Fighting Ebola with Freedom

[Razgovory]

I was recently given two examples of how a free society would fight Ebola.  I thought it might be well received by this board since there are so many liberty loving libertarians here.

Ebola is all over the headlines and airwaves. If it bleeds it leads, they say, and stirring up a panic about a lethal epidemic is a surefire way to drive ad sales through the roof for main stream media. I too shall capitalize on the hysteria, and try to make an actual point in the process.

At least 5 people have been transported to the United States for treatment after contracting Ebola abroad. There is one confirmed death from Ebola in the United States, the CDC has just recently confirmed a second infection, and dozens of at risk people are being monitored for symptoms of the disease.

The United States is dispatching military to Africa to fight the disease, because, you know, the Ebola virus is just terrified of America's military power.

Ebola is a terrifying illness. It has a fatality rate of approximately 50%, so if you become infected, your life is a coin toss. Ebola is highly contagious, spreading through close contact with bodily fluids, and has an incubation period of up to 21 days. A person can board a plane in one country appearing perfectly healthy, and not show symptoms until arriving in a different country, as was the case in Dallas.

These factors makes the virus a global public health concern, that as we've seen, mobilizes governments to action. Much of which is debatable as to whether it is effective, efficient, or detrimental. Sending American military personnel into yet another foreign country for example, raises quite a few eyebrows.

Still, people look to governments whenever there's something scary in the world. So whether the government action is good or bad matters not, governments do act, because people expect it. Talk about a society absent the State, and a question about such public health concerns is never far behind questions about roads. Fail to answer that question, and statists are left free to envision a world which more closely resembles that of AMC's The Walking Dead, than the market based orderly functioning society we describe.
So how would a free society deal with Ebola?
Medicine in General

The medical industry in the United States, and really the world over, is so tightly regulated that entry into the industry is all but impossible for all but the wealthiest and most politically connected people in society. Even after one enters the industry, complying with regulations regarding research alone is so cumbersome that you need not only a medical degree, but a legal one as well. Once a drug or other treatment is researched and developed, FDA approval is required to market it, a process which, if everything goes well, takes 6-10 months. If all does not go well, then the process can take years, or prevent the product from making it to market at all, thereby making all the investment in research a total loss.

By some estimates upwards of a million people in Africa will become infected with the Ebola virus. In a market environment, these people are customers, and with a fatality rate of 50%, you can imagine these customers would pay just about anything for a greater chance of survival. This creates a huge incentive to find cures and treatments for the illness, but if you or I decided we wanted to enter the Ebola curing business, it would take years of our lives and hundreds of thousands, if not millions of dollars to begin research. By the time we were able to market a treatment or cure, all our customers would already be dead or recovered.

In fact, there are treatments and possible cures for Ebola already in existence. ZMapp, an experimental cure, has been in development for years. In an experiment published in a 2014 paper, 21 rhesus macaque primates were infected with the Kikwit Congolese variant of EBOV. Three primates in the control arm were given a non-functional antibody, and the 18 in the treatment arm were divided into three groups of six. All primates in the treatment arm received three doses of ZMapp, spaced 3 days apart. The first treatment group received its first dose on 3rd day after being infected; the second group on the 4th day after being infected, and the third group, on the 5th day after being infected. All three primates in the control group died; all 18 primates in the treatment arm survived. The developer then went on to show that ZMapp inhibits replication of a Guinean strain of EBOV in cell cultures.

Unfortunately, only a small amount of the drug has been developed, and only began human testing during the 2014 West African outbreak of the disease. Patients treated with the drug have survived, but supplies have already been exhausted. US President Barack Obama says that even in light of this evidence, allowing the drug to be mass produced and marketed is "premature".

Now, I'm no medical expert, I have no way of knowing the long term effects of ZMapp, or if a safe treatment, cure, or vaccine would or could be developed under any circumstances. What I do know is that years of waiting, attorneys, civil liabilities, and hundreds of thousands of dollars just to comply with government regulations, are massive deterrents to economic activity. We can't predict whether or not a free society would find a cure, treatment, or vaccine for Ebola or any other illness, but we can clearly see that government is an obstruction to any effort towards finding and marketing one.

