Should the state be responsible for healthcare?
Per Wendy Brown:
"The role of the family in the American neoliberal revolution is the subject of Melinda Cooper’s rich 2016 book, Family Values, which reveals resecuring patriarchal family norms not as a sideshow, but rather as deeply embedded within neoliberal welfare and education reform. Cooper examines and links a series of policy domains in which the traditional family was explicitly adduced to substitute for multiple aspects of the social state. In her telling, market privatization of social security, health care, and higher education involved “responsibilizing” individual men, rather than the state, for teen pregnancies, parents, rather than the state, for the costs of higher education, and families, rather than the state, for the provision of every kind of care for dependents —children, disabled, the elderly.". -- In the Ruins of Neoliberalism.
What should the state be responsible for? And why?
"The role of the family in the American neoliberal revolution is the subject of Melinda Cooper’s rich 2016 book, Family Values, which reveals resecuring patriarchal family norms not as a sideshow, but rather as deeply embedded within neoliberal welfare and education reform. Cooper examines and links a series of policy domains in which the traditional family was explicitly adduced to substitute for multiple aspects of the social state. In her telling, market privatization of social security, health care, and higher education involved “responsibilizing” individual men, rather than the state, for teen pregnancies, parents, rather than the state, for the costs of higher education, and families, rather than the state, for the provision of every kind of care for dependents —children, disabled, the elderly.". -- In the Ruins of Neoliberalism.
What should the state be responsible for? And why?
Comments (176)
A society can't be considered a good one if large numbers of its members are without basic needs, including healthcare. It doesn't really matter to me how those needs are supplied. One thing we know - globalization and corporatism won't do it. So - it doesn't have to be government, but if no other institution provides it, the government should.
How about small numbers without basic needs?
It looks like various societies through history have left some members without basic needs per principle. Why would this be wrong?
Good question. The way I see it, a functional society should look after its members as and when necessary. Ideally, in a "one for all, all for one" situation.
So I agree with @T Clark, someone has to provide assistance to those in need. If family, churches, or charitable organizations, etc. cannot do it, then the state has a duty to step in and help out in some way.
I think a healthy society should have no problem in finding a solution. If society cannot do it, then something is fundamentally wrong.
Obviously this should not be allowed to lend itself to system abuse.
I don’t think so. The simple reason is that wherever the state is responsible for health care—for anything—we aren’t. When we delegate our essential responsibilities to one another to a “grinding ruthless piece of machinery”, a state monopoly, we also lose any will to maintain those responsibilities in our own relationships and communities.
What do you think?
As I see it, one problem with state welfare is that it has abolished the distinction between the deserving and the undeserving poor. An EMT friend of mine has had to resuscitate the same reckless, criminal drug user seven times, essentially eliminating the gravest penalties to his kind of lifestyle. I’m not so cold hearted to think this man should suffer the worst consequences of his activities, but it is clear that vast resources are spent trying to eliminate the consequences of reckless behavior, and I wonder the societal effects of that.
Like, a child does not choose to be born, or who their parents are, so the individual does not choose to be born either, or in which state.
Is a parent responsible for the well-being of their children? Is a parent responsible for the failures of their children? Can a child be held responsible for not knowing things it hasn't been taught? Can a child be held responsible for perpetuating those ideas it has been taught?
Some on this forum consider childbirth to be immoral. What does that mean for the existence of states?
I suppose your intended question was more about what powers states should have, and whether they should control healthcare, but I kind of wanted to share this train of consciousness.
I think furthermore Healthcare or basic needs, the State is responsible for not teaching the citizens how to live properly. It is interesting your example: "pregnant teens." this is an issue which are the states have to deal with. It is not about to provide a good health care service to avoid a pregnancy or even promote "free" abortion due to no consent (or promiscuous) sex but a better biology/ethical/sexual education system.
When a citizen goes to a hospital demanding health care because he or she had irresponsible relationships or took drugs, is also a fail of the State.
But, if you keep promoting a better system, then you will have less situations like those.
Note: I am not want to make negative prejudices. I do understand that probably someone could take drugs or been promiscuous without bad faith. I do believe everybody deserves an opportunity to be cured and rehab. What I want to say is that the state has to be responsible to avoid all these dramatic at all costs.
The problem here is a definition of 'work'. Is getting out of bed sufficient? It's certainly some work. To supply benefits in any way to those who 'work', you have to relate work to reward, but work is not related to reward - the super rich don't work (by any reasonable measure) 10 billion times harder than the poor. Reward is (in our society) related only to your ability to secure that reward by any legal means. One of those means might be to lobby governments, protest, vote..etc until one has a government which pays for one's every need without one even having to get out of bed. All legal, so on what grounds could we deny the reward gained from doing so (or from one's ancestors having done so - as with inherited wealth)?
To the actual question, which I realise I didn't address...poor health is, as we've discussed, difficult to discern the cause of, but without doubt it is at least contributed to by the consequences of government policy (anything from investing in a factory to taxing sports equipment) so it seems only fair that same institution pay for the health impact of those consequences.
The problem, as ever, is distinguishing the extent to which the massively obese smoker is responsible for their own diabetes from the extent to which poverty, fast food, recreational facilities, and advertising are.
Sorry to say that the broad (and boring) answer is still some balance exactly of the sort we already do. The question for policy, I think, is the extent to which the government's responsibility should be exercised by investing in prevention rather than cures. But that question is adequately answered by capitalism. Cures are more profitable.
Providing for everyone is the goal, but it'll never get met. People always fall through the cracks. So, keep trying.
It doesn't matter what other people have done. We should do what we think is right, based on our values. There are people in our society who don't agree with me. What we actually get will have to be a compromise between their goals and ours. That's the best we'll be able to do. As Aristotle, or was it Pauly Shore, wrote - Good enough is good enough.
"but it is clear that vast resources are spent trying to eliminate the consequences of reckless behavior, and I wonder the societal effects of that."
Vast resources? Trying to reanimate 7 times? Why do you wonder the societal effects of re-animating a drug addict? It shows me contempt for drug addicts under the comforting guise that you mean them no harm.
This seems to be one of the weak points where state welfare tends to go wrong.
The problem can be redressed only by establishing some form of balance and this would be for a particular society or community to decide.
But I think it would have to start with upbringing, education, and with creating adequate opportunities for all or most to avoid finding themselves in a position of being dependent on others.
Look to what Neandertals did for each other in and around the cave. That. Space, water, food, clothing, shelter, medical, education, defense.
Pretty fucking simple, really.
