Socialized Business Losses Versus Socialized Medicine: What's Wrong with this Picture?

Your example #1 is a little misleading- the total population of Canada is 32 million. As written, it might be interpreted to mean that 32 million Canadians are uninsured. Canada, like every other industrialized nation other than the US, has nationalized health care. In fact (at least in practice, if not under explicit law), if I get sick when visiting Canada, I am covered. Odd to think that I'm on my own here, but fully covered if I'm out of country.

Another useful way to consider the situation is that if you randomly pick 13 people in the US, on average 2 of them will have no health coverage.

okay, i fixed the wording on that. i hope my meaning is clearer now. let me know if it isn't.

I am constantly amazed that Americans - individually among the most generous people on earth - can become, as a collective, something else entirely.

I have come to think of it as a culture gap. The other industrial nations accept health care as a universal human right. Americans treat it as a commodity like T shirts.

I have many American friends and relative. It breaks my heart that the first conversation after an illness is diagnosed is "How's your insurance?"

What to do? How do you change a way of thinking? Sometimes I think the comparison to Europe or Canada does not help, as Americans prefer to see themselves as leaders and not followers. In truth every country runs their own system, and constantly updates it to meet new requirements.

"Socialized medicine" is not one size fits all. I hope eventually Americans can create a system of their own that will care for everyone. Until then I will other support in blog copmments to anyone willing to take up the fight.

I am Canadian, and am disgusted at our health care system. It is extremely inefficient, and wasteful. Many (most/all) foreign doctors that come here aren't even allowed to practice, since the State tries to protect it's own industries first. This lack of competition, of freedom (both among consumers of health care, but also among doctors) is extremely frustrating.

If a doctor offers a service that I want, nobody has the right to interfere. Nor does anyone have the right to FORCE me to pay for something I might not want.

I wish americans would appreciate the individual liberties on which their country was founded a little more :|.

Another category of uninsured Americans: My last employer offered health insurance, but no one got it because it was way too expensive. For most employees, the bill would be over half their paycheck.

I agree completely with the notion that universal, single-payer health insurance should be instituted in the USA. Furthermore, I believe that we are about to enter a prolonger recession, and that the only way to get out of it will be with a comprehensive set of New Deal-like programs. That should include universal heatlh care. Physicians are starting to agree. Industry leaders, at least in real industries such as manufacturing, agree. ( Leaders of fake industries such as finance and banking tend not to agree, but all they do is shuffle paper from one stack to another. There is no reason anyone should pay any attention to them.)

The problem, to which I would like everyone to be alerted, is this: The moment such coverage it is enacted, it will come under attack. It will be under sustained attack (forever). For this reason, it is important that proponents of such coverage be prepared for a very long, very dirty fight.

The reason has nothing to do with arguments about fairness, social justice, or the nanny state. The reason is that every dollar that does not go into the financial sector is a dollar that cannot be leveraged into 10, 20, or 30 dollars of investments, the returns on which are taxed at the 15% capital gains rate. It's like free Oxycontin to an addict.

Financial activity now accounts for a greater percentage of the GNP than manufacturing. When manufacturing was king, the health of the population was important. Now, health means nothing. The only thing that matters about the general population, is their ability to take on debt. You do not have to be healthy to do that. In fact, it helps if you are not. As long as people can take on debt, Wall Street is happy. This is a profound distortion of our national priorities.

In an age of international travel, antibiotic resistance, and emerging diseases, the best protection against a pandemic is a healthy population. The lack of universal coverage poses risks for everyone. Even those with excellent insurance are placed at risk. It is an enormous gamble for us to have a large uninsured population.

But then, it is increasingly obvious that some people like to gamble.

As a military brat, I grew up being taken care of by the military system, which is indisputably a totally socialized health-care system. It is totally funded by American taxpayers, and it is (or was when I was young in the 1960s) a 100% preventative-to-emergency coverage for all active military and their dependents. I got free operations, and lots of free corrective dental work done, not to mention free care whenever I got a flu or other temporary illness. And free inoculations which were required to attend the military school system.

Now I work in support services for a well-known technology company who is famous for their extremely generous approach to employee health benefits. What I see is this:

1. It is one the most motivational things they could do to attract top talent in the industry. Many people there have become employees even though they could have made more money as consultants to the corporation for the simple reason that they know the corporation will go the extra mile if any of their dependents become injured or seriously ill.

2. It keeps top talent for the same reason.

3. It frees up employees attention more to concentrate on their jobs.

4. It boosts morale

5. It saves employees time, headaches, and money having to sift through the unending vagaries and court-contestable details (and we know they ARE contested in court regularly by insurance companies) of a myriad of private-insurer plans.

I also saw that a primary motivator for people to make a career in the armed forces was that they knew the military would provide adequate housing, education, and health-care for their families.

So I am not quite understanding why people predict the end of the world as we know it if we have (big scary music goes here) "socialized" medicine. It's not going to turn us into a communist totalitarian state. I saw in the military that it certainly does not undermine patriotism.

From what I have seen it seems workable if implemented with reasonable intelligence. And it makes people happier and more loyal.

To the above two posters, Joseph and Yogi-one, I have absolutely no problem with you two opting in to whatever kind of health insurance you want--just don't FORCE others into it! If forcing unwilling people to pay for the services of /others/ is not totalitarian communism, I don't know what is.

@dennisn,
Well, if you don't know what it is, why don't you look it up?

"Totalitarianism is a concept used to describe political systems where a state regulates nearly every aspect of public and private life"

"Communism is a socioeconomic structure that promotes the establishment of an egalitarian, classless, stateless society based on common ownership of the means of production and property in general."
both from Wikipedia

Do you see how these things are different from everyone having to pay for collective healthcare?

By analogy to your objection, one could argue that it's up to everyone to ensure their own property and person are secure, and if people want to pay for police (or firefighter) protection they can, but it should be strictly optional.
Do you see why this doesn't work?

dennisn -

Most people are technically not willing to have health care, being as they would rather be healthy... in economic terms, healthcare is practiclly an anti-commodity, the less you consume the better off you must be.

But anyway; the US spends around twice as much per person on healthcare yet has poorer outcomes. Single payer systems deliver greater value for money for everyone. Do you enjoy spending more money for less results?

dennisn - how do you propose to pay for the health services for people who can't afford to pay for it themselves?

>>22,000 Americans actually died in 2006 because they dared to be uninsured!

Whenever I debate a person who is against national healthcare, my opponent is usually someone that believes that national security is the most important thing for the federal government to do. I think the best point to make is to ask: "How many people would die from terrorist attacks if the DoD budget was reduced by something like $10 billion?" Probably not many. Then cite to the fact that more people (22K, as you cite) die from being uninsured.

Healthcare is the cheapest form of national defense. We can save more American lives with less money and fewer resources using healthcare than any traditional means (missiles, fighter jets, air craft carriers...). I think more people should use this point to fight for healthcare because it appeals to those that value National Security. Nationalized Healthcare = Homeland Security.

dennisn rightly points out that there are problems with the Canadian health system. That's a bit of a red herring though - if, on principle, you reject universal health care as "totalitarian communism", then it doesn't matter if it works perfectly or has flaws. To this I can only say that dennisn and I disagree with that principle and leave it at that.

Having said that, there are inefficiencies in the Canadian health care system - as there are in all health care systems. How bad is it, however, in comparison to the US system? Here's a link to a New England Journal of Medicine abstract (2003):

Costs of Health Care Administration in the United States and Canada

Some of their results:

"Results In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada's national health insurance program had overhead of 1.3 percent; the overhead among Canada's private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers' administrative costs were far lower in Canada."