In the absence of the State, there would be no obstruction to ZMapp or other drugs being produced and marketed. If the drug proved safe and effective, Ebola would be a non-issue in short order. Imagine the difference in environments. In the world you live in today, you could contract Ebola, be held in isolation at a hospital, and have a 50% chance of survival. In a free society, should you contract Ebola, you could very well stop at CVS and buy a cure on your way home from work.
Quarantine and Containment

In Dallas, friends and family of the infected are being monitored by medical professionals. I have seen no indication that they are being forced to do this, but if they refused to comply, we could expect that they would be forced by government to submit to monitoring. If they aren't being forced, it is only because they complied voluntarily upon request.

It makes a lot of sense to do this of course. Simple self preservation instincts incentivize one to seek medical attention when there's a possibility they've been exposed a disease with a 50% fatality rate.

Were there to be a major outbreak of Ebola or any other contagious illness, we know that the US Government has already entertained handing control of a quarantine over to the military. George W. Bush said as much about bird flu just a few years ago, and there have already been a number of quarantine situations in the United States.

It is one thing for a hospital to isolate a patient. It's another for military to blockade a city, town, or state. Preventing healthy people from leaving a place where people are sick could be a death sentence in itself. Preventing goods and services from reaching that place, disrupts the economy, and prevents medicine from making its way to sick people who need it.

Imagine if your neighbor contracted some illness, and when he sought medical attention, military descended upon your town and threatened to kill you for leaving. Imagine trucks were not permitted into the quarantine zone, and the shelves of the supermarkets and pharmacies became empty. Imagine a foreign government sent military personnel onto American soil, you know, to "help".

Undesirable situations all, no doubt.

On the other hand, there is a very real concern that some deadly virus could infect a population, and many people would be comfortable with the above scenarios if they thought it meant keeping other people safe. Preventing one person from leaving a quarantine zone, in their minds, could well prevent the virus from spreading to another area and causing further infection and death. In the minds of many, initiatory force is justified by such circumstances.

So a free society needs to answer that problem, and at first glance it might seem difficult. The non-aggression principle is rather useless if we simply turn it into a suicide pact. A moral and legal platform that leads a people to their extinction is not of much practical use, of course.

What I'm about to describe requires some understanding of the general ideas of protection in a free society. I've written two articles describing them, one about crime, and another about regional defense from foreign invaders.

Call them defense agencies, dispute resolution organizations, or insurance, the basic idea is that one enters into contracts voluntarily with a person or group that provides services much like any other business. The provision of those services is dictated by the terms of the contract, and negative behaviors are curbed by the increased cost of protecting the people who engage in those behaviors.

Say for example a grown man has a propensity for raping children. One could expect this man to find himself with some well earned enemies, and protecting him from the outraged parents of his victims would be cost prohibitive. This being the case, one could expect that any contract of protection would require some basic rules of behavior, barring things like raping children. Should one break those rules, he would be in breach of his contract with the protection firm, they would drop his protection, and he would be therefore unprotected against threats to his safety. The lack of protection alone would be incentive enough for most to refrain from activities that would render them so unprotected, and if they did engage in such behaviors, we could expect to see them removed from the gene pool altogether either by the criminal element that is sure to exist in any society, or by the hand of someone he had wronged.

The same general idea can be applied to people who are sick, or otherwise risk spreading a disease. Imagine an insurance company's incentive to limit the spread of infection. If you're running around infecting people with a lethal virus, some of those people are likely to be their customers, and preventing you from spreading the disease is a lot cheaper than the treatment is going to be for all those that you infect. That's why they are already all too happy to pay for vaccinations and all manner of preventative care.

I see a lot of incentive there to build some quarantine protocol into any stateless health insurance policy. A client would have to agree to be held in isolation, by force if necessary, to avoid spreading his illness to others. I doubt this would even be legal in the current US health care market, due to existing regulations, and in any case the insurance companies rely on government to prevent outbreaks. In the absence of the State, insurance companies would either have to take some initiative, or risk going broke.

