 First of a quest, my mom hates it when people call me doctor because my dad's a real doctor like you guys and you know I just didn't earn the title in her mind so I'm Iran so just call me by my first name. My dad is a doctor, he's an internist or was an internist at a hospital in Haifa, Israel and so I grew up in a family with a father who was a physician, a very successful physician, a really good physician under socialized medicine so I'm here to tell you something you probably already know but I have first hand knowledge of this and you guys probably don't. It doesn't work, it's really bad. So in my dad, Israel has amazing doctors, you probably meet them at conferences and so on and it has more doctors per capita than any country in the world by a long shot because Israel is a Jewish country so there are lots of doctors because that means a lot of Jewish moms who want you to become a doctor and yet in Israel has you know given that it has a very good healthcare system but it's still true that if my dad had a patient who was who had you know something really bad and who could afford it then my dad would put him on a plane and fly with him to the Mayo Clinic in Rochester, Minnesota and that's been true for years and years and years. You know I'm not going to bore you with all the details of the fact that the United States in spite of all the statistics that we hear all the time still has the best healthcare system in the world by a long shot that all the problems in the other healthcare systems we just are not reported, they're hidden in the statistics, they disappear in aggregation, the horror stories, nobody has an incentive to report but it doesn't work, it just doesn't work. I mean the UK is now struggling with figuring out how to move away from the national health system even though it's very popular system people who actually know anything about it know that it's a disaster and it's crumbling and it's falling apart, Canada is moving slowly towards privatizing elements of its healthcare system again kind of under the radar without anybody saying anything. All these systems that we are trying to emulate, that we are desperately trying to emulate in this country just don't work and of course the expert on all that I think speaks later today which is John Goodman who will give you a lot of information about statistics about how these other systems fail. I want to ask a question, I want to start off kind of by asking a question, given that we know our system has problems, now let's pretend that this is a perfect system, it's far from it, I think we can also pretty much figure out where the problems reside and why they exist, we'll get to that in a minute but our system is the best system out there in the world, things like 75% of all medical innovation in the world happen here, just imagine if we socialize our system and we stop innovating, everybody in the world suffers, it's not just we suffer, everybody, Obamacare destroys healthcare for other people in the world as well because it will lower innovation here and therefore they just buy it right now and they won't have anything to buy. The question I want to ask is why is this happening? Why is it in spite of all the knowledge that we have about the superiority of our system, the superiority of elements of our system, the fact that their systems don't work, why is it that we're moving towards that and here I have to say that even if they repeal Obamacare, it matters, it's important, great, they should repeal Obamacare but given who the Republicans are, it's not going to be that big of a deal because they won't repeal many aspects of Obamacare, maybe the most important one that they won't appeal is the idea of pre-existing conditions that insurance company has to cover pre-existing conditions and if you don't repeal that you're basically destroyed insurance and if you've destroyed insurance then the market will collapse at some point and who will get blamed for it? The insurance, greedy insurance companies and you guys will get blamed for it and we'll get socialized medicine from Republicans which is my view anyway that Republicans will be the ones ultimately to institute this because they'll have no opposition, it always comes from the right. So you know why is it so bleak? That is even if we can get rid of Obamacare when we're gonna still have, I mean Romney is backpedaling dramatically saying no I won't repeal everything I'll keep the good parts. I mean he and it's not like he's proposing other stuff to replace it that is good. So what is it? What is it about socialized health care? What is it about government involvement in health care that we find so appealing, that our culture finds so appealing, that in spite of all the evidence, in spite of all the facts, in spite of all the statistics, you know we still want to jump off the cliff because that's what it is, it's a cliff. Maybe it's not a cliff, maybe it's a slide right because it's slower but it's basically downwards and it's a disaster. And if you look at the American system today and you look at what works and what doesn't work, again you get the same you get the same indications right as if you look at the American system versus the foreign systems right. What doesn't work in the US system is government involvement. What works in the US system is when you leave it private. So the private sector, the truly private sectors in the UC con in health care system work. It's Medicare Medicaid that are killing health care in the United States that are driving costs up that are bankrupting the country never mind the health care industry that the bank bankrupting the country. It's all the tinkering that government does with insurance companies the fact that there's no real in health care insurance no competition in that market that they you know that there's no robust insurance in this country that everything is mandate that everything's controlled. It's the lack of competition, it's a lack of market, it's the lack of privatization. You know and the most revealing statistic there is you know one I'm sure you all are familiar with of every dollar spent on health care in the US. How much is spent by the government? 