I propose 

• Congress should stay out of family decisions on life and death questions for the dying.
  
• I will not force a primary care physician on you.
• I am 100% pro-choice; government should have no role in this matter.
• There are no magic cures to medical care costs, so I propose some simple partial remedies.

Life and Death - There is no part of family life more fundamental than guiding medical care for family members unable to act for themselves. In the Terry Schiavo case, Congressional Republicans tried to steal control of medical care from a young woman's loving husband. Unsurprisingly, Republicans voted against real family values and in favor of pandering to Republican extremists. The Terry Schiavo case shows that Congress is happy to trade real family values for a few votes in the next election. Americans who support real family values should elect people who share their views, Libertarians who believe Uncle Sam has no business taking life and death decisions away from you and your loved ones.

Medical Care Choice - Finally, I'm not going to force modern medicine down your throat. Several Democratic candidates more or less said that you would be forced to join a government medical insurance program, and furthermore you would be forced to have a primary care physician, an M.D. I have a physician myself, but unlike those Democrats I respect the privacy of individual Americans who reject modern medicine in favor of religious dictates or folk practices.

Abortion - I am 100% in favor of defending each woman's individual right to choose for herself. Government should have no role whatsoever in this matter. It should not encourage or discourage abortion. It should not force women to bear children they do not want. It should not force opponents of abortion to pay for abortions. People who bomb abortion clinics and churches are dangerous criminals who should be brought to justice.

Medical Care Charges - Above all, there are no magic cures to the medical care cost issue. Medical care is expensive because it demands the services of large numbers of highly trained professionals and masses of expensive high-technology equipment, all available when it is needed 24 hours a day, 7 days a week.

I propose improvements in our medical care system. These improvements are changes that Americans will actually accept and implement, even as the changes move America in a Libertarian direction. Once Americans see that our Libertarian proposals actually work, they will be more ready to trust other Libertarian proposals.

Why is health insurance so expensive? One large reason is the cost transfers. Congress passed an unfunded mandate requiring hospitals to give free care to large numbers of people who have no insurance. That care is often emergency room care, some of the most expensive medical care there is. Who pays for it? It's a transfer cost, an 'administrative cost' charged to your health insurance, which in turn raises your insurance rates.

Cost transfers should be made illegal: Your insurance should only pay for your care. If Congress requires a hospital to provide free care, Congress should supply the money to pay for that care.

Second, drug costs come partly from redundant safety approvals. Medical drugs approved for use in Europe should be accepted for use here without being required to go through another approval process. Yes, Europeans make mistakes. So do we. If beta blockers had been brought to the American market as soon as they were approved in Europe, 100,000 Americans would not have died needlessly. Accepting European safety reviews is a first step, not the last.

Third, the tax treatment for medical care costs should be the same for everyone. No matter whether your employer buys your insurance, you buy your insurance, or you pay out of pocket, your spending should have the same tax treatment. This change will be very slow to have consequences, but it will have enormous eventual benefits for large numbers of people.

Fourth, we should allow interstate competition in medical insurance because competition is good. Now in 2008, your insurance costs can change several-fold simply by your moving residence across state lines. Interstate commerce will reduce inequalities in the market.

Fifth, some foreign governments inform our drug companies that either they sell drugs over there at some low price, a price that does not cover research and approval costs, or the patent rights to the drug will be voided. That's piracy, pure and simple, and I will work to defend Americans against piracy.

I'm not going to make fabulous promises about preventive medicine. Americans can take some steps for themselves to help live a healthier life. See a physician regularly and follow your physician's advice. Advice like: Avoid tobacco smoke. Achieve and maintain a healthy weight. Exercise vigorously and regularly. Maintain your adult vaccinations. Wear your seat belt. Have the routine screening exams that work. The old adage that an ounce of prevention beats a pound of cure is true, especially if that 'cure' involves high cost emergency room visits. However, almost all these steps were known 50 years ago. In fact, the most useful of those steps were known to the ancient Greeks. We can follow them, but they aren't suddenly going to start working miracles.

I'm not going to make fabulous promises about tort reform. The notion that large amounts of medical care costs are driven by fear of litigation is considerably exaggerated. We have lawsuits because medical people sometimes make gross blunders. People injured by incompetence or negligence deserve compensation.

I hope that individual states will experiment with radically different tort and insurance rules. Experiments helped with no-fault auto insurance, and it may yet help with medical malpractice insurance. Congress has opportunities in Washington, D.C., to try some experiments.