Debate:Should a just government provide healthcare to its citizens?

This is a Debate page. Feel free to add your own spin on the story. Please keep it civil! This debate was created by Electrified mocha chinchilla.

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I'd like to note that this is largely a question of ethics. The question isn't flawed just because a "just government" doesn't necessarily exist. Answers should prove why a just government (your subjective definition thereof) should or should not provide healthcare (non-private) to its citizens (individuals legally residing in said country). Good luck! --e|m|c ^[TALK] 14:21, 20 February 2008 (EST)

Back up one step. Should hospitals be required to make a best effort to save the life of anyone who walks in immediate need of medical treatment? For example, you are walking down the street in your home town and start vomiting and fall unconscious. I would assume you would like them to take you to a hospital and make a best effort to make you better - even if you don't have an idea or aren't from the area (check your pockets, oops, this guy is from Canada, ship him north guys). The extension of this is what do you do for a homeless person who starts vomiting and falls unconscious on the street. Well, the hospital is going to try to help that person too, and the tax payers are going to pay for it. It has been found time and time again that preventative healthcare is much more cost (effective?) than emergency health care, both in terms of time and quality of life. One could (I don't, but one could) care less about the quality of life of other people, but most people prefer to pay less taxes.

On a related note, free housing can also drastically reduce the cost to tax payers in some cases too.[1]

--Shagie 13:16, 20 February 2008 (EST)

Sorry to invade your space, but this is a kind of side note: first of all, isn't every doctor obliged to give care to people in immediate need of help? I thought it was in their oath. Second, I have read at least a couple of times, in the Mediterranean country where I am now living, of people who collapsed and died in front of a hospital. In this country, doctors/nurses are required to stay in the hospital, they can't go out - even if just 5 meters/yards! The correct procedure is to call an ambulance, which will come from who knows where and take you to the hospital when it's too late. Editor at RW^{Schumi on Ducati?} 13:44, 20 February 2008 (EST)

You sure about starting this debate, EMC? We're all gonna' get whumped by PalMD. :-) -- Radioactive afikomen ^{Please ignore all my awful pre-2014 comments.} 15:00, 20 February 2008 (EST)

Radioactive afikomen

Arguably, it is the responsibility of a state to concern itself for all its citizens/residents. An important part of such a responsibility is to protect the innocent and the helpless. The "helpless" includes those who do not possess the means to take care of themselves, which clearly includes those who are too poor or whose treatment is too expensive for them to afford on their own.

Guaranteed universal healthcare would greatly raise quality of living. Additionally, while some (read: libertarians and other anti-statists) may argue that government healthcare would make the people more complacent and dependent on the state, it would actually "help the people help themselves". Particularly when it comes to long-term, often lethal diseases, such as cancer or AIDS, paying for treatment is always very costly. Households often bankrupt themselves, or sacrifice any existing financial security, in order to pay for such long-term, often highly specialized treatment. By letting the government pay for it, people will no longer be driven into desperation or poverty by healthcare costs.

As for the free market, it is arguably ill-suited for providing healthcare. Despite libertarian opining to the contrary, the free market is actually business oriented—when consumers benefit it is only a pleasant side effect. On its own, the free market focuses on selling as much as possible in order for businesses to maintain as high a profit as possible. However, the entire principle behind healthcare is to sell as little as possible, and emphasize prevention over treatment. The ethical goal of healthcare is reach the point where it is only barely needed, and maybe even not needed at all.

There do, of course, need to be a few things purposely not covered by national healthcare. Frivolous procedures like cosmetic surgery shouldn't be covered, except for the injured (burn victims who need skin grafts, for example). Medical woo treatments should also not be covered. -- Radioactive afikomen ^{Please ignore all my awful pre-2014 comments.} 13:36, 20 February 2008 (EST)

I need to pen type a longer response at some point, but a few things. First, while preventative medicine is undoubtedly a public good, and good for public health, it is not clear how cost-effective it is. Whether or not it is cost effective should drop a bit in relevance anyway, as prevention is important to public health.

A few things are involved in centralized health care. First are the ethics, second is how it is put into practice, as the implementation effects the ethics. For instance, centralized health care with Draconian rationing would be perhaps utilitarian, but less ethical than other systems (current US system is rationed, not in a Draconian fashion, but in a somewhat haphazard, economic fashion).

Health care is not as amenable to a pure "marketplace of ideas" as other services. It requires highly specialized professionals who have a fiduciary relationship with their patients. The current (US) financial incentives can disrupt this relationship.

Under our current system, all hospitals (at least, all that participate in any government programs--US) are required to treat emergencies to the best of their abilities. People in private practice like myself have no such obligation (i'd go broke anyway).

More later, but it's just some things to chew on.-- PalMD ^{--You don't know harsh!} 14:04, 20 February 2008 (EST)

Do you have any quibbles with the financial argument (second paragraph)? -- Radioactive afikomen ^{Please ignore all my awful pre-2014 comments.} 14:10, 20 February 2008 (EST)

Any system that provides real health care (as opposed to voodoo, etc) will spend a lot of money on a few people. Given it's a gamble to figure out who will be the few expensive people, the only way to finance such a system is by pooling risk and money.-- PalMD ^{--You don't know harsh!} 14:40, 20 February 2008 (EST)

This subject is a veritable mine-field as the provision of universal healthcare can be a tremendous drain on the public purse if not controlled. I don't know if this debate was inspired by my posting about my wife's cancer therapy but we received a lot of value back from our health taxes. There's a lot wrong with the British NHS but there's a lot of good there too. In the UK the Government is the primary employer of health-care workers so has the controlling say in how most of them are paid, people don't want to pay a lot of tax so they try and keep wages low, this tends to lower the quality of native healthcare workers but our wages are still higher than say the Philippines or Poland so we get an influx of foreign workers who are often higher qualified than those they replace. However, they have no long term comittment to stay in the country and might return home if conditions improve there which means that a lot of qualified staff could disappear at short notice. Pharmaceutical companies spend a lot of money developing drugs and have to recoup their costs and make a profit. Now in some countries (like the USA) they can charge a high price as a lot of people either are prepared to pay for the treatment or can afford health insurance. However, at some point that price puts a cap on sales as there are a lot of poor people in the developing world who can't afford the drugs. Socialists (for example) then make a point of bashing big pharma for not giving the drugs to these poor countries or maybe charging a much lower price. Well as the actual costs of manufacturing the drugs are often not a significant part of the price the companies could charge a lot less and still make a profit on these extra sales, profit that they wouldn't have had if they charged the same premium price as in the USA. Now if you are an African entrepeneur of some kind you can see that there are a bunch of cheap drugs being brought into your country, so spotting a business opportunity decide to sell them back in the USA either to people who can't afford them in the first place, or to someone who can afford them but would rather spend their money on something else if they could. This then removes the drugs from those who need them in Africa and undermines the pricing structure in the USA. There is also the dilemma of how much treatment you give one person, there have been cases where a health authority has refused to supply a particular drug because of the cost. Patients in other areas where the needs are different may have been given the drug, the patient then goes to court to get the drug prescribed. This may cost as much £5000 per month for the rest of their life (although the cost would probably come down over time). The health authority now has to fund that drug which may mean reducing treatment for 10 people who need something that costs £500 per month. How we balance the value of the one person who needs the drug against treatment for all the others is really a no-win situation. Do we place a higher value on someone who has great potential or treat someone who is old but has paid their share of taxes and is entitled to something back? Cosmetic surgery may actually be a valid procedure. In my twenties I had a mole on my face removed (it was done privately) because I was very self-concious about it. Some people can be greatly affected by parts of their body which they find disfiguring, like birthmarks, harelips or even moles and may be driven to self harm or suicide. I am currently afflicted by a rapidly expanding bald patch and it's driving me to despair. In France, quite bizarre treatments which are more in the realm of health-farm treatments are available. Unfortunately the demand for these has led to an enormous national debt that must be settled at some point. It may sound callous but as everything has to be paid for, ultimately we may have to put a price on everything including people's lives and make those who can afford treatment pay as much as they can to subsidise the less well off. After all, a lot of rich people's wealth is obtained as the result of other people's low wages. People who cannot afford to pay for their own medical care. Some of us vote with our heart while others vote with their wallet, I'm just glad that I don't have to make a judgement of Solomon over this. Genghis ^Marauding 15:37, 20 February 2008 (EST)

tl;dr -- Radioactive afikomen ^{Please ignore all my awful pre-2014 comments.} 15:55, 20 February 2008 (EST)

Hey, go ahead and format it. I'm too knackered! Genghis ^Marauding 16:07, 20 February 2008 (EST)

THE GOVERNMENT SHOULD NOT PROVIDE HEALTHCARE TO PEOPLE WHO ARE DUMBASSES^{(How is dumbass defined?)} AND DO NOT HAVE JOBS^{(Dumbasses with jobs can have government run healthcare?)} ITS^(it's) THERE^(their) FAULT AND NO ONE CARES ABOUT THEM SO THEY CAN FUCK OFF ^{This incisive comment was inserted by:— Unsigned, by: 165.138.138.212 / talk / contribs}

I feel like that .. why shouldn't everybody deserve free healthcare ? were all the same damn species and knowing we didn't get put on earth to be so heartless that they have to DENY a person in need when they needed it the most , what people don't do is think what happened if this was your own sibling were talking about who is gonna die because they could of had a simple test run on em and see whats wrong and provide medicine for them instead of having the low income people struggle dying for money they need for medicine that could help them get better , I mean no one in the wealthiest state of em all should have to go without healthcare , that's damn near a bad name on us US citizens and Government at that , so when people look at our state / country , we want em to have good things to say about it not negativity that keeps em out and letting other people around the world how cruel our healthcare system is then have the ones who barely have resources have the most top notch healthcare their is like the Socialist healthcare , it just doesn't make sense how money is so wrapped around peoples head , it literally isn't that person they are no more now that's where Greed comes in , were made to empower each other not let each other die on the street cause they couldn't afford healthcare that the healthcare Insurance could of already did for em and just makes it look stupid on how they get paid 'EXTRA' more because they DENIED a persons health , damn near murder i say ! not everybody gets to see another day or accomplish their dreams so why not start today and give someone a hand who needs it the most ? good things come to those who are not selfish but Yet know that at the end of the day , were ALL HUMANS Nanaab (talk) 17:25, 10 January 2014 (UTC)^{— Unsigned, by: Nanaab / talk / contribs}

Socio-Economic analysis

My general feeling on the topic is "Yes, almost certainly." I probably ought to make some effort to justify that. I'm going to perform some slight of hand magic here, and argue not that a just government should provide healthcare but that a prudent government, just or otherwise, should provide healthcare. I tend to believe these two are equivalent. A prudent government is almost by definition just, providing your serfs with justice tends to be a prudent survival mechanism. Your mileage may vary.