51 cents. So the government spent 51% of all health care dollars in the US. We don't have a private health care system. We have a heavily done and that doesn't include regulations and all the different controls that are involved. So even when you look at when we look at our own system the stuff that doesn't work is government and the stuff that works as private. So what do we do? We increase the stuff that doesn't work. And by the way and I'm not gonna spend a lot of time on this you can you can read this in the book. That's the pattern everywhere, everywhere right. They tie economy works like this. What parts of the economy work really really well? Those parts that the government leaves alone. You know you're holding up a iPad there. There's very little regulation on iPads that's why all the geniuses of our culture go into business trying to make phones better. As if that's the most important thing in the world right. What industries are failing? Well how about education? Education dominated by government. Imagine the the brain power that goes into developing a little bit better phone going into developing competitive innovative models in education. No but that's government you know but that's a government thing. So you're never gonna get that right. All our problems seem to be focused financial crisis and everything always focused in banking and we always blame the bankers. But nobody ever mentions the fact that banking is the most the most controlled regulated industry in the United States. So if you know anything about economics you go oh well that's not surprising that the most controlled and regulated industry in the US is where all the crises happen. Just like public education fails public banks are gonna fail and our banks are mostly public. So in health care we government spent about 51 cents of every dollar. Banks are regulated to a degree that 70 to 80 percent of all their decisions are based on what the government tells them to do. There's only about 20 percent of freedom. So this is a white phenomena that you know government fails. Financial crisis is a good example of this and you can ask me in the Q&A but the financial crisis is a crisis a government from beginning to end right. Government fails. We blame the market and we do the things that cause the government to fail. We double up on them. Okay so one aspect of this failure in I know I know I know a little bit more about finance and medicine. So I'll give you a financial example. One of the one of the causes of the financial crisis right is Fannie and Fannie. And again you can ask me if you want elaboration right. So what do we do. Do we shut them down. Do we break them up. Do we privatize them. What do we do. No we take them over. We make them part of government and we grow them and we make them even bigger which is what they are today. They're much bigger today than when they were before the crisis. But that's always the pattern. It's always the pattern. And it never works and we don't learn right. So stimulus packages. Stimulus packages are being tried for a hundred years. They were tried in the Great Depression. They've been tried all the time now in Japan for the last 25 years. Since 1991. So they've been tried 21 years. They've been tried over and over and over again. How many times have they worked. None. Never. They've never worked. Never. But let's try it one more time. You know what Einstein called that. You know you try the same thing over and over again but expect different results. Insanity. This culture is literally insane. Because we keep trying the same thing over and over and over again. So Medicare doesn't work. So let's expand it and cover all that insured under Medicare. You know something doesn't work. Let's grow it. Let's make it more. It's completely mind boggling. And the question is going back to this question of why. And my argument is that it's not a lack of economic knowledge although there certainly is a lot of that. It's not a lack of history although very few people actually know history. Because even if you think about the lack of economic knowledge and the lack of historical knowledge you have to ask the question well why do people not have economic and historical knowledge. Well because they're not taught it. And the question is why they're not taught it. Because the intellectuals don't teach it. Well why are the intellectuals so overwhelmingly anti-capitalism, anti-freedom, anti-everything that's related to markets. All of them. Almost all of them. You know surveys at universities find that over over 80% of all faculty members on campuses I self-identify themselves as left of center. And their center's pretty left to begin with. It is. I mean the center's moved in the United States from so there were Republican parties on economic issues the Republican party's platform today is very similar to the Democratic platform from 50 years ago. And the Democratic platform today is very similar to the socialist party's platform for 50 years ago. The political center has moved dramatically to the left. And then when you try to argue from out here you know from the right they say well you know where's the bipartisanship and where's the working together. Well they moved so far at the left there's nothing to talk to them about. Or shouldn't be anything to talk to them about. But of course they talk anyway. So I think the reason is a lot deeper because it's dominates in our culture and it's all over our intellectuals. And the reason I think has to do with what a marketplace represents and a marketplace in healthcare more so than anything else. Because what does a marketplace represent? What do people do in a marketplace? What do people go to the marketplace in order to achieve? What? Exchange. But what do we exchange? What do we go to the Democratic exchange for? What's the purpose of that exchange? Self-benefit. Self-interest. In some form or another. Right? So the producers produce, they make stuff, they sell it, why? To make money because they enjoy producing it because they want to you know Steve Jobs it wasn't just about the money right it was about creating beautiful things. But it was also about the money because the profit margins in these things is well over 50%. He could have sold it a lot cheaper if he really loved me. It's about self-interest you know and I like to you know tell the story. In 2008 I bought my first iPhone and I went to the mall and I bought the iPhone because I wanted you know the economy was deteriorating. I wanted to stimulate the economy. I wanted to make sure that people in the mall had jobs. Now we go to the mall because we want to make our lives better right. People come to you because they want to become healthier. You do what you do because you love what you do and you make a living at it. You make a living. You're making a profit. Don't run away from the word. Profit is a good word. Good word. How do you make a profit? By providing somebody with a service or a good that they value and are willing to pay for why? Because they value it more than the money they're giving up. So I buy an iPhone for 300 bucks. It's obviously worth more to me than 300 bucks. Otherwise why would I bother getting up and going all the way there and and giving them the 300 bucks? If they were the same the trade would never happen. It's because the iPhone is worth more to me than that. The utility the value it's going to provide my life exceeds 300 bucks. So I'm willing to give up 300 bucks. When a patient comes to see you and folks over 150 dollars or a thousand dollars or ten thousand dollars it's because whatever service you're giving them is worth more than what they're giving you. When you provide a service to your patient who's the loser? Well I should have added in the marketplace. When there's a marketplace. Nobody. Nobody is a I mean the