A wolf pack will no longer provide any of that to a lone wolf who decides to leave the pack. Unfortunately, we extend the protections to the lone wolf and deny them to ourselves. "Ourselves" will someday wise up and reset. And the lone wolf will whine like a little bitch.
I agree that pregnant teens may be a problem depending on the situation and circumstances, but in the Western world, Europe in particular, there is a falling population. So, we must be careful that this is not pushed in the opposite extreme where pregnancy in general comes to be viewed as undesirable.
I may be wrong but my impression is that teens get pregnant not because they don't know better but because pressure is put on them by male teens to have sex. And this has to do with the popular culture and social media that tend to override everything that teens learn in school and at home ....
Is this view based on a principle such as liberalism? Ot what?
Let's back away from social engineering via heartless and criminally inclined paramedics.
Why should a drug addict be more responsible for herself than we are to her? What's the principle?
There is nothing criminally inclined about saving lives. The man is a saint.
The principle is that there are risks to certain behavior, and if people do not suffer them society will never learn to avoid them.
I think it's just common sense, really. In the old days there were high birthrates so a community or society could afford a percentage of citizens that failed to make it or fell on bad times.
When you had large families and close-knit rural communities where everyone knew one another, it was easier to get support in times of need. With growing urban populations where a lot of people don't know one another and are perhaps more indifferent to strangers, it tends to be more difficult.
But I think the state has an interest to eliminate poverty, disease, crime, etc. from society as much as possible. Otherwise a vacuum can develop that can threaten the state's own existence. Political groups and foreign powers are always ready to exploit any weakness in a given society to their own advantage.
You jump from people suffering the risks of certain behavior, to society learning to avoid them. I think that, from the opium dens to nicotine, to alcohol, opioids, meth and beyond, and all the suffering of the people who risk certain behavior, and the friends and family and society around, which likewise suffers therefrom, for hundreds of years, that society might want to finally take a fucking seat and think: "What, exactly, is it about me, society, that keeps producing people who would do this shit to themselves? I mean, I, society, have tried the "stick" and it just doesn't seem to work. Am I, society, fundamentally fucking stupid for continuing to use the stick? For treating a disease like a crime? Why are my citizens the way they are? Do they have hope? Do they have prospects? Are there any other societies around the world trying anything else? How is that working out for them?"
Nah, fuck 'em. Let 'em learn the hard way and die. That'll teach em. Next!
Yes, some people suffer the risk of certain behavior while others learn from their example. While you may blame yourself and society for the conditions of some, I refrain from idealizing my object, and am still capable of knowing that some happen to bear the penalties of their misdeeds.
Is misery not a natural consequence of certain behavior? The assumption that all social suffering is removable, and that it is the duty of the state (never yourself) to remove it, is as artificial as it is false. All you can do is penalize society for the wretchedness of a few.
My view is that a civilized state works to build cohesive community and the health and happiness of its citizens through the provision of care, essential services and amenities.
We have free medical care in Australia and have had so for many decades, It works pretty well and people are not bankrupted here if they get sick.
And the world does not fall appart.
The only curiosity here is, why can't 'mercans see this? What went astray in 'mercan culture?
I think you miss my point. We have been playing your game, to no avail, since time immemorial. When will you ever learn? Your way does not work. If it did, you would not be opining about this issue and saying the same shit your ilk has been saying forever, and saying it now, again, to no avail.
Nobody said "never yourself". If you don't think those people are suffering for the bad choices they made, then you have no experience with them whatsoever. They suffer greatly, as do their family and friends, and society at large. The question you need to ask yourself is not whether or not they are forced to suffer for their bad choices, or if they maybe have not suffered enough (because, after all, they keep making them). Rather, the question you should ask is, why do they make the bad choices in the first place? You think they make bad choices because they don't have enough evidence around them of what happens when people make bad choices? If that is what you think, then again, you have no experience with them whatsoever.
You should actually relate to them. I mean, here you are, doing the same wrong thing, over and over and over again, to no avail. Yet you want to double down and keep doing it. LOL! And here I am, trying to help you and you, like them, won't learn. You keep smashing your thumb with a hammer and wondering why it hurts. LOL! Stop! Help.
I've used this analogy before: A rider will pick a soft-broke horse out of the remuda every time, over a hard-broke horse. No comparison. But yeah, you let your pony run through the bob war all you want.
Well your boss exerts authority over you, but you're still responsible for yourself, right?
I think you stretched that factor all out of shape. I brought it up just to show that many cultures have allowed citizens to suffer hunger. On what principle do we say they're wrong?
This is utter bullshit Sparky. China doesn't have universal healthcare.
They were cannibals. :roll:
We are too, when the need arises. :roll:
... pretty much...
So your point of comparison is China? Not, say, Canada, Australia, or a European nation?
https://ourworldindata.org/grapher/life-expectancy-vs-health-expenditure
Get informed. You might want to understand better why China doesn't have universal healthcare and the social turmoil that has been associated with this fact.
It's not super apparent to me why it should work this way. Can't people litigate to receive compensation when they're victimized? Can't a govt agency like OSHA guarantee their safety?
Why?
This is not a moral argument, but it's a good one. In fact, this argument was the primary reason for post war embedded liberalism.
Free health care and the metric system - it's cominism I tell you! Cominism!
"The Lost Cause". Too many nonwhite citizens & immigrants scares White 'Murica. Also, antebellum nostalgia is still the religion, or ideology, of +40% of our electorate. :shade:
Quoting Tom Storm
:clap:
:up:
The shareholder state? No. Stakeholder self-government? Of course.
Does this say something about whether healthcare should be publicly or privately funded?
So it can be a civilized state. And I've seen it work very well here all my life. I understand some Americans with a libertarian bent don't agree or understand. Such is life.
There are and have been civilized states that didn't provide healthcare.
Remember that healthcare as we know it emerged in the 20th Century, mostly after WW2. Why should this new capacity be essential to civilization? What principle is at work?
Either you nationalize the health sector or you privatize it.
If you nationalize the health sector, more people can afford healthcare but quality takes a hit.
If you privatize the healthsector, quality is A1 but fewer people can afford it.
Also, why is (junk) food easy on the pocket but treatment of obesity-related issues expensive? Why is smoking cheaper than treatment for lung cancer? It's as if the state, that's us actually, finds it highly profitable to make us sick first and then treat us for that sickness.
[quote=The State]I'll first make you buy the poison dirt cheap and then once you fall ill I'll make you pay through your nose for the antidote.[/quote]
Reminds me of Fregoli Delusion.
[quote=Wikipedia]The Fregoli delusion is a rare disorder in which a person holds a delusional belief that different people are in fact a single person who changes appearance or is in disguise.[/quote]
This is the same issue Isaac raised. I think that's more capitalism than the state, tho.
