The Polluted Health Care Debate

The US Senate sets to vote on a health care bill over Christmas this Tuesday after what have been months of fierce political debate. As the opposition warned of “socialized medicine” and “death panels”, public support for “ObamaCare” and the president himself understandably plummeted.

Although America’s health care is among the most expensive yet one of the most restricted systems in the world, people began to fear that under the Democrats’ plans, they would face a further decline in quality against ever rising costs. Strangely enough, people also indicated that by majority that health care today is too costly on the whole and that it placed a serious burden on the already fragile US economy. President Obama repeatedly stressed that America’s health care is in desperate need of reform but critics seem to have a point when they say that the Democrats will only make it more expensive.

Unfortunately, Republicans prefer instead to devise little doomsday scenarios and warn people that their elderly will soon be put to death if the Democrats have their way. They point at countries as Canada and the United Kingdom and say, “look how bad things are over there.” In fact, health care in these both countries is far from terrible.

In spite of the rather communist qualities of the British National Health Service, it operates at a lower cost per capita ($2,560, compared to $6,096 for the US in 2007) while providing better care (PDF). Canada on the other hand, while much cheaper per capita than the American system, provides an approximately similar quality of care. It would appear then that a collectivization of health care doesn’t necessarily make things better or worse. A lot of other factors are in play.

Rather than denouncing “socialized medicine” as being impractical therefore, opponents should point out that it is immoral.

The NHS in Britain was established after the end of World War II, in 1948, with the express purpose of providing health care to all, “regardless of wealth.” Its principles were that the service should “meet the needs of everyone,” “be free at the point of delivery” and “be based on clinical need, not ability to pay.” This gave all Britons a right to proper care, no matter whether they were able to afford it or not. Need, not ability became the standard according to which care would henceforth be distributed.

This is a strange twist of ethics. Imagine that the law were to give people a right to much more basic needs than health care such as food and shelter. No such laws exist of course, for if people indeed are entitled to such rights, others must inevitably provide for them at their own expense.

Granting people a right to health care demands that others provide such care, for free if necessary. Only a government can allocate care under such conditions for few individual doctors and nurses would go about their work unpaid any more than a supermarket would remain in business for long if it is to meet peoples’ “right to food”.

Even the Republicans, supposedly the champions of the free market, dare not question the alleged right to health care in the United States. Probably because they know how most people would respond to such criticism: “Should we just stand by then and let people die?” they’ll ask

Perhaps proponents of collectivization are only more than willing to pay so that others need not insure themselves but as long as they can’t answer the simple question, “Why shouldn’t we?” to their own charge without speaking of non-existent rights and undeserved charity, no man should be held responsible for the health and care of others against his own choice.

That is what opponents of “ObamaCare” should have argued. Because they didn’t, collectivized health care is now likely to become a reality in the United States.

avatar Nick Ottens is an historian from the Netherlands who researched Muslim revivalist movements and terrorism in nineteenth century Arabia, British India and the Sudan. He also studied the history of transatlantic relations. Nick is a special correspondent for The Seoul Times and a contributing analyst with the geostrategic consultancy Wikistrat.

79 comments   Click here to show or hide them

  1. “It doesn’t. Taxes and slavery are to widely different things.”

    Widely different in degree, perhaps but very similar in principle. (the principle being the time and work of one man necessarily belongs to others).

    “And I can’t say how much that would be. I can’t. It depends on how much money is needed, “

    Then you can’t say that it won’t be 100% or close to it, if that is what is needed. In that case you do have socialism. If you say you only want small part, how do you define how much is needed? Who defines it? There is no way to do this objectively.

    “Yet how can we be sure that labor laws, union, historical coincidences, government funded research and education, social security and so on did not play a part.”

    You see, I happen to believe that you can be certain by their very nature that these things not only didn’t play a part but actually hampered progress. All of these you list (with the exception of historical coincidences which probably did play a part) are based on compulsion and if you understand the nature of force in relationship to human beings it becomes quite obvious that when you start forcing people to do things you are only going to make things worse. You make them less able to act on their own judgment. I point to the correlation between freedom and prosperity, as further evidence.

