The Logic of Liberty: Whose Responsibility Is Your Health?
I recently had an (imagined) conversation with my friend Julius, who calls himself a socialist. We met for coffee late on Christmas Eve and spoke about the Senate’s vote. Remember: it is not too late to contact your Congressperson to limit the worst excesses of the coming health care bill.
Julius: It’s a day of celebration!
Me: I thought you hated Christmas.
Julius: Don’t be a putz; you know what I’m talking about. The Senate has finally recognized our rights. It’s time to party!
M: A right, eh? So what responsibility is induced by that right?
J: Oh, I’m too happy to be bothered by your technical questions. But I’ll play along because you have such a sad face. It will be my Christmas present to you. Besides, the answer is easy: The responsibility is clearly the government’s.
M: So it’s “easy,” is it? Aren’t you the one who is always deriding others for their “simple” views of “complex” issues? Anyway, it isn’t nearly as easy as you think.
J: My, aren’t you the sour one. However, I remain cheerful. Our government has finally joined the international community in recognizing the rights of its citizens to health insurance.
M: Who, then, is the government?
J: The president, our wise Senate, and so on. I told you it was easy.
M: So you claim that just the president and members of Congress, and presumably its attached bureaucracy, is the government?
J: Of course.
M: Then the full responsibility for providing health insurance falls to this small group of people?
J: In a manner of speaking.
M: What manner? Surely, you aren’t claiming that these few people will pay the health care expenses out of their own pockets.
J: Of course not. They will administer the costs; that’s what I meant.
M: I assumed that’s what you meant, but I want to know where those funds are coming from. You claim it is the government’s responsibility, but then you say the members of the government won’t actually be the ones paying. So it appears the actual responsibility lies elsewhere. Where?
J: Come on, don’t be so obtuse. You know that the money will come from taxes.
M: And the taxes will be paid by me and you, and other citizens?
J: Yes.
M: So then, what you’re saying is that the responsibility is mine, and it is yours.
J: If you want to get technical.
M: I do. It comes to this: we, the citizens, are “the” government, are we not?
J: I guess so.
M: The government is not some abstraction, some far off, beneficent entity, but real people. People like you and me. When you’re always crying for “the government” to pay for this or pay for that, what you’re really saying, is that I should pay for this, or that I should pay for that. Is that right?
J: Well, yes, I suppose so. But I know you agree with me that since you are a citizen, you have a responsibility to contribute to our society.
M: Unquestionably. I just want to see what the limits of those responsibilities are. Just as I want you to see that when you ask the government for money, you are really asking me for my money.
J: Oh, you can afford it, else you wouldn’t be blowing three bucks on this overpriced coffee.
M: Maybe. But let’s find out. What new right do you claim that Senate created in their vote?
J: The right to health insurance, naturally.
M: I think you misspeak. Even you would agree that health insurance is not the same as health. Are you sure the “right” you’re claiming is health insurance?
J: Everybody knows that health insurance …
M: Let’s not bother with what everybody knows. Let’s figure out what we know. You agree, do you not, that having insurance is not equivalent to having health?
J: Not directly.
M: If not “directly,” then not at all. Insurance does not bring health, care (from medical specialists and so forth) and certain ways of living do that, am I right?
J: You are. But insurance pays for that care.
M: Once more, you are in a rush to jump to the simple answer. Let’s go a little slower. I don’t think we have reached an adequate definition of the new right. We need that so that we can figure what responsibilities are induced by that right. We have already agreed that these responsibilities are mine, and yours, so it is well that we understand them.
J: Then the right I mean is health. After all, the Senate was following the Constitution when it said we should promote the “general welfare.” Our citizens should be as healthy as possible.
M: I think you should have some more coffee, because you aren’t awake yet. You cannot possibly mean what you just said.
J: I do mean it.
M: Then let’s discover where the statement “as healthy as possible” leads. To guarantee your optimal health requires that I spare no expense, time, or effort, that I withhold from you no test or treatment, no matter how speculative, that I follow behind you with a safety net, even, lest you fall. Further, since you agreed that each citizen has the same responsibilities, each of us would have to spend the same effort for each other person. We would become a society where all that mattered was health.
J: If I weren’t wearing these sunglasses, you’d see me rolling my eyes. You know that the right to optimal health is not what I meant. It was clear that “health” means to be cared for in a manner which is reasonable. If I don’t have money, I should be given it so that I can seek care when I need it.
M: It was not clear what you meant; but now we’re getting somewhere. However, you left something out, which will be obvious once we decide how much of the responsibility for your health is mine, and how much is yours.
J: I’m not sure I follow you.
M: We already agreed that the responsibility for your health is not solely mine, and that you share some of it. We’re just trying to figure your portion. For example, we are as sure as can be that smoking causes a lack of health. Does your right to health require a law mandating you to stop smoking?
J: I could give up smoking. I was going to quit anyway.
M: Good. But how about chips, ice cream, cheap hamburgers, and other artery-clogging foods? These can certainly cause you to lose your health.
J: Dieting is no problem. I’m a little heavy as it is.
M: Drugs — you know the kind I mean — are also out. And how about driving a car? That really ups the chances of injury or death.
J: Wait a minute! I clearly have a right to drive!
M: Aren’t you always telling me that cars release pollutants into the air? Those can’t be good for health.
J: You know what I meant.
M: I didn’t. But I think what you’re hinting at is that you should be allowed the possibility of compromising your health in exchange for other benefits, or to enjoy the occasional excess. Driving or flying, for instance. Or having Thanksgiving dinner, a hot dog at the ball game, and so on.
J: It seems reasonable.
M: It isn’t. It doesn’t follow from your responsibility to maintain your health. If you believe that you have a responsibility, just as you say I have, for your health, then we should make it illegal for you to engage in behaviors that would affect your health adversely. If not, then you are asking to get away with whatever you like, and have society pay the bills to patch you up.
J: OK, I understand. What if I agree to wave my right to health in those cases where my lack of health was directly attributable to my own behavior? But then you’ll have to agree to restore me to health when the cause was external.
M: The first part of your bargain is acceptable. I’m not sure about the second. Can you explain it more fully?
J: Suppose I, out of the blue, develop cancer and I can’t pay for treatment. That kind of thing.
M: I notice you start with a dread disease, an extreme. Let’s start at a lower level where we are less apt to make a mistake. I’ll instead suppose you develop a planter’s wart, which is certainly a departure from health. Should I be required to pay for its removal?
