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On the back of prior discussions about forced 'voluntary' reporting of sleep apnea diagnoses in the State of Maryland in order to qualify for a drivers license, I'd like to draw attention to something similar happening with autism diagnoses in Queensland, Australia. Last year there was an update to the Assessing Fitness to Drive standards to list autism as a medical condition deemed to have an impact on driving.
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There's a fair bit more in the article that goes on about a few individual cases, but the gist of it seems to be that in the state of Queensland you need to provide medical clearance to drive from your doctor to the TMR (DMV) if you wish to apply/maintain your license once you are dignosed with autism. Most other Australian states seem to have a more reasonable 'you are legally required to report any ongoing condition that effects your ability to drive' standard.
In Queensland it seems like the above stated “Jet's Law” came about when someone with epilepsy had a fit resulting in a car crash that killed a baby and left his brother in a wheelchair for life. So this law was created To Do Something that then through bureaucratic ignorance has expanded to include other conditions such as autism as the Assessing Fitness to Drive standards were used as a list to determine what these conditions were. And then people have possibly decided to stop being diagnosed rather than deal with the hassle/stigma of reporting.
This is just so banal and unjust that someone diagnosed as being on the autism spectrum would then have to report that straight to the government or risk being fined thousands of dollars and stripped of their ability to drive. Luckily there is some pushback with a guy in the above link apparently filing a case with Queensland's Human Rights Commission, but still, it shouldn't have gotten this far.
Edit: fixed formatting
Why don't we get rid of driver's licences entirely and just rely on car insurance? If you pose a risk to others by not having the skill to drive or by having some medical condition, your insurer could require its own tests. It could ask you to get a licence from a third party private organization. Then the free market would figure out the optimal test of driving ability.
I suspect that insurance companies would ask you to take a driving test, how else are you they supposed to know you have the minimum acceptable levels of competence, before further actuarial concerns?
OK, so why don't we find out? There's a good chance they would come up with a better system of testing and licensing than we have now. Is there any reason the government needs to issue licences?
I am modestly libertarian, so I have no fundamental disagreement with 3rd parties providing licenses or the insurance route, I just happen to think government licensing is adequate and the majority of the debate is over whether refusals to license based on specific diseases like autism or sleep apnea are warranted.
We wouldn't need to have those debates though if we relegated the question to the free market, and I'm wondering if there is any good reason why we don't just do that.
Why you think so?
Effect on public safety depends on how well payouts of insurance companies (via laws and court system) are correlated with damage to public safety.
If payouts for accidents caused by someone driving with sleep apnea without XYZ treatment are much higher, then insurance companies will demand the same as discussed here.
If they can avoid payouts while damaging public safety they will happily do this.
You still need to decide on payouts via legislation/shaping court system. With the same debates happening in a bit different place.
(unless you propose to privatise also legislation and court system and have multiple ones competing at once but that is clearly not "why we don't just do that.")
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The level of competence that maximizes insurance company profits is not necessarily going to be the same as the level of competence which best* satisfies the tradeoff between public safety and the individuals' interest in being able to drive.
*There can of course be a variety of best tradeoffs, since "best" depends on how one weighs the competing interests. But insurance companies do not directly take either of those factors into account when deciding whether to insure someone.
But it likely does maximize the tradeoff between public safety and the individuals' interest in being able to drive plus their interests in saving other costs. And it probably maximizes the tradeoff you mentioned better than driver's licences do.
I don't see how you can know that, nor is it likely to be true, given that the insurance company doesn't particularly care about either one.
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Your simple faith in this religion of the free market is touching, I have to say. There's an argument that the instances in the original post are indeed over-regulation for the sake of it, but to put it all on the free market is optimistic in the extreme.
Every insurance company has its own licensing body? Multiple licensing bodies? Or in effect a monopoly? Any common standard, or LicenzRUz gives you one if you can turn the ignition on, nothing more required (and the insurance companies that take this licence then charge you out the nose for coverage) while Rules Rule Inc. ask for your family medical history three generations back?
Law cases even more lucrative for lawyers as the survivors of person killed in crash by "minimum requirements only" licence holder fight it out with the insurers, and judges have to rule on whether the driver was adequately licenced or not? This is where we get things like "Jet's Law" in the first place, and the subsequent over-reach. Adjusting the free market grave by grave may be one way of doing it, but I think most people would prefer a less final method than "Okay, fifty thousand extra deaths due to lax licence rules, pressure on insurers to put pressure on third party bodies to tighten up their requirements".
Whatever way you do it, the government is going to get dragged in by cases such as led to Jet's Law. After all, the 'free market' allowed the epileptic driver to operate a vehicle, and it was the consequences of that which involved the government:
If it were faith, I wouldn't be asking for reasons why it might not work. I don't think you're quite going this far, but there's this really common and very annoying thing that a lot of people do where, if you express any kind of belief that markets ever work, you're accused of being a free market fundamentalist. It's a subject on which people struggle to see nuance and seem to default to gesturing vaguely at market failures which they've heard exist but can never explain why any given case is one.
Competition and choice would be great, but we can't do worse than the current monopoly.
Why would it matter whether the driver was licensed? The compensation would be based on the harm caused and who was at fault. Why would this be any more difficult than it is already?
How so?
I'm not following this at all. What do you mean by "final"? Why would there be an increase in deaths? Why would there be any kind of grave-by-grave adjustment of the free market?
Why would the government get dragged in?
Because the government has the legislative power, and when the public want Something Must Be Done, it's the government that gets called on to do it - mostly to pass laws so This Can't Happen Again.
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Very simple example: If I speed, I cop a fine and a certain number of demerit points off my license. If I lose too many demerit points, I lose my license and risk going to jail if I continue to drive without a license. All of this applies pressure to me to drive at a safe speed.
In an insurance-only system, I face no penalty until I cause a crash and potentially kill someone.
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How is criminal law meant to tie into this? People who value retributive justice aren’t going to be satisfied with someone simply getting sued out their arse.
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