So, where was I? Oh, right. Economics. Health care it seems to me is not an industry that can draw any great benefits from a free market, at least not what we would call a free market. Like any pure service industry, it doesn't really have any great economies of scale. Health care providers and suppliers form natural monopolies and cartels. One can hardly choose where emergency medical care is provided, and since the recipient is in general terms almost never the payer, we aren't in the habit of getting quotes and comparing prices as we would with many other artisans who provide services to us. The supply of drugs and equipment to medical practitioners are largely monopolies too, thanks to the patent system. In really free market, this would not be so, patents wouldn't exist and industrial espionage would be the order of the day. Do we want to go down that road simply to get cheaper medical care? Probably not. On the other hand, I think the WIPO treaty with India a couple of years back is the greatest injustice ever perpetrated by man, no less so for being almost totally unreported in the west. India until recently was the world's largest manufacturer of knock off generic drugs, including AIDS medications at prices the third world could afford. If I ran the world, everyone affiliated with WIPO would be tried for crimes against humanity for forcibly putting an end to that, a crime far worse in scale than Hitler's holocaust. Whatever can be said of Hitler's motives, at least he didn't kill people for corporate gain. But I digress...

To restate, health care does not and can not benefit from the free market. Given this, where does that leave us? It leaves us trying to decide what is more prudent, with no economic distinction to be made. Can we simply leave it to private industry to care for the sick in our society? I do not believe so. With pure private industry involvement, the middle and upper classes can afford reasonable standards of health care without too much impact on their lifestyle. If they choose not to pay, well, that's their lookout isn't it? The poor however, are a different story. Poor people will get an inferior standard of health care, and in some cases no health care at all. What impact does this have on society? There are a number of societally damaging consequences, which include having a whole class of people in society who are simply a breeding ground for drug resistant illnesses and a reservoir for the preservation of illnesses that one might hope to eradicate through vaccination programmes. This is to say nothing of the moral implications of failure to provide health care to any individual. The prudent society must provide adequate health care to all in society regardless of wealth and social status if they wish to have any hope of implementing social health programmes. How this is done seems to me up to the country in question to decide, there are a number of fine schemes for universal health care operated by many different countries. It does not strike me that there is an awful lot to choose between them. As a British person, I naturally prefer our NHS. Since money is never, ever mentioned at any stage of proceedings it appeals to me a great deal.

As a final, personal opinion I'd like to add that access to a decent minimum standard of health care ought to be classed as a human right. Not something that we as a nation seek to supply to our own citizens as an ideal, but that we seek to supply to the whole world as a given. I freely admit this tends to colour my thinking on the matter, so take what I've said in this mini-rant with a pinch of salt. --Jeēv☭s^{Your signature gave me epilepsy...} 19:05, 20 February 2008 (EST)

I find it a bit worrisome that in the US right now, your right to exist is directly tied to how much money you have. --Gulik 13:23, 30 March 2008 (EDT)

"Right now, your right to exist is directly tied to how much money you have", Gulik? I think the times in history when this has been otherwise is in the minority. --TheNerd 17:27 1 May 2008 (EDT)

I believe there's an economic element to health care that hasn't been brought up here: collective bargaining. When I was growing up, both of my parents were electrical engineers at a major tech company, and they got health insurance for the family through their work. The company providing the insurance covered a very large number of people, including all the employees in the health insurance program at my parents' company. As a result, our insurance company had significant leverage in negotiating prices with healthcare providers, and it seemed to do so very effectively. My mom once told me that, on average, the total price our insurance paid for our medical care was about 1/5 (one-fifth) of what the provider initially quoted us for a given doctor's visit/checkup/procedure. We then had to pay 10% of what our insurance paid as a deductible. Her impression was that healthcare costs are ridiculously inflated, and that the doctors and hospitals we did business with could still cover their costs even if they were only paid the 1/5 price our insurance negotiated with them. That means that, when they charge some hourly-wage laborer 5 times as much as they charge us, they make a profit of 80% or more. The only reason healthcare providers don't appear to be absolutely reeling it in is that most of these working-class people can't really pay the inflated prices, so they end up going bankrupt or making some other kind of agreement with the provider. I'm still in college, so I (thankfully) haven't had to deal with insurance or healthcare much on my own yet. That means I can't verify how accurate my mom's description and speculation on all this was. PalMD? OneForLogic 11:37, 17 July 2008 (EDT)

Since I'm here, I might as well chime in on the rest. I agree that focusing on preventative medicine is definitely better for society than focusing on treatment. This may very well mean that the strict economic analysis favors the action (make and sell expensive treatments) that is less favorable for society; I haven't really thought about this enough to strongly assert that I consider this true, but at a glance it seems plausible. I'm also hesitant to agree with the conspiracy theorists who believe that Big Pharma is deliberately keeping us all sick to suck up our money selling treatments, if only because they're conspiracy theorists.

I think the macroeconomic analysis might get a little more interesting if you consider the entire aggregated economy, as it also seems plausible at a glance that better pubic health means more productivity and profit for, well, basically any company that makes and sells things, as healthier people will be both better able to work productively and produce things and better able to buy them. I find this effect very interesting, as it implies that it is in the best interests of all for-profit companies to help improve public health, education, and welfare in general (meaning the general kind of "welfare", not the government kind). This kind of analysis, obviously, requires considerations of really big time-scales (think centuries, not years), generally bigger time-scales than individual companies exist in (check on any large currently-operational US corporation; how many mergers has it had in the last ten years? Or, how many companies go out of business within ten years of operation? The answer to both is generally "lots".). Anyway, I digress a little. And I have to get back to work (irony, anyone?). OneForLogic 11:56, 17 July 2008 (EDT)

A Libertarian Perspective

Seems reasonably simple really. If your view is that the role of a just government begins and ends with the responsibility to provide Rule of Law, then I think the answer is a clear "no." I don't think any degree of word-mincing can place health care under the domain of the Rule of Law. Therefore I don't believe Healthcare is the domain of a just government.

Counter-arguments would need to make at least one of two cases: that the role of a just government should exceed the Rule of Law, or that healthcare is, in fact, covered by Rule of Law. I think the former is more likely to be an interesting subject of debate, while the latter is more likely to be an annoying debate about semantics.

But even this is missing the massive elephant in the room, i.e. what exactly is a "Just Government?" I'm pretty sure that question has been the subject of vigorous debate since at least the earliest of the greeks. Even so, I think at least a statement of the premise of what constitutes a just government is a necessary starting point for these arguments. I have not seen any clearly stated so far.

Cheers, BlueSprite 02:04, 1 December 2008 (EST)

The assumption that government's only role is to provide the rule of law is a rather big step to make. I've always believed that the role of government is to do for people what people can't do for themselves. The Libertarian view is fine for rich people, but from behind the veil of ignorance the rational view is that government should provide more than just a group of strong-arms to break up fights. Wazza (Not Wazzock, Wazza)^{Approach the Presence} 02:15, 1 December 2008 (EST)

It is a rather large step to make, you're right. Why is it the rational view that "government should provide more than just a group of strong-arms to break up fights?" Further, I assume you're trying to characterize Rule of Law as such. That is not quite the case. It covers a great many things, such as contract law, penal codes, restitution and so forth. It also covers the the establishment of a military to prevent the intervention of foreign law. In any case, sorry to make a meal of this point, but in my opinion this is what this question is really asking: why should the role of government extend beyond the rule of law? BlueSprite 12:55, 1 December 2008 (EST)

It's a very big step to make. One person providing their own healthcare is all well and good, but can one person afford an MRI instrument? No. Can thousands or millions of people contributing a fairly small amount? Yes, and then it's available for all. I've always viewed government as basically there to protect the people too, because there is so much that can be done when people pool together rather than go gung-ho by themselves. I'm not saying that that's what any one has at the moment working as effectively as it can, but it's damn well better than telling people to deal with it themselves. I'm sure it's a perfectly acceptable view to say that people can pay their own way for health when you're the one who's rich and can personally afford the running costs of some big ass pieces of diagnostic equipment and the expense of medical and surgical training. ArmondikoV^{d hominem} 04:55, 1 December 2008 (EST)

I'm not sure which point of view you're arguing. What is "telling people to deal with it themselves?" Did someone make that argument? BlueSprite 12:55, 1 December 2008 (EST)

If your view is that the role of a just government begins and ends with the responsibility to provide Rule of Law, then I think the answer is a clear "no." What if you're a filthy Altruist like me, who thinks that the government has a minimal responsibility to do things like provide relief to flooded cities, stop forest fires, build roads, maintain a standing army, and keep people from DYING IN THE STREETS? --Gulik 14:07, 4 December 2008 (EST)

If you mean Kantian Altruism, then all I can say is that I reject the principle that I must seek the good of others before I look after myself. Especially if I am forced to do so by the government. If you mean something else, then I don't know. In general, I'm not impressed by emotional appeals.

