to-B question: Time. Supplanting government activities, inefficient and excessive or not, requires the emergence of alternate, private sector structures to replace them, as well as a transition in public behavior. This is why I don’t advocate for sword-on-Gordian-knot speed. Effective and lasting change must be evolutionary, with each excision of a government over-reach given time to either stand alone or be replaced by private-sector solutions. Thus, we achieve real improvements while continuing to quell quackery.
It can be done.
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