Think you might have that around the wrong way.
But hey, it's your health. If paying more for a worse result is what you want...
A healthy population (and healthy workforce) is essential to a strong economy. In most countries health care is either funded by, provided by, or managed by the State. Given that the State is in the best position to coordinate public and private health care, it should be in charge.
The reason that health care is dominated by commercial interests (for-profit hospitals, clinics, and insurance rackets) is that the US (the state, and the nation of individuals) has always and strongly preferred to receive goods and services in a capitalist marketplace. Health care is just one more service and set of goods.
Inefficiency and diminished efficacy is no reason (under capitalism) to socialize medical care, since the corporate purpose is to generate profit. If an excess number of people die because of that decreased efficiency and efficacy, well... Who cares, as long as there are no unbearable liability issues?
However health care is managed and financed, it will cost money. The question is how much. We could certainly receive the same level of care we receive now for less money in a government financed / government managed plan.
We could deliver much better collective health care (aka public health) services were we free of supporting the profit level of corporate healthcare. Public Health services are directed mostly at disease prevention.
Personally... I've been satisfied with the quality of care I have received over the last 50 years. But, I've also been employed and have had fairly stable finances during these decades. People without employment and stable finances are not in a position to be proactive in their own health care. A visit to the doctor costs too much if one does not have health insurance, so one eventually ends up in the ER or hospital with more advanced, less readily treatable disease. Or, one dies without needed care.
So you don't have an answer other than ’because I'm in the middle of nowhere and I like the way we do it until our economy runs up on the rocks and we can't do it anymore'
Great. Thanks
Quoting Banno
It's The 'Murican Way (you foreigners just don't get how "exceptional" we are). Wealthcare über alles, y'all! :victory: :mask:
What a lovely coincidence! Good to know I'm on the same wavelength as Isaac.
What can I put on the table that someone hasn't already? Let's see...
It's not the ill that kills you, it's the doctor's bill that kills you! Double jeopardy! The state has to figure out why this is the case.
Why is the state in the best position to coordinate care?
Imagine that we go back in time to the 1960s and delete the coordinated effort to undermine black people.
People have good paying jobs and don't worry about healthcare, which is privately funded. What's wrong with this?
Quoting frank
People living in a civilized state where they experience a reasonable level of community cohesion and enjoy good health, education, personal security, and "amenities" experience much less social friction.
Too much social friction begins to undermine the stability of society, such that there is more disorder, more disruption, less production, less consumption, and so on. If social friction becomes very severe, one ends up with a revolution or worse, a failed state.
Social friction has been slightly elevated since Covid-19's appearance, and mild social unrest related to police-black community interaction. Moderate unrest? Yes, moderate. Nothing close to "severe" where the rioters burn down the richer folks' housing. Poor people burning down their own neighborhoods is more or less tolerable, depending how far close one is.
With more malignant neglect and aggravation, we could get beyond "moderate friction" to "serious friction" or even "severe friction". Some people say "speed the day." Those people generally do not have a pot to piss in.
According to the web, the United States is still the only country in the developed world without a system of universal healthcare.
Quoting frank
For what it's worth, it is my understanding that President Truman proposed universal health care in the US in the early 1950s. Richard Nixon also supported a system similar to Obamacare back in the early 1970s.
:100:
Correct. I think this principle has no power at the moment because neoliberalism says fuck social stability. Just raid and move to the next one.
China doesn't have universal healthcare. They're a hell of a lot bigger than we are.
a) it is national in scope
b) it has the power to compel compliance
c) it has law making authority
d) it has great revenue-raising capacity
Because it is national in scope, it can eliminate regional inadequacies (such as exist in the SE and SW United States).
Because it has the power to compel compliance, institutions (hospitals, AMA, pharmaceutical corporations, etc.) and individuals can not disregard state directives on minimum standards of care (affecting every aspect of health care). The state has extraordinary leverage when it is the pocketbook from which providers will be paid.
The state is in a position to legislate how health care will be organized.
Because the state has national revenue raising capacity, it can distribute the cost of care across the entire tax base (including corporations who would no longer have to provide expensive health care insurance programs).
I said "healthcare as we know it". That means x-rays and lasix. I work in ICU, so my view of healthcare may be a little skewed. Pretty much all of the basics of an ICU came along post WW2, specifically from doctors who had been in the military.
Perhaps China is not included among the "developed world." Anyway, the web says that 95% of Chinese are covered by subsidized healthcare.
All true. But competition between hospitals also improves care. So a private/public combo?
There is nothing intrinsically worse about the quality of socialized health care. There is nothing intrinsically better about the quality of privatized health care.
China is a regional power. it's definitely a developed nation.
Quoting T Clark
Not true. They would be if they stayed home in the country. They have moved en masse to the cities and lost benefits in the process.
You are probably right there. I think the idea was to introduce some form of state welfare in addition to higher wages, etc., in order to keep the masses happy and dissuade them from turning to communism. Apparently, the Russians were perceived as a huge threat at the time.
But I think in Europe it started long before the war, probably in the late 1800's and early 1900's.
:up:
Then what's all the fuss about? I'm curious.
So state funded healthcare because the US sucks.
I was looking for a principle. Don't leftists use those?
"Hayekian neoliberalism is a moral-political project that aims to protect traditional hierarchies by negating the very idea of the social and radically restricting the reach of democratic political power in nation-states.". --Wendy Brown
The idea is that morality and markets are the foundation of freedom and they spontaneously create order though traditions. A social democracy can't hope to intentionally create what M&M blindly plant in the world.
There is no such thing as society.
well, lots of people believe that "private is better" "public is worse". The question isn't whether insured well informed care consumers can get good care in the US, or not. They can. The question is whether the good care they get can be provided for less money (it can) and more equitably (it can). But not within the private, for profit model.
What the US has is a continuum of care quality ranging between excellent and mediocre. Where on the continuum of quality one will end up depends first on money (do you have good insurance) and then on knowledge. One really should get the same quality of care without respect to money or how well can decode the system.
Will everybody get luxury grade care in a single payer, government operated system? It may well be that in the government operated hospital NOBODY gets luxury grade care (private room, order off special menu, private nurses, etc.). And really, why should one get such care? Expensive frills like that relate to the ability to pay, rather than medical benefit.
In the free enterprise system, whether you get care at all can depend on the ability to pay. No insurance? No surgery.
Leftism seems pretty puny to me by comparison. Your argument for state funded healthcare was very persuasive, but do you see why it doesn't go up against Neoliberalism head to head? It's a case of fundamentally different priorities.
But as far as principles go, "whatever the US does, do the opposite" is not a bad one.
