Reality Is Not Optional

by Don Boudreaux on October 8, 2007

in Health, Reality Is Not Optional

The web-only edition of today’s New York Times published this letter of mine on health care.

Who cares what modern health care-delivery methods are called? The elemental problem is that more and more people feel entitled to vast quantities of high-quality health care paid for by someone else.

And politicians, ever lusting for office, are only too happy to conjure the ridiculous illusion that A will get top-flight service from B when C is forced by G to pay the bills.

Donald J. Boudreaux
Fairfax, Va., Sept. 28, 2007
The writer is chairman of the economics department, George Mason University.

The author of the letter published along with mine is like so many others: he forgets that — to steal Thomas Sowell’s phrase — reality is not optional.  Calling health care “a necessity” does nothing to make it universally available in quantities and qualities sufficient to satisfy all demands that would be expressed for it by individuals each of whom is not required personally to pay for the care he or she receives (or seeks to receive).

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muirgeo October 8, 2007 at 9:32 am

In the Libertarian society what happens to an ill premature baby born to a poor mother? Specifically a baby who will likely die or be severely damaged with out treatment. Some one please specifically explain to me what happens.

muirgeo October 8, 2007 at 9:35 am

To follow on. If it's unnatural to claim access to health care as a right of all people granted by society how is liberty even considered a natural right? Do I tell the grizzly bear or the sea pirate to halt his attack because I have a natural rights and liberties.? Or is liberty, as we describe it, no more a right then health both only granted by the dictums of society?

David October 8, 2007 at 9:50 am

What happens to the child is this:
If there is a sufficient proportion of society which wants to help babies such as this one, then they are not barred from helping the child simply because the government doesn't do it. You, Muirgeo, along with the people who agree with you (which I assume you believe to be a majority since you want the government to do it) can help the child. You can count me in on wanting to help, but I don't know why you and I need to get the government involved.

Some say "well we couldn't afford it without the government." There could be only two reasons for this. One,the people who say they want to help don't really want to do so, and using government is a convenient excuse to feel good about yourself without having to actually do anything. Or two, supporters of this just want "rich people" to pay for it (as if rich people don't give to charity anyway) so they do not have to do so, showing again they really do not want to help the child, except with other people's money.
In summation, if a majority of people want to help, they can do so without the government, and the only reason to use government is so that your preferences can be forced onto someone else. Also Muirgeo, don't paint me as heartless for simply disagreeing with you, because I give money to worthy organizations to help with problems similar to what you posed.

True_Liberal October 8, 2007 at 10:23 am

There are second-order effects.

If "the government" continues to provide more and more services (health care, retirement savings, aid to dependent children…) then the incentive for the individual to exercise care, thrift and restraint is largely removed.

Can we then expect the demand for these handouts to increase? If you answered "Yes", then (to quote Dr. Williams) Go To The Head Of The Class!

True_Liberal October 8, 2007 at 10:28 am

Here's an example of lack of planning – Can you say "Doh!":

http://www.snopes.com/politics/soapbox/jena.asp

I hope the Jena march organizers are properly billed for these services, but I'm not holding my breath!

Simon Clark October 8, 2007 at 10:57 am

"In the Libertarian society what happens to an ill premature baby born to a poor mother? Specifically a baby who will likely die or be severely damaged with out treatment. Some one please specifically explain to me what happens."

Don't feel compelled to give it a capital L or call it "the" rather than "a". There is a single libertarian system no more than there is a single socialist or conservative one.

In addition, the question has little to do with Don's letter. As Don says, declaring something to be a right does not increase the supply of it. If there are only ten incubators for premature babies, there are only ten incubators. A market system of healthcare might assign those based on wealth (which would accrue the healthcare company the maximum profits and ensure an investment in more incubators) whilst a socialised system would make them queue and essentially it would be luck which baby lived or died, with no profit maximisation and no natural expansion or contraction of supply.