In any case, Rule of Law generally applies to the maintenance of standing armies. You are right to correct me for leaving out response to natural disasters, that was an oversight on my part. The obligation of governments to build roads, though I generally accept it, is far from established in my view. BlueSprite 12:02, 7 December 2008 (EST)

If your view is that the role of a just government begins and ends with the responsibility to provide Rule of Law, then I think the answer is a clear "no." One may readily take this statement to imply that government has a duty to take any action necessary to prevent the breakdown of social order, and encourage the safety of its' citizens. The rapid spread of disease, aided by a lack of health care among a large enough section of the population, may certainly expose the population of a state to unnecessary risk of life and limb. This is because health care is an example of a good that increases in efficiency as it is used by a larger part of the population: if everyone is going to the doctor when they become ill, the chance of them spreading infection is minimized. Conversely, allowing a large part of the citizenry to mix with the general population with an untreated disease is, in quantitative impact to both production and casualties, little different than allowing a foreign power to plunder a city. Clayton0230 00:35, 12 April 2009 (EDT)

Re: Various criticisms of the Free Market w.r.t. Health Care

When discussing the free market and making the case for it failing in a certain regard, one has to bear in mind two critical things:

1) Free markets are not just about doing things more efficiently. It's about freedom. Everyone who participates in a transaction in the free market does so because they think they will be better off than they would be had they not made said transaction. In cases where the government enforces distribution of wealth/goods, this is not the case, i.e. some individual's right to choose is ignored, and so is their decision about whether or not they will be better off after a transaction has taken place. That is to say, some people will be forced to transact in spite of their desire not to. This is called coercion, and it is immoral. Hence, any case to be made for distribution of wealth/goods through something other than the free market *must* make the case that it is moral to coerce transactions of a certain type. Further, such a case should also demonstrate that it is possible to coerce the desired type of transaction without coercing others, or that these undesired coercions are nevertheless excusable given the stakes.

2) Free markets are not perfect. No one with intelligence should assert that free markets are perfectly efficient, or that they will always maximize wealth. What they do well, however, is allow people who observe waste or inefficiency who have spines to profit by eliminating that waste. Hence it is not a sufficient argument against a free market to say that inefficiencies exist. Rather, saying that inefficiencies exist is generally a statement that there is an opportunity for someone to make money. Indeed, to say that the free market cannot do something is to say that no individual with ingenuity can find a way to make money by increasing efficiency. This is a very strong statement, that touches on why many people are justly suspicious of a government's ability to take the free market's place. That is, in a government solution, one person or group of people are given the power of law to implement a particular solution which cannot be uprooted but by revision of the law. In a free market, *anyone* can rewrite the system. In short, to depend on government rather than the free market is to conclude that no amount of ingenuity can *ever* create a more efficient system. This is an extremely strong assertion, and one that should not be made without total certainty.

Hence my conclusion: if in doubt, leave it to the free market.

Please remember that a free market is not just a system of incentives. It is not sufficient to show that no one has found an incentive to the desired outcome to say that a market cannot solve a problem. Rather, a market is statement about the freedom of individuals to pursue their own ends, to come up with ideas, and to try those ideas at their own risk. Entrusting something to the government is not just about providing the "right incentive to get things done," it's about eliminating a fount of ideas and the freedom to implement them, as well as to profit by them.

Treating the Symptoms

I think many don't realize that what is essentially at the root of the health care problem in the United States (and many other countries) is, in fact, a shortage. There is not sufficient medicine to treat all diseases, there are not sufficient doctors to diagnose and prescribe. In short, there is not sufficient medical infrastructure to deal with the health care needs of the world, or of the US in particular.

Now, the question is, what to do about it? I think weather or not it is a right misses the point. You cannot simply declare something that is in short supply to be a right and expect justice to cause the shortage to disappear. Instead, you have two choices that are immediate and obvious: a socialist approach to distribution (by which I mean one that eliminates the capacity of the patient to pay as a factor in determining whether or not they are treated), and a free market approach.

Is one more just than the other? The injustice, as far as I can tell from most arguments, is that people who need treatment go untreated. But neither approach really addresses this. In free market systems, the poor go untreated. In socialist systems, those at the back of the line go untreated. In mixed systems, you often get both.

So why prefer one over the other? There are a few observations to be made here. One is that those by attaching a reasonable cost to something as determined by the free market, you avoid the classic price fixing leading to a shortage scenario, or, put differently, you force people to come to a decision about how badly they really need something and therefore conserve resources. In a socialist system, there is no such pressure. Indeed, if you hand out something for free, generally the incentive becomes to glut on it to the greatest degree permissible before it runs out. Whether this necessarily applies to socialist style health care, I don't know.

In short, the discussion between socialism as a means to justice in the health care generally amounts to a treatment of the symptoms of the problem, rather than the cause.

Treating the Cause

Should a just government provide health care to its citizens? I would argue that it is the role of government to guarantee the freedom of its citizens to work out their own solutions, rather than have solutions imposed on them.

That it is possible that a free market system cannot provide adequate health care is a position I am willing to accept, because the subject is so vastly complex that I cannot form a complete conclusion without vastly more study of the subject than I have thus far done.

Nevertheless, it is my opinion that it is horribly dangerous to focus on socialist measures (i.e. allowing the government to assume command of the industry), because that does not treat the cause. Rather, I am waiting for public discourse to get around to discussing the cause, i.e. how to create more medical infrastructure. It is my belief that reliance on the free market will eventually realize such a situation, and in my opinion it would be just and good to reward someone materially for causing this to happen.

Some observations that lead me to believe there is room for free market to ameliorate the present situation:

• If Insurance companies are making economic profits, then clearly the industry has not matured and there is room for competition.
• If medical equipment is too expensive, then someone must be making profits that are fully economic profits, and there must therefore be room for better production process, that is to say, to increase the availability of medical infrastructure.
• Inventions of life-saving drugs, equipment, and techniques continue to be made in the free market with the intention of generating profits for the inventor.
• Medical tourism is becoming an industry that offsets the expense of insurance companies, reducing costs for patients and rewarding the increase of medical capability worldwide.
• Price fixation leading to shortages and waste continues to be a problem in countries with completely free health care.
• I have personally had medicine sold to me in exploitative fashions that have resulted in higher costs than was appropriate for me to pay. I have since eliminated a great deal of those costs by taking the time to shop around for my medicine and double checking the advice I am given. This leads me to believe that taking the time to think things through is something that is still rewarded by the market.

BlueSprite 14:57, 2 December 2008 (EST)

You know, just about every nation in the European Union (plus Canada) have succumbed to the Dread Spectre of StalinCare^tm, and most of their citizens who've visited (or resided) in the US don't think our system is working very well in comparison.

Interestingly, having lived in Europe for 8 years, I got to know certain failures of socialist health care systems very well. For instance, competence, at least in the country I lived in, was generally not well regarded, on average. Long wait lists were common (probably still are, but I don't live there anymore). What the country in question did well was providing GP level care to everyone on an economic basis. But if you think there aren't serious problems with health care systems in Europe, I invite you to dig deeper. There are problems, many of them are not inherent to the US system. BlueSprite 18:58, 2 December 2008 (EST)

Free Market Economics^tm breaks down a bit when dealing with healthcare, for a simple reason: WE ONLY LIVE ONCE. If my car turns out to be a lemon, I can trade it in or roll it off a cliff. If I come down with Midline Lethal Granuloma, there isn't much I can do except hope Jerry Falwell was wrong, but it'd be nice if I could die in agony without having to bankrupt my family along the way.

I don't see how living once affects any particular argument. Medicine is a scarce resource. Medical equipment is generally scarce, and so is the opportunity to use it. Similarly with doctor's time. Who gets what can be solved by eliminating/mitigating the individual's right to choose, or by free market competition. Medicine, medical equipment and professionals are not the only thing that humans must have in order to live that is scarce. BlueSprite 18:58, 2 December 2008 (EST)

Fun fact: If they were private citizens, neither Dick Cheney nor John McCain could get health insurance. How come Socialized Medicine is good enough for them, but not us Filthy Commoners?--Gulik 16:23, 2 December 2008 (EST)

Cute, but not convincing. BlueSprite 18:58, 2 December 2008 (EST)

Socialised Medicene V Nationalised Healthcare?

I think it really boils down to how the healthcare system should be run. Does it work better under a private ownership system or under state control? Socialised medicene occurs when the state bears the cost of healthcare - but doesn't directly provide the service, except in some circumstances. I think France opts for this. Nationalised healthcare is when the state controls the supply of healthcare to the people - although in most cases, private systems work parallel to the public system, undermining it somewhat. In the case of Britain.

Personally, in the US case, it would have to be a case of socialised medicene as the government couldn't possibly allocate the resources to full nationalisation, and neither would it be in their ethos (Despite the recent 'pragmatism' towards financial institutions.) MarcusCicero 06:44, 1 December 2008 (EST)

Not the government

The first thing you have to consider about a government is that, regardless of system, no government can ever be fully "just", which leads to the first problem of a negative before the argument can even get started. Even if a just government could be formed, eventually, that government would be filled with self-serving people, rending the previous "just" label irrelevant. Because of this, I believe it is not the government that should be what provides the healthcare, but rather the current hospital system that should continue providing the already existing healthcare.

The problem with the existing healthcare is the costs that are incurred upon people in the system. As per capitalism, hospitals are forced to charge those absurd prices in an attempt to make up for the cost of malpractice insurance and frivolous lawsuits. My honest belief is that the best way to provide medical coverage for all is not to have the government provide it, but have the government regulate insurance companies and allow the dismissal of frivolous lawsuits, which would allow the cost of medical treatment to decrease. --V

A government full of self-serving people can still be just, so long as there's some sort of system for making them accountable to everyone else, so that it's in their best interest to be just in order to keep their job. But there's nothing like that, is there? On the other hand, the private companies have no incentive to be fair except that put on them by the government and competition (and given their size, competition is difficult, and complete information almost impossible), so even if it's privatised it comes back to whether or not the government is just. Wazza (Not Wazzock, Wazza)^{Approach the Presence} 16:45, 1 December 2008 (EST)

That is very true, a democracy is, at its core, accountable to the people, and the people are supposed to regulate corrupt officals by not re-electing them. The problem is that even in a democracy, officals become bent. Even when we manage to elect a clean offical, how long do you think the voice of the people lasts against the paycheck of lobbyists? When was the last time the House of Senate or Reps expelled someone for poor conduct, such as, say, the aforementioned bribery or abuse of power? Call me a pessimist, if you wish, but a government naturally leans towards unjust, or at least, corrupt, and it is this corruption that makes me unwilling to trust a particular government with regulating healthcare. --V

If I'm going to have a soulless, uncaring bureaucracy deciding whether I live or die, I'd rather it be a soulless, uncaring bureaucracy that doesn't stand to make better profits by letting me die in agony. --Gulik 16:56, 1 December 2008 (EST)

And where does this "Government Can't Do ANYTHING Right" meme come from? With Libertarians it makes some sense, since they think The Free Market is God's smarter younger brother, but with Conservatives (most of whom are in favor of wars and the death penalty), you get the amusing situation of people who trust the govenment to kill, but not to spend money. --Gulik 16:56, 1 December 2008 (EST)