J: Maybe not.
M: How about we put the wart on your nose. Should I pay to have it cut away and restore your good looks?
J: Well …
M: Or suppose you developed a hangnail. Or zits. How much should I contribute to your acne wash funds?
J: Nobody is asking you to pay for trivials!
M: Aren’t you? OK, suppose you only thought you had cancer and you sought care. But it turned out to be nothing, a false alarm. Should I pay for your hypochondria?
J: It isn’t always easy to know when to go to the doctor. Better safe than sorry.
M: Perhaps, but that’s an evasion. Should I pay? After all, even if I agree to pay for your care when the cause of your lack of health was external, in this case there was no lack of health. If you insist I pay, then this isn’t a right to health you’re claiming, but an entirely new right. We can call it a right to “peace of mind.”
J: There is mental health, you know.
M: Of course there is. But your mistaken doctor visit cannot possibly weaken your mental health; if anything, it strengthens it.
J: I’m sensitive.
M: Don’t I know it. But should I pay? You still haven’t answered.
J: I guess not. However, now you must answer: Will you pay for my real cancer?
M: First answer this: Is your cancer treatable of fatal?
J: If it makes any difference, fatal.
M: OK, you have incurable cancer, for which, by definition, there is no treatment. All medical costs are thus solely for your comfort, because you cannot be saved.
J: I suppose so.
M: Then can’t you see that you have invented for yourself the “right” to be comfortable?
J: Why should I be in pain?
M: Indeed. But if you are and you’re going to die, why should I pay for your comfort? I mean, why should I legally have that responsibility? I might, of course, desire to alleviate your suffering out of compassion.
J: Ha! What do you conservatives know about compassion?
M: I’m surprised that you think such a blatant non-sequitur answers me. Surely you can see how unlimited and ridiculous a ‘right’ to comfort can be; there would be no end of applications for the lack of it.
J: I suppose you shouldn’t be forced to pay. And now I see why you wanted to differentiate between types of cancer. But since I’ve agreed with you that I should be responsible for small departures from my own health or for my comfort, let’s suppose my cancer is treatable. Cancer is clearly different than indigestion, a common cold, and so on, and if left untreated it will kill me. I say that you should pay for my care. And since I’m on to you, I do not mean those costs that are not associated with the treatment of the disease. I’ll even beat you to the joke and say that I will pay for my own Jello in the hospital.
M: You’re learning, Julius. But tell me this: Do you have the money to pay for the treatment? If you do, then you already know that you have no solid reason for demanding my money. Shall we amend your scenario and say that you haven’t the funds to pay?
J: Grudgingly. I don’t like the idea of having to pay for the whole thing myself, even if I have the funds. It could turn out that paying bankrupts me.
M: Then why not buy insurance? You could write a contract to indemnify yourself, even against trivials.
J: Aha! You think you have scored a point, but we are back to the beginning. You have talked yourself into a circle! If you agree to pay for my externally caused departures from health, why not just pay for my health insurance, and save yourself some money?
M: Someday I’m going to have to teach you math; then at least you’ll be able to calculate a decent tip for our waitress. Look — pool all the costs of care from each citizen whose lack of health was external. It is cheaper to pay for this care directly and to not add the overhead associated with insurance. After all, the costs of care must still be paid by the insurer, plus we must pay him for administering the fund. If you insist on me funding your insurance, you are creating yet another “right,” this one for underwriters to make a profit.
J: That doesn’t make any sense, since you just suggested that I buy insurance for myself!
M: Even though you don’t celebrate, I’m buying you a calculator for Christmas. Insurance is like buying a lottery ticket that you hope doesn’t win: if your ticket comes in, you win a lot of money, but also a lot of sickness. The reason to buy insurance is if you estimate the probability of being paid (that is, of you getting sick) is high. For some people, buying insurance is a bad bet. The way you live makes it a good one.
J: Very funny. However, I’ll concede that I don’t understand the math, but since I know you, I’ll accept it — for now. I am smart enough to follow an argument, though. You still haven’t admitted that you should be responsible to pay for care when I, and others less fortunate than myself, lack the funds.
M: And if I pay, what do you owe me? Do those who accept funds owe a debt to society that they have the responsibility to repay? Should they be required, legally, to honor their debt? Don’t answer by invoking a new ‘right’ to dignity, because then you’d have to explain how my dignity is unaffected by giving away my money for free.
J: Of course people shouldn’t have to pay you back!
M: Why?
J: Because you have more money.
M: And that’s what makes you a socialist.
In principle a comprehensive public healthcare system with full-population coverage is Socialism, but is it in practice?
Look at the UK. It has that kind of healthcare, but the per capita tax burden is lower then the per capita tax burden for the current public part of healcare spending in America.
UK citizens are as free as American citizens to take up private insurance but the UK public healthcare is such that the vast majority choose not too.
So, surprisingly it seems that UK citizens get better healthcare with, in practice, less socialism.
Now UK-style healthcare is politically incorrect in principle as described by Williams question “Why should I pay for your healthcare?”, but it delivers more freedom in practce because the answer to that question is “Because, the amount of money you have to spend on healtcare through taxes will be lower.”
Oh, snap! Nice work Mr. Briggs. It is all true.
If such a thing were to occur, years after, people, especially Liberals (as they care most about what they-think-others-think-about-them – (no one can know really, or control)), will hide their candy bars and ice-cream at the bottom of the cart to avoid the scowls from those in the check-out line behind them. Mark it.
I mean seriously… would I then not have a “right” (forget duty) to speak out in public against their un-wise and “costly” purchase, to their face? I suppose I do now, but I also suppose that the ACLU would then, as soon as I am tied to it by Law, call that harrassment… and we will need even more legislation for anti-glutton-bashing.
Now maybe you can have a conversation with someone who couldn’t buy health care because she had the absolute cheek to be seriously ill and everyone then refused to reinsure her. Maybe your socialist friend will then be able to reply that couldn’t possibly happen in France or Canada or indeed anywhere civilized.
Or, as was said more succinctly by a Presidential candidate;
“You want to overeat, not exercise, smoke, take drugs, and engage in other hazardous behaviors, and then you want me and everyone else to pay for your health care? I don’t think so.”
The candidate in question? California then-Governor (and now State Attorney General) Jerry Brown, in the 1980 campaign.