Moving on to the specific question though, I can only answer for the type of system I would like to see: either the mother's insurance would cover it (even poor people have insurance) or charity would pay for the child's care. In a system which takes 40% of everything we earn. charities pay for huge children's hospitals, hospices, expensive treatment for rare diseases and all sorts of other costly healthcare related goods and services. There is no reason to believe that healthcare for poor children would be provided by insurance and charity any less than it is under socialised medicine (and of course it is provided less than I might like under socialised medicine). Babies would not be left to rot becuase their mothers could not afford to pay for their treatment, that seems certain.

"To follow on. If it's unnatural to claim access to health care as a right of all people granted by society how is liberty even considered a natural right?"

It's not unnatural to claim that health care is a right. Throughout history people have claimed that they have the right to various pieces of land, or certain women, or to enslave particular races and so on and so forth. Humans are naturally self-interested so claiming that someone must give you something to their own detriment is as human as opposable thumbs.

"Do I tell the grizzly bear or the sea pirate to halt his attack because I have a natural rights and liberties.? Or is liberty, as we describe it, no more a right then health both only granted by the dictums of society?"

Liberty, unless you are religous, is not a magic concept that is woven into the fabric of the universe. It is simply the best system yet discovered for creating the best possible society with the maximum human happiness or wealfare or whatever you want to call the stuff we want from life.

dave smith October 8, 2007 at 11:21 am

Also, muirgeo, you are making the unrealistic assumption that government financed universal health care will indeed be universial. It won't be.

Gil October 8, 2007 at 11:23 am

'Liberty, unless you are religous, is not a magic concept that is woven into the fabric of the universe.' Hahahahahahah. Is too! Wouldn't a true Libber say that to demand that someone refrain from 'force and fraud' is imposing themselves onto someone else and therefore being contradictory? To be non-contradictory means a Libber doesn't impel anyone but rather simply identifies someone else ready to use 'force and/or fraud' and ends up taking the appropriate defensive measures? Anyway if Libertarianism is basically based on 'no force or fraud' isn't that really just ho-hum Pacifism? And since Pacifism has been espoused aeons ago and plenty of people still choose to be _____s (insert preferred word there) means it's a nice goal but let's not go holding our breath either! Yep, a desirable goal, Yep. :|

muirgeo October 8, 2007 at 12:29 pm

"And politicians, ever lusting for office, are only too happy to conjure the ridiculous illusion that A will get top-flight service from B when C is forced by G to pay the bills."

No one is promising "top flight" service but as good or better and for less money. Also A and C are the same people and they are also G so they get to decide how B is implemented. If they push and pull from both extremes then B might not be so good. If they can come to reasonable agreements on how best to implement B then B will likely be very cost effective and efficient.

Simon Clark October 8, 2007 at 12:47 pm

"Wouldn't a true Libber say that to demand that someone refrain from 'force and fraud' is imposing themselves onto someone else and therefore being contradictory?"

No. Libertarianism (the Ayn Randian brand of it, anyway) is about non-agression. If you wish to think of an enforcement of non-agression as an imposition then you may do so. I do not but that is neither here nor there. The other brand of libertarianism, consequentialism, works on the basis of achieving the maximum freedom for each individual to pursue his own interests so long as he does not use agression to interfere with anyone else doing the same. So in either case preventing a murder or a theft is not contradictory.

"To be non-contradictory means a Libber doesn't impel anyone but rather simply identifies someone else ready to use 'force and/or fraud' and ends up taking the appropriate defensive measures?"

Not necessarily in the case of consequentialists, but for other libertarians that is essentially correct, though a little simplistic. Your statement (posed as a question) ignores, for instance, the punishment of criminals which is wholly compatible with both brands of libertarianism.

"Anyway if Libertarianism is basically based on 'no force or fraud' isn't that really just ho-hum Pacifism?"

Pacifism is the doctrine of non-violence. Libertarianism (at least the Ayn Randian brand of it) is a doctrine of non-agression. The two are very different.

"And since Pacifism has been espoused aeons ago and plenty of people still choose to be _____s (insert preferred word there) means it's a nice goal but let's not go holding our breath either!"

See above.

"Yep, a desirable goal, Yep."

Indeed. Do you not value freedom of speech or movement or assembly in and of themselves? Would it not displease you to become a slave or serf?