Ressentiment?
Me, I'd call it a case study in massive failure of healthcare policy.
Ok. As an answer to Neoliberalism, there's not much content there.
Who champions the state and society? Not Marxism. Who?
Edgelord Nietzsche wannabe lol
This isn't a fair translation.
From the same Wiki article as your quote above, it is noted to say:
"If anyone is not willing to work, let him not eat.[1]
The Greek phrase ?? ????? ??????????? (ou thélei ergázesthai) means "is not willing to work". Other English translations render this as "would"[2] or "will not work",[3] using the archaic sense of "want to, desire to" for the verb "will".
https://en.m.wikipedia.org/wiki/He_who_does_not_work,_neither_shall_he_eat#:~:text=If%20anyone%20is%20not%20willing,for%20the%20verb%20%22will%22.
Not willing means to have the ability and to refuse, which means you must help the needy, but are not required to help those who can help themselves but just don't want to.
For a general discussion of the Christian NT ethic of assisting the poor:
https://www.gotquestions.org/Bible-charity.html
The Old Testament commandments to give charity and assist the poor were just that, commandments, not recommendations.
So, it all boils down to how much one's able to spend - graded service with costs pro rata are available for the ill. That's the classic format for private enterprise. There's money to be made of course - the rich will shell out the cash for services that match 5 star hotels they're so accustomed to - but the downside is the lower-income groups will be left out in the cold because they're no longer the demographic the privatized health sector caters to. One filthy rich person will be equivalent to, money-wise, probably 50 average Joes. You do the math.
But they didn't mean the state should help the needy.
Stoicism does.
Bottom line is that any kind of leftism that discounts the importance of states is in agreement with Neoliberalism for all practical purposes.
To create a counter narrative you'd have to provide a genealogy of states that says they also form spontaneously as something essential to some cultural forms. Like the brain of a society, it organizes and protects.
These are also words. Well done.
So you have no interest in this topic?
Uh huh.
I don't get it. What's your point?
If you read the thread, you'll find that several people gave really thought provoking answers to the question.
This is just a punt on your part. A baloney response because you have nothing relevant to say. I went back and reread the posts in this thread. There is nothing that deals with the state of health care in China and how it relates to health care in the US. Or did I miss it?
I worked today. I'm tired. Go to bed.
I don't think Pakistan is an artificial society. What happens today in Asia comes from all the mess the British empire did back in the day mixing all the tribes and ethnics each other. I guess they were forced to create a state because it was impossible to belong to India due to religion and cultural facts and issues. The Nobel prize winner Abdus Salam, explained so well what happened in their construction as a nation. He was born as a "British Indian" but his identity belonged to Punjabi Muslims. Thus, an ethnic which was important to the creation of Pakistan.
So, I guess UK was guilty here of mixing them all in an unique colony when they always were been so different from each other. Result? Civil wars due to territory issues and a big mess when UK left.
It seems like neoliberalism is just the theology of capitalism. Capitalism is selfish, so what's new?
Unlike life or citizenship, work is a voluntary agreement. But even then an employer carries a certain responsibility for their employees.
The principles I just laid out. Either reward is related to work or it isn't. If it is, then we'd not have a problem because the gap between rich and poor would be impossible (no one can work a billion times harder than another), if it's not, then why shouldn't the lazy get rewards (benefits), we've no grounds to deny them because reward is unrelated to work.
Quoting frank
For a start, litigation is controlled by law which is in turn controlled by the state, so their ability to do so is already a state response. Secondly, litigation has a cost barrier so it's not an available recourse to everyone - the state would, in effect, be providing recourse to the wealthy but not the poor.
Quoting frank
From all health harms? It could, I suppose, but it'd have to have laws against bad diet, lack of recreational facilities, taxation and investment in aspects of the food and drug industries, negotiations at world summits and trade deals... It'd quite the remit if it were to cover every way a government policy might harm the health of it's populace. Likewise with litigation really. Which industry/car owner would one sue for one's lung problems resulting from urban air pollution?
Why would I?
Found in many civilized societies.
The church was the state. This distinction between a state that had power to enforce and a voluntary morality of religion is a new invention.
I pay, OBLIGATORY, 125 euros every month and must pay nevertheless 380 euro as my own contribution! And I have to pay a visit to a shaman myself. That pisses me off! I think I need a doctor... I get stressed by these kinds to worry about (not to think about the destruction of Nature...)
What? Why do you have to pay a shaman? Also I am interested, those 125 euros to what medical (or health care) assistance is related? Is like an insurance or something? I am European like you but never heard of that.
But suppose we say that the state is good and that state welfare serves the purpose of preserving the state. Would this make it a moral argument?
I pay that every month to a health insurance company. My girlfriend too! Costs upto 380 euro I must pay myself. In Holland. I dont know about the shaman but virtually all alternatives have to be payed for. Not included in the assurance.
OK, now I understand you better. My parents and my pay for a health insurance company too. The costs are around 129 €.
I thought you were referring to the State itself as the inversion from the taxes.
I've just been interested in Neoliberalism for a while now. I was just noting that the best argument for state funded healthcare would be rejected by a neoliberal because of the importance it places on states and the health of society.
We're still not on the same page. Some of the early responses to the OP were
1. Most countries do it
Which isn't true. Few countries provide 100% state funded healthcare.
2. A country isn't civilized if it doesn't.
Which isn't true.
I often wonder if, when people talk in universal, either/or, black/white dichotomies, they know they are doing it? Maybe someone said "100%" or bothered to define what "civilized" meant. But unless and until those questions are properly addressed, people will continue to talk past each other; talking to straw men.
No state anywhere is 100% anything. And the definition of "civilized" is wide open. How about "more or less funded in X state than in Y state" and "X state is more or less civilized than Y state"? Seems to make more sense to me.
Countries that fund health care more than countries that don't fund health care as much, are more civilized. I define "civilized" as a state that takes care of it's citizens. Civilization - civilized - citizens - civics. Get it? An advanced stage of social and cultural development, a civilized society, enlightened, educated, advanced, developed, cultured, polite and well-mannered. You know, as opposed to "sink or swim" barbaric, "you're on your own" capitalistic BS countries that imprison a large percentage of their population, have the highest health care costs with the least desirable health care.
:up: Beautiful attitude! Kudos.
I want to bounce this nagging doubt I have off of you and others interested:
Indian Giver Tax Puzzle
Scenario 1
Person A to person B: I'm going to pay you $2,000 for the work you've done but I'm gonna need $250 back. You get in your hand $1750. The typical way taxes work.