whole nature of market transactions. The whole nature of the marketplace is we go into them to benefit ourselves to make our lives better and the other side does the same and the result is a win-win relationship. It's a win-win transaction. Trade which is what you engage in like every other producer in the economy is a win-win relationship. It's a win-win transaction. Both parties are better off. That's true of every relationship in the marketplace. When I employ somebody I pay them what? Less than what they're worth to me. I make a profit on every employee. How much are they getting? More than what their time is worth because they're taking the employment. I know we don't like to think about human beings this way but that's the fact. Just as an aside if you if you create a minimum wage of 10 bucks an hour who loses? Everybody who's only worth i.e. can produce less than 10 bucks an hour who will never find a job and now you've institutionalized them into unemployment equality and they'll never learn the skills to make 40 bucks an hour. So just a plug against minimum wage. One of the most evil laws we have in the books because it hurts the people explicitly it's trying to help. It's hurting them. It's hurting them directly and it's why a lot of jobs leave the country but more importantly it's why we get so much you know what the unemployment rate is among teenagers in the United States? I mean not teenagers what is it 16 to 24? It's 18 percent but you know how much it is among black teenagers? It's in the high 20s. I mean it's not their fault. They're just priced out of the market. It's our fault for passing such stupid laws. Well stupid is a nice term for it. No because it's malicious. It's malicious. This is bad stuff. So the marketplace is about these win-win transactions. It's about everybody pursuing their own self-interest. It's about making stuff better. I mean the end result is a better result and yet how are these transactions characterized out there in the culture? Greedy. Greedy meaning what? Greedy meaning exploitative. Greedy meaning negative. Greedy meaning somebody's losing although nobody can actually point anybody losing. What is it about these transactions that people find offensive? What is it about the marketplace that people find offensive? Well it's it's well it's chaotic but it's not really chaotic right other than the chaos you actually get more order than you do with regulations of chaotic. Talk about I mean you guys know just filling the forms is chaotic. They hate freedom but why? It's not fair. Why isn't it fair? What do we mean by fairness? Yeah it's equality it's these are moral terms. What are what have we learned right? What are we taught from when we're this big right? What are we taught about morality? No life is fair. It's inequality is fair. Equality is unfair. They have stolen this concept of fairness and completely and utterly destroyed it. Nobody ever thought that fairness 100 years ago meant equality. That's egalitimism and Marxism brought that about but there's no such thing because when are we all equal? When we're dead and decomposed. There's no such thing as fairness. The whole point is there's no such thing as equality. The whole point is to make fairness unreachable and be able to to knock everybody down in the meantime but there is no such thing as equality. Quality I get animated on this one. Equality is an evil idea. It is one of the most evil ideas in human history. So I'm out of order here but you know in terms of my talk but she said fairness so why is equality evil? How do you make me equal to Michael Jordan in basketball? Yeah what kind of force? What would you have to do to Michael Jordan? You'd have to break his legs. He could still beat me. You'd probably have to break his arms as well but that's the reality. How am I going to become equal to you in medicine? There's no way. There's just no way. Even if now I went to study it it would take me I mean you never when you advocate for equality people who advocate for equality never ever ever actually advocate for raising up the bottom they always knock down the top because that's the only way to achieve equality. I can train for a hundred years and not be as good a basketball player as Michael Jordan. I'll never be. I just don't have it right but so what's the easy solution? Knock him down. That's what equality demands. That's why equality the whole idea of equality is is wrong and it's evil because it's about knocking people down and if you want an image of this the best historical example of a people who try to attain equality is Cambodia under the Cameroosh. Pol Pot went in there they had a population of five million people and he said I want to achieve equality. I've got a lot of people who live in the rural areas and I've got a lot of people living in the cities and the cities you can't achieve equality so let's kick everybody out of the cities. Oh but the problem is that those people in the cities are educated and they're smart and they and they read and they've got all this stuff. How am I going to create equality between them and the poor uneducated peasants? Kill them. So he killed two million out of five million. Forty percent of the population was slotted in the killing fields of Cambodia all in the name of equality. You know where he was uh you know where the Cameroos uh went to school? Yeah they're so born. In France they studied under the best western philosophers who taught them egalitarianism and equality and Marxism and they went and they implemented it. So that's the problem. The problem is we've bought into these concepts. The problem is we believe in fairness but it's more than that. What do we believe about self-interest? We believe it's bad because what's them all ideal? What is them all ideal in our culture? What does it mean to be a good noble heroic virtuous person? Sacrifice. It's about selflessness. Think of yourself last. And this comes from all quarters of our culture. Selflessness is the ultimate virtue. So Bill Gates making the money. How much more credit does he get? Nothing. I mean he's considered either neutral person or a bad person from a moral perspective. Think morality a second. He gives it away. Now he's okay. Particularly because he's not working and making anymore. God forbid that he make more money. He's giving it away. Now I have a bet going that I can guarantee Bill Gates sainthood. I don't know if the Catholic Church will go with this but cultural sainthood. What would he have to do in order to achieve sainthood? Give it all away. Move into a tent and if you could show some bleeding it would help. I'm not kidding. That's what we value. We think that that's goodness, nobility. It's sacrifice and what does sacrifice mean? Trade we said was a win-win. What is the sacrifice that gives you something and what do I get in return? Nothing. So sacrifice is a lose-win. We idealize lose-wins and we demonize win-wins and that's bizarre. We demonize making money and creating wealth. We demonize that. We