"Between 1969 and 1999, the share of the U.S. health care labor force accounted for by administrative workers grew from 18.2 percent to 27.3 percent. In Canada, it grew from 16.0 percent in 1971 to 19.1 percent in 1996. (Both nations' figures exclude insurance-industry personnel.)"

We may be inefficient in Canada, but 16.7% vs 31.0% for administration? I'll take the Canadian level of inefficiency any day.

Another link (which refers to the study above):

U.S. spends 300% more on health care administration

contains this gem:

"For example, one of the biggest U.S. private health plans, WellPoint, looks after 10.1 million customers and has 13,900 administrative staff. By contrast, the Ontario Health Insurance Plan covers 11.7 million people with about 1,400 employees."

Hooray for private sector efficiency!

Too be fair, I've heard it argued that a big portion of the cost of health care administration in the US is the need to follow government regulations. The claim is that the government has downloaded the burden / its responsibilities (depending on your politics) onto the private insurers. The current system is therefore completely half-assed. The solution is obviously get out of health care altogether / convert to a single-payer system for efficiency (again, depending on your politics).

Being Canadian, familiar with our system, and its history, I favour the single payer system. DA brought up the issue of nation defence. One of the (many) impulses towards the implementation of universal health care in Canada was the experience of Canada's military forces in WWI and WWII. High percentages (30% - 40% depending on the type of service and the year) of men were rejected for service overseas due to health problems - tuberculosis being a particularly notable example. Here's a simple example of where better health care made a huge difference in WWII (from EVOLUTION OF MILITARY RECRUIT ACCESSION STANDARDS:

"Dental defects were the leading cause for rejection at local boards and accounted for 17.7% of all rejections. Providing treatment for dental defects resulted in the qualification of almost 1 million additional men for military service."

1 million additional men once their dental problems were fixed. That had a direct affect on the armed forces - what price do our economies pay because people lack adequate health care? (One can comment on the irony of making men healthy enough to go overseas to fight in the trenches, but I'll pass on that.)

I've just never understood the American rejection of universal health care. Is the word 'socialized' so hated and feared that it destroys rational thought on the issue?

dennisn -- you are getting me wrong! i absolutely appreciate my freedom to die on the sidewalk -- that my taxes helped to build -- because i cannot afford the medical care that might fix whatever problems i was suffering from. after all, worthless losers such as i deserve whatever crappy situation we are stuck with, right?

currently, i am being sued for numerous medical bills due to my last visit to the ER that happened 18 months ago. it's always fun to start off my day by telling a lawyer who works at a collection agency that, if she dares break my kneecaps in retaliation for these unpaid medical bills, i will exercise my freedom to sue her for assault, pain and suffering, and of course, the resulting medical bills.

I wish americans would appreciate the individual liberties on which their country was founded a little more :|.

Yeah, such as the right to die from lack of insurance! Have you read the post?

I have absolutely no problem with you two opting in to whatever kind of health insurance you want--just don't FORCE others into it!

Then who will pay for your health insurance? Will you never get sick? Will you never get old? Don't tell me you never thought about that.

dennisn - how do you propose to pay for the health services for people who can't afford to pay for it themselves?

That may indeed be something he has never thought about.

dennisn wrote:

If a doctor offers a service that I want, nobody has the right to interfere. Nor does anyone have the right to FORCE me to pay for something I might not want. I wish americans would appreciate the individual liberties on which their country was founded a little more :|.

Do you somehow have the impression that medical and surgical care are things that people go shopping for, like shoes or cars? ("Hmmm, I can't afford that prescription for my asthma. Got something less expensive, like, say, for a mild headache?")

I wonder if you feel "forced" into having your taxes pay for police and fire services. Or would you prefer it if people had to whip out their credit cards before the fire department agrees to hose down their burning homes?

dennisn makes all Canadians named Dennis feel ashamed.

I just want to give an example of our wonderful health care system. My mom is disabled and gets social security and Medicare. What she gets from social security is not enough to live on and pay for health insurance. Nor is it enough to live on and pay for the health care she needs. Its barely enough to live on period. But she has Medicare right? Well, recently she fell into the GAP with her Medicare ins. and they will not cover any of her medications until she pays out $3000.00. It would only take about 5-6 months to reach this amount b/c her meds cost about $600.00 month.(BTW, She gets about $1000.00 from Social Security a month and she has other bills just like everyone else too.) But when you can't afford it what do you do? Right before Gustav hit our area and we evacuated I was faced with having to make the decision of which medicine to buy for her. I picked the one that treated the most life threatening alignment. We simply could not afford the others. I am currently looking into other options to make her meds more affordable but if I can't find help then what next? Should she take out loans to pay for the meds? Should I? What if I/she can't pay the loans back? The more I think about her situation the more it seems, if you are too poor to pay for medicine then you deserve to die. If socialized medicine is the answer to stop situations like my mom's from happening then I am all for it!

dennisn: You sure you're a Canuck?

Because I am, and I don't-quite worship at the altar of this system you feel has been so unethically forced upon you. By your standards, I was forced to accept having my life saved. And the surgeon who did the job was forced into saving it, apparently.

Forgive me if I feel grateful that we were each so coerced.

Have you considered moving? It's a short distance south to a place where all have the freedom to be unattended by the best medical science in the world.

Of course, the net tax rates run pretty similar for those making under about 50K. But you won't be "forced" into actually being able to get health care when you need it.

The old protectionism that forbids foreigners to practice here was from the Canadian Medical Association, by the way. The same people whose president is now enthusiastically championing further for-profit elements.

Their judgement remains poor, so it seems.

An effective contrast drawn, and a rather poor report card for our political leadership. Yes, let's privatize profits, but socialize losses; go figure!

Eventually sobriety will be achieved and we'll go the way of Germany, Switzerland or other democratic developed nation who understand there need be a "public trust" like entity that is more concerned about the health safety net of its citizens than their own profits.

Flatten the insurance industry. Make them serve, and not cherry pick, the risk pool.

Count me in as another very satisfied consumer of the Canadian health care system. (And as someone who has seen first-hand the US system, being an ex-pat, I can make direct comparisons.)

@mac,
I would actually like police and firefighters and everything to be voluntarily paid for! But, either way, nobody has a right to FORCE me to pay for anything. What is so hard to understand about this? In reality, though, I probably would try to find some insurance coverage, IF I felt it was necessary, and IF I felt satisfied with the services and price offered.

@Bob O'h,
Charity. Either way, it's not my fault that they are poor. And it's evil that anyone should FORCE me to pay at gunpoint. Chances are, though, they have family and friends who can help them, and doctors who might give them a discount. Or maybe they were smart enough to get some kind of insurance before. Either way, there is simply NO excuse for forcing anyone to do anything! That is my only point. Surely we can agree on this??

@GrrlScientist :),
I am not calling the less fortunate worthless losers. I don't even know them! Every one of these unfortunate cases would have to be looked at individually. In your case, for example :), how aren't you able to pay for the ER bill? And why didn't you have insurance? (Surely there are some reasonable plans down there?) Surely a bright scientist such as yourself shouldn't have a problem finding a job?

@Marjanović :),
Actually, yes, everyone does (should!) have the right to die. (Suicide). But we're getting off topic. At the end of the day, there is simply NO excuse to violate another person's liberties. You're best and only legitimate option, if you are in the rare unfortunate case of being so poor and dependent on others, is to simply ask for charity. You can't just steal from other people's pockets. I mean you could, (and that's what taxation does), but just please don't call it legitimate.