Scenario 2
Person A to person B: I'm gonna pay you $1750 ($2000 - $250) for your work. You can keep it all. You get $1750.
I can't for the life of me get why scenario 1 is better than scenario 2? A government can save millions by saving on the paperwork that's involved in tax deductions/payments which is no longer required.
Quoting TheMadFool
Where is the $250.00 in scenario #1 and #2?
That's tax. If the government wants to keep it why give it and then take it back? Something doesn't add up.
I guess I'm confused. I've been both an employer and an employee in my life. As an employee, the $250.00 was never given to me and then taken back; it was just taken. The employer would offer to pay $2k, withhold $250.00 and send it in to government. As an employer, I withheld the $250.00 and often matched it, or a portion of it, and then sent it to the government on a monthly or quarterly basis.
While I agree that employers should not be burdened with doing the government's job for it (the government should tax the employee at the end of the year) I understand why the government does not do that. Employees don't make enough money, or are not disciplined enough to save the $250.00. So the government puts a gun to the employers head and makes him/her tap the employee's check before the employee even gets it.
I think you agree with those who say state funded healthcare is a sign of civilization.
I think the reason people think the alternative to state funded healthcare is a grey cultural wasteland is the success of Neoliberalism at making people assume that exploitation and disregard for labor is the norm for corporations. It wasn't that way in the 1960s and 70s, and (white) people then just as firmly assumed that corporations were supposed to care about communities (of white people).
Maybe that's partly why so many responders to this thread didn't understand that I was looking for meaty supportive arguments.
I think the other reason is that leftists aren't used to actually having to support their viewpoint. They think raving like a schizo is their main job.
Why is the state good? You could say states are natural and that health and goodness are equivalent. Healthy pine trees are good. Healthy states are good.
I do. But I also think it is a part of human nature. Even Neandertals took care of their people.
Quoting frank
Yes. I'm no expert, but it is my understanding that we used to have up to a 90% marginal tax rate. With that high a rate, the rich naturally started buying politicians and legislating loop holes and exemptions. Unfortunately, when their employees in the legislature got done providing loopholes, they started dropping the tax rate, precipitately, and there was no commensurate closure of the loopholes and exemptions. So now those (white?) communities have garnered unto themselves the majority of the loot and pay little or no taxes, and everyone else subsidizes their socialist freeloading asses.
We aren't descended from Neanderthals (for the most part), but I take your point. We care for one another by nature.
I toss them out as an "even" argument. Cro-Magnons and others which were our ancestors did likewise. I just think it more demonstrative to say "Even a Neandertal is more civilized than a Republican."
Neanderthals never built civilizations. Civilizations are the product of, and the means by which humans maintain advanced skillsets over time.
We are not talking about civilizations. We are talking about acting civilized. Regardless, I would argue that taking care of one another is apparently and advanced skillset, since so many countries have yet to maintain it.
You're saying that per founding principles, the US govt doesn't fund healthcare.
I would say that if you put more Jefferson in your mix, you'd see that this isn't strictly true. He thought the Treasury should be controlled by Congress. I don't think anything in the Constitution rules out the legislation of universal healthcare.
Quoting Xtrix
You're referring to the govt's bias toward protecting the wealth of the wealthy. :up:
The US government has no national healthcare service, but yet it helps with the cost for poor people (medicaid), the elderly (medicare), children and the disabled. This money -- taxpayer money -- goes to directly into the private healthcare system: to doctors, hospitals, and pharmaceutical companies. So in the sense that the state "should" mostly serve private wealth -- then yes, having no national health service is based in the principles enunciated by Jay, Madison, et. al.. and is in my view a disgrace.
It's irrational that we allow something as fundamental as healthcare (especially life-saving drugs) to be in bed with private ownership, with not even a public option. That's a monopoly of private owners, funded largely by taxpayers. That's like saying education should consist only of privately owned schools -- which, in my estimate, would be in some ways less detrimental than our current healthcare system, at least in terms of deaths (although you can certainly die from ignorance).
Similar things happen in national defense. This is one of the more egregious examples. There's another privately owned monopoly on something that the taxpayers fund, at the tune of $703.7 billion dollars in 2021. Directly into the hands of Boeing, Lockheed Martin, Raytheon, General Dynamics, etc.
Behind these companies are "owners," which are just people with a lot of money, who can afford to be major shareholders and who stock the boardrooms and executive suites. It is to these people that our collective taxes are ultimately destined, to say nothing of the subsidies, tax breaks, infrastructure and defense, and the well being of millions of their employees which the state provides.
It's a wonderful set up. If you're wealthy.
Quoting frank
Indeed.
Let me get this straight:
Are Americans here on PF starting a debate about universal healthcare?
Let me give a hint before you start the debate that usually will in the end break up on the lines of the "culture war"; with progressives and pinko-liberals on one side and conservatives and right-wing libertarians on the other side.
Just ask yourself:
How much worth is the life of your fellow citizen?
Is it much? A new car? Or not much? Few cents? Does it matter? If not, do you then have something, anything, in common with your fellow citizen?
Ask yourself, is your fellow worth anything to you or not. If you answer that you don't care a shit about people's citizenship, whether if they are your countrymen or -women or not (and nations and nationalities are bullshit), just remember: The World does give a shit, on your nationality even if you personally think it doesn't matter. Just look at what is happening in Kabul airport.
(Quite separately of the issue, why citizenship does matter:)
If you answer that the "market mechanism" will take care of it, look at how nearly all other prosperous capitalist societies have solved the problem.