Proving that even “Governor Moonbeam” can figure it out once in a while.
clear ether
eon
Excellent dialogue…Socrates and the rest would proud…just don’t let the ‘Government’ let you drink poison!
Reasonable and logical conversations with socialists. As a friend once asked me, “How do we get some of those?”
“Free health care” is a lie that is more than capable of compounding itself. In this nanny state model, the government upsurps the individuals’ need to take care of themselves, thus producing a less healthy populace. Unless the nanny state can control the dietary, exercise, and risk regimes of its citizens, then it can not increase the general welfare by making everyone more healthy. Obama-Reid-Pelosi-care enables a self abusive and degenerate health matrix while taking over the financial costs and incentives. It is also a vote getter for the entitlement society.
Insurance companies, like casinos, work against risk for profit. Big government health care works for taxes, and a failure of its system to promote the general welfare becomes a success for its own collections and control. That increases the other meaning of welfare.
Optimal health is a reward for self discipline and no government can supply that. As in France, any doctor for a dollar, degenerates a society of hypochondriacs. Put down the fries and take the stairs!
@2 Jas Garnier,
You are confusing health care and health insurance when you say everyone “refused to reinsure” your hypothetical sick female. That ill woman does not need insurance, she needs health.
It is clear that you do think we should pay for her health. Could you tell us why we should pay? To answer, “Because she is ill” is, I need hardly tell you, an answer: it is just a restatement of your belief.
What I’m after is your reason why we should pay.
@2 Roy M,
This would be a good argument if true for everybody, but it is clearly false logically (only the sickest would pay less; the healthiest must pay more), and also false empirically. You are in the minority in arguing that Britons have better health than do US citizens.
The operative result of sosialism rests on the question of ‘why should I work to support you when you will not work to support me’?
Socialism, which takes from those who have, without consideration for HOW they achieved this ‘having’…and gives to those who do not have, without consideration for HOW they arrived at this negative state — results in a population in a state of so-called ‘heat death’. There is no longer anything to redistribute.
The Haves have stopped producing for their profits are taken from them; they are unable to repair or build factories and shops. The Have-Nots have increased their numbers as the population became aware how easy it was to live without work.
And the bureaucracy — that parasitic set who mediate the two, have also increase their demands. They take up most of the money! We’ve seen this trend in many charities and ‘poverty-agencies’ where the administration after a while absorbs 80% of the incoming revenue.
Then, come the constant cuts in treatment and services, for those who Have are reduced in wealth-generating capacity and number, and the expanding Bureaucracy absorbs most of the income.
I applaud your ability to remain patient until the conversation came full circle. Bravo!
#1 Roy M – you seem to suggest that in the UK, private health care, funded by yourself, is available for the same treatments funded by the public.
This is not the case: there are a great many health situations that are NOT covered by the public fund. These include what are known as ‘choices’, such as cosmetic surgery, many types of eye treatment, obesity clinics, fertility clinics etc. You may buy insurance for this, and SOME policies will cover part, only part, of these costs.
It’s the same in Canada. Various health treatments are absolutely NOT covered by the public health system, and other treatments are available only on a limited basis, i.e., an eye exam only every two years. Other treatments require long, long waits of months and even years for treatment.
The FACT is that no economy can operate where the costs of the WHOLE population are born by a small set of that population. It is simply financially impossible.
#2 Jas – being seriously ill, can mean, in the socialist health care system, that the system will acknowledge your illness and will treat you with minimum care; you’ll wait for treatment.
Health care is not a factor of how compassionate a society is, for we are all rather similar in that respect. Health care costs money: for the equipment, for the drugs, for the paying of doctors, nurses and the buildings! A society has to figure out how to get the best results that it can afford.
Does socialism, which relies absolutely on a wealthy class, succeed? No – because it reduces the wealth of this class and thus, its ability to provide health care after a first flush of success, dries up.
And remember, socialism INCREASES the costs of health care because it increases the number dependent on the public system AND it adds the costs of that very expensive bureaucracy.
Holy condescension Batman. So what about our current socialist single-payer system of Medicare. You know, the one that George Bush just extended to cover drugs?
Shouldn’t we do something about all those seniors taking advantage of you? After all, aren’t Grammy and Grampy spending money this country doesn’t have? They would make a better target than Maynord G. Krebs clone you put together.
The Marxists really don’t care about health care; however, it is a means to a end. It’s all about CONTROL & telling us what to eat & drink through taxes & fines; they will also have the power of life over death by denying us options we would otherwise possess in a FREE MARKET system. The Democrats are Communists; the mask is off. Do you like what you see? From the response, no, you don’t. However, the POWER HUNGRY COMMUNISTS don’t care. This is liberalism unchecked, without any restraint. It’s insanity.
I have a feeling many Congressional Democrats will need their health care when they campaign later this year. The elitists will think we will forget, but how can you forget about you mother, father, sister, brother, grandmother, or grandfather? Taxes will go up in the first 4 years & the rationing has already begun with Medicare patients. We will not forget this November…
@12 Lefty,
Pointing to any mistakes President Bush might have made is a non sequitur. It does not in any way answer any of the questions posed in the dialogue.
Nor do your emotional appeals to the aged (“Grammy and Grampy”). Anyway, if you wanted non-logical appeals to emotion, it’s better to cry “What about the children!?”
So, Lefty, why should we pay for your care?
While I would never argue with any of Mr. Briggs’s thrusts, all of which are nicely struck, there’s a simpler way to come at the question:
What is a right? What properties must a claim of rights possess to be admissible as such, even potentially?
– If you could not provide X to yourself in the absence of interference, can you nevertheless have a right to X?
– If you must have others’ active cooperation or contribution to acquire X, can you nevertheless have a right to X?
– If your claim of a right to X causes an irreconcilable conflict with someone else’s claim of some right, how do you propose to settle the matter?
I have yet to meet a leftist who can handle those challenges, whether the subject is health care, welfare, abortion, or biting your toenails. If we can win on this battleground, we win on all of them.
#16 francis porretto – that’s an interesting set of questions but don’t they all rest on an unexamined assumption that a ‘right’ exists only ‘as itself’ and requires no interactions with anyone or anything? Do you believe that or is it a point of argument?
After all, if we discuss the basic constitutional rights to ‘life, liberty and the pursuit of happiness’ none of them can exist without the goodwill, at least, of others. The society is obliged to enable one to ‘be alive’ (but does not define the quality of life); it is obliged to enable one to be free as long as one lives within the laws; and, obliged to enable one to work and study and explore, etc. ..i.e., freedom of thought.