I think thats an innately unfair caricature of conservatives. The Conservative coalition has always been based on the principle of equality of opportunity and the 'self made man' ideal. I will admit it doesn't help their appeal when a corporate billionaire spouts these grand principles, from his family background of obscene wealth. MarcusCicero 18:15, 1 December 2008 (EST)

Is it really equality of opportunity if you're sick all your life from not getting proper treatment as a child? Wazza (Not Wazzock, Wazza)^{Approach the Presence} 08:25, 2 December 2008 (EST)

Well, you're just getting the opportunity you deserve. Remember, if you're poor, it's because God hates you. --Gulik 14:39, 2 December 2008 (EST)

Which is the main difference between classical liberals and neoliberals. They both, however, would not support getting healthcare to poor people, which is why I'm a modern liberal. Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 19:04, 2 December 2008 (EST)

I call straw man =| I doubt there are many people that would say that poverty is a result of the hatred of God. In any case, Equal opportunity refers to opportunity before the law, so yes, if you're sick all your life, it's still equal opportunity. BlueSprite 19:11, 2 December 2008 (EST)

They're out there. As I said, it's an old view, but some people still support it. In any case, we were joking, you joyless, selfish bastard. Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 19:23, 2 December 2008 (EST)

Jokes are communist =| BlueSprite 14:07, 7 December 2008 (EST)

Another Question

If we accept that 1) everyone should have a right to health care, and that 2) there is a shortage of health care, and that 3) wealth is not an appropriate reason to discriminate between who gets access and who does not, then on what basis should we discriminate? BlueSprite 19:11, 2 December 2008 (EST)

coming from australia where we have socialised medicine, i believe the discrimination should be based on self help and history. by this i mean people that try to help themself, get moved higher up on the list. for example, in australia regarding organ transplants, if you smoke, or still drink heavily then you are pushed further down the list, using the logic of "ïf your not going to help yourself, why should the goverment?" this then raises the issue of accidnets involving a moment of stupididty. during my placement with the Queensland ambulance service, we attended a car accident where two younge men had rolled their car whilst high on E and alcohol. these peoples actions have caused their prediciment, why should we help? i personally believe that mistakes happen and they should be helped, but if you saw the same people a year on, in the same sort of situation, it then raises the question, should we help again?Hoare 08:25, 20 March 2009 (EDT)

There is only one fair way to "discriminate" in such a case: a lottery. If people start being punished in this manner for doing things the State disapproves of, such as smoking and drinking, they will be able to start blaming the State for their own shortcomings. ListenerX^TalkerX 11:32, 20 March 2009 (EDT)

a not the government responsibilty fi provide free health fi the people them. ^{— Unsigned, by: 208.131.185.143 / talk / contribs} 14:37, 10 March 2010 (UTC)

But the State has a justifiable reason to disapprove of these things. For example, there are two patients of exactly the same age, sex, socioeconomic group, ethnicity, the same in every way that would affect their health. So who should be higher on the list of recipients: the person who smokes a pack and drinks a sixpack every day, or the person who drinks occasionally (never to excess) and has never smoked?

The State has an interest in ensuring that whatever it supplies is used to greatest effect. Placing smokers and heavy drinkers on a lower rank than nonsmokers and non-to-moderate drinkers is entirely reasonable. The smoker is not being 'punished' for anything, they are merely being recognised as a less worthy investment of that organ than the nonsmoker is.

Veil of Ignorance

I'm sure some of you have heard of this philosophical concept. The idea is, there's a veil behind which you can go. While you're behind it, you can completely reorder society in any way you like, but you will be ignorant of where in society you will have to live when you come out. In other words, you can organise things so that it'll be great for rich people, because you're a rich person when you go in, then come out and find you're living in a slum. It's used for determining what the fairest kind of society would be, without bias from your own position in society (hopefully). Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 19:04, 2 December 2008 (EST)

I am familiar with this concept. There are two basic answers to this: a society in which everyone has the same amount of things, and a society in which everyone is afforded the freedom to alter their circumstances. I find the latter more appealing, since the former denies freedom. BlueSprite 19:14, 2 December 2008 (EST)

Or the third option, the one practised in most states: a society with a robust social safety net (providing people with other options if they fail in the practise of their freedom), robust social services (so that everyone is healthy, well-fed and has access to resources in order to use their freedom) and also the freedom to follow your own path. NZ, where I come from, has national healthcare AND private healthcare, the former being available to all, and the latter offering better service for a higher price. We also have a lot of entrepreneurs, using their freedom to do what they want to do in life. My brother in law is one. He's also a strong supporter of the liberal side of our government and willing to pay higher taxes to support our social services, because he knows that if he was poor, he would want those to be there. He's not poor and so he has other options, but he can feel these strange human emotions called empathy and sympathy and so support things that other people need even at slight expense to himself. I, the rest of my family, and a lot of people I know support this view. It works, too; NZ is doing pretty well right now, despite the economic problems. Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 19:22, 2 December 2008 (EST)

Please refrain from implying that I do not have feelings. I know little about the case of new zealand, but of course I have to concede that it was an oversight on my part that the choice is not discrete and twofold, but rather a continuum bounded by the extremes I mentioned. Of course, the question then is exactly how much of which do we use and for what. That is a complex question. At this time, I'm not prepared to argue that a solution should be 100% free market. Neither am I willing to accept something that is 100% or even mostly socialist. My purpose thus far in arguing has been to counter many arguments that have been made against the free market that I found were simplistic. Clearly there's room for common ground here, but I'll need to consider my position more carefully if I were to enunciate a clear view of exactly what I think is a good balance. BlueSprite 19:28, 2 December 2008 (EST)

You're espousing a view which has been succinctly boiled down by someone I admire as "I want the freedom to be rich, and you can have the freedom to go starve". It's hard to see where empathy comes into your view. In NZ, taxation is I believe somewhere between 30 and 40 percent. From that the government maintains a wide range of social programs including interest-free student loans (a nice compromise between paying for all tuition and making people pay for the benefits of education themselves). There's a social security program which, admittedly, is often abused by people who don't wish to work, but cutting it off probably wouldn't make them work, and a lot of people who genuinely need it rely on it too. I'm not going to say our system is perfect, but everyone's housed, no one starves, there's general access to healthcare and education and you have the freedom to do what you want with your life, within the limits of the law. We sometimes get accused of a nanny state, but it's better that people get looked after than that they try to find a way to look after themselves. The crime rate here is fairly low. Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 19:39, 2 December 2008 (EST)

Again, I know little about NZ, clearly it will benefit me to look into it. In the meantime, I will address the personal insult. I clearly do have feelings, or I wouldn't ask you to respect them. If you're rational, then this should be obvious to you. Instead, you hope to imply that my having feelings should bring me around to your point of view. This is clearly silly. To illustrate, while my view can be boiled down to what you said, it can also be boiled down to: "I want the freedom to get rich for both of us, knowing that freedom implies responsibility, and the risk of failure, because I do not wish to have things stolen from me by individual or by state." Surely we can agree that we'll get a more interesting debate if we leave the bile of personal insult out of it, no? Unless, of course, you're not interested in debate, but rather in an opportunity to subject those you hate to clever quips. BlueSprite 19:50, 2 December 2008 (EST)

2¢

Presumably one would have no qualms about providing health and welfare support for one's husband/wife & children? How about parents, grandparents, brothers sisters? How about nephews & nieces? Nephews'/nieces' wives/husbands? The friend or guy next door who falls and injures himself leaving his family unsupported? You see where I'm going? When do you stop, assuming you've started?
Also don't forget "rich" is a comparative term - it needs "poor" to remain valid. In a decent society everyone would be "rich", as far as health care is considered. So the problem shouldn't arise.
In the kind of libertarian society seen many times in science fiction, the "rich" live long, healthy lives in walled enclaves served by the ravening hordes of "poor". If that's what you want then good luck, but it's not my ideal world. _and marmite 20:21, 2 December 2008 (EST)

Sloppy reasoning. First, it depends on circumstances. It would depend on what I have, what is needed, and who it is for me to decide whether or not I have a qualm. If someone got into a car accident a block over that I didn't know and needed extensive surgery to ever walk again, I would probably feel bad, and be willing to chip in, but I wouldn't be willing to break my bank to do it. Of course, this is a fundamentally different situation. You're giving me a choice (at least I think you are). I object to being coerced into assisting people with their problems. I think it is objectionable to forced into anything unless as part of a punishment administered through due process of law. It is not ok to steal, just because the majority of people think it is. It is not ok to steal from someone just because they have something. I therefore object to having things stolen from me.

I don't see how the observation that rich contrasts with poor affects any particular argument. In a decent society, everyone would live in houses built from gold bricks, be perfectly sculpted physically, have enough food to eat, and keep 300 anteaters as pets if they wished, and be able to talk long walks on the surface of the sun and return home with a nice tan. Wishing for the impossible doesn't interest me. I hope you're not saying that because you saw something in science fiction that was horrible, you are drawing a conclusion about how society should act. BlueSprite 20:35, 2 December 2008 (EST)

In reverse order: gated communities? Aren't we heading that way, where the rich have their own patches of real estate and the poor are allowed in to service them?

The rich/poor dichotomy is valid because the libertarian mindset seems to thrive on it, without someone to look down on they are nothing, I suspect that this is a human failing - we all want to feel superior in some way - for example: me by decrying your apparent lack of empathy and you by decrying my lack of logic.

The reasoning is sloppy, granted, but no-one implied a bank breaking exercise. Presumably you (not personally of course) achieved your wealth by exploiting (I know that's a loaded word) others in some way either through ingenuity, accident of birth or some fortunate happenstance. You owe it to them to repay this exploitation. _and marmite 21:06, 2 December 2008 (EST)

So there are gated communities. So what? I own a lavalamp. Somebody is poor. This is argument by non-sequitor, presumably intended to induce an emotional response. I'm guessing it's that I remain unconvinced by this non-argument that you keep accusing me of not having feelings. I can have different emotional responses to do different things than you do, but I still have feelings. And fyi, I do feel bad that some people are poor. I also feel bad that some people get shot in the face and die. But applying the same argument, I should be outraged at myself for being alive? Don't be absurd. Think your position through.