True, but a lot of American hospitals are non-profit institutions. Here's a few of the bigger ones:
1. University of Pittsburgh Medical Center Presbyterian (Pittsburgh) — $10.19 billion
2. The Cleveland Clinic — $9.14 billion
3. Cedars-Sinai Medical Center (Los Angeles) — $7.99 billion
4. New York-Presbyterian Hospital/Weill Cornell Medical Center (New York) — $7.52 billion
5. Florida Hospital Orlando — $7.12 billion
6. Stanford (Calif.) Hospital — $6.71 billion
7. Montefiore Medical Center-Moses Division Hospital (Bronx, N.Y.) — $6.19 billion
8. Hospital of the University of Pennsylvania (Philadelphia) — $5.98 billion
9. Temple University Hospital (Philadelphia) — $5.9 billion
10. Orlando (Fla.) Regional Medical Center — $5.71 billion
11. Massachusetts General Hospital (Boston) — $5.64 billion
12. Crozer-Chester Medical Center (Upland, Pa.) — $4.81 billion
13. Hackensack (N.J.) University Medical Center — $4.72 billion
14. Brigham and Women’s Hospital (Boston) — $4.58 billion
15. Vanderbilt University Medical Center (Nashville, Tenn.) — $4.52 billion
16. Indiana University Health Methodist Hospital (Indianapolis) — $4.19 billion
17. Tampa (Fla.) General Hospital — $4.16 billion
18. Northwestern Memorial Hospital (Chicago) — $4.15 billion
19. Thomas Jefferson University Hospital (Philadelphia) — $4.12 billion
20. The Methodist Hospital (Houston) — $4 billion
21. Duke University Hospital (Durham, N.C.) — $3.92 billion
22. Yale-New Haven (Conn.) Hospital — $3.9 billion
23. North Shore University Hospital (Manhasset, N.Y.) — $3.84 billion
24. Norton Hospital (Louisville, Ky.) — $3.77 billion
25. Loma Linda (Calif.) University Medical Center — $3.69 billion
26. New York University Langone Medical Center (New York) — $3.64 billion
27. Lehigh Valley Hospital-Cedar Crest (Allentown, Pa.) — $3.54 billion
28. Methodist University Hospital (Memphis, Tenn.) — $3.49 billion
29. Rush University Medical Center (Chicago) — $3.49 billion
30. Beaumont Hospital (Royal Oak, Mich.) — $3.38 billion
31. Abington (Pa.) Memorial Hospital — $3.31 billion
32. The University of Chicago Medical Center — $3.3 billion
33. Geisinger Medical Center (Danville, Pa.) — $3.22 billion
34. Baptist Hospital of Miami (Fla.) — $3.2 billion
35. Aurora Saint Luke’s Medical Center (Milwaukee) — $3.19 billion
36. Baptist Medical Center (San Antonio) — $3.18 billion
37. Robert Wood Johnson University Hospital (New Brunswick, N.J.) — $3.15 billion
38. The Mount Sinai Medical Center (New York) — $3.11 billion
39. Barnes-Jewish Hospital (St. Louis) — $3.09 billion
40. Saint Joseph’s Hospital and Medical Center (Phoenix) — $2.98 billion
41. UMass Memorial Medical Center-University Campus (Worcester, Mass.) — $2.94 billion
42. Sharp Memorial Hospital (San Diego) — $2.92 billion
43. Long Island Jewish Medical Center (New Hyde Park, N.Y.) — $2.9 billion
44. Washington Hospital Center (Washington, D.C.) — $2.90 billion
45. Saint Luke’s Hospital-Bethlehem Campus — $2.89 billion
46. Albert Einstein Medical Center (Philadelphia) — $2.82 billion
47. Memorial Hermann-Texas Medical Center (Houston) — $2.77 billion
48. Memorial Sloan-Kettering Cancer Center (New York) — $2.77 billion
49. AtlantiCare Regional Medical Center-City Campus (Atlantic City, N.J.) — $2.76 billion
50. Sutter Memorial Hospital (Sacramento) — $2.75 billion
This is from a website commenting on how wealthy nonprofits are like they don't have to plan for the future. Their CEOs do make insane salaries, tho.
No. The question was about responsibility. Wendy Brown analyzes Neoliberalism from that angle.
My son, we are prone to find evil interesting, and our God-given curiosity may want to investigate it. Beware of Darkness, though. It is seductive and offers the gaping gates of Neoliberal Hell masqueraded as the high road to salvation. Only peer into the dark if you must, but do not step so little as a nanometer past those hideous gates, lest you be lost forever.
After reading the evil book, sprinkle yourself with holy water from the left side of the sacred spring of collectivism. Say 10 Hail Marx, and burn the paper effigy of Margaret Thatcher announcing that there is no such thing of society.
Go and sin no more.
Neoliberalism is an imprecise term. It interests me that Hayek, the founding thinker of neoliberalism was no fan of big corporations, oligopolies or big banks. He liked a free market but he hated what people call crony capitalism (The Constitution of Liberty and Law, Legislation and Liberty) . He would have detested what passes for neo-liberalism today and, as I was taught in economics, Hayek believed the corporations should be bound by the same rules and moral expectations as individuals.
Not sure this gives us much more, but it's worth noting.
He said "pretty much" (not "every single one"), and if the best counter you can find is China, you're pretty much conceding the point. Here's a list of countries with universal/singlepayer/government-provided health care. Its.. pretty long. But sure, China's not on it- what a compelling argument.
Also probably worth noting that basically all comparable countries to the US have better health outcomes with universal/public health care than the US does with its private system. Better outcomes, with a lower price tag, and these national programs tend to be wildly popular.
So this one's not even a fair fight; universal healthcare is a no-brainer. Basically the only downside is that the CEOs of those pharmaceutical and health insurance companies won't make quite as many millions of dollars... the other 99.99% of the population is better off in basically every way. Doesn't get much more open and shut than that.
Well, you could say that the state is good because it maintains cohesion in society, it provides infrastructure and services, it defends society against external and internal enemies, etc.
The state may be bad if it extracts too much taxes or interferes with civil liberties, but you could say that the average first-world state is probably sort of good on the whole.
Is that everyone does it a good argument for doing it? Could it be that everyone is eating tide pods?
Quoting Seppo
That's great. The world has left the US in the dust with its only remaining ally: Sierra Leone, the only friend with a higher homicide rate. Why would a person without an America complex care?
Quoting Seppo
Oh good. So we don't have to think through issues of responsibility at all. Wonderful. Thanks.
:cool: No worries. I remain a steadfast defender of the common man even tho up close and personal, he's actually pretty offensive.
Except for the defense part, all those things can be done by religion, right?
King: "The people are revolting!"
Queen: "Yes, they certainly are."
Is religion good at maintaining social cohesion? Infrastructure? Services?
Only a cautious "Perhaps" applied to the pre-Reformation church, when it had a monopoly. Where it didn't have a monopoly (post-Reformation) it was the subject of quite a bit of rancor. The American colonies had good cohesion when only one sect had a monopoly -- like the Puritans, the Anglicans, or the Quakers. Otherwise, they weren't producing all that much cohesion.
That said, I think "faith", "regular and sincere divine worship", a common narrative of origin and salvation, and so forth can be a healthy element of society. But the State does a better job of providing social cohesion which over-arches sectarian and partisan interests (at least, most of th time).
Because the State is the custodian of the law and not salvation, it can ignore behavior which offends priests and theologian. The church may shoehorn its morality into the law (regarding divorce, abortion, homosexuality, etc.) and once the State gets rid of that influence (as it has over the last century) law becomes tolerant of what the church can not stand.