I frankly think that the health care debate is muddied by the left’s definition of ‘health’ as a basic right. The reason is because health, as a state of existence of living, is not strictly a result of societal input but is also a result of individul choices in self-care (smoking, food, drugs), genes and, quite frankly, luck. How can a society define its obligations to these variables? It can’t.
Therefore the question comes down to: how does the population of a society pay for its health care? Individually? By insurance policies? By public taxation?
Each has its pluses and minuses, but the most costly and the least efficient is the one that moves the responsibility for health care farthest away from the individual. That’s the public taxation option. The reason for its high cost is, as pointed out, that increases the demands on the system – which actually results in the end in a REDUCTION of services. And it adds the exponential costs of a mediating bureaucracy.
And the reason for its inefficiency is that the costs to wages outstrip the input from taxes – and the result is lack of equipment, lack of trained expertise, and rationing or outright denial of services.
William – Ya know, I reserve the “What about the children?” for righteous indignation at the Investment Banks, Hedge Funds, Rating Agencies and other fine upstanding examples of the free market system that built a precarious house of cards that taxpayers get to clean up.
Pointing out the mistakes of Bush isn’t a non-sequiter. It’s really more of a knee slapper for me. C’mon, you guys get all fiscal responsibility-ish and here’s the last POTUS and most Republican Congressmen with a spiraling deficit in 2003 making sweetheart deals with big Pharma to buy Grammy and Grampy’s vote with no funds to pay for it.
Republicans and Conservatives voted lock step on that one and there was quite a lot of Chicago style “Brass Knuckles” stuff to keep everyone in line on.
As for my healthcare, it’s quaint of you to assume I can be your own little Lefty basket case, but I will have to disabuse you of that notion.
Only a liberal could reason that he is entitled to the wealth of others merely because he exists. Health is not a right. Liberals will always run out of other peoples money to spend. The government is only responsible to see that we have the right to PURSUE happiness, not the obligation to assure we have it. Mommyism is the end result of women voting. Since 1920 we have been on the road to socialism. Barack is the result of mommy and grandmommy and a black maternalistic society, deciding others are responsible for their welfare. I am responsible for my family , myself and my country, not for the welfare of every drug using, hip hop loving, layabout in the country. Our own Congress is guilty of violating our Constitution’s bill of rights. They envision powers they have no constitutional right to assert. It is time to either change the Congress or to revolt. I will not give up MY constitutional rights for any reason, and will fight next to anyone who will defend those rights. As Jeramiah Wright said, “God damn Congress”. It’s time we advised all those lawyers that they are never going to find anyone willing to enforce their laws. The American people have had it with our representatives, they don’t represent US!
@Lefty, The major flaw with your statement is ignoring the fact that Grammy and Grampy have paid into that system their whole lives. If anything, this makes a strong argument for never creating these entitlement programs to begin with. How do you stop it? How do you support these individuals within the system that have already paid in without taking from those who will never benefit from it?
The article sets up the lefties, who routinely check all the idiotic non-replies in the comment section: you hate grammy and grampy! Bush did it! Pre-existing conditions! Et cetera.
But the answer remains the same: if the health care market were free of government intervention, these problems would largely take care of themselves – certainly more successfully than they do now.
William, no, its not about sickest or healthiest. I just stuck to talking about taxes.
An average US taxpayer pays the same as an average UK taxpayer on publicly funded health TODAY. Everyone in the UK,including the taxpayers, gets a public healthcare system for the tax pounds. In the US, TODAY, the taxpayers do not get a public health system because most of the benefactors of US public health are non-taxpayers. Hence the point about there being more socialism in the current set-up compared to, say, the UK. On health UK taxpayers get a better deal compared to US taxpayers wether they are sick, healthy or dead.
Looking at quality of care: if the UK taxpayer doesn’t like the public healthcare on offer then they can get insurance on the same basis as US citizens but very few choose to do that. As was pointed out ETAB the few who take up insurance do so for additional services, not replacement services.
Looking at quality of care: per capita, the UK spends about half the amount the US spends (taking public+private in bouth countries), and UK coverage is more even, so those who have coverage in the US really SHOULD be getting MUCH better healthcare. They are certainly paying for it. As I said before, the UK public healthcare is good enough to make insurance for standard healthcare un-attractive to UK citizens. So from a consumer choice perspective we can conclude that UK healthcare is ‘good enough’ compared to the private alternative, but given the differences between the countries, most notably the amount of cash spent, it is a tricky call to say which SYSTEM, all other things being equal, offers better quality of care.
About a year ago I looked at the health stats from the WHO: infant mortality, life expectancy, that kind of thing. The US came out about average of OECD countries (countries that have decent economies and healthcare) for those kind of gross measures of health, but spent much more than anyone else, about twice as much.
My first thought was that this showed that US healthcare was terribly inefficient compared to other countries, but looking more closely accross all countries it appeard that these gross measures of health levelled off after the first $1100 per capita of healthcare expenditure. So the additonal spend by countries such as the US and UK doesn’t effect these numbers much.
All in all, when we look at the real world (as opposed to the technique of using logic to deduce which system must be most efficient on the basis of zero-sums and ceteris paribus!) we don’t see demonstrable inefficicency in public healthcare compared to private when comparing the US to the UK. In fact the US healthcare looks overly expensive at first sight, but it is very difficult to compare.
@18 Lefty,
It is also a fallacy to counter with errors Presidents Bush and Obama have committed with respect to the “bailout” (which, though it is not relevant, I did not support).
Your response is, in fact, a non sequitur. Whether or not it is a “knee slapper” is irrelevant.
You have danced prettily, but you have avoided all real attempts to answer my main question. Can you do so now?
Can’t tell the difference between health care and health. Typical. Just like AGW deniers who conflate climate and weather. Next time try a conversation with an actual socialist. You might learn something.
Peace.
DS
Good health is not a right. But access to good health coverage should be. And No. 1 Roy is correct. America ranks number 37 in health care because it accepts “third world” health care standards. New York bankers will be paid about 600 grand each in bonus money this month. Yes, they can afford to pay their fair share of tax to help those that actually work for a living that do not have access to affordable health insurance. Any other arguement holds no water against common sense. The rich will cry and moan, so what? the old, the sick and veterans suffer all the time. If we can afford to give billions to the oil companies, we can afford to allow the sick to see a doctor.