@Julie S,
Yes, I do have that impression. Do you have the impression that the salaries for doctors are set in stone? Every doctor should be free to charge whatever he feels like charging, and provide whatever service he feels like providing. It's basic liberty for both the consumer of health care, and the doctor. Viewing patients as consumers may feel a little odd, but there is simply no other legitimate alternative. (The nationalized alternative enslaves both doctors and patients.)

And yes, I do feel forced and oppressed into paying for police (who enforce many rediculous anti-constitutional laws) and fire services (who don't really help me much ;). Taxation /is/ evil.

Whipping out a credit card to pay for the rare case when a firefighter is ok with me. If I had a lot of valuable stuff, though, I'd probably buy into some kind of insurance plan :P. But the key here is that I would do so *voluntarily*. Incidentally, I probably wouldn't pay for police or firefighters, if I had the option. I simply don't need either at the moment!

@Dennis
You make me feel ashamed to be Canadian ;). I've been thinking of moving south, but it looks like they want to become just like us :|.

It looks like dennisn should just sell his home and leave his job, and take up a nomadic lifestyle where he is beholden to no one, and expects help from no one. As for me, I am more than happy to help out my fellow man, and I would hope they would do the same for me. I can't help it - I just love humanity!

To anyone who thinks there is no hope for universal health care in the US, look up the Healthy Indiana Plan. Read up a bit about it. I can assure you they are doing things right; I am a member. For the first time in years, I can finally go to the doctor for preventative medicine!

Just a few loose comments, although I'm not sure they'll be relevant: I'm from well outside of the USA, so I'm not familiar with the health system there.

Most countries I know of that have so-called "socialised" health services, also have "private", insurance-based ones too. Its not one or the other, its both with people choosing as suits their needs/wants. In my own country, while the latter does cost a little its not so expensive as to prevent those less than very wealthy use it. Most people use the "public" system for most things, with the exception of some types of elective surgery and the like.

I don't think comparisons with Communist, etc., states are helpful, especially as they don't preclude private services. "Socialised" health systems provide a lowest common denominator service if you will. They are egalitarian in that sense, but elective surgery and other choices will still likely favour the private practices for some people and some operations/treatments.

dennisn, you may have a right to freedom (and, hence, to choose where your money goes), but don't forget that others also have a right to life and the pursuit of happiness.

Just as your right to do what you wish doesn't allow you to kill another human being, your right to choose where your money goes doesn't allow you to not pay taxes to fund for other people's (AND your own) lives to be saved. Your rights conflicts with the greater rights of others.

Charity. Either way, it's not my fault that they are poor. And it's evil that anyone should FORCE me to pay at gunpoint. Chances are, though, they have family and friends who can help them, and doctors who might give them a discount. Or maybe they were smart enough to get some kind of insurance before. Either way, there is simply NO excuse for forcing anyone to do anything! That is my only point. Surely we can agree on this??

We can't agree - I'm not an anarchist. I like living in a society with fire services, running water, roads,electricity secure borders etc. and I'm aware that this has to be paid for. So I'm happy that the government organizes this, and they force me to pay taxes to support the infrastructure. If you don't like it, emigrate to a country with no social system. It sounds like you have the money to be able to afford to.

As for people having family and friends, for many people without insurance, their family and friends will also be poor, so they won't be able to pay for their own insurance.

Either way, it's not my fault that they are poor.

But it is in your best interest that they aren't poor. Even if you completely lack any shred of empathy (in which case I'd like to urge you to get psychiatric treatment, assuming any exists for this dangerous condition), it's easy to make utilitarian arguments. Suppose you own a business, and your employees show up to work ill, lowering your productivity, because they delay each visit to the doctor for as long as possible because they can't afford going to the doctor right away.

This is why companies like GM want universal health insurance, and why France has higher productivity than the USA!

Chances are, though, they have family and friends who can help them, and doctors who might give them a discount.

Evidently not. Or how else do you explain the situation described by GinGin above, the situation that has led 22,000 Americans to die in 2006 from lack of health insurance?!?

You are entitled to your own opinion, but not to your own facts.

Or maybe they were smart enough to get some kind of insurance before.

Not "smart". "Rich" is the word you're looking for.

I mean, please!

Either way, there is simply NO excuse for forcing anyone to do anything! That is my only point. Surely we can agree on this??

If you don't want to pay your membership fee for living in a democracy, go to Somalia. Seriously.

Surely a bright scientist such as yourself shouldn't have a problem finding a job?

:-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D :-D

Welcome on the planet Earth, my friend. Jobs for scientists don't grow on trees. In many countries their number is even decreasing.

Have you ever thought any idea through to its logical conclusion?

Actually, yes, everyone does (should!) have the right to die. (Suicide). But we're getting off topic.

Yes, that is another topic.

At the end of the day, there is simply NO excuse to violate another person's liberties. You're best and only legitimate option, if you are in the rare unfortunate case of being so poor and dependent on others, is to simply ask for charity. You can't just steal from other people's pockets. I mean you could, (and that's what taxation does), but just please don't call it legitimate.

Human rights.

Healthcare is not a privilege or an undeserved gift. It is a right. A human right.

And charity? How naive can one be? For millennia now, societies have encouraged charity, commonly to the point of making it a religious duty, and what is the outcome? There has never been a country without large numbers of poor people, except for First World countries with a well-developed social net, of which universal healthcare is an important part.

I can only repeat: Have you ever thought any idea through to its logical conclusion?

Viewing patients as consumers may feel a little odd, but there is simply no other legitimate alternative.

Again: we are talking about a human right here.

Taxation /is/ evil.

So you'd actually like to live in Somalia?

Whipping out a credit card to pay for the rare case when a firefighter is ok with me. If I had a lot of valuable stuff, though, I'd probably buy into some kind of insurance plan :P. But the key here is that I would do so *voluntarily*. Incidentally, I probably wouldn't pay for police or firefighters, if I had the option. I simply don't need either at the moment!

Yet another idea you haven't thought through. Health insurance companies work for profit. Logically, they compete for those who are least likely to need health insurance -- rich young people -- and try hard to never insure those people who are most likely to need it. These people will wind up without health insurance -- and that's what we see in the USA today!

But, see above, it is in your best interest that everyone should have health insurance. What to do? Simple: don't run health insurance for profit. Have at least one insurer that merely tries to not make a loss and is required to accept everyone. That's what the whole rest of the First World does, Canada included.

"Socialised" health systems provide a lowest common denominator service if you will. They are egalitarian in that sense, but elective surgery and other choices will still likely favour the private practices for some people and some operations/treatments.

That's the case in Germany -- "two-class medicine", better treatment for rich people. The difference to the USA is that still everyone does get treated when the need arises.

How much health insurance can 2 trillion in Wall Street bailouts buy?

What about 2 trillion for an illegal war based on lies, how much health care can that buy?

Why does somebody who makes 100,000,000 a year pay the same in FICA taxes as somebody who makes 100,000? Why do many large companies pay less income tax than the local 7/11?

Why is corporate welfare somehow good but food stamps or welfare for the poor evil?

ABC News reports the bailout comes less than a year after Wall Street�s five biggest firms�Bear Stearns, Goldman Sachs, Lehman Brothers, Merrill Lynch and Morgan Stanley�paid a record $39 billion in bonuses to themselves. Yet these people are worthy of tax dollars but some 48 year mother with cancer is not?

America wake up, stop voting against your best interests...

Obama 2008

I only have this to add: health care is not a right. It doesn't make sense. Doctors don't grow on trees. They become doctors through their own individual volition, and have the right to perform whatever services they want, at whatever prices they want. Trying to say other people have a right to force them to offer a specified service at a specified price, no matter how eloquent or convincing the argument, is idiotic.