Of course, Frank, things can go the other way. The Nazi State generated a degree of social cohesion, and where it did not, it forced cohesion, compliance, and cooperation. Similarly, the Soviet State achieved cohesion, but seems to have required a very heavy hand to get and keep it. There are a number of states which perform miserably on just about any measure. Western Europe, North America, Japan, and some other states have, it seems to me, done a pretty good job.
The real argument for it, is the fact that it delivers better outcomes at a lower cost. The argument for private healthcare is... that it allows a tiny portion of the population to get excessively rich, at the expense of everyone else. So it really is a no-brainer; not every issue admits of equally compelling arguments or equally valid opinions for and against, this one is really open and shut- wanting to pay more for worse outcomes is ridiculous and irrational.
I agree. Where there is competition between sects, the state is best positioned to create a stable peace.
Quoting Bitter Crank
For the last few decades, yes, Western Europe hasn't exploded into a massive bloodbath.
Ok. There are tide pods at your grocery store. Go take a long consideration around eating one because everyone, well not everyone, and not even most of everyone, actually a vigorous minority ate them. :up:
Quoting Seppo
So a hefty portion of American healthcare is actually publicly funded. Old people get sick more often, and their costs are covered by Medicare. Pregnant women and babies are covered by Medicaid (at 100%). The average American hospital would go under without Medicare, which is why they take scrutiny by CMS very seriously.
So the relatively crappy outcomes are not a result of a lack of public funding. They actually don't know why it is.
Isn't that the issue?
Yes, as opposed to the issue being what's wrong with the USA.
I think that in every country it is an issue just where to draw the line with personal responsibility and where public funding is used. Naturally not all services are paid / subsidized by the government. I assume that primary first aid to bee free is quite universal.
Here's a way to at least get some evidence for a conclusion. Look at the nations of the world that scores the highest on well-being and happiness. If we want to establish what the state should provide and what not to provide, the voice of the people should be the deciding factor. You could argue that we must first answer the question of purpose, meaning, we must decide what the purpose of a nation and its people is. If it's a nation conducting large-scale warfare for survival, then the needs and wants change drastically. But if we are asking the question for a nation in peacetime where the aim and goal are for the people to live life in a good condition for themselves and with as little pain and suffering as possible. In essence, if the people are happy and feel like their needs and their wants get realized, that is key to answer the question.
So looking at the nations that score the highest on this list, you can deduce what key features these societies have in order to reach this high level of satisfaction among their citizens.
https://worldpopulationreview.com/country-rankings/best-countries-to-live-in
Well, it's not just the CEO's that have good salaries. Overall, the US health care sector enjoys good salaries...which basically makes it so expensive. (duh!)
How do you see that relating to the OP?
It all looked kind of reddish purple.
Ok, making it easier for those who won't read all data.
So, looking at the commonalities between these nations should give hints as to what the role of the state is and what the relation between the people and state should be.
Don't you see the link? I think it's obvious.
Quoting frank
If you have market privatization of health care, it is very likely that the services of doctors salaries are higher.
Think about it.
If you are ill and can die if you don't get treatment, then I guess you have a real incentive to put down some serious money to get good treatment. If you have money, that is. And usually people do have that when it's their own life (or their health insurance is able to afford it). You can always sell the house and live more modestly.
Yep. And the fact that universal programs outperform our own system at a lower price tag is why its such a no-brainer. Like I said, the only real argument against a universal/singlepayer system is that those CEOs won't make quite so many millions of dollars as they can in a privatized system. For the other 99.99%, its better in virtually every way that matters.
Which is, of course, why every other 1st world nation already has one, and why a majority of the American population wants one here too.
Why not just make it tax-funded like in Sweden? I pay like 20 euros every time I go to the doctor and every time I need something from some hospital. But if it goes over 100 euros we all get a free pass for the remainder of the year. Essentially, everything is paid through taxes, but to keep people from not overcrowding hospitals with irrelevant issues, the minimal fee keeps things going even better while addressing that problem.
All in all, my stance is that any basic needs of the people should be issued by the government. Food, shelter, medical care, education, security, and public transportation should be provided by the government through taxes. If you study the domino effect of this then the general well-being of society as a whole goes through the roof. Everyone has the chance to bounce back from bad times in their lives. Not even Sweden has enough of what I'm talking about. We still have a lot of problems with helping people with mental health problems and we have a problem with criminals and young people shooting each other up and creating unrest. All of that is due to the inabilities to plan integration properly. But all in all, I'm quite happy with how Sweden handles the well-being of the people. It's one of the reasons it's high on that list. We have minimal differences between the different Nordic countries in this regard and Norway, Sweden, Finland, and Denmark all rank high for being so geographically close to each other.
But I think more could be included in what the state covers. The cocktail effect makes it close to impossible for large groups to fall into a vicious circle that's impossible to recover from. Of course, the general attitude of the people towards each other is also important, but when money isn't a problem to help someone in need, it gets a hell of a lot easier.
Just think of how many plots in US television and films start out with the main problem being that the main character can't pay for medical bills. It's like no one even questions the stupidity of such a system.
Yes. It's not really apples to apples tho. A fair portion of what a doctor does in the UK is done by nurses, nurse practitioners, and physician's assistants in the US. If you assess by service rather than provider, I think you'd get closer to a valuable figure.
Research shows that a lot of the money in American healthcare is actually going to all the bureaucracy involved in funding, which is another reason to consider government control. It would allow those funds to go to preventative care which would mean Americans might not be so sick when they get to a doctor and so outcomes would improve.
Why all you people think Americans don't see the problems with there own country is beyond me. It's just one case study tho. Why are you trying to extrapolate from one data point?
Seems well arranged in Sweden! I wished it was here like that! Whats the cocktail effect?
We spend even more, of our nickel, training up Tier One Operators to be the best soldiers the world has ever known, and then the private sector lures them away with our big bucks to run security for their executives.
And our private contractors receive a huge chunk to train up Afghan forces who cut and run.
The point here is, while gubmn't can indeed be wasteful, such waste usually comes from those old-school private sector MIC types who have cost over-runs and whatnot on their widget production. But when we actually turn the job of using the widgets over to them, then the fleecing really begins. The private sector is no great panacea when it comes to serving the people. They know gubmn't is not capable of overseeing them, and holding their feet to the fire, and to the contracts; and they have congressmen and women to make sure they don't.
Health care is the same. The people are getting fucked, coming and going.
The private sector could never have won any war we have won; nor should they be given such powerful tools as the military has. Some jobs are just best performed by Private Snuffy and the Tier One Operators, and every one in uniform in between. Same with health care and other essential services. The private sector simply lacks the wisdom, intelligence, patriotism, selflessness and incentive to do right by the people. That's why they should not be allowed to own politicians the way they do.