Bruce October 8, 2007 at 12:49 pm

Muirgeo,

I am having some trouble comprehending your last post. Are you suggesting that if we could all just be more agreeable with regards to third party payment health care we could supercede the laws of supply and demand? If so, how do you explain the fact that elective procedures like Lasik and cosmetic surguries – which are not covered by insurance – have declined in price over the last decade (in the case of Lasik by as much as 90%) while insured procedures have seen double and triple digit increases. Could it be that third party payment insulates the end user from the true cost and thus artificially escalates demand and price? If so, wouldn't a grander scale third party payment system only make this problem worse? In fact, isn't any system that attempts to eliminate the basic financial transaction between patient and provider inherently inefficient and costly?

Michael Blair October 8, 2007 at 12:50 pm

"Wouldn't a true Libber say that to demand that someone refrain from 'force and fraud' is imposing themselves onto someone else and therefore being contradictory?" [Gil]

A simple search for the differences between "negative rights" and "positive rights" should help to clear up your confusion.

Essentially:

Natural rights — such as life, liberty, property — impose only negative obligations upon the other members of society and can thus be held by an infinite number of individuals simultaneously without conflict. Manufactured rights — such as health care, or really the right to any particular good or service — impose positive obligations upon the other members of society and cannot be held by even two individuals simultaneously without conflict.

Simon Clark October 8, 2007 at 12:52 pm

"No one is promising "top flight" service but as good or better and for less money. Also A and C are the same people and they are also G so they get to decide how B is implemented. If they push and pull from both extremes then B might not be so good. If they can come to reasonable agreements on how best to implement B then B will likely be very cost effective and efficient."

This has not been the case in any other nationalised industry. Why should state monopoly and bureaucracy prove so effective for healthcare where markets and competition have proven superior for every other non-public good?

Michael Blair October 8, 2007 at 12:59 pm

"Also A and C are the same people and they are also G so they get to decide how B is implemented…" [muirgeo]

A and C are not the same people; A is A, not C.

You seem to be ignoring that A, C and B are different individuals with different goals and values, to say nothing of the fact that there are essentially an additional 300 million+ other individuals who would have to be taken into consideration in the real world.

To expect so many individuals with so many differences between them to all agree is beyond unrealistic. You might be able to see that once you drop your apparent collectivist view of society.

Simon Clark October 8, 2007 at 12:59 pm

"Are you suggesting that if we could all just be more agreeable with regards to third party payment health care we could supercede the laws of supply and demand?"

Yes, if only we could think of a system where people agree on goods and services and what to pay for them! :|

Greg October 8, 2007 at 1:14 pm

"In her novel Atlas Shrugged, Ayn Rand exposes the viciousness of this moral principle, showing how it sacrifices the productive and successful to the incompetent and indolent. 'A morality that holds need as a claim, holds emptiness—non-existence—as its standard of value; it rewards an absence, a defeat: weakness, inability, incompetence, suffering, disease, disaster, the lack, the fault, the flaw—the zero. Who provides the account to pay these claims? Those who are cursed for being non-zeros, each to the extent of his distance from that ideal. Since all values are the product of virtues, the degree of your virtue is used as the measure of your penalty; the degree of your faults is used as the measure of your gain' (Atlas Shrugged).

dave smith October 8, 2007 at 1:36 pm

IF A and C and G are the same, then why not let G decide what church A and C go to?

OR what newspaper to read?

OR what groups can form?

Xmas October 8, 2007 at 1:55 pm

Actually, A and B could both be part of C.

The bigger problem here is Group A (sick people) want more and more from Group B (health-care providers) while Group C (pool of payers) wants to pay B less and less. Coercive forces G (Government) while obstensibly under the control of Group C is actual under control of Groups D, the most vocal advocates of various subcomponents of Group A (subgroup D1 advocates for sick babies, subgroup Daarp advocates for old people, subgroup D3 politically powerful advocates of disease du jour). Group G then decides that more money from Group C should go to Group B for those things advocated by Groups D and less money to group B for those in group A without political clout (polio and whooping cough vaccination recipients, people in need of a good podiatrist).

So A wants more from B who wants more from C while D convinces G that it needs to take more control over A, B and C. Unless you are an healthy, but underachieving male aged 17 to 30, you are likely fall into one or more of the categories (A, B or C).