Also, nothing is stopping the more "enlightened" people from joining this utopian insurance plan. All of you who want to sacrifice for others (I'm not saying it's a bad thing!), should feel free to. Just don't force it on unwilling participants.

Bob O'H above plainly said that he is happy that government forces him to pay for health care. But is he happy to pay for other "public" services, like the Iraq war? Or bad education systems? In other words, does his happiness of forced seizure of his private property only extend to programs that he agrees with, or does he agree with everything the government does?

@dennisn: As I've written elsewhere on this blog, 91% of Canadians think that the Canadian version of Universal Health Care is better then the American System. You wouldn't find a single issue in the US that has that much support among Americans. As a Canadian living in the US, I have to say that my experiences have validated what most Canadians think. You must be an aberration (within the Canadian population).

I'll also point out that Libertarianism (which I gather is your political affiliation), is the equivalent to anarchy. Most libertarians are moderately well off and have profited from the very social institutions that they love to denigrate. Somehow they mistakenly believe that they did it on their own. They do not realize that if they were born in Mogadishu, they would have a short, nasty and brutish life. I am glad that neither you nor your party has much support anywhere.

Dear Mr. Palazzo,

If it is indeed true that over 90% of Canadians agree with state-enforced health care, that is simply sad. But it doesn't make it right. I remember reading Orwell's 1984 a while ago, and thinking how absurd it was--in particular the notion of double-speak--ideas like "war is peace", or in this case "slavery is freedom". Surely nobody in reality--surely not 90% of the population--could be so gullible. I think I have a new-found appreciation for Orwell. How do his books end again?

Also, libertarianism most definitely is not anarchy. Libertarians still believe in state-enforcement of a minimal set of laws, that protect individual liberty (and by induction, private property). They also want a state-funded judicial system. The great nation of the USA was founded on libertarian roots--on the liberties of the individual, and the minimal intrusion of government, who's SOLE purpose was to guarantee individual liberties. How this beautiful and fair and simple goal has become so twisted and double-spoken and complicated is truly a sad to behold.

I only have this to add: health care is not a right.

I refer you to the United Nation's Deceleration of Human Rights, Article 25, which states:

Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

This sort of right should really just be derived logically from the right to life.

Libertarians [...] want a state-funded judicial system.

I only have this to add: police protection and a judicial system is not a right. It doesn't make sense. Cops and judges don't grow on trees. They become cops and judges through their own individual volition, and have the right to protect and serve whomever they want, at whatever prices they want. Trying to say other people have a right to force them to enforce specified laws, no matter how eloquent or convincing the argument, is idiotic.

I only have this to add: health care is not a right. It doesn't make sense.

To (more or less) say what others already have, that's the same as denying the right to life. Are you seriously arguing that?

But is he happy to pay for other "public" services, like the Iraq war? Or bad education systems?

As it happens, I didn't pay for either - Finland didn't take part in the Iraq war, and it has a good education system. But people in the US have the right to vote, so if they don't like the way their government is treating them, they can vote for a party they believe is better.

Or they can (at least in principle) emigrate, which is what I did (from the UK, not the US).

Regarding cops and the judiciary: dennisn can correct me, but I believe the basic libertarian principle can be summed up with the oft-quoted line: "The right to swing your fist ends where my nose begins". Thus the cops and the judiciary are in place to protect people from those who would swing their fists at others. I can understand and accept this basic principle of minimal interference.

However, I'm a utilitarian, not a libertarian. dennisn, let me ask you about one specific example, because I would be very interested in your take on this. Smallpox was a disease that ravaged humanity for the last 12,000 years or so, killing millions in that time, perhaps even as many as 500 million in the 20th century alone. In 1979 it was finally wiped out by a vaccination campaign, which, from your point of view, was forced on people. (For example, the British government make smallpox vaccination compulsory in 1853.) Not everyone wanted to be vaccinated, but it was forced upon them. The result was that (short of a stupid lab error), no human being will ever contract smallpox again. Did this compulsory vaccination campaign violate your libertarian principles, or was it an acceptable intervention by government, and if so, why? If it did violate your principles, are millions of deaths due to preventable disease an acceptable price to pay for your personal maximal freedoms?

@dbrown,
Forced vaccination is indeed a violation of individual liberty. In the event that a person cannot be convinced of the benefits of the vaccine, he can still be quarantined reasonably well from the rest of the population. And so long as the majority are able to be convinced, the disease would be largely stopped.

@Bob O'H,
You (and Josh and article 25 of the UN Declaration) seriously misunderstand what the right to life means. There is no way it can possibly allow someone to force another person to do something against their will. Do you see how your logic is fundamentally flawed? How, if guaranteeing someone's alleged right to clothing necessitates oppressing an unwilling participant, there is a grave contradiction?

@Tulse,
You're right. And I agree. But if things got back to at least a libertarian framework, I would be satisfied. It would be a significant restoration of the right to one's life. Unfortunately, what I am seeing much too often, is a trend in the OPPOSITE direction--in more oppression and violation of individual liberty.

Wake up people!

dennisn, thanks for your reply. I'm impressed you stick with your principles and politeness despite the bit of baiting I gave you.

In the end, though, I have to say, with responses such as:

"(Surely there are some reasonable plans down there?) Surely a bright scientist such as yourself shouldn't have a problem finding a job?"

and

"... he can still be quarantined reasonably well from the rest of the population"

your approach is at best naive or ill-informed.

Look at the history of smallpox quarantine and eradication. (Check out the Wikipedia article for a pretty good introduction.) Historically smallpox was first quarantined and dealt with in exactly those countries that had the strongest governments - Western Europe, America, Canada, Australia, New Zealand. The countries with the weakest governments were those where the disease persisted longest. (The Middle East, Africa, India, parts of Asia). You would knock from our hands the tools best suited to best deal with the problem. The last outbreaks in Europe in the 1960s and 1970s were brought there by travelers from the Middle East and Asia - given that you can now travel anywhere in the world in just over a day, how would you work this? Would you restrict people's travel? Would you quarantine everyone who went to a smallpox zone long enough to make sure they hadn't got the disease? Would you test their blood for the virus upon their return? And these measures are less intrusive than required vaccination how? You're Canadian - you remember the SARS outbreak, I hope. Compared to smallpox SARS was not nearly as infectious, or as deadly, but the economic dislocation and panic were huge.

Let me make it clear that I am not claiming that a wave of smallpox epidemics would sweep the world as they did before the 19th century. We in the industrialized world would probably be fairly well off. The 1972 outbreak in Yugoslavia only infected 175 people and killed 35, but it required heavy government intervention to put under control. And that type of intervention would always be required every time something like this happened. Further, smallpox would still be widespread (and therefore a constant source of infection) in places like Africa without the intervention of government-sponsored organizations such as the World Health Organization.

I have some sympathy for your position and philosophy, but in the end I am a pragmatist. The eradication of smallpox was one of humanity's greatest accomplishments. To count on it being "quarantined reasonably well" depends, I suppose on your definition of "reasonably well". I'm not going to ask you how many outbreaks and deaths a year - world wide, not just in Canada - you would accept in order to consider it "quarantined reasonably well" - that would be a cheap shot. Let's just say that we'll have to agree to disagree. Apply your cry of "Wake up people!" as much to yourself as to us - purity of principle may have to give way to 'reasonable' compromise sometimes.

I refuse to agree to disagree :P. That cheapens both sides of the debate. There are many weak points in your arguments. In particular, in your assumption that it is the lack of government enforcement that makes disease rampant in poor countries. There are far more compelling reasons for this--like rampant tribal and religious violence, for one.