#22, Roy – You state that UK taxpayers get a better deal than US taxpayers – but your reason seems to be the most of the beneficiaries of US public health care are NOT taxpayers. That’s hardly a legitimate comparison or argument for supporting socialist health care!
And no, your argument seems to suggest that IF the UK citizen doesn’t like the public health care, that they have the option of purchasing private health care insurance. This is fallacious. You do NOT have the option of purchasing insurance for standard health care.
And you haven’t provided any evidence that the UK (or Canadian) health care is ‘good enough’ to preclude purchasing private insurance, because your basic argument for such a purchase is flawed. Again, you cannot purchase private insurance to cover standard healh care! You can only purchase it for optional coverage, for such extra non-standard services as cosmetic surgery, obesity and fertility treatments, etc.
These private health care policies do NOT cover the health services covered by the public system. You cannot declare that you want ‘superior treatment’ for your influenza and receive such compensation from your private health care plan. It covers only those areas not funded by the public system.
Therefore your argument that IF someone in the UK does NOT purchase private insurance, THEN this means that their health care system is sufficient is invalid. The questions ought to focus on the availability of the standard health care treatments and the costs. In the UK and Canada, as pointed out, treatments are either non-existent, delayed or slow, or reduced and rationed in number, quality and availability.
http://www.angelfire.com/pa/sergeman/issues/healthcare/socialized.html
The reason is simple: costs. This is due to the escalation of users of the tax money. You cannot fund any public system by taxes while increasing the costs of that system! The costs of a public system increase because the number of users massively increases AND the costs of a mediating bureaucracy bloat the system! If you increase taxes to pay for this double-whammy, you put the economy at risk because you reduce the capital held by citizens for business investment and development.
Dear Mr. Briggs,
I think you’re missing an important point about the health care debate; you are already paying for someone else’s health care. If you want that to stop, you should be advocating for ending universal access to emergency room care. If not, then there has to be universal health insurance coverage. And it doesn’t have to be a so called ‘public option’ but everyone must have health insurance.
Thank You
#25 poor citizen. Could you explain why access to good health coverage is a ‘right’ – by which I presume you mean that it ought to be paid by the taxpayers.
First, could you explain why an insurance policy that you pay for yourself or in collaboration with your employer CANNOT provide ‘good health coverage’?hy is paying for it via increasing taxation a better tactic?
Or why paying for the service you need, if it’s minor, cannot be ‘good health coverage’?
And second, could you explain what you mean by ‘third world health care standards?
Oh, and could you define what ‘actually work for a living’ means and why bankers, according to you, don’t do any work? Oh, and do they pay no taxes, like so many of those who currently abuse the US health care system? Or the UK and Canadian system?
#24 David S- we are all differentiating quite clearly between health care and health. Therefore, what’s your point? And kindly provide evidence that people who reject AGW don’t know the difference between ‘climate’ and ‘weather’. Oh, did you know that weather is a result of climate and the two are, heh, connected? So, if it’s freezing cold for days and weeks and even months, that’s indicative of the nature of the climate and might be empirical evidence of the fallacy of AGW. I bet you didn’t know that.
Just let ‘em die. Even if they have health insurance, they don’t look the sort who should.
Dear Poor Citizen and Lefty,
You (appear) to making the mistake of trying to tie health care reform to a new civil right. What you should be focused on is how the uninsured cost all of us to more for health care every year. Too many REBs view this debate as an assault on their sense of libertarianism. Too many DEMs are trying to make the case for health care reform by in effect saying “well yeah socialism has never worked on its own or anywhere else, but it will work here”. The best argument for health care reform is how it will benefit those with health insurance not for those who don’t.
While “health” is not “health insurance”, and of course a person has a responsibility to look after themselves (or their children), life happens and medical issues may arise in people that were not irresponsible regarding their health.
A child may be born with Type 1 diabetes. Did they do something in their lifestyle choices to make them this way? A non-smoker can get lung cancer. What did they do? You’re flat broke, cannot afford health care and someone hits you, a pedestrian, necessitating a trip to the hospital for you. Should you have to go bankrupt to pay your exhorbitant hospital bill? What about the worker who got laid off and cannot afford health insurance anymore because of high costs? Does that make them less responsible about their health because they cannot afford $600 plus a month in insurance for their family on no income or unemployment?
YES, you can argue that health problems can be caused by the person. Duh. I don’t think anyone would argue that people do not bring circumstances on themselves. That said, you can consider yourself a moral person and not fight for our nation to do what others have? Namely, figure out how to spend less than we do and give more/all of their citizens some access to basic health care.
But the fact that we are the sole Western nation who has citizens that can go bankrupt because of healthcare bills, you don’t think that is worrisome? Tragic? Embarrassing? Immoral? at minimum, wrong?
You don’t think that people are entitled to basic preventative health care? Dental care?
As stated by previous posters, our per capita cost of healthcare is significantly higher than other western nations and the benefits derived are not. England can (per capita) spend less money per citizen (and per their GDP) and have all citizens covered by nationalized health care. Canada, Japan, Switzerland, Germany, France, etc. can all make similar claims.
At minimum: those countries spend less of their GDP, less per person, and have better coverage for health care than the US does. What does that say about the value those countries place on a right to health (care) versus ours?
Where is your sense of decency?
World Health Statistics 2009: http://www.who.int/whosis/whostat/2009/en/index.html
Table form of Health comparisons from above web page: http://spreadsheets.google.com/ccc?key=tsI9mtBAHd84DHdNQhO17Pg
ETAB,
Google “health insurance UK”.
You’ll find 500 companies offering health insurance for surgery, chemotherapy, hospital stays etc all standard treatments. You can get insurance that excludes treatments that are publicly available if you want. For example ‘Axa’ offers insurance that covers treatments that you could get within the public system, or you can choose to exclude them if they are available quickly in the public system to pay a reduced premium.
What I said about public care and consumer choice in the UK stands. UK healthcare, with 100% coverage at 50% of the per capita cost of US healthcare is good enough to dissuade most conumers from using insurance. And given that UK consumers have the public option available to them at ZERO additonal tax cost compared to a US consumer that sounds like a good deal, even if the care is slower is some areas.
One thing you can’t do in the UK is be treated within the public system but change one part of that treatment privately. If you have a condition the treatment of that condition has to be all public or all private and the patient chooses which. You can change your mind but you can’t have public care for a condition at the same time as private treatment for it.