"Libertarians are nothing without someone to look down on, therefore the fact that rich and poor are not the same thing is a valid point." I have no idea what you're talking about. I don't know what this is supposed to be in evidence of. It has no structure that I can analyze. I don't know what your point is. That you appear to be angry at libertarians in some form is all that I can deduce from this statement. I am sorry that you are angry at libertarians. Are you interested in debate or not?

Why should we presume that I achieved my wealth by exploiting anyone? If my wealth was achieved within the law, then voluntary trades took place in which both parties felt they were better off. If that is the case, then the fact that I have accrued wealth is evidence that someone else benefitted. Every dollar I earn is evidence of my having helped someone. I think the account is even. And why should I not assume a bank breaking exercise? The basic point I've tried to make on this page is that how you distribute health care does not address how much health care you have to distribute, or more simply: "There is a shortage, not a free market conspiracy." BlueSprite 21:28, 2 December 2008 (EST)

I was about to pinch my nose, close my eyes and leap into this, but stumbled over "Answers should prove why," right at the start and never really got going again. Prove why? I have a tee shirt, made specially for me by my daughter that states, " There is not why.." Carptrash 21:51, 2 December 2008 (EST)

Blue, you talk about the government stealing from you, but you apparently have no objection to using what the government provides, things like roads and other infrastructure. I'd love to see a free state actually set up so we could contrast it with one with a proper level of taxation. And yes, I do fully intend to insult you. I find your political views disgustingly selfish. I'm sorry if that offends you, but I feel it's more honest to tell you straight out. And if I didn't think my views were rational, I wouldn't support them. And your statement about there being a healthcare shortage is a non sequitur. If there were government funding, supply would be increased to meet demand. It's just that right now there isn't a demand for medical equipment so it's not mass-produced the way cars are. Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 22:50, 2 December 2008 (EST)

Of course you think your point of view is rational. The point being that rational people can't disagree? For things like roads, I pay through my nose to use them, as where I live at the moment it's very difficult to get around without using toll roads. Nevertheless, I do pay taxes. And although I'm not thoroughly convinced public roads are a good idea, I generally am willing to support them. Interestingly, can a rich man really take that much more advantage of a road than a poor man? And who will pay more for a road, even with a flat, or single grade tax?

By the way, I'd like to point out the argument you've just made: A person steals from you. That person gives you something in return. You use what that person gave you. Therefore having something stolen from you is legitimate. For a little reductio ad absurdum, let's try this: Your person is stolen and you are put into slavery. You are given food every morning and evening and allowed to use the latrine. You make use of these amenities. Therefore your slavery is legitimate. Sir, I beg to differ.

It doesn't bother me that you disagree with me. I think your brand of liberalism is selfish in its own way, in that you believe it's ok to take from people without their consent for your benefit, but you think this is ok just because you happen to be willing to give something up too. Just less, of course. And here I descend into the realm of insults, but I hope to at least illustrate that political debate can always be characterized in menacing ways, and that it is silly to use insults where logic would be more effective. If we follow the path of the insult, what possibility is there to arrive at a conclusion? Whoever is more upset leaves? I'm offering you the opportunity to change my mind, in exchange for a little common courtesy and the opportunity to change yours. This might be a strange request if we were not in a place of public debate under the auspices of rational discussion.

That would not be a non sequitur but rather made irrelevant by a result of government funding, if we accept it as true. By the way, thank you for correcting my spelling. In any case, the issue of a shortage is an essential one when discussing how to provide health care, which surely we must do if we are going to posit that just governments must provide it.

What I've seen in countries with socialist health care systems has not led me to believe that their approaches generally lead to amelioration of shortages. Government funding also doesn't have the greatest of track records, but at least we may be on track to having the right discussion now. Government funding for training doctors, building medical equipment and manufacturing essential medicines is generally more attractive to me than just funding for the patient so everyone can have a piece of what there is.

Now as for selfishness, I don't actually see what's wrong with selfishness. I have every right to build a better life for myself, and would deny no one else that right either. It is only violation of the law and aggression against others that bothers me. And I think it is a more than fair point that tax is theft. It is, in fact, the confiscation of property backed by the threat of force. Now of course it is impossible if you accept even just the rule of law to escape that taxes are necessary. But it should nevertheless be remembered that tax is theft, and that therefore governments should do as little of it as possible. I am open to some social programs, but in my opinion, the case must be made that said social program is better off in the hands of the government than in the hands of individuals, and that it is worth stealing people's money to do it. I don't think that's an unfair point. I believe, as Thomas Paine put it that: "government is at best a necessary evil, and at worst an intolerable one." His point being that government necessarily means coercion, that coercion is wrong, that coercion is also necessary, and that therefore we should coerce, but strive to do it as little as possible. BlueSprite 00:06, 3 December 2008 (EST)

EZ Edit Button

You make the assumption that taxation is theft, and make the analogy of slavery. But slavery doesn't give you back goods equal to the labour you give. You're quite welcome to leave the parts of the world where people are taxed, if you should so desire. I understand Somalia won't tax you at all, and you'll be entirely free to do whatever you want... but if you want the benefits of living in our society, you have to subscribe to the social contract, which includes paying taxes and getting the benefits in return.

I was particularly interested by your mention of toll roads. Under a libertarian minimalist government, all roads would be tolled, because they'd all be built by private companies according to demand. Is that system preferable to being taxed, and then having freedom over all the roads? I mean, I presume you've lived under both systems, since there are still places even in Bush Administration US where roads are free... so which did you prefer? Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 01:59, 3 December 2008 (EST)

I made no such assumption. I assumed that tax will be taken from someone regardless of their consent, and that if resistance is given such seizure is ultimately backed by force. This fits the definition of theft. Somalia fails because there is no Rule of Law. Please note that I conceded that tax is necessary, and that I am not arguing in favor of zero taxes. I am arguing in favor of minimizing taxes because they are coercive by nature. What you say about being able vote with your feet, as it were, is a valid point. Nevertheless, I don't think any amount of verbal acrobatics can lead to the conclusion that taxes are not coercive by nature. Since I regard coercion as necessary but to be avoided where possible, I am left with the conclusion that it is reasonable and appropriate to tax, but that it should be done minimally.

I'm not sure it's safe to say that a libertarian minimalist government would necessarily require all roads to be tolled. I think I see what you're saying, but in any case, I'm of the opinion that taxes for roads is not unreasonable because of how easy it is to monopolize routes. I am not thoroughly convinced of this, but for the sake of this debate, I'll use that as my position, and possibly challenge it elsewhere. I think it is still constructive to apply a libertarian perspective, even accepting taxes for roads, to the consideration of social programs. Especially one as expensive as health care.

If I may risk speaking for the both of us, I think we've established that there's probably an answer somewhere in the continuum of socialism vs. libertarianism that is probably appropriate for this subject. I think it would be sensible to acknowledge that rational people can disagree on exactly how much is appropriate.

As for the rest of it, I need to think about it. I'm unable to articulate a clear vision of what I think a "just government" should do with respect to healthcare at this time. Thank you for a spirited debate, and I'm sure I'll have more to say on this subject later. BlueSprite 03:07, 3 December 2008 (EST)

Likewise. Now for my final notes: pure Socialism isn't a position I'm prepared to support either, but at the same time I will always feel that government should help people do what they can't do for themselves, and one of those things is affordable healthcare. Whether that then necessitates the government paying for anything I don't know; a hybrid system with both nationalized and private healthcare seems a good compromise but requires a large initial investment to set up, whereas insurance-based healthcare is easier to set up but lets people fall through the cracks. Somewhere in between there is probably a practical and satisfying answer for the US. Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 04:40, 3 December 2008 (EST)

A free-market argument for government-financed health care

On the subject of government-financed health care, arguments that start out from the premise of a free market usually end in opposition to that sort of health care. They usually fall into one of these two categories:

• Arguments that current government-financed health-care systems are failures.
• Refutations of arguments made by left-wingers in favor of government-financed health care, such as that "the government has an obligation to further social justice by ensuring that everyone receives proper health care," or "we all have an obligation to look after each other."

There are also arguments, such as the above by "BlueSprite," which, instead of arguing from the premise of a free market, argue from a stronger set of principles of which a free market is a logical conclusion, usually a notion of extralegal, sacrosanct property rights.

The first category of arguments above are usually anecdotes of people who got a raw deal from a government-financed health care system. There are also such anecdotes for the case of a private system, which indicates that the existence of these problems has nothing to do with whether or not the government finances the health care.

I largely accept the soundness of the second category of arguments, supporter of capitalism that I am, but that does not rule out the left-wingers' conclusions being correct in this case.

I put that if certain sorts of health care are not financed by the government, they act as a counterexample to one of the premises of a free market, viz., that a participant in that market gets to choose with whom to trade. If any threats are made against a person's life or health in order to force a certain trade, it is not called trade, but extortion.

Visits to the emergency room of a hospital are very often not made voluntarily, but under pain of death. Demanding payment in this case is similar to walking up to someone hanging on the edge of a cliff, helping them up, and then demanding $1000 for the help. Even allowing that a person has the right to do this, that does not make an argument that a tax-funded police officer should not drive out to the cliff and help the cliff-hanger up at no charge.

Of course, it also violates free-market principles if doctors are not free to offer their services in a private practice and patients are not free, when it is possible, to choose their doctors. A government-financed health care system based on free-market principles would probably look very different from one based on, e.g., socialist principles.

ListenerX 13:59, 3 December 2008 (EST)

ListenerX, I find your observations crystallize some ob my ambiguously ambivalent feelings on the subject, so that you for your insight. That said, and while there is a lot in what you say, there is a serious flaw in the argument.

Developing a general theory for how to deal with catastrophes in a free society is not something I have worked out fully, but I will say this: that the free market is a good and just way to plan. Indeed the free market generally rewards good planning. If you isolate your scenario to the point of being struck ill, then your argument has merit. But this ignores that everyone has the opportunity, and I would say obligation as well, to plan for their own futures. It is hard to know things like whether or not a meteor will fall on your house, but it is easy to infer that everyone is likely to get sick. Entering an agreement beforehand with a medical professional, a medical service, or some representative thereof I think is something that can prevent the extortionate scenario you describe. In any nation that enforces contracts well, I think eliminating or mitigating an individuals right to shop for medical care arrangements is something I would be suspicious of as possibly damaging rather than improving quality of health care as well increasing tax burdens.