Moreover, it is only those who choose not to be vaccinated that are at risk--and as it was a voluntary decision of the individual, he alone is responsible for his life. (On a side note, I take back what I said about quarantining :P--it's not necessary--whether it's done on a local or international scale. Everyone who wants to be protected would want to be vaccinated against all known diseases--which would also deal with the "problem" of global travel.)

Admittedly, it would be wonderful if we were all predictable and programmable machines--at least from the perspective of disease control--but the costs FAR outweigh the benefits. Not to mention that it would be a cruel fate to be resigned to. Albeit a microscopically healthy one.

Nay. There is absolutely no reason to violate individual liberty. But, since this is not some universal quantum mechanical constant--but rather a personal creative desire that most of us allegedly adhere to--I don't have anything more to appeal to than your empathy of my struggle for freedom. And should this fail--should needles begin forcing their way into my arms, or black leather gloves into my wallet--I may very well resist in defense. And maybe one day it will be acknowledged who the aggressor was, and what the defender was actually trying to protect. It's just too bad that that day was not today.

Wow, for a site with science in the name, I don't see a whole lot. Lots of rhetoric, of the sort I can find any time on Daily Kos, but not a whole lot of science. I expected at least a little comparison of the costs of the financial bailout versus the costs of universal health care, I mean the title does sort of imply that, but nada, gar Nichts, nichevo.

One issue that gets lost in discussions of "welfare for business" is this. When we bail out businesses, it's generally in the form of loans, which, unlike social benefits, are paid back, or there are other concessions. In the case of the financial bailout, the Government isn't exactly giving money away. They will get control of a lot of mortgages, and those aren't exactly worthless. You can do a lot of good with that control - eliminating energy-wasteful covenants that ban things like outdoor clotheslines comes to mind - but you can also do a lot of harm. But with a little luck, if the plan works and the markets stabilize, we could end up ahead. Oooh, here's an idea. We mandate that occupants maintain their property and really enforce it.

A number of folks have pointed out that we outspend a lot of countries with universal health care, but get very uneven results, because a lot of money gets wasted on administrative costs. Now if there's one thing government excels at, it's wasting money on administrative costs. So you can't exactly condemn people for thinking the end result of universal health care will be tons of regulation, huge increases in cost, and no improvement at all in health care. A modest proposal: every health care decision that has to be approved under our universal health care system will be signed off by a person who will be fully accountable for the timeliness and accuracy of the decision. I mean, everyone says tort reform is bad, accountability is good, right? So prove it.

Speaking of "prove it," a couple of posts pompously announced that health care wasn't a commodity. It is a RIGHT. So, let's play scientist here. Prove it. Define "right." Start with fundamental axioms and prove that health care is a right. No solipsism allowed - it's not right just because you say so. Also, if you plan on using moral terms like right, wrong, obligation, fair, just, etc., tell us what the source of that morality is. The Declaration of Independence stated what it believed the source of rights to be, but that theory is kinda out of favor in many places right now. So let's hear yours.

Oh, Karl Popper stated that tests of theories needed to be "risky," that is, there needed to be a real possibility of the theory failing the test. So what test will you propose for your theory?

dennisn,

re: rampant violence - although some of these places are indeed violent, rampant is far too strong a word. You'll note that smallpox eradication was successful despite this violence. In the absence of government enforcement, 'grinding poverty' would be a better explanation. Choosing to be vaccinated is a great idea - if you can afford it. Just as choosing a 'reasonable health plan' is a great idea - if they actually exist.

As to vaccinating against "all known diseases" - I'll give you the benefit of the doubt and assume you mean all known diseases with effective vaccines. There are lots of diseases - I already used the example of SARS - without vaccines. How would you have dealt with SARS?

I don't really understand your third paragraph. I will address your point about costs. The current cost for vaccinating against smallpox is $0. And it will, from now on, always be $0. It is also 0 in terms of human suffering, economic damage, and, interestingly enough, no one will ever, in the future, have their freedom violated by forcing them to be vaccinated against smallpox. Yes, of course, there was a price paid in the past for this. But the price has been paid. In your world we would never be free of this disease. People would still have to pay to be vaccinated, and those who couldn't afford it would still suffer from it.

You ask for "empathy for my struggle for freedom". We have been asking for your empathy for those who can't afford vaccination or health care, or just don't have access to it. Is the answer "tough"? (And please don't say "charity". We've had a few thousand years to make charity work, and it has a long way to go.)

Steve Dutch,

I wouldn't argue that health care is a right, but as a pragmatist I would argue that it is a really good idea. One specific example: the rejection rates of recruits into the American army in WWI and WWII. High percentages (30% - 40% depending on the type of service and the year) of men were rejected for service overseas due to health problems - tuberculosis being a particularly notable example. The following is interesting:

"Dental defects were the leading cause for rejection at local boards and accounted for 17.7% of all rejections. Providing treatment for dental defects resulted in the qualification of almost 1 million additional men for military service."

1 million additional men once their dental problems were fixed. That had a direct affect on the armed forces - what price do our economies pay because people lack adequate health care? (One can comment on the irony of making men healthy enough to go overseas to fight in the trenches, but I'll pass on that.)

See: www.bordeninstitute.army.mil/published_volumes/mpmVol1/PM1ch7.pdf

As far as inefficiencies go, here are a couple of quotes:

"For example, one of the biggest U.S. private health plans, WellPoint, looks after 10.1 million customers and has 13,900 administrative staff. By contrast, the Ontario Health Insurance Plan covers 11.7 million people with about 1,400 employees."

"Between 1969 and 1999, the share of the U.S. health care labor force accounted for by administrative workers grew from 18.2 percent to 27.3 percent. In Canada, it grew from 16.0 percent in 1971 to 19.1 percent in 1996. (Both nations' figures exclude insurance-industry personnel.)"

See: content.nejm.org/cgi/content/short/349/8/768

and

www.nupge.ca/news_2003/n21au03a.htm

Government may excel at inefficiency, but private industry clearly isn't too shabby either.

@Steve Dutch,
It would be purely academic to compare such costs, since we have (hopefully) established that they are BOTH evil. Akin to comparing the economic efficiency of Hitler's Germany to Stalin's Russia. Admittedly, it does sound like ugly internet rhetoric--but only if you choose to ignore the underlying issue--namely, the violation of individual liberty. Which, alas, you appear to choose to do :(.

Just to bite quickly though, government has no right to force us to pay for others' (Democrats for interfering in the mortgage business, and bankers for lying to their investors) mistakes. Nor does it have any right to force me to pay for the (inefficient) care of others--an issue you conveniently COMPLETELY ignore.

I do commend you, however, for reminding people that health care is indeed not a right. At least not at the same time that individual liberty is a right. Pick one. They cannot coexist. (And somebody for the love of god fix that horrible UN declaration).

@dbrown,
If market forces (ie. people's freedoms) were respected, people /would/ be allowed to afford vaccines. And, similarly, acceptable health care plans /would/ exist. (Demand = supply.) But, a more important point is that this is the only fair system to do things. Any kind of government coercion is simply wrong--no matter how rosy you try to paint the picture.

With respect to SARS, we in Toronto did just fine, without any need for government enforcement. You seem to be hell-bent on trying to concoct a scenario to justify government's putting a gun to someone's head, "for the common good". Please stop trying :). Even if such a scenario could be conjured up, I think I would prefer to die than to be so enslaved. (Even though slavery would be a more "pragmatic" option.)

I strongly disagree with your predictions for "my world". I am pretty convinced that disease eradication would be just as (or more) effective in a freer society. I believe the correlation between societies that value individual freedom and disease control is far stronger than the correlation between government enforcement and disease control. Ie. the freer the people, the better disease control you have. Not that that changes anything about the ethics of government enforcement.