Randy October 8, 2007 at 3:11 pm

Greg,

Exactly. Or to keep it simple, social responsibility is dependant on personal responsibility.

I think the primary advantage of voluntary welfare systems is that those in need have to ask for help. That is, they have to make a plea that will necessarily involve an explanation of how they at least attempted to be personally responsible. Voluntary welfare systems build character, while involuntary welfare systems destroy it.

Chris October 8, 2007 at 5:06 pm

Muirgeo –

I don't know about where you live, but every Children's Hospital I've ever known has had an enormous charitable arm — many many voluntarily give money so that premature baby will be taken care of.

But, let's look at the other side: what happens when a nationalized health-care system reduces payments to doctors to the point that few people are willing to become doctors capable of taking care of premature babies? In general, healthy people in national systems are very happy with the system, until they get sick. And then, if they can afford to, they often come to the U.S. for treatment.

Brad October 8, 2007 at 6:51 pm

In the Libertarian society what happens to an ill premature baby born to a poor mother?

People bid for the naming rights. Seriously muirgeo, you're a doctor. Open up a clinic and help them. Or maybe WalMart sets up regional incubator centers. This is so typical of your strawman arguments: how would it be in a Libertarian society… Nobody here really cares what the ideal would be from the perspective of trying to implement it. Find an Objectivist blog if you need that. What we have now is far from ideal, and small-l libertarian principles (such as responsibility) can steer things in a better direction. Our other blog co-host posted an excellent podcast today on Joseph Schumpeter. One thing Schumpeter wanted in his time was for economists to be familiar with and embrace accounting. It wouldn't hurt doctors of today like yourself to do the same.

Ray G October 8, 2007 at 8:50 pm

This is a perfect example of Sumner's forgotten man.

His example said that if A sees that X is suffering and wants to do something about it, great. If A enlists the help of B to help X, then that is great also.

But when A and B force C to also participate in this "charity" then C becomes the forgotten man.

See? Contrary to what muir, John Edwards and the Left in general would have the population think it is C, the common man, working his 40 hour + week, struggling to do something better for his own family that is going to bear the brunt of others' healthcare and general welfare.

In light of all of the socialists experiments and the economic history behind us, believing otherwise takes an immense amount of ignorance and/or dishonesty to oneself.

muirgeo October 8, 2007 at 8:55 pm

IF A and C and G are the same, then why not let G decide what church A and C go to?dave smith

See the United States Constitution, Amendment I

OR what newspaper to read?dave smith

See the United States Constitution, Amendment I

OR what groups can form?dave smith

And again,See the United States Constitution, Amendment I

Any other questions Dave?

muirgeo October 8, 2007 at 9:04 pm

…showing how it sacrifices the productive and successful to the incompetent and indolent…Greg

Wow Greg that's kinda sick. You're calling a pre term baby "incompetent and indolent"…"an absence, a defeat: weakness, inability, incompetence, suffering, disease, disaster, the lack, the fault, the flaw—the zero."

That's real big of you and Ms Rand. While the, "…sacrifices of the productive and successful"…where all completely done on their own. Not like they took advantage of a preformed society that was made that way and kept that way by many who came before them…those that volunteered and those that paid their do to make a country stable for them…and these "successful ones" think they owe nothing back. That's some seruious BS!

M. Hodak October 8, 2007 at 9:39 pm

Michael Blair wrote: "apparent collectivist"

There is nothing "apparent" about muirgeo's collectivism. The assumption that A, C, and G is the same is pretty much the premise of collectivism. And the fact that A and C through G get to "decide how B is implemented," as if B were a tool of the state, is the logical end of collectivism, i.e, totalitarianism.

True_liberal October 8, 2007 at 9:54 pm

muirgeo, why not read up on the experiences Canadian citizens have under the fine and glorious health system? Ditto for France and the UK. A little education in the realities of "universal" health care should scare the **** out of any sane citizen.