idealize giving it away. That's bizarre. How do you give it away if you haven't made it? And isn't making it? What do you think Bill Gates helped more people when he built Microsoft or by giving it away? It's not even the same ballpark. Microsoft has touched every human being on the planet. Networking. I don't know that we'd have an internet today without the standardization and so on. Microsoft touched everybody. I mean I'm sure what Bill Gates is doing in his philanthropy is very nice and very good and saving and helping a lot of lives but it dwarfs in comparison to the benefit he did humanity at Microsoft. Yet does he get any credit for it in Microsoft? No. Why? Because he benefited from it. He engaged in win-wins. But now that he's losing he's just giving money and not expecting anything of return. Now he's a good guy and again I think he'd be a much better guy if he was actually suffering. If he could show that he was suffering by giving it away. Because you know what? He might be having fun with his philanthropy and then it's you know Immanuel Kant the German philosopher who I think has shaped modern philosophy more than any other philosopher ever said that if you in making a decision if you even for a moment think about how that decision would affect you. If you bring any self-interested motivation into your decision making then it's not moral. Morality is only about the truly self-less the true sacrifice. You can't have freedom. You can't have markets as long as you have that kind of attitude to morality because it does two things. The fact that we're all engaged in self-interested activities what does that what does that suggest to people? Well that's you know Adam Smith by the way Adam Smith got this Adam Smith the wealth of nations writes about this the baker bakes his bed and when Adam Smith said don't worry about the ethics of this he said yeah everybody's doing self-interested stuff and we know that's not very noble and not very good but if you aggregate it all up then these visible hand makes everybody better off and that's a good goal. So it's okay to engage in immoral activity or immoral activity because the goal at the end is a good goal and nobody buys that. Nobody buys that. If what you're engaged with in these transactions is an ignoble activity then they want to control it. They want to regulate it. They want a piece of it. So the two aspects that this that this manifests itself which we talk about at the book one is what do we know about self-interested people if they're not moral what are they and what does that mean what what does that mean right that they're gonna lie steal and cheat. So even though 99% of transactions 0.999 of transactions in the marketplace happens without people lying and cheating and stealing you're suspicious because these people are self-interested and there's a suspicion. The best indication of this I got was you remember you remember a law called Saul Bain's probably didn't affect you guys that much but it affected big businesses a lot. It probably cost the US economy somewhere between 1.5 to 2 trillion dollars of economic growth which is a lot. I know we're talking trillions now it's not a big deal. But why was it passed? It was passed because they caught a few guys like Enron and Wiltcom and Tyco who are real crooks right and the conclusion was the instantaneous conclusion was that people had was oh they're all crooks we just happened to catch these guys. You guys watch Bill O'Reilly? Since 2002 I was on Bill O'Reilly's show and Bill wanted to fire every CEO in America. Bill's a populist right he puts his finger out in the wind and so if you want to know what the American people are thinking that's what you go to bill for. He wanted to fire every CEO in America because they're all crooks look Wiltcom and Tyco and they're all about profit they're all self-interested therefore they must be crooks. And that was the logic for Saban's Oxy. Saban's Oxy is a bill that basically puts a bureaucrat on every CEO's shoulder and every CFO's shoulder to look at the numbers and make sure they were all adding up. And how many crooks is it caught? Zero did it prevent the financial crisis? No it doesn't matter it doesn't matter there's not enough regulation that's the problem. So we treat businessman including doctors as crooks insurance companies certainly are just waiting to steal my money and we start controlling and we start regulating and we put the bureaucrat on the shoulder and we can't do that and you can't do that and you can't and you have to report this and you have to report this and you have to report that. Just how you would treat somebody who is a crook who you're still letting them go out there but you want to monitor it like that ankle bracelets you know they put on criminals that's what regulation of business is. That's why they regulate they do regulate you because they think you'd be let out of the asylum and you're just about to exploit your patients and it's why they do it to insurance companies and the more profit you make the more they want to regulate it you the more they want to control you and it's all because they know that what you do is about profit what you do is about self-interest and that can't be right there's something wrong with that we have to control it somehow. They is the culture the people the politicians the intellectuals it's everybody it's us to the extent that we don't fight it it's us how did we get these regulations I mean they always happen the same way you find one rotten apple you conclude everybody's a rotten apple you regulate everybody the regulations create weird incentives to create cause people to do you know maybe shady things maybe not you find a not oh well it wasn't the regulation there was the problem we need more regulations and at some point the industry's taken over that's always the path you look at every industry and you look at how it progresses and it's all to control behavior it's not to prevent market failures what market failures they can never point to an actual market failure it's to control it's to keep an eye on so that's one side of the equation the other side of the equation is that if morality is about sacrifice is morality is about being your brother's keeper if morality is about other people's needs and use sacrificing for them and particularly in health care this one's an easy one right so the people here who don't get as good of a health care as the people over there right so they need better health care who are you to say no they need it and it's your moral obligation your moral obligation to give it to them and it's only a small group today we'll just start with a tiny the really really really poor right i mean who could deny them and you get medicaid or they're really really really old and it's not a huge group right now and don't worry it's just a small population we'll give them medicaid right that's what you add in the 60s know that people weren't dying in the streets that you needed to adopt medicaid and