Do you really think that insurance bureaucracy is much less than public bureaucracy? Aren’t they pretty equivalent? Or do you have an amazing insurance company??
@28. ETAB:
We are all differentiating quite clearly between health care and health.
You might be – the author of the piece was not. His attempt at imaginary dialogue was, to put it kindly, pathetic.
Therefore, what’s your point?
My point is that no, there is no right to “health”. It’s a logical impossibility, given the nature of illness. But there is a well established right to health care services, as can be seen in the case of emergency room admissions. We DO have a right to health care. The big problem in the USA is that we don’t have a rational, logical payment system in place, which causes us to spend more on health care as a nation, and as individuals, than is necessary. The “socialist” health care systems which are standard practice in the rest of the west are very good at delivering health care services at a lower cost, and with superior outcomes. That’s my point.
And kindly provide evidence that people who reject AGW don’t know the difference between ‘climate’ and ‘weather’. Oh, did you know that weather is a result of climate and the two are, heh, connected? So, if it’s freezing cold for days and weeks and even months, that’s indicative of the nature of the climate and might be empirical evidence of the fallacy of AGW. I bet you didn’t know that.
You answered your own question. Local weather in your area is not indicative of the state of the global climate. Most of the AGW deniers on PJM, including comments and articles, make this very basic error. You’ve proven that at least one person doesn’t know the difference. If you look around, you’ll see that you are not alone here. Yes, weather is the result of climate – but you can’t define the state of the global climate based on your local weather report. It’s a global phenomena, and understanding it requires global perspective. Something you apparently lack.
Peace.
DS
#27 M Independent – I don’t understand your reasoning in this section. You are saying (Ithink)that because access to emergency services cannot be denied, THEN, one must support universal health care. I’m afraid I don’t see the connection. That’s like saying that IF the govt provides a start-up loan to a small business, THEN, it must provide full financing forever.
#31 avoidswork – the argument is not about the cause of disease, but about how a society can best finance its treatment. Medicare and Medicaid and Children’s Aid help those with low incomes, as I’m sure you know. Yes, health care costs are higher in the US – and the quality of treatment is also higher. As noted, in the UK and Canada, for example, treatments paid for by the public system are inadequate, with some treatments unavailable, or long waiting lists or not permitted for people in various age groups.
Oh – and the systems in France, Germany, etc ae NOT fully and only public, but include private care. That is, you can choose to go to a private clinic and pay for the treatment there. In Canada, such clinics have been forbidden but a recent Supreme Court ruling enabled private clinics to start to develop.
But the general lack of treatment is why so many Canadians, for example, choose to go to the US for treatment.
#32 Roy – Right- so the taxpayer is paying double; he is paying taxes for the public system AND paying for his private system. And the fact remains that the private insurance pays for a lesser set of care than that by the public care – paid for by your taxes.
No, it can’t be concluded that most UK citizens don’t purchase insurance because the UK NHS is sufficient. First, it is an extra cost; second, it is not a duplicate of the services provided by the NHS. Therefore, it cannot logically or empirically be concluded that the REASON for this non-purchase is the ‘sufficiency’ of the NHS.
Yes, the bureaucacy of an Insurance Company HAS to be less than that of the public service. The reason for this is because the Insurance company MUST be cost-efficient, unlike a public service which has no need of cost-efficiency because its source of money is the taxpayer. The insurance company has to offer free-market competitive services and if its wages/benefits of its staff increase beyond the carrying capacity of its income and the quality of its service operations -it’s in financial trouble.
I’m sure you are aware that the public sector employees are one of the largest sets of workers in socialist countries; that their wages/benefits are usually two-three times that of the private sector and that, as unionized, they are ‘permanent jobs’.
The question remains: how does a society provide health care for citizens? I maintain that a combination of public and private, with the latter heavily dominant, is the most fiscally responsible AND the most qualitative.
William – It seems like such a me, me, me day. As a self abnegating apparatchik please allow me to answer why I would pay for your care. Fair enough?
1. Because there for the grace of God go I.
2. Because my cup is full while others are empty.
3. Because a society is represented by how it treats its lowest members.
4. Because it is in my naked self interest to prevent the spread of disease.
While these aren’t the exact reasons we’ve created entitlement programs, I find little to debate about in terms of whether we should or should not aid those who are in need of health care.
As far as the Medicare reference, I would argue that in talking about healthcare you raise certain questions as if the endeavor of providing government run health insurance were some tabula rasa fraught with complexities and moral ambiguities that require experts with very long beards to unravel. To the contrary, we have an existing socialist program that many people find quite popular already.
The “children” bit does not follow.
ETAB@34 –
No system will be perfect with respect to health care. But our current system in the US is woefully pathetic, cost-inefficient and Insurance companies are supposed to deny claims.
Yes, I am aware that systems in France, Germany, Switzerland are not nationalized like UK, however, they still spend less per person/GDP than the US and offer coverage to their citizens. We cannot make a claim like that in the US by any stretch of the imagination. Do you know what the administrative budget is for insurance companies versus Medicare?
Our current system of health insurance is a for-profit Beast. They deny claims to people who are insured and who do need the services. So what is your take on that? Moral? Okay for now?
Lefty @35 sums up perfectly why we, as a society, should all be endeavoring to push for a system that covers our citizens, that costs less and has more efficient costs. And profit must be removed or severely reduced from health insurance.
Access to health care should be a basic right in the U.S.
Etab,
I know that private health provision ‘must’ be more efficient than public provision because of free markets. But when I look at the numbers, the evidence, it just doesn’t look that way.
Not much I can do about that.
Real Americans are fat, stupid and lazy. That’s why they’re fat, stupid and lazy.
#35 – you still haven’t provided an explanation of how a society funds health care.
Your numbered list is not an explanation but is intellectually empty and thus, morally empty. Why?
1. Your ‘equivalence’ argument rests on an assumption that I have more money than you. But what if we both have the same or you have more. Why should I pay for your treatment?
2. Same invalid argument.
3. Nonsense – ambiguous and ad misericordiam. A society is defined by how it enables ALL its citizens to function -and that includes its productive investor class.
4. Invalid – rests on an assumption that all diseases are infectious. The majority are not.
You haven’t answered the question of how a society FUNDS health care.
36 avoidswork. Nope, I disagree. Your argument is that SINCE insurance companies DENY health care, THEN, public health care is necessary.