David October 8, 2007 at 10:15 pm

Muirgeo:
As long as we're doing lessons on the Constitution, why don't you look up Amendment 10? If we actually followed it, many of our problems would solve themselves.

brotio October 9, 2007 at 1:55 am

Muirgeo is very good at ducking questions. Notice he didn't answer Simon Clark's question about how he (Muirgeo) would assign those ten incubators to one-hundred babies who all need it equally to live or die. Coin toss?

Muirgeo also claimed on a previous thread that libertarians prefer to be ruled by kings, and that he, the person who loves the government to take others' property and give it to him (and doesn't really care if they are damaged in the process, as long as he gets his) is a patriot in the mold of Adams and Jefferson.

Lee Kelly October 9, 2007 at 7:29 am

I agree with M. Hodak. I think we would all do CafeHayek a service by ignoring muirgeo. It cannot be said that the respondents here have no given muirgeo a say, and have no responded time and time again.

To continue letting muirgeo hijack the comments section of every post, is to the detrmiment of CafeHayek.

tiger October 9, 2007 at 7:53 am

I used to think that there is no way the American people would go for the phony "universal health care, health care is a right, everyone should be covered for free.." nonsense but now it appears to be a reality. I'm not sure why the majority of the working American people don't get this fact: You can pay $400, 500, 750 or each month to a private health carrier to purchase insurance or…you can just let government take $400, 500 or 750 each month out of your paycheck in the form of taxation.

muirgeo October 9, 2007 at 9:20 am

muirgeo, why not read up on the experiences Canadian citizens have under the fine and glorious health system? Ditto for France and the UK. A little education in the realities of "universal" health care should scare the **** out of any sane citizen.

Posted by: True_liberal

I have and it works pretty good. Most people are very satisfied. I think people like you confuse the idea of it not being perfect with it not working. Further it cost less, keeps companies competitive by cutting their health care cost and frees up workers NOT to be dependent n their job because of health insurance.

No the Canadians are pretty happy with it. Maybe you should read other then your usual sources on the subject.

muirgeo October 9, 2007 at 9:34 am

Muirgeo is very good at ducking questions. Notice he didn't answer Simon Clark's question about how he (Muirgeo) would assign those ten incubators to one-hundred babies who all need it equally to live or die. Coin toss?

Posted by: brotio

Infant mortality rates are better then ours in countries with universal health access. So there's no point to argue. Simon posed a hypothetical that the real life facts refute with out need of response from me.

People live longer and babies die less in their systems so they are obviously not that bad especially when you consider the cost savings.

vidyohs October 9, 2007 at 9:39 am

Muirgeo, here you go again diverting a very good topic off into your own little idiocy world to make your own little foolish, weak, and ignorant points.

I'll answer your question posed here, which by the way most of know you already posed and was unable to defend on a previous thread.

"In the Libertarian society what happens to an ill premature baby born to a poor mother? Specifically a baby who will likely die or be severely damaged with out treatment. Some one please specifically explain to me what happens."

It doesn't matter whether yuou believe in creation or evolution, we humans are here and live in the natural world of reality. If you, muirgeo, had ever spent some time studying nature you would know how un-natural your question is.

What happens is that the baby dies because nature dictates that it wasn't ready for life, and it is a big natural ooops!

The the baby was created in the first place was as of the act of two people totally unrelated to all but a very few of "society". People (animals) in nature do things and nature assigns responsibility that is uncompromising. I accepted that long ago, and you need to get over it. A previous poster said that he disagreed with everything you wrote and in his opinion you wrote like a child; and, I see his point, you frame all of your words as if they were being composed by a 14 year old girl who has just discovered marxism.

We humans have developed an intelligence, wasted on the socialist, that allows us to intervene with nature's dictates if we choose. But any intervention in your little scenario is un-natural and not the responsibility of anyone but the mother, the father, and other volunteers. If the mother can't, the father isn't identified, and no one else volunteers…nature rules.

Oh, and in closing, I feel absolutely no guilt in providing you with my knowledge in the words I used.
Is that clear enough for you.

vidyohs October 9, 2007 at 9:53 am

Another muirgeo idiocy:

"No one is promising "top flight" service but as good or better and for less money. Also A and C are the same people and they are also G so they get to decide how B is implemented. If they push and pull from both extremes then B might not be so good. If they can come to reasonable agreements on how best to implement B then B will likely be very cost effective and efficient."

muirgeo, you need to go back to your church for a refresher in the history of socialism and how there is no escape from reality.