medicaid we adopted it because the health care the fact is some people's health care is not as good as others i drive a nicer car than a lot of people we're not equal equality is not a goal but how can i not sacrifice for them how can i not give some of my money to them how can i not give some of my time to them they need it and that's what morality demands of me it demands it and then you know then there's another group right so we've given them there's another group and they still don't get quite as good of a health care as these guys and you know maybe they're stuck in between that gap between medicare and insurance and they don't you know whatever chip is a good example right there's the children the children and they don't get medicare because they're not poor enough and they can't afford health supposedly can't afford private health insurance how can we how can we deny them so the republicans passed chip right eighties and then the people who show up in the emergency room and the emergency rooms turns them around and sends them home because they can't pay for it well that's terrible here people in need and for a profit reason for a self-interested reason they're being turned away from emergency rooms again i don't know how many real cases of people actually dying but it doesn't matter there's a need that's not going fulfilled and it's your moral obligation to fulfill that need so let's pass you know the law that requires emergency rooms to treat everybody and turn them into clinics in the evening right what's that i'm taller yeah that's how it comes it always it's always and who can vote against it that's why republicans never do because they've granted the left the mall high ground we've already said that you are your brother's keeper we've already admitted that self-interested bad and you should be selfless and giving them more is selfless it's just a little bit of sacrifice a little bit of taxes now we've got i don't know 35 million and should whatever the numbers doesn't matter they're not getting as good a health care as they should all we're trying to do is make things a little bit more equal is to help you become a moral to help you satisfy the needs of people who really need stuff and this is health care they really need it and how can anybody fight that nobody does nobody does that's why the republicans cannot fight on this pre-existing condition because that would mean some people couldn't get insurance or not cheap insurance anyway or not the kind of insurance they feel entitled to and who are we to to do that to somebody right it's our moral duty our moral responsibility to take care of them so i know this is an uncomfortable topic but this is the core of it if you can't stand up and challenge that if you can't challenge the fact that they need creates a duty on you if you can't challenge the fact that you are not your brother's keeper if you can't challenge the fact that the being noble is sacrifice that selflessness is the moral ideal then you cannot challenge socialized medicine socialized medicine is not and doesn't intend to increase efficiency it's not and doesn't intend to make health care better socialized medicine is about taking care of those people who need it and if it's at your expense who cares it's still the right thing to do people don't vote their pocketbook they don't vote economics they don't vote what's efficient people vote what they think is right what they think is just what they think is fair and if they think fairness means equality or if they think fairness means sacrificing one group for another for the sake of another group then they'll go for it they'll vote for it over and over and over again and they won't stop and that's the trend we've been going on for a hundred years in health care maybe it's only 50 years but for a hundred years in the economy generally that is the trend we've been going on and that's the trend we will continue unless we're willing to challenge this ethical code and to me that is what Ein Rand contributes to this debate primarily is that she rejects and again you'll get a lot more of this in the book reject the whole idea that your life somehow belongs to others that you're a sacrificial animal that your purpose of morality is somehow for you to live for other people that you are your brother's keeper why are you your brother's keeper Rand says no you're your own keeper your responsibility in life your moral responsibility in your life everybody's moral responsibility in your life is to take care of themselves is to make their life the best life that it can be to pursue their own individual happiness to make of life to use a Aristotelian term to use Aristotle to live a flourishing life Aristotle's whole ethics is about human flourishing individual human flourishing how to achieve success in life happiness in life that that's what morality is about so creating stuff right building stuff that's the good being productive taking care of yourself making money nothing wrong with that contrary that's good because it means you're taking care of yourself and more than that it means you're offering a value out there that people value right because they will need to pay you more than it more than what you put into it that's a profit profit is virtuous profit is good you're making your standard of living higher and everybody else's standard of living higher win-win how can win-wins be bad but self-interest therefore is a good and self-interest is not about lying stealing and cheating you know Bernie Madoff do you think he's self-interested see i don't think so i define Bernie Madoff as self-destructive because self-interest in my view is something that you attain it's something that hard to achieve because it means figuring out what's in my self-interest what is going to make me the best human being i can be what is going to make me happy and successful over the my lifetime that's not easy that doesn't mean oh there's money over there feel like it and i'm just gonna take it or the drug is over here i'm gonna snort the drug because it'll give me a high that's not self-interest that's not figuring out what's good for me that's just emoting and emoting generally generally in life living by your emotions is incredibly self-destructive everything we have everything we create all the values that we achieve are values of reason in the mind so let's apply that to life life is about figuring out rationally what's good for me and doing it and living by it so the idea is is if we want to if we want to be successful in a battle for freedom right for liberty what we need is to reject the morality that's inconsistent with it which is a morality of selflessness and we need to adopt an alternative and in my view the alternative is a code of rational self-interest a code of independent responsible individuals pursuing their own success pursuing their own flourishing life and interacting with other people and what principle mutual benefit what Rand called the trader principle mutual benefit why