12 January 2008

What would Franklin say about universal health care?

At the root of our motive to work is a desire to survive and to feel secure. Universal health care will be a demotivator to work and an incentive to plan poorly for the future. When the government redistributes wealth, it gives society a false sense of security and lulls people away into a state of carelessness and non-productivity. Such programs rob the industrious and give undeserved, (and perhaps more importantly) unsustainable rewards to those who have not labored for them. There is a way to help the poor and unfortunate. That is through charity and free-will giving. Free-will interactions of that form elevate both the giver and the recipient. Governmental redistribution of wealth is too easily taken for granted by the recipient and yielded begrudgingly by the taxed. Neither group is lifted and both are given incentives to work less (the taxed because he is deprived of his reward and the recipient because he receives without work).

3 comments:

  1. That's a really great perspective on the issue. Here are some of my random thoughts on the issue (not all that coherent)

    I was talking with my friend from Sweden (where they take Universal health coverage for granted) and he was emphatic that in a 'civilized' state people had a right to health care coverage. I agreed that it would be nice, but in order to achieve that state of things, you must hold a gun to someone's head and force them to give over their money (or at least that's effectively what occurs) and he seemed to agree that freedom from forced-redistribution of wealth trumps the right to health care. However, we as Americans can certainly vote that this is how we want to deal with our health care (in which case the aforementioned person with gun to head can choose to go to a different country or to live by the law [however flawed in principle the law may be]). So, at the end of the day, the 1) principles and 2) intended and unintended consequences are what must be considered carefully. The above post really focuses on the unintended consequences.

    Consider a few examples. How shall we build roads? Well, we could say that every property owner is responsible to build his portion of the road and the free market will 'do the rest' to generate a system of useful roads. Well, we voted to let the government (state and federal) step in to regulate things thinking that this solution best fits the nature and scale of the problem and our desired solution. Another example would be public education. Now, we could all get together on the block and choose our own teachers and build our own school for our kids (and many people did this and still do this on differing scales). However, the people voted and decided that a public school system (paid for by land/home-owners) would ensure greatest stability and give access to education to the most people. So, for better or worse (you decide), that's what the people voted for.

    Let's examine Universal Health Care by principle and consequence. In principle, 'less govn't is best' seems at play here. Also, 'thou shalt not steal' seems applicable when considering forced-redistribution of wealth. I'm certainly not convinced (as my Swedish friend is) that health care is a human right. We do seem morally obligated as individuals to help people in times of need and distress, but health care really goes well beyond that. Considering the 'small village' view of things: if someone has a 'right' to health care that means that said person has the right to force another person to stitch their wounds or give them open-heart surgery or provide them with life support (someone has to pay for health care and someone has to deliver it, after all). Hard to argue that its a right. Nonetheless, if the parties agree to enter into such an arrangement, then fine, Universal Health Care (which is the choice America is currently contemplating). If America decides it, I can't see any direct violation of fundamental principles (maybe I'm missing something). Though I always think of the quote that says democracy works great until people realize they can just vote to give themselves money. It's a dangerous slope to slide down.

    Question is, what are the consequences? My Swedish friend has explained that there is a drastic difference in health care here and at home as exemplified by a trip to the doctor here in the U.S. for a fainting spell he had. Doctor said it was probably that he's very tall and that he was just dehydrated. Nonetheless, they did something like three complete analyses on him (including MRI and CAT scans) just to make sure. In Sweden, he says, the doctor would have told him that he is tall and dehydrated, so go home and drink some water and don't be so stupid as to get dehydrated like that again. So, what are the root causes of such a difference in treatment and what are the benefits of each?

    One could argue that a capitalized system of health care promotes unnecessary treatment since doctors can just recommend all kinds of treatments and people (or insurance companies) will pay and they get rich. Moniz made a lot of money going around offering lobotomies even after the medical establishment turned against the operation. A 'real' capitalist system would have enough competition involved that a person could/would 'shop' around for a good deal. Problem is, shopping around takes a lot of effort and competition does increase duplication, so it does burden the whole system (at least viewed from one angle). On the other hand, lack of competition can result in lack of innovation to deliver better health care for cheaper price to more people. Money is a great motivator. The problem with health care is that it is so far outside the realm of most people to make informed decisions for themselves that it becomes really easy for the system to take advantage of them. Capitalism works best with buyers informed and able to make knowledgable choices about the products they are buying. These assumptions don't hold up very well for health care (although in an ideal world they would).

    On the other hand, one can argue that in a Universal system doctors would have less incentive to give people expensive treatments since the govt would have a vested interest in keeping costs manageable (again, nothing is free). This is good for keeping costs down (at least short term) but bad if you are the one they cut corners on.

    Total Cost To Health Care System: Short term, Swedes win.

    Long term, depends on cost-risk analysis for diagnosing serious problems associated with fainting.

    Total Cost to Person?: Probably Swedes win, unless my friend really had something wrong with him, in which case America would have won hands down.

    Peace of Mind: America wins. My friend knows for certain he has nothing else wrong with him.

    Now, if it is true that prevention ends up saving a lot of money over the long run (no lost wages later, no expensive treatments later) then the collective may do better if everyone can get treatment and it is relatively easy to access (i.e., roughly 'free' (although nothing's really free)). The current state of things really does seem geared towards fixing problems rather than preventing them (again, the capitalist sees more money to be made fixing bad problems)

    My point is that the consequences are tricky to untangle. The left trusts the government more than capitalists, the right trusts capitalists more than the government. Hard to know for sure which is best on consequence, so I'd probably go with the principle until further notice.

    ReplyDelete
  2. I think that you keyed in on an important principle with capitalism, which is knowledge about the product. I wonder if with the internet people will begin to be more knowledgeable about their own health conditions and begin to bridge the gap. Knowledge is the key.

    ReplyDelete
  3. I think that an agreement such as universal health care is of the nature that one should only enter into it voluntarily and individually, which, by the way, makes it not universal. If left to a popular vote then you allow the disadvantaged majority to plunder an advantaged minority. Without the constitution and a basic respect for the law and it's fundamental purpuse (recall that government is created in order to enact laws that protect life, liberty and property), the law is turned against its purpose and becomes an empowered offender. The constitution is designed to protect a popular majority from making the law a means of plunder (wealth redistribution is the essense of socialized health care).

    ReplyDelete