Summary: Left free to pursue their own interests, people naturally establish markets, voluntary private organizations, and enough government to accomplish collectively what they cannot do alone. Government of the people respects the people's wishes to receive health care from whom they want, when they want, and how they want, subject to the usual constraints of commerce. The starting point is to understand what people want.

Arelene had fallen in a Florida parking lot, fracturing her femur in three places and requiring surgery to reconstruct the knee. Having traveled by plane and wheelchair to recuperate in her daughter's home in another state, she complained of harsh leg pain the next day. Her daughter took her to the local overcrowded emergency room, where she was made to wait. Three hours passed. Her daughter and son-in-law took turns imploring the admitting nurse that she be seen. Finally, her daughter remonstrated, “My mother is 81 years old, has just had major surgery on her knee, taken a long plane journey, and complains of severe leg pain in her lower leg. If she has a blood clot that causes her to have a stroke or die, do you want this to happen on your watch?” This produced action, examination by a physician, and ultimately prescription for blood thinner.

But why was the emergency room so crowded and the wait so long? One reason was Mabel. In the examining room, Arelene and her daughter could hear the conversation in the next curtain-separated booth. “Hello, Mabel,” the doctor said.