    The singular reason why people are now enjoying such a good standard of living is their minds and the fact that our system has freed our minds to the greatest extent ever known in history. Yes, we needed a certain technological level before this could happen but allowing people the use of their minds to the fullest extent is the basic factor.

    “But so are resources, social stability (because you can’t invent if someone bashes your head in), geographical and historical coincidences and what not. “

    They may be necessary conditions in some cases but they are not sources. Resources are useless without a human mind to shape them – but conversely, the human mind can discover resources which were not previously thought to be of any use. Social stability is important condition and look historically at what capitalism did for that as well. And further, social stability is necessary simply as a condition which allows the human mind to be free.

    “Its an extremist ideology.”

    Only because most people don’t follow it. Extremism is defined by what most people in a society believe not in relationship to the truth. I could say it is a very true extremist philosophy.

    If we want to truly understand out world we have to get beyond the superficial and deductive arguments and really get to the basics of how humans operate using their minds. That means induction. That means understanding the (metaphysical) nature of force and how it paralyzes our minds.

    I could (and I did) simply point to the strong correlation between how free a country is and its progress (today and in the past) and use the valid scientific method of extrapolating to a country a little more free and predicting even more progress. I could point to big difference in quality between private and public education. We could look at social security and see what a mess this is. We could show how minimum wage laws force people out of work. We could look at the mess that governments have made of health care time and time again. However, a much stronger argument in my opinion is show that in principle all these cases are based on compulsion and the results are to be expected since pushing people around is always a bad idea. It comes down to the fact that the system which best fits humans based on their nature is capitalism.

    “Both of you are saying that risking one life and risking ones suit are one and the same, just as paying taxes and having government goons drag you into the street and shot you are one and the same.”

    If I don’t pay my taxes then what happens?

  2. “Widely different in degree, perhaps but very similar in principle. (the principle being the time and work of one man necessarily belongs to others).”

    Actually no. Slavery is based on the principle that certain people for various reasons belong to others. It means someone owns your life, not just your property. The modern tax system means that the public has the right to a certain amount of the excess money you earn to use for the purpose of public good.

    “In that case you do have socialism. If you say you only want small part, how do you define how much is needed? Who defines it? There is no way to do this objectively.”

    Of course there isn’t. Objectivity is individual; human beings looking at social phenomena invariable come to different conclusions. Now, socialism demands total control of resources. That’s not the end of the ideology, it’s the means; it’s based on this premise. A national healthcare system, for an example, does not necessitate complete government control over resources. The problem here is the demand on healthcare systems differ over time, like any budgetary post, hence it is nonworkable to believe you can decide the amount of money before you identify the problem.

    “The singular reason why people are now enjoying such a good standard of living is their minds and the fact that our system has freed our minds to the greatest extent ever known in history.”

    And I have not criticized the current capitalist system. Which happens to include national healthplans and such. In fact, it seems to me that what causes trouble with many governmental programs is not their existence so much as the way they are handled. Public school, healthcare etc are not naturally failed propositions. They have become such by mismanagement. Look at the overly expansive American healthcare system. Is that more state managed then the relatively cheaper western European ones?

    “It comes down to the fact that the system which best fits humans based on their nature is capitalism. ”

    So how do you prove that humans are naturally onehundred percent individualistic and selfish then? Considering that most major primates are communal animals after all. Doesn’t the historical existence how communal values prove that to a human being, community is a very important factor?
    “If I don’t pay my taxes then what happens?”

    Depends on the laws where you live. Once again not an issue that can be decided by wholesale morality but rather by debate.

    “If I don’t pay my taxes then what happens?”

    Depends on the laws where you live. Once again not an issue that can be decided by wholesale morality but rather by debate.

  3. Both of you are saying that risking one life and risking ones suit are one and the same, just as paying taxes and having government goons drag you into the street and shot you are one and the same. I dispute this.