It's also reasonable to expect that insurance companies would keep the lines of communication between each other open in the absence of the State. Collaborating between companies on the spread of disease would be beneficial to all parties, so resources could be geographically allocated most efficiently. Without the CDC centrally planning such matters, a vacuum would open up that the market could fill. Say for example, some clever programmer developing a tracking system of some sort that health insurance companies could collaborate across while maintaining the informational security of individual patients.

As stated earlier, there's also a great deal of incentive for patients to cooperate voluntarily, due to their own need for medical assistance. Running away is no cure when one becomes infected with, or exposed to, a deadly virus. If one is made aware of their exposure to an illness like Ebola, simply informing them of their exposure would generally be enough to get them into isolation in exchange for treatment should they become symptomatic.

In the case of Ebola at least, only symptomatic persons can spread the illness, and only through close contact with bodily fluids. The virus is not airborne. So simple respect for property rights could help prevent spread of disease. If there's a risk of my family becoming infected with a deadly virus, sick people are not going to be welcome at my home or place of business. Under those conditions, I'm at no risk of infection. Should some sick person decide to trespass or break in, I or my agent could use force to stop them, and if the dead body of an intruder needed to be removed from the property, some simple preventative measures could prevent infection from reaching those who removed it.
As Usual Government Passes Itself Off As The Solution To The Problem It Creates

As we've demonstrated, simple market forces and incentives do a great deal more to solve problems than government violence. Only a government could have a cure ready to be produced and delivered, and choose to instead prevent that cure from being produced and marketed, sending soldiers into foreign countries as the alternative. Only a government could force healthy people to live with sick people. Only a government could obstruct contracts that prevent the spread of infection. Only a government could disarm people and otherwise prevent them from defending themselves against threats to their safety.

Markets on the other hand promote cooperation and mitigation of damage through incentives. Market actors are incentivized through profit and loss to develop safe and effective medical treatments, to respect property rights, to defend against aggression, to honor contracts, and to solve problems.

Government is not necessary to stop the spread of infection. Government is an infection, and the cure is teaching people how human beings respond to incentives in a market environment. Accomplish that goal, and not only will we stop Ebola, we'll also stop the number one preventable cause of human death and suffering – the State

http://www.christophercantwell.com/2014/10/13/ebola-free-society/

The Ebola outbreak shows the standard pattern: Whenever there is a major social problem, the deep thinkers in the major ebolamedia report it as a lack of sufficiently powerful government. With regard to Ebola, I've heard people lament that the West African governments do not possess the resources to (a) maintain adequate infrastructure, (b) enforce a quarantine, and (c) provide medical care to the infected. If only their governments were as powerful as those of Europe and the U.S., the implicit argument goes, then this tragedy never would have occurred.

On the face of it, this perspective has things backwards. The affected African nations suffer from a lack of private property rights. The Fraser Institute maintains an "Economic Freedom of the World" index. According to the latest issue, out of 153 total jurisdictions ranked, Guinea ranked 109th while Sierra Leone ranked 72nd. (Liberia wasn't listed.) Nigeria, which is also reportedly in danger from the Ebola outbreak, ranks 98th. So say what you will about these areas and why they were vulnerable to the outbreak, but it's not accurate to claim that they have relatively weak governments. You can claim that the regions are poor, and that therefore their governments don't have the resources to do what other, richer governments would do in their position–but a major reason they're poor is that they have relatively intrusive governments.

(To avoid a possible counterargument: The Fraser EFW rankings aren't a mere tautology; they look at criteria such as "sound money," "size of government," and "freedom to trade internationally," when ranking a jurisdiction. They don't simply look at wealthy countries and then conclude, "Hmm let's give them high marks on economic freedom.")

Yet moving away from the individual case of our current Ebola outbreak, what about the more general question: In a truly free society, where the vast majority embrace voluntarism and there are no institutional violations of property rights, how would people respond in case of a highly contagious disease? Would there be mandatory vaccinations? Would there be the free-market equivalent of quarantines?

In my view, the answer here is not to try to "deduce" the blanket answer from first principles, and declare that in a free society, we would necessarily see either outcome X or outcome Y. Instead, I think we should be humble and acknowledge that one of the supreme virtues of freedom is that its outcomes derive from the contributions and expertise of the millions or billions of people composing the society. We don't know exactly how a free society would handle a hypothetical outbreak, just like we don't know how a free society would handle food distribution, education, or transportation.