I shouldn't have used that appeal to empathy. But rather that one primary right that we all are supposed to follow. Our MAIN social contract, above all others. To not violate our neighbour's right to his own life--be that neighbour a doctor, a poor sick man, or a rich healthy man. The appeal to empathy was only supposed to kick in if you decided to violate this fundamental social contract. Your answer of "tough" is a slap in the face to our most important social building block. I hope you weren't too serious.

dennisn,

*You* may be convinced of the magical powers of the free market to eradicate disease, but I'm certainly not. Try, for a start, checking out 'orphan diseases':

"Orphan disease: A disease which has not been "adopted" by the pharmaceutical industry because it provides little financial incentive for the private sector to make and market new medications to treat or prevent it."

i.e. no demand, no supply. Well, not *no* demand, but not enough for free enterprise to bother coming up with drugs to treat these people. Good luck with those rare diseases, gang! There just aren't enough of you to be worth us doing anything about it.

See: www.medterms.com/script/main/art.asp?articlekey=11418

And who do insurance companies want to sell medical insurance to at affordable rates? Young, healthy people, i.e. the people who need the insurance the least and the people who are going to make the least demands on the company. Older people, people with illnesses, people who need the insurance the most are exactly the people who are going to have to pay the highest premiums, are going to have the largest deductions and the lowest pay-out ceilings and are very often the ones who are the least able to pay those higher premiums. No insurance company, no matter what the demand, is going to enter into contracts that cost them more in payouts than they get in income. That's free enterprise.

Let me make it clear, free enterprise isn't evil, and it often works very well and does amazing things, but it just isn't going to do things that aren't worth its while. You'll have to do a better job explaining just why free enterprise would have done a better job of eradicating smallpox than saying you're "convinced". When you are dealing with sub-Saharan Africa, where people live in grinding poverty of often less than a dollar a day, how exactly is it that they are supposed to afford vaccinations? And not just smallpox - measles, malaria, etc. All of those are a huge chunk of their meagre income.

Re: SARS. No need for government enforcement? What are you talking about? Who did the screening at the airports? Who issued the province-wide guidelines for hospitals for dealing with quarantines, hand washing, public education, and all. (I'll give you a hint - the various public health authorities.) Who came up with those guidelines in the first place? Who came up with the research funds for universities and hospitals to try and figure out what was going on? Feel free to claim if you want that in the absence of these government authorities these measures would have been adopted anyways, but please don't make the patently ridiculous claim that there was no government involvement in the SARS epidemic.

Your faith in free enterprise is touching, but doesn't stand up to scrutiny. For another example, check out the Great Famine in Ireland of the 1840s. Here's an interesting tidbit:

"Christine Kinealy, a University of Liverpool fellow and author of two texts on the famine, Irish Famine: This Great Calamity and A Death-Dealing Famine, writes that Irish exports of calves, livestock (except pigs), bacon and ham actually increased during the famine. The food was shipped under guard from the most famine-stricken parts of Ireland. However, the poor had no money to buy food and the government then did not ban exports."

Hey, lots of demand - but the peasants had no money to purchase the supply and people outside the country did. The famine led to the death of approximately one million people through starvation and disease.

"Tough" was my summing up of your position. Got money to buy food, vaccination, or health insurance from free enterprise sources? Great! Not got enough? Tough.

And no, you shouldn't have used that appeal to empathy.

dennisn,

I've figured it out. It's taken me too long, but it's been 20 years since I engaged in this kind of discussion with dedicated libertarians. You have a rose-tinted vision of a libertarian utopia where everyone can afford health care and diseases are wiped out because everyone can afford vaccines and starving peasants can, well, do something. Thus far our discussion has been going like this:

dbrown: "What if x happens?"
dennisn: "In my libertarian utopia, it won't."
dbrown" "But what if x does happen? What do you do?"
dennisn: "It won't happen!"

You are passing over the fact that freedom also involves the freedom to fail. People, sometimes through their own efforts, and sometimes through events beyond their control, fail. Those who fail may just not be able to afford to buy the fruits of a free society. (I find it difficult to credit that you really believe that *everyone* will be able to afford 'reasonable' health care insurance in your libertarian utopia. Heck, you originally seemed to believe that was true in the real world.)

Thinking back I remember a similar conversation I had with someone who fervently shared your beliefs. The difference was that he had, how can I phrase this nicely?, he had the cojones to recognize the logical outcome of his ideology. There are going to be winners and there are going to be losers. And as my acquaintance put it rather eloquently of the losers, "If I have to step over bodies in the street on my way to work in the morning, so be it."

Step up to the plate on this. Recognize that there are going to be losers, and that they may lose very badly. Stop spinning tales of a world in which the free market makes everyone a winner in an attempt to sugar-coat the logical outcome of your ideology.

You are already, as you put it, willing to allow "black leather gloves into my wallet" to pay for the judiciary and the police (and the army?). You don't like it, but you're willing to put up with it. So you're not against taxes per se, you just draw a very thick black line and say, "This far, and no farther". Of course you are clearly willing to put up with more because you're not in jail yet for tax evasion or joining an armed resistance group, or whatever. (Not a criticism by the way - you are clearly taking a pragmatic view of living in modern Canada and not letting your ideology trump your good sense.)

My line is much thinner, much greyer, and further away. As a society we can do better than leave bodies lying in the street. You don't a society that violates your freedom, I don't like a society that leaves bodies lying in the street to be stepped over. You don't want to agree to disagree, fine. We'll just disagree.

You vastly oversimply "free enterprise" by implying that it exclusively and necessarily researches only profitable cures. And you vastly oversimplify and insult both the researchers and the sufferrers of those cures which YOU call "less important".

You also vastly oversimplify insurance companies, by lumping them all into this malicious stereotype. People are free to create whatever kind of insurance companies they feel like. Nobody is stopping you from creating a better insurance company.

And, no, I don't have to explain why I feel freedom "does a better job". In fact, neither do you have to explain why slavery (partial or otherwise) might do a better job--it's wrong by definition.

With respect to yet another one of your extreme cases of poverty (which have nothing to do with "free" countries like ours'), believe it or not, there IS an economy there. They DO have native doctors there. And these doctors will accept whatever payments they can get. It is not so hopeless as everyone seems to try to portray on those tv infomercials with starving kids with flies running all over their faces. It is extremely insulting to portray the situation like this. As if they NEED us white christian westerners to save them--poor hopeless black people. It's neo-racism.

Re: The SARS outbreak--yes I will continue to claim that appropriate measures would have been adopted anyways. Your claim to the contrary is far less credible--it assumes a level of ignorance and outright stupidity of the population that frankly even I am not yet prepared to accept.

Also, "tough" is similarly a summation of your position. "Don't feel your money will be spent appropriately, or disagree entirely with where it's being spent? TOUGH." That's precisely what you are arguing for. However your position is far more intrusive, in that it *actively* hunts me down--whereas my position is incredibly indirect--if it has any substantive affect at all among those "poor others" that you always seem argue for.

Finally, no, I have no such illusions of utopian libertarianism. There's a famous saying that I'm sure you've heard of: The free enterprise system is the worst possible one, except for all the others!

And, I'm not saying that x won't happen--only that your proposed measures do not justify the horrendous violations of liberty that would be needed. Moreover, you constantly use rare and cataclysmic cases to justify the existence of entirely less urgent systems. People are not dying of starvation in the USA. Anyone can get a job if they wanted to. Using (what may very well be false) african starvations to justify a US welfare system is ludicrous.

I fully appreciate that there will be losers. And if they didn't have the forsight to have some kind of insurance plan-b, they can only appeal to charity. Which is exactly what you seem to advocate for, except you want to force it on everyone, regardless if the donors agree with the way it's implemented.