    So might I, personally. But it’s not up to me. It’s not up to me to say that someone else shouldn’t value their life or their suit, just as it’s not up to me to decide what part of their money another person can miss.

    How about if you couldn’t afford [health insurance]?

    Tough. In the nearly unregulated health insurance market that my own country has (since recently), however, everyone can afford insurance, whether they have a job or live off social benefits. Only in a market that’s frustrated with government regulation and control do the costs of health insurance become unbearable to so many as is the case in the United States.

    Human freedom is important. But so are resources, social stability [...], geographical and historical coincidences and what not. There is no single source of progress.

    Sure, that all matters. But without man’s mind, none of those factors, not even all of them combined, will produce progress. Without a mind to use them, resources are just resources; stability is just stability, no more; geography is just geography, etc.

    (After typing this, I noticed Steve D had pointed out the same)

    Yet no mans wealth is his and his alone. Practically speaking it can of course be taken at any time.

    By force. That doesn’t mean it isn’t his.

    Less practically, even your objective moral demands him to pay the state, pay for policies he might not agree with.

    True. It’s unlikely, under my definition of a proper government, but possible.

    Now I believe that if a society can demand him to pay for some wholesale killing somewhere else, it can demand that he pay’s for healthcare for those who cannot afford and should he need it himself.

    That’s like saying: “one evil has been committed already, so what’s one more?” You understand, I’m not convinced.

    A national healthcare system, for an example, does not necessitate complete government control over resources.

    It does over the people involved. What about the doctors, nurses and other medical professionals? And what about the patients, who oftentimes have no or little choice in where and by whom they are treated?

    So how do you prove that humans are naturally onehundred percent individualistic and selfish then?

    It’s not about individualism and selfishness in the first place. Those are logical outcomes of a philosophy that values man’s rights to life and property.

  4. “In the nearly unregulated health insurance market that my own country has (since recently), however, everyone can afford insurance, whether they have a job or live off social benefits.”

    And voilá! We have replaced public healthcare with social benefits. That’s one solution. Quite frankly, I like the sound of that. As I said, its the right to healthcare I care about, not the public healthcare system as such system.

    “But without man’s mind, none of those factors, not even all of them combined, will produce progress.”

    And without those factors mans mind will produce nothing. Once again, progress does not stem from singular source.

    “By force. That doesn’t mean it isn’t his.”

    Technically, yes it means that. Your rights cannot exist if they are not backed up by force.

    “That’s like saying: “one evil has been committed already, so what’s one more?” You understand, I’m not convinced. ”

    And I’m far from convinced it’s evil to make him pay back to society. Want to call it quits there. to me it says: ‘one evil has been committed, how about we take its resources and use ot for good’

    “It does over the people involved. What about the doctors, nurses and other medical professionals? And what about the patients, who oftentimes have no or little choice in where and by whom they are treated?”

    National healthcare systems do not mean you cannot have private practices. Nor does it necessarily mean you cannot choose your own doctor, unless your going into the emergency room in which case you are seldom all that capable of making a rational choice anyway.

    “It’s not about individualism and selfishness in the first place. Those are logical outcomes of a philosophy that values man’s rights to life and property.”

    So they are the outcome of a philosophy that is based on the same presumption that human beings are, amongst other things, selfish?

  5. Not necessarily. I just meant to show that private health care can be cheap in an unregulated market (about €100 per month on average). Let’s have the debate on social benefits another time, OK? ;)

    And without those factors mans mind will produce nothing.

    True, but resources are a given; a man using his mind is certainly not.

    Technically, yes it means that. Your rights cannot exist if they are not backed up by force.

    Aye—which is the proper purpose of government: to protect men against force.

    National healthcare systems do not mean you cannot have private practices.

    Not quite true, unfortunately: public health care constitutes unnatural competition, making private health care oftentimes unprofitable unless B) it specializes in a certain field or unless B) the quality of public health care is so poor that people of means will demand enough quality care to warrant a wider supply of private health care.

    So they are the outcome of a philosophy that is based on the same presumption that human beings are, amongst other things, selfish?