What happens, chile, is that A is Joseph Stalin, B is Boris Approachenoff, and C is Dr. Rudi Medensky; and, Dr. Rudy is always required to give prompt, top notch, and complete medical care to A in the best facility in Moscow, while B unfortunately is lucky to see the inside of a clinic. That's reality, chile, and it always shapes up like that in true socialist countries.

It is exactly what will happen here in the USA after Billary imposes her insanity on us. And it is fools like those in your church that will make it happen.
And you wonder why you are despised and reviled on this blog? Son, no one loves or wants to deal with someone who is a thief and devoted to it.

muirgeo October 9, 2007 at 10:02 am

Lee,

It always makes my day when you in all your "liberalism" (neo-) want me silenced. Don't you ever feel pitiful when you do so? Aren't you supposed to be a rugged individualist?

Anyway on this is a blog centered around F. A. Hayek and I'd argue from his writings I'm closer to his views on the subject of health care for all then all of you who are arguing against it.

Hayek was not a collectivist but he believed that a wealthy society should provide limited security to all which included comprehensive social insurance. " Where, as in the case of sickness and accident…..- the case for the state's helping to organize a comprehensive system of social insurance is very strong." F.A. Hayek

OUCH!!!!…that's gotta hurt.

Every-time one of you imply I'm a collectivist you cheapen the true meaning of the word. And on this issue you might as well be calling Hayek a collectivist. And that fact underscores the absurdity of your arguments.

I've got Hayek and the facts of successful universal health care in 30+ other countries while all you have is innuendo and an ideology that doesn't even fit with the views of the name sake of this blog.

TLWP Sam October 9, 2007 at 10:02 am

Is this not the bane of technological advancement? Once upon a time many people died in a way that it was 'natural' but nowadays because of whiz-bang technology these people may not need die but access to the life-saving technology may be problematic? Or to put it another way people can bemoan poverty in a poor society but nonetheless see it as their lot in life whereas 'poverty amongst plenty' inevitably nudges some towards some type of redistributive thoughts. "He has too much and the other has too little . . ." "He wouldn't miss the money that much whereas the other could really use it . . ."

Yessirbob, life in the low-tech ages may have been hard but at least it was rather more Capitalist as in 'if you are barely feeding yourself, you are hardly going to feel obliged to share any with someone else'. One of my two cents as why Libertarianism (amongst plenty of others) would work best in a low-tech environment.

Randy October 9, 2007 at 10:02 am

Muirgeo,

Why doesn't separation of church and state apply to progressivism? That is, why is the government allowed to establish progressive idealism in law? There's nothing secular about progressivism – it is very much a religion. In its early days it was even known as progressive christianity. It seems to me that the progressives have simply found a way around the constitution. They stopped mentioning god but keep right on pushing the same old ideas. Seems to me that what is needed is an amendment to prohibit the government from establishing ideology – period.

Gil October 9, 2007 at 10:02 am

Crap! Used the wrong pseudonym!

Chris October 9, 2007 at 10:11 am

muirgeo –

You may be right that most people are satisfied in universal health care plans in those countries that have them. But, that's actually a weakness of such plans — as long as most people are satisfied, the plans will continue and the administrators of the plans will continue to be employed.

I suggest that the opinions of a subset of those people is really more important. I'm talking about the people who have serious life-threatening conditions. How do they feel about the national systems? If you need Orthopedic Surgery in Canada, you'll wait, on average, 41 weeks. A wait for Coronary Bypass is, on average, 12 weeks. In the U.K., the average wait for surgery (across all varieties) is over a year. This subgroup is not happy.

Entrepreneurs in Detroit, Buffalo and other US cities on the Canadian border have set up MRI, CT and Ultrasound clinics for Canadians whose own national healthcare system prevents them from getting those services in a timely manner. They have a lot of business because Canada's health care system is failing those who need it the most.

In fact, if you look around in Canada, you'll find that the system is slowly losing public support.