Lastly, I am entirely against ALL taxation. It is stupid to have to pay for police who promote unconstitutional laws. The army is infinitely more stupid. The judiciary slightly less so. The only thick black line I draw is the one that we all /claim/ to draw--it's wrong to force people to do things against their will. Your vision of a friendly society is laudable, but entirely irrelevant to the discussions at hand. I share in that vision, but recognize that no person or group of people can legislate such a thing into existence. It either happens on it's own, or we are a doomed species anyways.

Finally lastly, tax evasion is a synonym for "refusing to pay for the middle-east wars" or "refusing to pay for bad education" or "refusing to pay for inefficient health care systems" or "refusing to pay for things I DON'T WANT". If these things are indeed crimes, than I am clearly guilty. And may god help you all.

dennisn,

I'll only make a few final comments on what you've said. You wrote:

"You vastly oversimply "free enterprise" by implying that it exclusively and necessarily researches only profitable cures. And you vastly oversimplify and insult both the researchers and the sufferrers of those cures which YOU call "less important"."

No, I don't believe those diseases are less important. I believe they are important enough to direct tax money towards. My original statement was: "i.e. no demand, no supply. Well, not *no* demand, but not enough for free enterprise to bother coming up with drugs to treat these people. Good luck with those rare diseases, gang! There just aren't enough of you to be worth us doing anything about it."

That's called 'sarcasm'. It was a representation of your position, and your vast over-simplification "(Demand = supply.)" I never claimed that free enterprise never researches unprofitable cures, but the fact remains that there *are* orphan diseases. Try looking some of them up and see just how much free enterprise time and money is actually being spent on them. Compare that to how much time and effort is spent on erectile dysfunction. And let me re-iterate: I have no problem with companies researching erectile dysfunction or selling cures for it at whatever the market will bear. I'm simply saying that your utopia vision is rose-coloured, and I'll say it again - these orphan diseases exist. Look them up.

I referred to other countries in connection to smallpox - you made the claim that free enterprise would wipe the disease out even in those places, despite the poverty and the rampant violence you claimed. That link was yours - I just followed it.

No, you don't have to tell me why you think free enterprise would a better job at anything - with your utopian vision you don't have to justify anything at all. Tell me though, why does WellPoint need 13,900 people to do a job that OHIP can do with 1,400 serving roughly the same number of customers? Free enterprise is clearly always the better way - except when it isn't. I simply asked you to explain a mechanism, a process, a path, to me as to how free enterprise would wipe out smallpox. Something that has actually been accomplished by, amongst others, the WHO (World Health Organization). If you're satisfied to wave your hands in the air and chant 'free enterprise', that's great, but you'll excuse me if I find that less than convincing and adequately argued.

As for cataclysmic examples - hey, you've got to be able to handle the good with the bad and the really bad. (Hey, if you can handle the really bad, then I'll assume you can handle the merely bad as well.) The Irish Potato Famine really happened and merchants really did ship food out of the country for a bigger profit. If you're OK with that because of your principles, fine. Just don't try claiming (I know you didn't, let's make that clear - you ignored it) that somehow free enterprise would have ridden to the rescue on that. It could have. It didn't. What would you have suggested been done? By your principles, nothing.

You're still a utopian. 44 million Americans can demand all the affordable health care insurance they want, but that doesn't mean they can get it. They can all demand an $1,000 Ferrari too, but they aren't going to get that either. Some things are inherently more expensive, or difficult to procure, or take more resources to administer, and you insult people by simply telling them to go out and get it when you clearly have no idea what the facts on the ground are.

I suggest you do some real research. Try looking at, say, a day care worker, someone with a job, earning $25,000 a year. (A non-cataclysmic example and a realistic salary - I know daycare workers who earn this.) Factor in food, clothing, housing, transportation, life insurance, telphone. Maybe even a bit of entertainment, if that is not asking too much. Children, if they are allowed to have any from an economic point of view. How much salary is left over for health care insurance? How much will it cover? What are the deductibles? What are the spending limits? Take a few examples of costs - say, a pregnancy, or an emergency appendectomy, or breast cancer, or a broken leg, or diabetes and its complications. What are those going to cost? How much will the person have to pay? How much time will they have to take off work and how much will their insurance cover during their absence? Will the money run out, or will it cover them up to old age and the vastly increased costs that brings?

You're welcome to your principles, and please feel free to promote them all you want, but before you start telling people what their plan A should be, get a clue. Get some facts. Then get back to them.

dennisn,

I've been unfair - I shouldn't claim a final comment and walk away without giving you a chance at either the last word or an opportunity to respond in a useful way.

Let's start with the basics. You are trying to do two things here:

First, enunciate your principles regarding freedom. Fine. You've enunciated them many times. You claim that some of my ideas violate those freedoms. And yes, they do. There is no doubt that taxing the citizens of Canada infringes upon their freedoms. Yep. I agree. It's true. We differ, of course, on whether that is necessary. But it's quite true.

Second, claim that the free enterprise system is always preferable to the alternative, whatever that alternative may be, but in particular government action.

This second claim is unnecessary to support your first. Even if a free enterprise approach to some problem was inefficient, expensive, and didn't work well, it would automatically be superior to another (for argument's sake, government) approach, no matter how efficient, how well it worked, or how noble in intent, because it violated your freedom. Again, that is consistent with your principles. Fine.

This is where the problem comes in. In arguing for the superiority of free enterprise in all cases, you are committing the fallacy of begging the question. The question is, "What makes free enterprise better in case x?" You are begging the question because you assume the truth of the proposition that free enterprise is better. This is why I accuse you of believing in a utopia - your only answer so far has been, "Free enterprise can fix that / is better at / can do that", with no counter examples, analyses, or anything other than ideology to back it up. All you've done is make assumptions - and I'll harp on this again, the existence of 'reasonable health insurance' in the US.

And speaking of insurance, no, I didn't apply a viscious stereotype to insurance companies. I simply pointed out that they exist to make money. They make money for their owners and investors by making sure that their payouts are less than their premiums and their investment income. It's a fact. An insurance company that accepted high-cost clients at affordable rates would simply go out of business. That's viscious how? Again, I'll reiterate, I have no problem with free enterprise when it works well. If insurance companies can successfuly insure a particular class of people and make money at it, more power to them. My argument is, and millions of uninsured Americans, some of whom commented here earlier, are the facts to back this up, there are classes of people who cannot be insured at 'reasonable' rates. The nubmers don't work. If they did, we wouldn't be having this discussion.

Hey, you told me to start my own insurance company. Let's reverse the challenge. Why don't you? Prove that 'reasonable' insurance can be offered to the type of people we have been talking about in these comments. I'm happy with OHIP. Do it better, and I'll be happy to shut OHIP down.

Fact: smallpox is gone through government action. (It looks like polio will be wiped out the same way within five years. Ask your parents or grandparents about polio.) Could free enterprise have done this as well? Maybe. But you haven't explained how - you've simply waved your arms and said, 'free enterprise is better!'. Back it up. Show me a similar case where that has happened. If one doesn't exist, I'm willing to entertain an analysis of how this would work. Why? Because if you can show me that free enterprise would do a better job, then I would say, "Great, let's do that instead." All you are doing, though, is begging the question.

Fact: Calamities happen. They need to be dealt with. Unless in being dealt with your freedoms are violated - I get that. If free enterprise can deal with it, and not violate your freedoms, then great. You don't have to argue it's automatically better. It simply fits your principles. Yet you insist on arguing that free enterprise will do it better anyways, yet don't offer any analysis of this would actually work. Ontario's public health system did a pretty good job of dealing with SARS. You believe free enterprise would have done as well or better. Why? Because you've begged the question.