    Human beings are selfish by nature—survival usually demands it. (That is not to say that selfishness is therefore right though.)

  6. “Let’s have the debate on social benefits another time, OK? ;)”

    Agreed ;)

    “True, but resources are a given; a man using his mind is certainly not.”

    Of course. But this doesn’t take away from the argument.
    “Aye—which is the proper purpose of government: to protect men against force.”

    And I agree with you. But then I do not just count force and threats in simple military terms.

    “Human beings are selfish by nature—survival usually demands it. (That is not to say that selfishness is therefore right though.)”

    Yet humans have also shown a great ability to sacrifice themselves for the group, whether that is a family unit or a country. This suggests that human survival, as with any communal animal, is closely tied to the group. As such, human selfishness does not disenfranchise the group; rather it naturally ties human beings to various groupings.

  7. But this doesn’t take away from the argument.

    Which I’ve indicated I agree with: man’s mind alone is not enough to produce progress. My point is only that you can’t have progress without it.

    But then I do not just count force and threats in simple military terms.

    Me neither! Hence the need for police and courts of law.

    Yet humans have also shown a great ability to sacrifice themselves for the group [...]

    Of course! Indeed, I think humans are the only species on Earth who are able to be selfless, i.e.: act against their own interest.

    This suggests that human survival, as with any communal animal, is closely tied to the group.

    I beg to differ. The fact that men sacrifice does not “suggest” that sacrifice is somehow a necessary part of survival. If that is what you’re saying, I’m going to have to ask you to elaborate on that.

    As such, human selfishness does not disenfranchise the group; rather it naturally ties human beings to various groupings.

    That is very much possible. In many cases, it can benefit the individual to “join” the group—in fact, it can benefit him very much.

  8. “Which I’ve indicated I agree with: man’s mind alone is not enough to produce progress. My point is only that you can’t have progress without it.”

    Then we agree.

    “Me neither! Hence the need for police and courts of law.”

    More importantly hence the need for proactive measures so that people do not become criminals in the first place.

    “Of course! Indeed, I think humans are the only species on Earth who are able to be selfless, i.e.: act against their own interest.”

    I’m not an expert on the subject but i believe you can find similar tendencies among many communal mammals.

    “The fact that men sacrifice does not “suggest” that sacrifice is somehow a necessary part of survival.”

    Sacrifice as such isn’t a necessary part of survival. The group is. And since survival of the group is important to the survival of both the individual itself and its possible offspring, human beings have a tendency to value the group over the individual in certain situations, a basic fight or flight reflex. This instinct has then developing into various socially based ideologies that can be found all over the political spectrum.

  9. You’re observations on the historical development of man’s group nature might be sound, but I’m hesitant to draw any moral principles from that. You can’t argue, “it’s right to sacrifice for the group’s sake, because people have done so for a long time.”

    More importantly hence the need for proactive measures so that people do not become criminals in the first place.

    Then you’re presuming that under the right circumstances, everyone will be a criminal.

    Why should I have to pay money so that others don’t turn to crime? It almost sounds like a threat: “pay up, or I’ll become a criminal.”

  10. “Slavery is based on the principle that certain people for various reasons belong to others.”

    No, that’s just one type of slavery (chattel) although I admit you may define other forms of forced labor as not exactly slavery. In any event, its not really critical to the argument; even if it is not slavery, taking resource belonging to another by force is definitely theft and still wrong in any circumstances.

    Since I have to work in order to live I am pretty much forced into giving my resources by taxes. Not much different in that essential respect to involuntary servitude. (what are my choices – go on the dole and depend upon the servitude of others?) It’s still essentially forced labor.

    There is no real distinction between my life and property in respect to my rights. The proof of this is that society does claim to own my life. Otherwise how could they draft me and send me off to war to die whenever they want? The government obviously doesn’t believe I have a right to life or there could never be any such thing as the draft.

    I think once you start violating a person’s right to property all other rights will eventually succumb. Its just a matter of which ones and when.

    “So how do you prove that humans are naturally one hundred percent individualistic and selfish then?”

