In a comment on this recent post , the always-insightful John Dewey says
To the "true libertarians" who would substitute free markets for medical licenses and the FDA:
Why don’t you fight battles you have a chance of winning? The
problem I have with libertarians and the Libertarian Party is that they
take extreme positions on issues based on principle, and ignore
political realities. The American public is not going to accept
unlicensed medical practice any time soon, if ever. Quite frankly,
suggesting that anyone should be allowed to practice medicine makes you
guys look a little kooky, and undermines some of your more acceptable
I believe society has a right and an obligation to protect children
from truly stupid, life-threatening actions by parents. You
libertarians probably disagree. I guess I’m not one of you, though we
agree on many issues.
There’s more here than I have time now to take on — but before I get to my main point, let’s be clear about one thing: to argue against medical-licensing requirements by the state is not to argue that quacks will or should practice medicine. It’s simply to argue that state licensing is neither the only, nor the best, means of certifying the quality of physicians.
My main point in this post has to do with the important question between pursuing goals that are today perceived as being politically achievable and making a case for an ideal society that is humanly achievable if not politically achievable today or even ever. My interests largely run along the latter lines. I am not a member of any political party; I never vote in political elections; and I’ve long ago lost any and all hope of finding salvation in politics. Politics, in my view, is almost completely responsive to the prevailing public morality and ideology. As I wrote here , the American Constitution really isn’t written on parchment; it’s in Americans’ hearts and minds. My goal is to contribute, in the best way that my modest talents permit, to changing ideas over the long-run.
And we would do well to heed the lesson of this observation from historian Richard Pipes  (found on page 10 of his book Property and Freedom  [Knopf, 1999]): "But men who take pride in their pragmatism often follow trails cleared by idealists."