Fact: orphan diseases exist. Can free enterprise deal with them? Of course. Is it? Certainly not all of them, or the term 'orphan disease' wouldn't even exist. Once again, I don't think drug companies are evil because they aren't busy trying to cure every disease that strikes less than 100 people in North America. Like insurance companies they have a duty to their shareholders. My argument is simple: if free enterprise isn't going to do it, then something else can. (And it doesn't even have to be government - I'm open to a third alternative - if it works.)

Here's another fact - you wrote:

"There's a famous saying that I'm sure you've heard of: The free enterprise system is the worst possible one, except for all the others!"

Certainly I've heard of this saying, except I've heard of the real version:

"Indeed, it has been said that democracy is the worst form of Government except all those other forms that have been tried from time to time."

ATTRIBUTION:WINSTON CHURCHILL, speech, House of Commons, November 11, 1947. Winston S. Churchill: His Complete Speeches, 1897-1963, ed. Robert Rhodes James, vol. 7, p. 7566 (1974).

The only thing your quote proves is that whoever came up with it had to steal it from Churchill because they weren't clever enough to come up with a catchy saying of their own. (And no, don't try to tell me 'democracy = free enterprise'. Quick counter example: post-WWII Hong Kong. The facts: wide open free enterprise, almost zilch democracy. Fascinating case - you should look into it.)

I've offered examples of successful government programs. I've offered examples of free enterprise failures. My point is not that government is always better than free enterprise - simply not true. My point is simply that government can play a successful role when free enterprise can't or won't, and I've offered facts in support of that. Heck, I've even offered links and books. You've offered me ideology and cribbed quotes.

This is why I challenged you in the last comment to get a clue and facts. Assuming the truth of what you are trying to prove wastes everyone's time. If you want to enunciate your principles and tell me I am evil for violating your freedoms, fine. Go for it. If you want to tell me that free enterprise is better in all cases, offer facts, not slogans.

If you are going to come to a gunfight at the Argument Corral, where the weapons are facts, you shouldn't come unarmed. When you can do better than beg the question, let me know.

You're a little confused. One sentence you pretend to claim that you are not making personal value judgements on whether erectile dysfunction is more or less important than other diseases, and the the next you're whining about how other so-called orphan diseases are being neglected--the obvious implication being that they are more important than erectile dysfunction. At the end of the day, *somebody* does have to make these value judgements. And, apparently, you don't believe it's individual people, but rather distant populist professional politicians. And, somehow, you can still claim with a straight face that in your future there would be less orphaned diseases. That sounds pretty rosey to me.

Regarding OHIP, I know for a fact, from first-hand experience that our system has GROSS inefficiencies. The fact that WellPoint is less efficient doesn't change anything. Nor does it matter at the end of the day--if I don't want it, you can't force me to pay for it!

Regarding the "potato famine"--yeah, I may very well have done nothing. You got a problem with that? Would you do the dirty work of coming to my house and violently stealing my food, or would you hire big goons with guns to do it?

Also, it is not my resonsibility, nor your's, nor ANYONE else's to tell people what their plan A should be. Turning the table around, what right do you (or anyone else) have to tell me what to do? I thought we already established the fact that you have no such right. Why are we still debating this? Just to remind you, I have no problem with you debating the efficacy of certain policies over others--so long as you don't FORCE them on EVERYONE! If you actually had a valid point (which I still don't think you do, even in your cataclysmic scenarios), you won't have a shortage of people signing up.

My point about "free enterprise"--ie. letting people decide for themselves--was not that it's always the most efficient, but that it's the most just system. It's a sad reality. And I can see great torment in your posts in trying to come to terms with that (in your acknowledgement of the violations of liberties involved in "universal" plans). Trust me. Accept it. You'll sleep better.

Your reluctance to (help) start a better insurance company (assuming you're not already forced into a bloated government-led plan) proves (a) that you actually DON'T care about those poor starving orphaned and diseased children, or (b) you aren't unsatisfied enough with the current offerings. Either way, the "free market system" (ie. *doctors* and *patients*) is working exactly as it should be working! Don't blame your laziness on the system!, tempting as it may be.

Also, your "facts" are greatly distorted. Smallpox was not eradicated solely because of government action. I would say the greatest contributing factors were capable doctors, and a free and informed public. Whatever government action existed, I would say, was merely a formal representation of already existing social action.

I'll conclude with your suggestion--to simply call you evil for violating my freedoms. And repeat an idea I raised earlier: Are you going to come to my house and steal my property, or are you going to hire big goons with guns to do it?

(P.S. I feel a little out of place discussing such a fundamental and ultimately philosophical idea (of freedom) on a science-oriented blog, but it started it. Science and you can only go so far as laying the facts out, and trying your best to convince me--but you simply CANNOT force me to agree with you, much less force me to slave for you. That is my only point. Accept it, and I have nothing further to say. (And, the argument for "universal" healthcare, or any other nationalized program crumbles)).

I'm curious as to where this idea has come from about "socializing" business losses. The much maligned Exxon pays more taxes than the bottom half of all individual taxpayers. And it is so easy to look up data on taxes by income group and see that the top few per cent of taxpayers pay the vast majority of taxes that claiming the "rich don't pay their fair share" is simply a deliberate lie. On top of that we expect businesses to cure social ills like inequality and access for the handicapped, largely at their own expense. So it's misleading to complain that we're "socializing" business losses when we socialize their profits pretty heavily.

There was a quote from the UN Declaration of Human Rights in one post. Might I point out that merely declaring something a right doesn't make it a right? So far nobody's even remotely addressed the issue I raised in my earlier post about actually defining what a right is and proving that things actually are rights. All I have seen are proofs by assertion, or appeals to authority. But I'd like to address a different issue. The declaration says "Everyone has the right to ... security in the event of ...circumstances beyond his control." The ellipses are for brevity.

I once asked a Norwegian why, if his country offered such generous welfare benefits, people didn't simply stop working and go on welfare. He looked shocked and finally said "Well, they just wouldn't do that." Does anyone doubt that lots of people would do that in the US given a chance? I'm all for helping people who are victims of circumstances beyond their control. Finishing school with decent grades, staying off drugs and alcohol, staying out of trouble with the law, and not having sex until you can care for a child are all eminently under your control. Yes, I realize there are mistaken arrests, rape, etc., that are not under a person's control, but I'm not talking about those cases and you all bloody well know it, so don't waste bandwidth even bringing it up.

Norway, by the way has a culturally homogeneous population of 4.8 million, less than a number of US counties and slightly less than my home state of Wisconsin. I'd like to see the government of Norway try to manage Los Angeles County for a year. Does it ever occur to anyone that an ethnically and culturally diverse nation of 300 million people might be a bit harder to run than a nation of 4.8 million? Or that Norway and Sweden are so prosperous because they exported all their poverty to the US in the 19th century? If you get to cite Norway or Sweden as a typical example of what government can do, I get to cite Beverly Hills as a typical example of laissez-faire capitalism.

dbrown's imaginary dialogue with a libertarian was fascinating because I've had very similar discussions with libertarians. But Ive also had almost identical conversations with liberals:

Steve Dutch: "What if we have subsidized health care, a huge increase in costs, enormous increases in regulations and bureaucracy, and no improvement in quality? What if the bureaucrats run the system for their own benefit rather than the public? What if people flagrantly abuse the system? What if we offer generous social benefits and people simply sponge off the system?"
dbrown: "In my liberal utopia, it won't."
Steve Dutch" "But what if it does happen? What do you do?"
dbrown: "It won't happen!"