because it's good for me why should i interact with you in the mutual benefit because i am better off and if i expect you to lose in a transaction any businessman knows this that if you negotiate with one of your suppliers to the point where he's losing from the transaction what is going to happen you're both going to lose long term lose wins lose lose lose are never good nobody benefits from nobody benefits from so we need to stand up and reclaim them all high ground we need to reclaim them all high ground in the name of win wins of the trader principle in the name of our own self-interest in the name of our own happiness and this is true for the health care profession and this is the only way we're going to move towards a free market in health care where we interact with one another's what as equal participants in a transaction which is win win where we don't suspect each other of being lying stealing and cheating where we try to profit because profit is good not bad so that's the kind of world i think we need to move towards um that is the kind of uh more high ground we need to capture and you know i think that you know just to end on this i i think we're well positioned to do so because this country was founded on on principles that are very consistent with this it was founded on the principle that each one of us has a right an alieba right that nobody can take away from you to your life to your liberty and in the most self-interested political statement in human history each one of you has an inalienable right to pursue his own happiness that's the concept we need to fight on thank you all so we have a few minutes for q and a i have a question um do you make a distinction between force charity which is what medicaid program is and voluntary charity yes absolutely so i have nothing against charity however there's another distinction i want to make so force charity is wrong in my view force generally is wrong why is force wrong what's bad about force it's not in your self interest obviously but what is force what is it human beings need as i try to argue very briefly human beings need their minds need reason in order to survive in order to thrive in order to do well force is the enemy of reason forces the enemy of the mind forces what cripples you if i tell you the two plus two equals five and i tell you you have to practice that principle and if you don't i shoot you you can't build anything because it doesn't work you can't think you can't create so force is the anti-mind the anti-life the anti-self interest so force charity is immoral and wrong it's stealing there's no difference between that and stealing um you know i like to use this example you know your neighbor your neighbor has a really life-threatening medical condition and they don't have the money to pay for the procedure they only have two choices in life right they can come and they can come to you me and ask for the money right would you help me and most americans history suggests are quite benevolent and quite willing to help their neighbor and that's the kind of charity i believe in but they have a second alternative and the second alternative is to pull a gun on me and to force me to pay them right and that everybody in the culture everybody in the culture knows is wrong somehow we have this trick of mind where we go okay it's wrong even to pull a gun and take my money but it's okay for him to get all the neighbors together and vote to take my money then it's legal then it's okay then it's moral somehow as long as the group is big enough right because you couldn't just do it in the neighborhood you'd have to do it nationally how does democracy make right something that's a crime okay it can't theft is wrong it's always wrong and redistribution of wealth in any guys is wrong it's theft but i do want to make one more distinction which you might not agree with but anyway i do distinguish between two forms of voluntary charity charity that you do out of guilt and duty which i think is wrong and charity you do out of a sense of benevolence out of a sense of valuing human life out of a sense of your own values your self-interest which i think is good i think philanthropy should be done in self-interest they are in self-interest remember it's not about money self-interest is a spiritual thing i mean there are lots of things we do not because of money right for our self-interest so charity should be in pursuit of one's own values not because society expects it not because you're commanded to do that by your moral philosophers not because you feel guilty because you made a lot of money those are all bad reasons to give charity so voluntary charity that's in pursuit of your own values i'm all for that i think that's wonderful but remember you know there's this uh i'll just give you one this one example you know microlending microlending is this you go into very poor countries and you make very small loans to people and they and the two models there's a non-for-profit model there's a for-profit model and it should be shown that the for-profit model works a lot better because the incentives are right but people make a profit doing this guess who is perceived to be the good guys and who are the bad guys even though the profit model helps more people the fact that you're making a profit does not mean you're not helping people quite the contrary it means exactly that you're helping people so it's not that you have to do charity and to compensate because you're not helping people when you're for profit it's you do charity because it's one more thing you want to do but it's not to compensate because it's so you're not giving back i hate that term you didn't take anything you didn't take anything you're not giving back you're giving because you want to give because it's a value to you for you to give to causes you believe in that's it got one there two there yeah words are so important and there's two questions i have about words that are being bantered about in the media uh the first uh can you tell me if you think there's any difference between these terms corporatism crony capitalism and fascism and the other question i have is what do you think about it because i've heard it from both parties that this disgusting term shared sacrifice yeah so corporatism corporatism is the idea that corporations run the world it's silly um and you know corporations are too involved in politics but the fault of that is our politicians because they butt into you know how many dollars microsoft spent on lobbying before the justice apartment went after them zero you know how much they spent today tens of millions when microsoft was spending zero they were being harassed by senator hatch a republican from utah for not having their officers in what inside the beltway and not spending money on lobbying and today the firm that is being most harassed for not spending money on lobbying is apple because apple spends very little on lobbying and yet they are being harassed it was an article in politico