    I don’t have too. People can act however they want. It’s how they think (not what they think but the process itself) which is important. Thinking has to be done by individual human minds – there is no way to socialize this process. In that very important respect humans are and must be one hundred percent individualistic and selfish or not act in this respect as humans at all.

    I think the fundamental difference between us is that I do not see any difference in principle between thought and action (with respect to how they should be treated morally or legally). A man has to think to survive but in order to survive he has to translate thought into action. Both are necessary for his survival but the thought process has to be done by each human individually. There is no way to get around that and this necessarily, leads to the fact that a society in which thought and action are free MUST be the best society for human beings. You cannot restrict action without to some extent restricting thought as well (and vice versa of course).

    If you correctly induce the metaphysical nature of man and the nature of force, then the fact that selfishness is the optimal morality and capitalism is the ideal society is a necessary deductive conclusion.

  11. Well we seem to have fallen of the front page so maybe its time to end this debate

    “Then you’re presuming that under the right circumstances, everyone will be a criminal.”

    In a word, yes. Naturally there are multiple reason why people become criminals but predetermination is not one of them.

    “Why should I have to pay money so that others don’t turn to crime? It almost sounds like a threat: “pay up, or I’ll become a criminal.””

    By that reasoning law enforcement is ‘pay up or someone will come along and take all your stuff’. It’s about being smart on crime. Though if you want to throw that away based on your principles go ahead.

    “I think once you start violating a person’s right to property all other rights will eventually succumb. Its just a matter of which ones and when.”

    This sounds like a contradiction to me. You have already established that the right to property do not exists (since you do pay taxes) and that the state can draft you into the military and yet have your rights disappeared? Taxes are a far older phenomena then these rights and yet they appeared without fuzz. The support for rights of life and liberty are far more anchored then your clearcut version of property rights so why should they be as endangered. you are of course few to believe what you will but pardon me if i am not convinced.

    “Thinking has to be done by individual human minds – there is no way to socialize this process. In that very important respect humans are and must be one hundred percent individualistic and selfish or not act in this respect as humans at all.”

    Yet since complex thinking is fundamentally based on knowledge and experience, the process is partially socialized. You are still underestimating the effect of the society outside the individual.

    “You cannot restrict action without to some extent restricting thought as well (and vice versa of course).”

    This sounds like one of those ridiculous scifi scenarios where people get arrested for thinking about committing murder. But anyway;

    “There is no way to get around that and this necessarily, leads to the fact that a society in which thought and action are free MUST be the best society for human beings. You cannot restrict action without to some extent restricting thought as well (and vice versa of course).”

    This I do not really dispute. Yet I think you and I can agree that actions that cause harm should be regulated. Our main difference here lies in what actions we perceive as causing harm.

    What can be proven, really, is that people do not agree. I still hold to my deduction that morals are not given by nature but abstract sociological thought patterns fundamentally based on consensus. Your morality is an example of this; if you cannot convince enough people to agree then it will hold no sway. It has no existence of its own. I still hold that you underestimate the effects of the group, both detrimental and positive, both direct and indirect, consensus and not, on the individual. Progress requires flexibility; setting strict definitions of certain right will not help this.

    And of course I do believe that people should, if at all possible have the right to healthcare.

    But as I said we have been doing this for weeks and have fallen of the main page so how about we end it here?

  12. I agree, it may be about time we end this ;) Still, I’ll provide answers to these, just in case…

    Naturally there are multiple reason why people become criminals but predetermination is not one of them.

    No—but you’re forgetting about choice.

    By that reasoning law enforcement is ‘pay up or someone will come along and take all your stuff’.

    Not quite. What you’re suggesting is to pay in order to prevent people from becoming criminals. My law enforcement only deals with punishing those who have become criminals.

  13. I do want to end this but one last answer:

    “Not quite. What you’re suggesting is to pay in order to prevent people from becoming criminals. My law enforcement only deals with punishing those who have become criminals.”

    Still the purpose is the same; to prevent crime. once again i here propose a little less rigidity. But let’s discuss crime some other time. ;)

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