Though of course it is less a life and death situation, I think what you're describing is akin to being checked through airport security. If you didn't plan ahead, forgot to pack a lunch or eat before you arrive, you're going to pay through the nose. BlueSprite 12:46, 6 December 2008 (EST)

It is also possible to buy insurance against robbery, and to plan on getting robbed. This is not unreasonable in many nearly-lawless areas. Notwithstanding, robbery of an insured and prepared person is no less coercive than robbery of an uninsured and unprepared person, and one would expect the government to go after the robber in either case.

I agree with you, however, that the government should not regulate private insurance firms or private medical practices as part of financing health care. Then, if when the government-financed system does not do its job properly, the private sector can rise to the challenge, in a similar manner to private schools in an environment dominated by public schools. ListenerX^TalkerX 18:59, 6 December 2008 (EST)

Well, there should be enough regulation to prevent people from getting completely ripped off... though the government shouldn't interfere in competition between private corporations beyond that protective role. The problem with insurance is that you can't tell if the service is good until you're in a place where you're more or less at the insurance company's mercy.

One thing that should be noted is that many poor people might like to plan for the future, but simply don't have the resources to be able to buy insurance as well as doing other things like eating and having shelter. That's where the government should be aiming with even the most basic healthcare plan. Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 19:40, 6 December 2008 (EST)

The sort of regulation I was talking about was the sort applied specifically to insurance companies and private medical practices; I did not mean that insurance companies should be allowed to, e.g., defraud people, if that was what you read into it. ListenerX^TalkerX 23:34, 6 December 2008 (EST)

It does seem that many libertarians and palaeoconservatives would prefer to remove all regulation; witness the recent wall street crash, which was the result of lack of regulation and lost people a lot of money. I have no objection to removing regulation that isn't about consumer protection, however, so long as there is a government option which provides people with basic services. Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 01:59, 7 December 2008 (EST)

Actually, no. It came from the failure of people selling these instruments to account for the possibility that loan failure can indeed be statistically correlated. And from the failure of those who invested to realize just how leveraged and therefore risky their position was. And from the failure of those receiving loans to realize that they could not afford them. And from the failure of those who purchased loans and securitized them to realize that paying people per loan is a stupid model if you want good loans. In short, it resulted from stupidity, and nearly everyone who is losing is complicit. I regard this as business as normal for a free market. A large number of people made a large number of very bad decisions, and now they are being penalized. Even so, I think a fair number of distortions can be traced back to the interference of the federal government, particularly the federal reserve.

In any case, getting back to ListenerX's point: I think robbery is very different from getting sick. Everyone gets sick. Planning for it therefore planning for a basic need. In a robbery, someone is guilty of a violation of the Rule of Law, and therefore redress of grievance through the courts/police is appropriate. It is for things like robbery that government exists. There is an element of duress in sickness, and also of catastrophe in the sense that illness is less predictable and frequently more serious and difficult to solve than, say, hunger. But for me, it seems clear that a just system must preserve an individuals personal responsibility to seek for themselves the best care they can, and to plan for the future. But, as you pointed out, there are situations in which a just system should address the catastrophic that causes duress. If someone gets shot in the gut, hit by a car, or has a stroke at 20, let's get them to the hospital and treat them before we start discussing payment. How to strike that balance is something I don't really understand yet, but it's clear to me that there must be a balance that preserves these elements. BlueSprite 11:56, 7 December 2008 (EST)

It is quite true that the law-breaking robber has no analogue in the case of people who die through inability to pay for medical care; this is probably the weakest part of my initial argument. But my analogy of the robber was not intended to argue that the government should finance health care; it was meant to counter your statement that my initial argument was possibly valid if people could not plan ahead and buy insurance, but if they could, it was invalid.

Also, although less people get robbed than get sick, in some areas, enough people do get robbed that people who do not plan ahead in case they do are considered imprudent, which makes it a roughly analogous case. ListenerX^TalkerX 13:39, 7 December 2008 (EST)

Am I correct in inferring that you would not make the case that a just government should excuse the individual from planning for their own interests entirely w.r.t. health care? If so, do you have any light to shed on what you think would make a good balance? BlueSprite 14:10, 7 December 2008 (EST)

Firstly, I do not believe in holding governments to extralegal standards of "justice." Many bloodthirsty, tyrannical systems (e.g., Christendom, communism) talked big about "justice," etc., used that rhetoric in aid of overthrowing the systems they replaced, and then failed to deliver on their own promises. I believe that the only standards to which governments should be held is their own: Do they do effectively what they set out to do?

If that is the case, then you wish to inspect the title of this page, sir. I was attempting to frame my answer with respect to the original question, which is "what should a just government do?" But I think you are simply reading more into my statement than was intended. By "just", I interpret to mean effective and founded on moral principles, which in my case is generally a fairly classically liberal set of moral assumptions. BlueSprite 20:21, 7 December 2008 (EST)

I think the answer is "no" in the case of a tyrannical system and "yes" in the case of a "good," reasonable government. The American revolutionaries pointed out, rightly, that in the case of the British regime here, the answer to that question was "no."

In the same vein, I do not believe that the health care question is one of "excusing" individuals from some responsibility to plan for the future, and the government should not take a stance either way on that.

If it took a stance that people should be "excused," it would probably respond by instituting a full-blown national health care system with a legal monopoly; we all see how that turns out. So, no, I do not believe that the government should take especial action in aid of "excusing" people this way.

If, on the other hand, the government swung too far in the other direction, and started trying to enforce this responsibility, it would probably come up with some sort of system where people were forced to buy private insurance (similar in effect to the Massachusetts reforms of 2006). I doubt that you, as a libertarian, advocate this sort of thing, but I clarify that I do not either.

Finally, there is something in what "Wazza" said about poor people: one cannot expect them to plan ahead for their futures, when they have not the money to do so. This does not infer that the government should finance health care, only that any argument against government-financed health care should not rely on the assumption that people can plan ahead; some cannot. ListenerX^TalkerX 16:35, 7 December 2008 (EST)

I'm roughly with you... I think. But my basic point is health care is a complex subject and that the individual should be invested in the maintenance of their health, both in terms of doing smart things to keep healthy and planning ahead. I think you got a little caught up in the semantics of what I said. What I intended to imply was that I think that a good (in sense of both moral and practical) system will have the property that it rewards those (in the hidden hand sense of reward) who plan ahead and invest in their health, while penalizing those who disregard their future. This is without regard to other properties of said "good system," i.e. it is not a complete description, nor a comment even on execution.

What to do about the poor is generally complex. I generally don't like the idea of leaving people on the street to die. But things like welfare tend to have unintended consequences, and are rarely as effective as implementers hope. Should we aid the poor? Certainly. Should the government play a role? I'm not sure, probably some. How exactly do we address this issue properly? I don't know.

I don't know why we can't expect the poor to help themselves, by the way. That some people need a little extra help along the way I fully understand. I also understand that even those who try to help themselves may not succeed. But I would expect and indeed hope that everyone have an interest in improving their conditions, and that they act intelligently and legally to do so. In my personal life, it is generally those that help themselves that I am most willing to assist, and those who have no regard for themselves that I have the least regard for. BlueSprite 20:21, 7 December 2008 (EST)

DEATH TO THE DEPRESSED!

Edit to add non-snark: You may not realize it, but there seems to be a strong undertone of "Poverty is a Moral Failing, so if you're poor you DESERVE TO SUFFER" to the stuff you write, like most Libertarians. Or I could be reading too much into it. --Gulik 22:48, 7 December 2008 (EST)

EZ Edit Button

Blue, you say there's no reason not to expect people to help themselves... but consider the case of a child who will grow up to be a go-getter entrepreneur, the very model citizen you want to see, but born to useless parents and at risk to easily-treated diseases which could impair or even destroy their ability to be able to make their life better (maybe even kill them). Why, in this case, should this child suffer for the failings of its parents? Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 06:51, 10 December 2008 (EST)

AND ANOTHER THING (don't you hate it when you submit just as you're thinking of something to add, and you're sitting there waiting for the page to load?)

Insurance is, by its very nature, a way of paying for treatment of symptoms. The insurance company won't pay out until you're sick. But government healthcare can pay for preventative measures, which are far more efficient. In fact, it's probably cheaper for the nation as a whole to pay taxes and get preventative care than to wait until everyone gets sick and treat them. This isn't even factoring in agencies like the CDC, that do unprofitable but necessary work identifying and isolating new diseases. A case in point is the dental care I received as a child. Every year our school's little dental clinic would be opened up and a traveling nurse would examine every child's teeth, putting in fillings and prescribing more specialist work. We could have waited until the kids' teeth rotted and fixed them then, but it was cheaper to catch the problems early. My teeth now are pretty damn good. I'm fairly certain it's because I was examined every year for problems, fillings were inserted where needed, and each of the kids was given a talk about how to brush your teeth properly, which is the cheapest and most basic preventative care you can give, and one that I guarantee the insurance companies won't even think of. Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 06:58, 10 December 2008 (EST)

Totally different freedom-based argument I suddenly remembered last night

A lot of the objection to government-funded healthcare has been on grounds of freedom to not pay for others' misfortunes, freedom from coercion. I'd like to point out some things about freedom, if I may, that are important to remember. There are two types of freedom. Libertarians generally focus on the freedom to pursue wealth, to do whatever you want within the bounds of the law, in fact. But this freedom to must be balanced against freedom from fear, illness, hunger... to my mind, the role of a just government is to provide not just a safe and impartial arena to practice our freedom to, but also one to protect our freedom from, without which we can't fully enjoy the former. That's why any government policy must balance both, and why a just government must provide healthcare to its citizens. Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 18:06, 3 December 2008 (EST)

A quote from the opera, The Handmaid's Tale: "In the Time Before, it was 'freedom to.' In the Republic of Gilead, it is 'freedom from.'" --- ListenerX 19:41, 3 December 2008 (EST)

Which is why we have to balance both. In any case, from what I've heard of The Handmaid's Tale, they didn't have much of either. Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 02:39, 4 December 2008 (EST)

The context in the opera was that women had been deprived of all their rights, and now had "freedom from" the work-a-day world, and "freedom from" financial independence, and "freedom from" having to think, and all the rest of the religious-right malarkey. This illustrates that it is much easier to euphemize totalitarian policies as "freedom from" than "freedom to."