which is kind of the insider about how how horrible it is that apple doesn't lobby enough so i blame the politicians not the corporations although after a while the corporations buy into the model and then they start and then then they call it crony capitalism now i don't like the term crony capitalism because it's not that the different forms of capitalism there's only one capitalism free markets true free markets i call it crony socialism or just cronyism right white white white you know besmirch capitalism let the socialist have it um and cronyism is bad um business should have no involvement in government government should have no involvement in business uh most business today does it in order to survive as a self-defense mechanism and then in order to capture rents which they shouldn't it was that fascism you know fascism is a system by which the government controls the means of production without owning them but it controls them through regulation in that sense america is much more fascist than it is socialist in socialism the government owns the means of production in fascism they control it through regulations and through various controls but fascism is also associated with racism and everything else that the nazis and so on had so it's not a great term to use i like to use statism we're a status we're going toward statism a state involvement in the economy is statism and then i can't remember the second question shared sacrifice i mean sacrifice in my view is bad and awful and horrible because it involves losing when it's done individually when you put a bunch of people to do it it's all the more bad and evil i mean if you're gonna do something really bad do it alone yeah hi heron um just a comment not a question my son is six foot seven and he went to high school you're talking about your michael jordan comment he went to high school in canada and he was prohibited from playing basketball because he had an unfair advantage they only let kids under six foot three onto the team because of that yeah and the good part of it you know ben powell yeah he said he's doing his dissertation in public choice theory under ben powell now as long as it doesn't become an anarchist like ben is then you're okay but yes uh today there are sports leagues for kids where they don't keep score because god forbid somebody should win and somebody should lose right i know the kids keep strong of course the kids keep strong because no child believes in egalitarianism you have to be incredibly irrational as an adult to believe in egalitarianism i think something that we uh libertarian leaning people have to promote is the way that our um our clergy has been hijacked by socialists and statists and you know initially when christian terms were invented there was no free market wealth was uh taken by force big strong men would enter a country with weapons and take all the money from that country by force and enslave those people so when their children of these rich people like nicholas and myrna when he gave away all his all the money he had a spiritual benefit and then he benefited you know like the three girls were going to be sold into slavery and he made three gold balls and that's where the three gold balls of the pawn shop come from but anyhow um you know there was a spiritual benefit but there was no free market and i think starting in the 19th century our clergy started to get brainwashed in the seminaries and somehow the government taking your money by force and giving it to the state and the state district uh takes gives it to the port is somehow christian and it's not so there's a i think i think there's a broader principle here and that is that that it's true before the 19th century the way you made money was by taking it from other people there was no there was no wealth accumulation through trade and through production and and they called the really rich they called them robber barons why were they robber barons this is before the 19th century because they literally were highway they would put tolls on the highways and they would steal people's money as they passed and the barons who were the rich guys they were robbers right then suddenly something happened in 19th century we discovered capitalism we discovered these you know win-win relationships but our thinking never got out of the 16th century right and so we called the industrialists of the great industrialists of the 19th century robber barons because they became rich and we couldn't conceive of the fact or this is a very benevolent interpretation anyway we can conceive of the fact that they made the money because we were still stuck in that 15th century thinking of the if they have money they must have stolen and to this day we call them robber barons but they didn't steal anything Rockefeller, Carnegie, Vanderbilt they built the stuff they created the country that we have today we wouldn't have this without Ford and Rockefeller and Vanderbilt and Carnegie everything we have here is due to them they are the heroes of America but tell everybody I mean remember the 1890 antitrust laws were passed in order to attack them exactly because of the mentality of the middle ages that couldn't conceive that everything wasn't a zero sum game but capitalism changes the world it turns the zero sum game world into an ever-growing world have you ever seen and I'll take the question after this have you seen a graph of human wealth per capita so there's a graph famous graph of human wealth per capita that goes it goes back tens of thousands of years and it's easy to do because it's flat average per capita wealth is not that different 10,000 years ago, 5,000 years ago, 2,000 years ago 300 years ago it's basically flat and then at some point it goes like that like that and what's that point yeah I mean I like to I like to point to the I like to use the 1776 it's not exactly because it's a little before that but it's basically around there and why 1776 two things happen in 1776 this country's founded which is the first real free country that allows for this win-win relationships to flourish and secondly an important book is published Adam Smith the wealth of nations published the first book about capitalism is published and wealth takes off like that but really what happens is the industrial revolution which is capitalism which is win-win which is that for the first time we're not in a zero sum world anymore we're in a growing world and nobody realizes what people talk about child labor in the 19th century what were children doing before the 19th century they were working on the farm 14 hour days and dying most kids didn't make it to age 10 they didn't they didn't survive childbirth most of them so people don't know yeah children were working in the 19th century and it was a huge improvement over what they had before but nobody realizes where we were 250 years ago where we've come from I mean look at us I mean this is amazing will we take it all for granted oh they had politicians politicians have always