We can come up with some general thoughts, but the specific circumstances would influence how many kids went to group schooling versus stayed home to learn, how many restaurants and grocery stores there would be, whether there would be train service at 6am on a Sunday morning, etc. You can't give blanket answers to such particular questions, because their answers depends on economic considerations. Instead, you embrace a free market economy in which people voluntarily trade property titles, so that "the market"–which is just shorthand for the totality of voluntary trades–can produce the outcomes.

Within this context, then, we can speculate about a free society responding to an outbreak of a highly contagious disease. The first thing to remember is that individual property owners could set their own rules. For example, the owners of schools and factories could insist that any students and employees first show proof that they had been vaccinated (if a vaccine existed for the pathogen in question) before allowing them entry onto the property. In a free society, individuals don't possess some abstract "right to go wherever I want without people checking my papers." No, in a free society, people own property and nobody else can violate their ownership rights. If the owner of a building wants to keep it closed on Sundays, he can do that, and if the owner of a building will only let people in who prove to his satisfaction (perhaps because they are listed in the database of a reputable medical clinic) that they've been vaccinated against the contagious disease ravaging the community, then he can do that, too.

As in other areas of social life, here too the existence of competing agencies would check potential abuses. For example, suppose a particular medical clinic keeps very poor records; its database lists some people as "Vaccinated" who haven't been, and/or lists some people "Not Vaccinated" even though they have been. Well, unlike the government's Centers for Disease Control (CDC), any such medical clinic would enjoy no special support from a large institution with all of the tanks and missiles. People who had gone to the clinic to get vaccinated, and then weren't listed on their database, would raise hell and take their business elsewhere. If there were multiple examples of this, the shoddy clinic would soon go out of business. And if anybody who was actually contagious ended up infecting others because the medical clinic said "Vaccinated," then that news would quickly spread to the owners of large buildings in the community and they would no longer trust that particular clinic's database. Thus, the whole point of getting vaccinated by that clinic would evaporate, such that–again–it would quickly fold as people took their business elsewhere.

On the other hand, if there really were a very miniscule risk of infection–perhaps because the outbreak occurred in a distant region–then paranoid property owners would lose business. For example, if a particular mall required entrants to prove their health at the door, while the other malls in the area had no such checkpoint, then the first mall would lose many potential shoppers. Here, as elsewhere, there are tradeoffs, and the best way to find the "optimal" balance on a spectrum is to give people the freedom to use their property in voluntary ways as they see fit.

For a more comprehensive treatment, you should first read my pamphlet Chaos Theory, which discusses the possible role of insurance companies in a free society.  Then you will have the framework to imagine how, say, a free society would handle the "choke points" of airports and land borders, if there were a contagious outbreak in a nearby region. For example, the owners of the airport might have contractual relationships with contiguous landowners, in which they promise monetary compensation in the event that planes crash into their homes, or if someone with Ebola infects them because they entered the community through that particular airport. In this context, large insurance companies could handle this legal liability for the airport, but in exchange the insurance companies might insist on safety precautions and have procedures in place for handling an Ebola outbreak. (See my article dealing with the TSA and the false tradeoff between liberty and security.)

For the thorny issue of quarantines, I think a free society would handle this type of case just as it would handle serial killers; either read my discussion in Chaos Theory or listen to this lecture excerpt on "Would There Be Prisons in a Free Society?"

In conclusion, let me admit that a free society would not be paradise: People would still get sick and die, and there might even be outbreaks of contagious diseases. It's true, the mechanisms I sketched above would not be perfect. Yet the question is always a relative comparison: Our current world, filled with monopoly governments, hasn't eliminated contagious diseases, either. For a given group of people, letting them either (a) solve problems voluntarily or (b) create a State, which outcome is more likely to lead to sensible, effective solutions to genuine social problems?

http://www.libertychat.com/2014/08/free-society-handle-quarantines/

[Admiral Yi]

What is the point you're trying to make, and have been trying to make for the last 10 or so years?  That all libertarians are kooks?  That anyone who values individual freedom is suspect?  You've expended thousands of keystrokes, but I still don't know what you're trying to prove.