My response to that is that IF insurance companies routinely deny NECESSARY services, THEN, they’ll lose customers. And since it’s a competitive market, they can’t afford this. Please note the term ‘necessary’. Insurance companies are justified in refusing unnecessary services. In public insurance systems, the health care is overwhelmed by people overusing the services, going to emergency care for minor colds, making repeated appointments for trivial concerns.
And, most certainly, any system, private or public, MUST be profitable. If it is not, then it is unable to meet its expenses. These expenses include staff (whose wages are always increasing); office etc… ‘Profitable’ in a public system means that its costs must not require an ever-expanding tax base. And the history of public services is that they are most certainly NOT profitable but require constant new taxes.
The problem with a health care system that is primarily public is as I have noted – the costs exponentially increase, the quality of service rapidly deterioriates and the type of services provided is reduced…and the number of people who are given service is reduced. Because the public system simply cannot PAY FOR IT ALL. It is inefficient, does not cover everyone, and does not cover all medical needs.
@roy M twice:
It’s unfair to compare the cost of healthcare in the US to that of healthcare anywhere else in the world while the US is shouldering the burden of almost all medical research and overpaying for drugs to assume the drug development cost, too.
Lefty,
Good attempt.
1. This fails in general—it doesn’t answer how to account for self-inflected illnesses—but it does fit in with #2.
2. Let me know where I can send my bills.
3. This is not true either, in general. How we treat our “lowest” members is only part of what societies are judged by; and, of course, it depends very much on what you mean by “lowest.” The burden of proof is also on you to prove, and not merely assert, why taking from others and re-distributing what you have taken leads to a better society. Singular anecdotes, while entertaining, are not proof.
4. This is the only point on which we agree. With you, I can imagine a situation where all should be compelled to act to preserve life and property. Say, some emergent, heretofore unknown, deadly disease that would respond to treatment that could only be obtained by a population-wide effort.
@36, Your screen name negates your argument, friend. Get back to work.
#36: Medicare loses about $60 billion per year to fraud – about 15% of its total expenditures. The top 10 private health companies make a total of $8 billion in profits each year.
Also, there is absolutely no way that any government operation will be more efficient than a private company. Probably not by a factor of 10.
But the overriding problem is that the consumer gets disconnected from and becomes totally unconcerned about the payer. Think about going on a shopping binge knowing that someone else will pay off the credit cards. Think you would be a smart shopper? Show any restraint at all? Yeah, I’ll take one of those in each color and one for my mother.
This is a recipe for ballooning demand and runaway costs. That in turn will require raising taxes and denying other public services until it can go on no longer. Then comes rationing and reduction of pay for medical workers – which will drive down supply and quality of services.
This whole thread badly misses the point. Of course liberals are for Obama care because they feel that inequities in results in a free society need to be smoothed out. Its a spread the wealth thing. Any attempt at economic justification is total BS.
What we need is to get back to the concept of insurance. Policies should only cover the more catastrophic things that befall us. There are many good and workable ideas along these lines that have been proposed including provision for covering poor and low income Americans. Bu t the politicians don’t want anything reasonable to mess up the creation of a dependant majority. Then there is no turning back.
Should have been
Whose Responsibility Is Your Health **BILL**
According to Liberofascists, the answer is: the evil greedy racist homophobic rich (light skinned, non ghetto-jive-talkin’) whitey.
William – I don’t have time to refute your refutations, but then again I’m arguing for a moral position which has no value. However…
“A Jewish man was traveling on a trip from Jerusalem to Jericho, and he was attacked by bandits. They stripped him of his clothes, beat him up, and left him half dead beside the road. By chance a priest came along. But when he saw the man lying there, he crossed to the other side of the road and passed him by. A Temple assistant walked over and looked at him lying there, but he also passed by on the other side. Then a despised Samaritan came along, and when he saw the man, he felt compassion for him. Going over to him, the Samaritan soothed his wounds with olive oil and wine and bandaged them. Then he put the man on his own donkey and took him to an inn, where he took care of him. The next day he handed the innkeeper two silver coins, telling him, ‘Take care of this man. If his bill runs higher than this, I’ll pay you the next time I’m here.’ “Now which of these three would you say was a neighbor to the man who was attacked by bandits?” Jesus asked. The man replied, “The one who showed him mercy.” Then Jesus said, “Yes, now go and do the same.”
For me that sounds about right and I think this is reflected in laws that have been created to help those in need.
side note: We don’t pay taxes for rights. Period.
‘Then Jesus said, “Yes, now go and do the same.”’
My friend, Jesus, the Model of Compassion, would ]NEVER[ take from one to give to another.
I don’t think most understand this. It should be pondered as there are more answers that lie beyond its fruit. The answer lies in the idea of Charity (or willing acrifice), but not many understand that either. It is a reward for both. It involves neither the barrel of a gun nor the threat of punishment; and cannot.
He despises the idol of money.
Yet, some still give it the weight of weighing someone’s inherent worth or happiness. It is but an illusion.
The Idea illuded to in the above passage is a 2-way street. It must be. Not a 1-way. Do all not see this? If not, peer into its mystery again, for your own sake.
He said to show the way, but not to impose it. He would never. The Sword is forever buried. How could one not see this? You sully his Name and he weeps for your self-righteousness as your way will incur the unrequited suffering of many; the benefactors are irrelevant for He weighs no souls against another, but itsown (ref: desert island). That is never the way. For a man, it must be a requited; know this.
Geeze this is frustrating. No one is arguing against compassion. It’s how it gets done that is the heart of the matter. Giving control of our health care to a bloated, highly politicized government bureaucracy is not ultimately very effective or compassionate.
49. Lefty:
Two things negate using this parable as a justification for government health care. 1. The Samaritan was not forced to provide aid for the injured fellow by Caesar. It was entirely voluntary. 2. The Samaritan set the level and extent of care. He had total say on it.
You are to be commended for contributing from your excess to the needy, but you show a lack of judgement or character in demanding I do the same, imo. Or do you think you are better than I, and thus somehow more qualified to make those decisions for me?
44. Wrong answer! See, the Good Samaritan was using his own money and effort, not compelling anyone else to do so. It’s a great argument for charity, but government health care isn’t charity- charity (from Latin charitas- love) by definition must be voluntary. If it is forced, it ceases to be charity.