wanted the same thing back in 2000 I read Atlas Shrugged and it was a huge turning point for me because I had absorbed all these ridiculous moral concepts and I believe them for you know the first 40 years or so of my life and it's because I read Atlas Shrugged that I stand here in the United States right now I knew I had to move out of Canadian healthcare and moved to the United States because of Atlas Shrugged but in the lecture previous to this I don't know if you heard it or not but it was about you know this maintenance or maintenance of certification and the intern is being coerced and to recertify but the thing that crossed my mind is that you know that's just one little issue but it's just a symptom of a huge greater issue which is that it's rampant in our culture that the way we achieve our goals is through coercion yes and that is a disease that just rampant everywhere but look that's right everything coercion is everywhere in our culture and of course most people think coercion is fine I mean as long as you coerce people to do what's good for them or to do good for other people then it's okay so a lot of libertarians this is why I disagree with libertarians a lot of libertarians say we just agree on non-coercion principle nothing else matters and I go nobody agrees on that principle nobody no philosopher in history has agreed to the non-coercion principle because the fact is that they all believe that in order to do good coercion is necessary it's only if you understand the philosophical premise the the morality of self-interest the role of the mind in human survival and human flourishing and the fact that forces antagonistic to the mind can you say oh well yeah coercion is bad but coercion is fine for most people they're fine with taxing you as long as they think it's going to benefit somebody it's making you more moral what's that it's being made right it's mediocre how about that the first one was mediocre I haven't seen a second one yet I think it's mediocre as well but it's not awful but it's not it's not good it's not as good as the book read the book there's there's basic confusion in the human mind and there will always be confusion but there's confusion between the freedom and the family and the synagogue the family in the church the government is considered to be a family and the the church the synagogue the mosque whatever there there has to be that separation because the government is forced and other things don't have the monopoly on force I agree with you but again I'll go back to the fact that we will never get that separation not consistently unless we have a change in the way we think about morality and and and this morality is not just for the marketplaces it's a morality that's true for the family I don't sacrifice for my kids I happen to love them so I give them a lot of stuff including time and that's not a sacrifice not going to the movies because you have kids as a sacrifice no my kids are more important than the movies so if we have win-win relationships in with with your I mean imagine that you had a win-lose relationship with your spouse how long do you think that relationship would last all right okay let me exclude from discussion masochists all relationships should be win-win otherwise it's lose-lose okay we have time for one more question we're going to go to one of our medical students here who's attending so first of all great book by you and don loved it thank you I have a confession to make I I lied on my medical school application there's there's always an essay every medical school application asked for an essay on altruism and I had to explain why the volunteer time that I wanted to do uh that they wouldn't pay me to do of course because I didn't know what I was doing that volunteer time was selfish I had to explain why I did that out of altruism and my question to you is my my question to you is what do you say to a 20-something year old college student who decides he wants to go into medicine just finish reading Atlas shrugged loves that idea completely resonated with it and then looks at the people who are in charge of medical school to even get to the point where everybody else in this room is they have to go through that and be altruistic to even get to that point well but yeah I mean self-interest shouldn't involve lying but if if the conditions are such where lying is the only way where you can pursue your values and they have no right to force you on it then you have to lie but look I mean it's a tough question because I couldn't advise anybody to go into healthcare today I mean I no I'm serious my father my father is a great doctor I mean he was one of the I mean he was known in Israel as one of the great physicians in the country he worked like a slave I mean he worked hours that are inconceivable I mean I work hard and I don't even come close to how hard he worked he would work all day in the hospital because that's what you had to do but the the income from the hospital was nothing you couldn't survive as a middle-class family and income that you got from the hospital so then you come home grab a quick bite to eat at like five o'clock and then go and see patients from six o'clock to 10 p.m. and he worked from seven in the morning till 10 p.m. almost every day I mean and that and he's still never I mean he's still not wealthy right I mean he's okay in Israel he's middle-class but that's it that's what he had to do just to do okay right uh it's you know if that's what we're heading I couldn't record I mean I when I was a little I want to be a doctor like most kids who have and and I reached like 12 or 13 I looked at the way my dad was no way I'm not gonna be a doctor um and so it's it's a very hard profession given the direction because I mean this is what drives me crazy right in my view the the two most important professions that we have out there are teachers and doctors right one takes care of the body and one takes care of the mind and we want to cripple them both one is already crippled one doesn't you know doesn't exist as a profession because it's state a state monopoly where public education just dominates right and there's no as I said there's no innovation there's no there's nothing and the kids are suffering so we want to give that to the government and now we want to take the second most important other important profession and turn into a government a government thing I mean the justice and and how much will all suffer as a consequence is just horrific but this is why we have to fight this is why there's a fight but you know you have to do what you have to do look if you're in a classroom and the professor says uh and you know that if you say you like Ayn Rand which is what happens to most philosophy students who like Ayn Rand if you say you like Ayn Rand you're gonna get an F and you just don't say you you know you don't do it because I mean he's irrational you don't give him the the benefit of dealing with the irrational thank you very much thank you and we