[Valmy]

I presume that anarchists are insane.  I was not aware we had lots of anarchists here.

In the case of Ebola at least, only symptomatic persons can spread the illness, and only through close contact with bodily fluids. The virus is not airborne. So simple respect for property rights could help prevent spread of disease. If there's a risk of my family becoming infected with a deadly virus, sick people are not going to be welcome at my home or place of business. Under those conditions, I'm at no risk of infection. Should some sick person decide to trespass or break in, I or my agent could use force to stop them, and if the dead body of an intruder needed to be removed from the property, some simple preventative measures could prevent infection from reaching those who removed it.

He makes it sound so simple.  Simply get in your bunker and murder anybody who tries to get inside.  Problem solved.  Nobody will ever get sick with any diseases ever again.

[Razgovory]

What is the point you're trying to make, and have been trying to make for the last 10 or so years?  That all libertarians are kooks?  That anyone who values individual freedom is suspect?  You've expended thousands of keystrokes, but I still don't know what you're trying to prove.

Perhaps you shouldn't assume that all my posts are designed to illustrate one transcendental point.

[Admiral Yi]

I think it's a safe assumption that all your posts that start off "I'm posting this for all the libertarians here" are meant to support some point or another about libertarianism.

[Razgovory]

We have libertarians here.  I thought they would naturally be interested in how a free society deals with an epidemic.  Do you take umbrage with my post?

[Admiral Yi]

I take umbrage with your incessant efforts to discredit ideas through guilt by association.  That's a tool of political spin, not collegial debate and discussion.

[grumbler]

I take umbrage with your incessant efforts to discredit ideas through guilt by association.  That's a tool of political spin, not collegial debate and discussion.

  It's Raz.  Trying to saddle anyone he disagrees with with the mantle of defending some kooky idea or other is his entire schtick.  Obvious troll is obvious, so I don't know why you continue to even question the schtick.  Ignore it and move on.  No sense taking umbrage with it, since it is so clumsy that it deserves laughter far more than umbrage.

[Razgovory]

I take umbrage with your incessant efforts to discredit ideas through guilt by association.  That's a tool of political spin, not collegial debate and discussion.

  It's Raz.  Trying to saddle anyone he disagrees with with the mantle of defending some kooky idea or other is his entire schtick.  Obvious troll is obvious, so I don't know why you continue to even question the schtick.  Ignore it and move on.  No sense taking umbrage with it, since it is so clumsy that it deserves laughter far more than umbrage.

Grumbler you totally should go back to ignoring me and let the adults talk.

[Razgovory]

I take umbrage with your incessant efforts to discredit ideas through guilt by association.  That's a tool of political spin, not collegial debate and discussion.

I'll have you know that an honest to god Libertarian gave me these links.  Same one I argued with a few months ago about the coercion and the nature of law.  I do find the ideas of libertarianism abhorrent, but I'm letting them speak for themselves.  Who I ask is being associated with who here?

[CountDeMoney]

Don't listen to Yi, Raz.  Your bullshit is no worse than his bullshit.

[Admiral Yi]

I'll have you know that an honest to god Libertarian gave me these links.  Same one I argued with a few months ago about the coercion and the nature of law.  I do find the ideas of libertarianism abhorrent, but I'm letting them speak for themselves.  Who I ask is being associated with who here?

"many liberty loving libertarians here" are being associated with your linked kooks.

[Admiral Yi]

Don't listen to Yi, Raz.  Your bullshit is no worse than his bullshit.

You're not that much better than Raz.

[Razgovory]

I'll have you know that an honest to god Libertarian gave me these links.  Same one I argued with a few months ago about the coercion and the nature of law.  I do find the ideas of libertarianism abhorrent, but I'm letting them speak for themselves.  Who I ask is being associated with who here?

"many liberty loving libertarians here" are being associated with your linked kooks.

Oh, so you consider these people kooks?  How am I suppose to know which libertarians are kosher and which or not?

[Jacob]

Don't listen to Yi, Raz.  Your bullshit is no worse than his bullshit.

You're not that much better than Raz.

I'd be interested in seeing your relative hierarchy of quality posters on politics.