Part of the irony here is that many seniors object to the new plan because they are afraid that it will curtail their current MEDICARE.
And is the fear that the government will permit all treatments and go broke or have some restrictions, which can then be pilloried as death panels?
Any plan, to remain remotely solvent has to have at least a moderate co-pay with every visit to the doctor/HMO.
The broad philosphies of socialism vs free market aren’t all that helpful here, since the devil is in the details and we already have a mix of government and private medical coverage that interact is ways that do not lend themselves to broad, doctrinaire generalizations.
Point of clarification. The question I was asked by William was not whether health care should be provided by government but why he should pay for my care, or as I answered it, why I would be willing to pay for his.
It’s a bit of a trick question and posed a problem for Plato as well. In the Republic he punts and chalks this up to religion. I don’t think it’s necessarily a cop out. Read the scripture and ask yourself which person do you want to be in life?
To jump from compassion and charity to government healthcare and redistribution of wealth. I’ve said that I think the programs which our government has created to tend to those who are in need are an extension of the spirit of what is taught in scripture.
If you object to this and find the whole idea of taxation fraudulent and wanting, or wish to further define the proper scope of government, that’s a much longer question which I don’t have time to address.
ETAB,
Thank you for your response. In answer to your question, the point I was trying to make is that the uninsured are responsible for the majority of health care inflation. So that problem can be dealt with in one of two ways: we can have universal coverage or we can end universal access to ER care. I think a more accurate comparison of that situation is immigration. Do you really think that we can have real immigration reform without securing our borders? Probably not. Likewise we can’t have real health care reform without dealing with the uninsured. BTW, what does ETAB stand for?
David S,
#33 Well said.
50. You are more than free to volunteer your own money to pay for other people’s health care, but you have no right or business volunteering mine. I’ll dispose of my money in the time, place and manner of my choosing, and that includes my charitable donations.
@33, While you say, kindly, that my dialogue was “pathetic”, you made no attempt to refute any argument I presented, nor to answer the main question. Your evasion is understandable.
@44 Lefty,
Acts of kindness cannot be mandated. They cease to be kindnesses and become obligations. Anyway, I still eagerly await when you have the time to attempt to refute my arguments.
I take issue with this debate. The question should not be about MY responsibility to provide for the healthcare of others, but rather why should it be the role of GOVERNMENT to provide for the healthcare of it’s citizenry or more precisely why any sane electorate give politicians the naked power that would be in their hands if they were to control whether or not their citizen’s live or die when they develop serious illness?
Whether or not it is my responsibility to pay for the healthcare of others is a question of morals and personal charity, which should be handled as such. It should not be a question for government one way or the other.
@54. William M. Briggs:
@33, While you say, kindly, that my dialogue was “pathetic”, you made no attempt to refute any argument I presented, nor to answer the main question. Your evasion is understandable.
The “argument” you presented doesn’t begin to address the topic at hand. You go back and forth between a right to health and a right to health insurance, when the main question is about access to health care. Logically we all have a responsibility for our own health, and for taking care of ourselves, but we also have a right to health care services when our health is impaired. Most countries with comparable incomes and health care have universal coverage and dramatically lower costs for health care.
You accuse me of being evasive, but I’ve gone straight to the heart of the matter that you are trying to avoid: Socialized health care is more effective AND cheaper, and does not preclude the liberty to obtain additional health care services if one so desires. In truth, the logic of liberty supports pooling our resources for health care, just as it supports pooling our resources for the common defense. Sure, we could each be responsible for our own self-defense – but as a nation we are more secure and our liberty is better safeguarded by sharing the responsibility. Health care is no different.
If you want to interview or debate a real socialist, rather than your pale imagination, I’m here for you.
Peace.
DS
55. CJL1138:
The problem with your comment is it comes several decades too late. We’ve had government “providing healthcare for its citizenry” in some form or another for at least that long. So if you desire to reverse that decision you should probably go for it somewhere else. This thread is about the current flap. Ie: Swarmy socialists wanting to use the power of the government to force everyone to provide an unknowable amount of money for an unknowable level of healthcare to cover the ill-defined and uncounted “needy”. In short, a disaster in the making for the nation but a socialist’s fondest dream.
50. Lefty
You confuse scripture with Karl Marx’s “Manifesto”. He’s the one who thinks governments should take from the rich and give some of it back to the poor. God, on the other hand, holds each of us responsible for our own “charitable” efforts. You go to your church and I’ll go to mine, thank you.
One thing is clear: the current healthcare “Bill”, such as it is, will only result in a worsening of the Nation’s healthcare system, if not also its effective destruction.
For example, let’s hear how the further defunding of Medicare – which is already critically underfunded and its standard of care maintained only by the increasing rates charged to private insurees – is going to not lead to massive rationing of Medicare. Especially given that Medicare already has the highest rejection of payment rate in the Nation and is about to go into the red as a tax-fund to boot.
Or: why is the current plan to collect premiums for the first four years without providing any benefits, then provide coverage for the next six years based upon the total 10 years, not simply going to have to be repeated every 10 years?
The current Bill is in outright chaos and it will only get worse over the next weeks. It did not even originate with the idea to do anything reasonable to begin with, because it does not deal with tort reform and the lack of competition across State borders, just to mention two obvious ways to improve the system.
And who can tell me why the people writing this Bill for practical purposes do not have to be subject to it?
What I’m telling you is that regardless of whatever people are arguing about here and now, this Bill will only make things worse.
And while you’re at it, why is it that the people who claim that healthcare service is being denied on the basis of inability to pay, cannot provide even one valid example of this alleged epidemic.
I’ll tell you this too, no one goes bankrupt from the average medical bill attaining to bankruptcies as derived from the first mentioned Study claiming “medical bankruptcy”, of $11,000 to $12,000.
@57. 49erDweet:
While I agree that this problem is a very old one going all the way back to FDR, I do not agree that this is not the time to posit the question. We will never see a return to sanity if we don’t start examining first principles. The debate over the proposed legislation is the perfect time to raise that topic.
I will restate my point. Whether it is an individual’s responsibility in society to help another with health care or any other personal expense is a separate issue from the one that confronts us today. The issue that confronts us in the proposed legislation is not whether or not an individual should be responsible for the costs of another person’s health care, but whether government should confiscate the wealth of one individual to pay the private expenses of another.
The only way we will ever begin a rollback of government excess is to stop growing government today. We can deal with shrinking it tomorrow.