Additionally, upholding "freedom from" things, such as hunger and fear (?), would often violate natural law, whereas upholding "freedom to" do things never does. So those who emphasize "freedom from" are more often totalitarians in the Orwellian tradition, who are willing to uphold the lie with Ministry of Truth-style tactics. --- ListenerX 11:19, 4 December 2008 (EST)

What is this "Natural Law" of which you speak? Aside from "some people must be the losers"? --Gulik 13:57, 4 December 2008 (EST)

Natural law consists, roughly, of the laws of physics and the implications to be drawn from them. "Some people must be the losers" is a statement that I believe is true, in most cases, for these reasons.

But in the case of fear, it is hardly disputable that people are going to be afraid whether or not there is said to be a right to "freedom from fear." Similarly, microbes will enthusiastically decline to obey a law granting a right to "freedom from illness," which at this time necessitates a narrower definition of that right, such as, "the right to receive treatment for any illness" (obviously what was meant, but certain hyperbole has been taken at face value and it is better to make precise statements if possible). --- ListenerX 14:31, 4 December 2008 (EST)

Note that I said you need to balance the two. If people have freedom to own guns for hunting and personal protection, others have the right to freedom from being shot for no reason. If people have freedom to choose where they get their healthcare from, they also should have freedom from being deprived altogether because they can't afford it.

Also, you state that some people must be the losers, but so many things aren't zero-sum. If I give you a music file, to take an example out of everyday life, I don't lose anything, but you gain. It's estimated that we have enough food to meet everyone on earth's needs right now, but inefficiencies in markets and shipping keep it from getting to large groups of people. No one needs to lose out in order to feed everyone on earth, assuming it's true that we really do have enough food. Some americans might lose weight, but they need to anyway :P Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 10:53, 6 December 2008 (EST)

When I made the statement "Some people must be the losers," I did not mean that all games are zero-sum (this belief is held much more frequently by those of the anti-capitalist persuasion). All I meant was that if there are not resources enough for everyone, some people will not get any, period.

I dispute that the distribution of the food supply can be shifted in order to feed everyone; here is why. You note that "some Americans might lose weight" if this happens, i.e., Americans will get less food under the deal. But it is Americans who grow the food in question; the U.S. is a food-exporting country. If American farmers are made to export more food in order to feed people in other countries, this will necessarily result in them getting less money for their food. If the price that can be commanded for a certain good decreases, so does its supply. This decrease in supply would leave the world short again. ListenerX^TalkerX 23:22, 6 December 2008 (EST)

Actually, given the subsidies on corn and other food products in the US, there's not much of a connection with market fluctuations. Moreover, any attempt to distribute food evenly would be designed with the aim of not defrauding anyone; presumably NGOs would purchase the food for a fair price then sell it at a price better fitting to the market, with the shortfall being made up with the amount of money our governments are supposed to be devoting to development projects but aren't (the most basic part of any development project is to make sure the workforce isn't starving). Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 01:56, 7 December 2008 (EST)

NGOs paying farmers "full price" and selling at the lower export price would, as you note, pass the cost differential onto the taxpayers, including farmers. And insofar as the farmers did not pay this differential directly through taxes, they would pay it indirectly: the extra money gained by receipt of the "full price" would not buy quite so much under the increased tax burden. ListenerX^TalkerX 13:20, 7 December 2008 (EST)

There are NGOs that aren't funded by taxpayers; charitable organisations could ease the burden. Moreover, if we can help develop poorer nations into modern democracies (admittedly a task of two or three generations - one of the most basic requirements for a truly functioning democracy is the training of a fairly incorruptible bureaucracy and the education of the general populace in order to have a base of informed voters) we would then have a more stable world requiring less by way of military spending. The US doesn't actually contribute much to development funds and such. Most of its spending on such things currently is funding the State Department's work in Iraq. In any case, development assistance now can be looked upon as a government's investment for the future. If you make other countries rich, they can buy things. More specifically, they can buy things from you. At full price, too. But I note that we're straying a long way from healthcare in developed nations, though there's still a connection insofar as the most basic healthcare is making sure everyone's fed. Wazza^{Hello? Is there anybody in there? Just nod if you can hear me...} 07:48, 8 December 2008 (EST)

Your previous statement suggested that you were talking about government-funded NGOs, but you are absolutely right here. Private charities follow market rules, hence are much less likely to interfere with the curve of supply, and if hunger ever be stamped out, it will probably be by their action. However, this goes rather against your case that government action is needed, either for health care or hunger-stamping.

Although I am skeptical of the idea of "building democracy," and do not trust politicians to make wise "investments" with taxpayers' money that they do not stand to lose if they slip up, there is also something to be said for the idea of developed countries investing in the Third World in aid of developing those countries into strong trading partners. ListenerX^TalkerX 12:03, 8 December 2008 (EST)

USA overspending on healthcare

A little-reported fact is that the US spends more per capita on health care than any other country. Don't believe me? see here: http://www.kff.org/insurance/snapshot/chcm010307oth.cfm So why don't Americans have the best healthcare in the world? As I understand it, it's because a lot of that money goes to make the medical companies profitable and pay dividends to shareholders instead of going to make people healthier. Ain't capitalism grand?--Herbert the Hamster 03:49, 4 December 2008 (EST)

I saw a documentary on this. The US spends something like 16% of its GDP on healthcare and other nations with heavily government regulated universal healthcare, such as Japan, Germany, were spending between 7%-10%. So maybe from an economic point of view it is better? - User $\scriptstyle 2\int _{-1}^{1}{\sqrt {1-x^{2}}}dx$ 03:54, 4 December 2008 (EST)

Horray found cite. - User $\scriptstyle 2\int _{-1}^{1}{\sqrt {1-x^{2}}}dx$ 03:56, 4 December 2008 (EST)

You wouldn't deprive the shareholders, insurance companies and allied spongers of their meagre incomes, would you? _and marmite 04:09, 4 December 2008 (EST)

Perhaps there is something wrong with system which both costs the most and delivers the least?--Herbert the Hamster 04:16, 4 December 2008 (EST)

Actually Germany had the solution to that problem, the insurance companies run at no profit but the boards are paid based on membership, so they are in a competition with each other in order to raise their pay but without the obscene profits. Of cause they all cut their premiums so as to attract more members. - User $\scriptstyle 2\int _{-1}^{1}{\sqrt {1-x^{2}}}dx$ 04:18, 4 December 2008 (EST)

That graph referred to by Herbert

_and marmite 04:26, 4 December 2008 (EST)

The UK doesn't come out very well does it?--Herbert the Hamster 04:33, 4 December 2008 (EST)

4th? - Not bad, I'd have thought. _and marmite 04:54, 4 December 2008 (EST)

4th from the bottom out of 19? I suppose it could be worse.--Herbert the Hamster 04:57, 4 December 2008 (EST)

Is the U.S.'s overspending on health-care really so "little-reported"? I seem to hear about it all the time. I have also heard people argue that what regulations we do have (heavy malpractice fines, government-mandated employer-provided insurance) has sent up the cost of the system (large premiums for malpractice insurance, insurance companies having an artificial absence of competition). --- ListenerX 11:32, 4 December 2008 (EST)

The "little-reported" bit was about the fact that the Us government spends more per-capita on its citizens than the amount spent by governments which have fully-socialized, free healthcare systems. At least it's little-reported in the Uk. Perhaps it's well known in the US. But that rather raises the question - "Why have they not changed the system to a cheaper socialist one?"--Herbert the Hamster 12:59, 4 December 2008 (EST)

We do not do socialism here in the U.S.; unlike in some other countries, our socialists are a pack of cranks. Even our social-democrats are cranks (e.g., Cynthia McKinney). This is a problem, because whenever a socialist has a good idea it is immediately taken up by all the cranks and made completely useless. --- ListenerX 13:21, 4 December 2008 (EST)

Ok, I see that. (I suppose) Bit it seems pretty weird that a system that is free at the point of use to all citizens, would reduce taxes and also stop people dying does not have more support.--Herbert the Hamster 13:38, 4 December 2008 (EST)

┌────────────────────────────────────────────────────────────────────────────────────────────────────┘The money spent would be less, presumably, but whose money is altogether a different kettle of fish. Much of our current system is bankrolled by the private sector and if the government took it over, it would probably mean a tax increase. Not mentioned are the "trickle-down" benefits of eliminating the burden of the waste from the shoulders of employers, etc. --- ListenerX 13:56, 4 December 2008 (EST) (9L)And where does this money which the private sector invests come from? Comes it largely from government programs perchance? I know not the details of the US system - only the the government seems to spend the most and get the least. If it is largely financed by private corporations paying the governments money back to it then it s possible that a "little" is being lost in administration. --Herbert the Hamster 14:35, 4 December 2008 (EST) (9L)Fun fact: I've been told that part fo the reason the American auto industry is in such hot water right now is because the unions negotiated for decent healthcare in the past, and apparently the extra costs are breaking the companies. (Personally, I suspect their inability to make vehicles that AREN'T gas-gizzling land barges has more to do with it, but things can have more than ONE cause.) So, we now have a big American industry that's become PRO-national-health-care. Go figure. --Gulik 14:46, 4 December 2008 (EST) (9L)Most employers have health-insurance plans, but the government does not put up the money for this. The employers pay for it out of their revenue, which is not necessarily from a government grant; hence, the auto-industry's troubles. --- ListenerX 14:53, 4 December 2008 (EST)

Some Blogger Weighs In

How I stopped worrying and learned to love paying for the scalpel:

“”"Can you imagine a situation in which a person has been so careless in socking away money that doctors should put their implements aside and just let them die?" If your answer is 'no' then you see health care as a right, and if your answer is 'yes' then you are a psychopath.

(Read the blag entry--it's pretty good.) --Gulik 20:50, 13 December 2008 (EST)

We'll call this one Gulik's False Dichotomy.CarwreCk 09:29, 10 May 2009 (UTC)

Two questions from the east side of the pond

Assuming that I am American, with a decent health care policy,

1. If I give birth to a profoundly mentally handicapped child, who'll need life-long care, would my policy pay for him?
2. A routine health-check picks up something non-life threatening, but needs monitoring to stop any problems (say type-II diabetes). My health-care is provided by my employer, and I then lose my job. I can't afford to keep up the payments. I then start work with a new employer, and a different health insurer. Would my new insurer declare my diabetes to be a pre-existing condition, and refuse to treat any problems arising from it?