But alas, just like NASA: they did all the heavy lifting and open the doors. But fifty years from now they will be forgotten and Bezos and Musk, et al, will be hailed as the entrepreneurs, rugged individualists, risk-taking, bootstrapping men who led us into the new frontier, boldly going where no man (well, no private sector man) has ever gone before! Just like the pioneers who opened the west, all with the sweat of their own brow (forget the U.S. Calvary, land give-aways, etc.)!
Can the private sector produce widgets? Yes. But they should not be endowed with the power to use those widgets in furtherance of the public good. Likewise healthcare. (Don't get me started on publicly funded Universities and the tech and medicine that come out of those.)
The private sector needs to be harnessed, like a fucking horse, and put to work, by the people, for the people. It's a free country, they don't have to work if they don't want to. But if they want oats and grain and a stable, that's part of the deal. Work you little bitches! Or go away and let in a horse that's ready for the harness.
End rant.
It is unthinkable that health care systems aren't totally free for everyone. At least the basic health care.
For me, It's one of greatest disgraces for humanity nowadays that with all that progress that has be done, not to open health care to every single person for free. Someone to be abandoned when his Life is at risk, cause of Money! It's another classic example of how humanity values Money over Life.
That someday would have to change. And for me the only way as I see it for health care to be free is through State's responsibility. I cant imagine how "free" and "private" could work together.
:100:
Where is this happening?
But for me health care should be totally free everywhere worldwide. Here in my country you have to pay if you don't have insurance (working insurance) . And only a small amount of health care services are totally free. Which aren't enough and not important either.
If you're in the US and your life is in danger, call 911 or go to the nearest emergency room. They'll take care of you. No abandonment.
You set the humanity bar far too low. For you is just good enough that 911 won't tell you at the phone :
"oh go fuck yourself man and die!".
As if afterwards won't ask you money for the taking care in USA also.
Believe it or not, I'm not in charge of the world.
Believe it.
What, if anything, is stopping you from offering free healthcare?
The private sector insurance industry, for one. You know, that giant sucking sound between the patient and doctor.
Nothing but I don't want. Thanks. I pay my taxes for that though. And I would be willing to pay even more if I knew that this gonna happen indeed!
Tax-funded healthcare isn't free, by any means. It's just that the money to pay for it has been taken from others. To provide free healthcare one must do so through his own efforts and charity.
Charity can't be used as an excuse for States not providing free healthcare. We can't expect the State's job to be done by charity organizations. Of course it's amazing anyone who does that(personally I admire them), but you can't expect all people to be so altruistic and act like that. One should offer charity only if he feels like doing it.
I didn't say people stop paying taxes totally. Of course State needs money as to provide free health care. It won't rain money suddenly. The thing is taxes to have actually some useful outcome. And what is more useful than free healthcare?
That's not free either.
A phrase for when unseen and unintentional side-effects occur due to the combination and sum of many different separate things.
Free med care!
Yes. And let's remember that also part of the money goes to for example medical malpractice insurances and bureaucracy. Or it could be explained simply: when something is intended to make a profit, it naturally means that the costs will be higher than when the intention is just to cover the costs.
Things like preventive care are those things that are extremely difficult to do without programs that cover all the population. And preventive care is naturally far cheaper.
Quoting frank
It's not just one data point. It's a multitude of data. Now I don't want to bash the US and of course we can talk about the UK health care system, the French system, the Swiss system or my country's system (Finland), but I gather that many here are Americans.
And it's an interesting issue that the Worlds richest country has this kind of health care system. There are underlying factors just why it is so and they do start from issues like how the responsibility of the individual is seen.
Taken from ourselves, you meant to say. Not "others".
And this isn't unique to healthcare, the same is true for all other public expenditures- it comes from taxes- the only difference here is, unlike e.g. the billions of dollars we light on fire every year for military toys that sit unused in warehouses somewhere, is that the people footing the bill would actually enjoy some benefit from it. More benefit than we're currently getting, paying more for worse outcomes to our private health insurers/providers.
Again, a no-brainer. Which is why people are having such a hard time coming up with arguments against it.
Makes sense, but my experience with for-profit hospitals is that that just trim the staff down to bare bones and charge the same thing non-profits charge. Costs are actually regulated by Medicare. Private insurance companies use their schedules. Payout is mostly by diagnosis. The hospital or clinic gets a lump sum for GSW (gun shot wound) or URI (upper respiratory infection).
If the provider spends less than the lump sum, they keep the extra. If they go over, they eat the loss.
To get Medicare funds a hospital has to be accredited by Joint Commission, which comes out and grills the staff and looks over documentation. The only times I've had to talk to them, they were actually really nice, buy it still makes everyone nervous.
What is the responsibility of the state? A complex question. When the state will be attacked or even dismantled at the very suggestion of telling people what they can and cannot drink, eat, consume, etc. it comes down to the state having to protect its own existence. So the answer would simply be providing a reasonably safe enough and free environment for people to choose whether or not to live healthy and proper, without rewarding those who don't at the expense of those who do. Which is quite the conundrum.
Well said, yes.
It hasn't been for a long time now
Quoting ssu
Yes.
Quoting ssu
It's a feature of gridlock.
My question was more about principles than what's wrong with the US. This is the second time Ive told you this.
It's basically about individualism and collectivism. What things are understood to be a collective effort, basically being financed with taxes and service given to everybody. Defense is quite universally understood as this kind of collective service. We have no trouble understanding that defense and policing is something that the state has a monopoly over. Anyone with a clear head understands just why this is so and how absolutely insignificant the market argument is in this case. If you would have competing military services, likely they would start fighting each other.
Hence we understand that defense is different. The real question is if health care is different too?
Is this basically what you are asking?
Yes. That was sort of the reason for the federally funded transcontinental railroad and universal telephone service. Competing entities just couldn't do the job. It would have to be centrally planned, so there were provisional monopolies with profit caps and heavy regulation.
A case where a central plan emerged spontaneously is computer technology. The IBM scheme came to dominate partly because they didn't patent their design. Anyone could build an IBM clone, so it became the standard by virtue of popularity.
Other public functions are things like education, where the original principle was that voters need to be able to read. The post office, which I think was meant to facilitate development in general.
I don't know how to compare healthcare to those things. How would you?
That's a perfect example of an actual company getting close to a monopoly situation. Add there just how Microsoft became to be so important.
Quoting frank
I would always look at the history how the healthcare sector has been organized in a country. It tells a lot just why the health care systems are the way as they are. And in that historical narrative you find the major actors, the political parties and elites who have driven through the decisions. Also you then might understand better sometimes a very confusing system.
How was it traditionally organized in Finland?