CS Miller (talk) 13:50, 11 December 2009 (UTC)

YES. Is there even a debate to be had?

Surely the debate should be "can a modern, civilized country possibly justify not providing healthcare?" Or maybe it's just because I'm communist/socialist/leftist British anti-American godless heathen. DeltaStar_{Senior Sysop}^{Speciationspeed!} 14:55, 10 March 2010 (UTC)

I am a diabetic and had a stroke. The insurance company started increasing my premiums by 24% every six months. That 1% under a threshold that would make me eligible for state aid. When my premiums got to a thousand a month + 50% deductible I had to drop coverage. With a preexisting condition no company will cover me at any price. Even the emergency room wont treat me, unless I sign over my house, because state law only requires them to attend to immediate life threatening situations and only to a stage for transfer to another facility. I am not eligible for state aid because I own my own home. For a country like the United States to say, either pay us or die you deadbeat scum in my opinion sucks. _{ill deadbeat scum}Hamster (talk) 15:44, 10 March 2010 (UTC)

That is pretty grim. I know here in Ireland that there is free cover for people with medical cards, but one would need a pretty low income to qualify. Many of us earn moderate amounts, and have to pay some part of our medical treatment. Trips to the doctor are always payable, and there's the cost of prescriptions and scans. Trips to the dentist are the same. Hell, I had some grit in my eye, was in quite a bit of pain, and had to give my credit card details at the emergency room. I'm covered for long-term and chronic conditions, but I still find myself deterred from visiting the doctor unless I think it's really necessary. That I consider to be bad, but obviously nowhere near the level you describe, Hamster. I see a lack of universal healthcare as being a form of social darwinism. --^{Ask me about your mother} 15:54, 10 March 2010 (UTC)

This is a debate that would never even be started in the UK, except possibly by a fringe organisation or individual. None of the political parties would dare to dismantle the NHS - to do so would be political suicide. To leave a diabetic who has previously suffered a stroke out to fend for themselves would be unthinkable.

If I wanted to live in a country without a socialised health care system (and, for that matter, access to firearms), then I'd emigrate to one. Bondurant (talk) 16:01, 10 March 2010 (UTC)

@Hamster: Shitty man, totally wrong! I'd probably be 6 feet under if I lived in the US. I must have cost the NHS over £100,000 in the past few years and I'm still getting it. The ones with chronic illness actually get it cheaper (= free) than others (who ave to pay for prescriptions) here.

@ CR, I didn't know that about Ireland, suppose I thought there was a similar system to the UK. Definitely "Social Darwinism"; Good call. 16:03, 10 March 2010 (UTC)   ^Contribs_Talk

"None of the political parties would dare to dismantle the NHS..." Here in the U.S., health care is a political third rail in the other direction, it seems.

"Surely the debate should be..." One cannot dismiss the opposing argument in this case so lightly. Arguments against State-provided health care are as follows: (1) people should pull their own weight rather than have the State do it for them; (2) it can put the State in possession of a lot of private medical data, which might be unwelcome; (3) it can require most or all doctors to become employees of the State; (4) like any public agency or enforced monopoly, a State health care system can become corrupt and inefficient without worrying about losing its subscribers; (5) if the State does not provide needed medical services, people would be hard-put to find them elsewhere. These arguments can be countered, but they cannot be summarily dismissed. ListenerX^TalkerX 16:36, 10 March 2010 (UTC)

Allow moi.

1) The counter for this is that people, who are employed and do contribute to society may be left uninsured if they have pre-existing conditions, and then unable to pay for their own medical care. See Hamster above.

2) Quite apart from this being a typical scare-mongering argument (Oh noes! Goverment has more data!), from my experience of working in a data driven industry, most organisations can't match "customer" data internally, much less across multiple departments / divisions. And so what if the government has medical information? This argument never seems to say why it's a bad thing. The NGS has had my medical information since the day I was born, and I'm quite happy that they do. Why wouldn't I be?

3) Rubbish. You will always have private medical care alternative. Even in the NHS-centred UK, we have a private alternative, and many companies (including mine) provide coverage for their employees.

4) Efficiency can be a problem in any industry, and it is a myth that things are automatically better in the corporate world. The alternative is having to phone your insurance company and negotiate with them whether or not you are entitled to care, and then have to deal with the increased insurance premiums afterwards. If I have a medical problem, I go see my doctor and if I need medication, pay the prescription charge.

5) I'm not sure what this argument is saying. Is it saying that the presence of state health care means that all private care will disappear? Is it saying that state health care is inadequate? I disagree on both counts.

Bondurant (talk) 16:56, 10 March 2010 (UTC)

I should add for point 2 that medical information should be ring fenced within the medical establishment, preserving doctor-patient confidentiality. This is certainly the case in the UK. If the Patriot Act has provisions to snoop on medical data, then this is a problem with the Patriot Act, not socialised health care. Bondurant (talk) 17:16, 10 March 2010 (UTC)

Note that I am playing devil's advocate there; just repeating the arguments.

Your response to argument 1 completely misses the point: it is not that only people who "contribute to society" should get society's help, but that the State should not be in the help business at all.

"Why wouldn't I be?" Perhaps if a neo-Nazi government were brought in and your medical records indicated that you were a Tay-Sachs carrier, or otherwise qualifying as lebensunwertes Leben?

Argument 5 is an abstracted form of the argument about people having to come to the U.S. to get health care services they cannot get in Canada. ListenerX^TalkerX 17:24, 10 March 2010 (UTC)

┌────────────────────────────────────────────────────────────────────────────────────────────────────┘Good point on the neo nazis. Remind me not to vote for them on 6th May. (9L)On point 5, I'm sure examples will always be found on either side where the health care system has let some people down. Health tourism goes both ways Bondurant (talk) 18:12, 10 March 2010 (UTC)

Another point that might be worth mentioning is that with the State bankrolling health care, it allows politicians a much broader latitude of excuses to bring politics into health care; for example, this flap about abortion language in the U.S. health care bill. ListenerX^TalkerX 20:27, 10 March 2010 (UTC)

Which, I guess, is another thing that wouldn't even enter into debate in the UK (maybe how late abortion can be carried out, but never prohibiting it altogether). I've even seen the argument of "why should I pay for my neighbor's (nod to the US spelling) contraceptive pill?" as an argument against government health care in the US, another completely daft argument to those of us from more enlightened countries. Bondurant (talk) 21:31, 10 March 2010 (UTC)

All I want to say is...

I always found it pretty amusing that most people see no problem with paying taxes for a military, or the fire department, but some see a problem with healthcare, despite a virus being able to kill you like a murderer and spread like a fire.

Is it that difficult to treat healthcare as the military that protects us from the evil terrorist illnesses? (That want our death) Frankly, as far as I am concerned there should have been "health pentagons" and bio-research "Manhattan projects" as well. Sen (talk) 17:31, 10 March 2010 (UTC)

== '''Health care should be free!!!!!!!!!!!!!!!!!!!!''' == ^{— Unsigned, by: 75.176.16.196 / talk / contribs}

So Now..

I hate to dredge this out of the -ancient- history bin, but, Now that the Universal Healthcare bill has passed, and soon-to-go into effect, what are your feelings on the bill? do you think it will cover the needs of the US to handle the large portion of debt brought on by the uninsured? what about the Reforming of Medicare? some say it Cuts Medicare funding, while i have reason to believe it's in regards to the massive amount of Medicare Fraud reported in the US. I know I'm not taking on statistics and rattling information but thats because before i dive deeper in that rabbit hole of a Bill, I'd like to hear other views on it myself.^{— Unsigned, by: HKJGN / talk / contribs 2010-10-02T12:25:06}

I think it's good step forward and I hope it remains intact. I hope in the future more steps will be taken to achieve better universal healthcare though. Sam ^Tally-ho! 06:11, 8 December 2011 (UTC)

IP post

morality is not a just government you can not find one just government with morality based laws like in Neavada postituion is legal and highly taxed but i dont think anyone would be able to tell you that is a moral thing and killing people is imoral but is used as a legal punishment now where is the morality in any of that? ^{— Unsigned, by: 208.126.204.23 / talk / contribs 2011-12-07T22:06:25}

No

No. Government provided healthcare is socialism. Talsley (talk) 15:18, 4 January 2013 (UTC)

Re: Yeah, totally, and it's been rife within the US elsewhere for far too long. The US Military, all non-toll roads and highways, education, police, firefighters, municipal water, prisons--all socialist, paid for by hardworking Americans' taxes instead of being industries run by competing private corporations! I hope you're making your voice heard about further de-socialize all these services ASAP.

Just picture it, when people sit down to negotiate Benefits with their employers, we'll negotiate way more than just Health Insurance and paid days off! Employers will get to decide even more Private Plans for employees to purchase via a chunk of their salary, for everything from Police, Military, and Firefighter Protection to Water Service, Road Use, Political Affiliation, and Offspring Education!

The competition is sure to drive prices down, just make sure you don't ever loose your job for any reason. Also that your employer stays in business. And that they don't shrink benefit plans in favor of higher profit margins. And that you aren't afflicted by any Conditions, like family who live on roads your company's Road Use Plan doesn't cover. If you skip having kids, think of all the money you can save on plans for Health Insurance AND Offspring Education! The Police and Firefighter Companies will look after and compete, so if they help anybody who isn't covered by a good Plan then that individual has to pay out-of-pocket. If they can't pay and go bankrupt, the protection company will have to eat the costs unless and until they decide to forbid helping people/hosueholds without Insurance. I'm so glad US Health Insurance already works like these scenarios.

/sarcasm. So Talsley, why is Socialism so automatically bad that it shouldn't even be considered in any circumstance? Why should basic health care be a mostly for-profit privledge decided upon by employment and personal wealth, instead of a basic government-provided right like government military, public roads, basic education, and police + firefighter protection? ^{— Unsigned, by: 89.134.117.11 / talk / contribs}

Ah, BoN, whilst I agree with you I'm afraid you don't know the history of our friend Talsley who posed as a sweet little old biggot to wind up the likes of you. Innocent Bystander (talk) 12:11, 23 October 2013 (UTC)

Yes, otherwise it would be unfair on the poorer people.