I recognize that anecdotes are far from proof, but here's an example of what I'm talking about: http://www.liberty-page.com/issues/healthcare/cancer.html

Michael Blair October 9, 2007 at 10:13 am

I have and [health care in Canada] works pretty good. Most people are very satisfied. I think people like you confuse the idea of it not being perfect with it not working. — muirgeo

Perhaps you should check even the Canadian criticisms of the long waits for service, particularly the time lost between seeing a general practitioner and a specialist. There was a successful lawsuit against the system addressed by the Canadian Supreme Court just a few years back which arose because of such waiting.

Also, you seem to have ignored that the post you reponded to specified that people are pretty content so long as they are healthy and not in need of the subpar service. People can sing a different tune once they actually have to try and use it.

Still, even if people were satisfied despite the waiting, such satisfaction would not make the system any more morally justified in using the government to take from C what is his to give to A.

People live longer and babies die less in their systems so they are obviously not that bad especially when you consider the cost savings. — muirgeo

Simply put:
Correlation does not equal causation.

Mortality rates aren't a good indication of the quality of health care in a country as they are affected by numerous factors such as eating habits, violent crime, accidents, etc.

Bruce October 9, 2007 at 10:16 am

Muirgeo,

You don't really have Hayek on your side. Hayek did believe in a social safety net as a charity of last resort, if you will. However, he was very clear in his opposition to reditributionist policies disguised as social insurance.

I quote from Hayek:

"Though a redistribution of incomes was never the avowed initial purpose of the apparatus of social security, it has now become the actual and admitted aim everywhere. No system of monopolistic compulsory insurance has resisted this transformation into something quite different, an instrument for the compulsory redistribution of income….

It is essential that we become clearly aware of the line that separates a state of affairs in which the community accepts the duty of preventing destitution and of providing a minimum level of welfare from that in which it assumes the power to determine the "just" position of everybody and allocates to each what it thinks he deserves. Freedom is critically threatened when the government is given exclusive powers to provide certain services– powers which, in order to achieve its purpose, it must use for the discretionary coercion of individuals."

To quote another of my heroes "facts are stubborn things"

By the way, any time you feel like responding to my previous question regarding the declining costs of patient funded medical procedures (as opposed to insurance funded), please be my guest.

vidyohs October 9, 2007 at 10:25 am

If you, like I, read the linked letters then you see that David Berman write much like muirgeo. Ambigous words that can mean different things to many people. The interpretation and application of the word necessity, as Don pointed out, is one.

""America’s publicly financed and government-run systems include not only the Veterans Administration and Medicare — our most advanced and most efficient health care systems, respectively — but Social Security, public education, law enforcement at every level, and the biggest socialist boondoggle of all, the military (the recent privatization of which isn’t going too well).

The great Republican coup of the last half-century has been its successful demonization of socialism and its deification of market forces. This has created an ideology that Americans no longer question, despite its dissonance with our own reality, and the fact that it’s contradicted by the experience of every other democracy in the world.

Health care is not a commodity but a necessity, just like education, police protection and national defense, and if calling the efficient provision of health care “socialism” is too challenging for American sensibilities, let’s just call it “civilized.”

It is stunning to me to see someone claim that the VA is a model of efficiency and a successful example of socialist health care. Adequate yes, efficient no, but an example of socialism it is, at least here in Houston. The VA here is servicing many thousands of people that aren't really qualified to receive the care they get. They are getting it because of their minority status and not their service record.

MEDICARE, socialism for sure, but efficient, Mr. Berman needed to go out and talk to people, who are actually on MEDICARE, going in and out of the clincs. I personally can't even assign the label adequate to MEDICARE, it appears to me to be as much about appearance of medical care rather than real care one would receive when one pays for it themself. It is, in other words, a roll of the dice when you're on MEDICARE and become ill or need treatments.

Berman, like muirgeo, twists the facts when he calls the military an example of socialism. However, I find it curious that Berman castigate the free markets, promotes socialism and then calls the military a great socialist boondoggle. A tad bit of contradiction in concepts in which he manages to shoot himself in the foot. Whatever your view of it, the military is definitely free market.

And this from Berman cracks me up, much like muirgeo's lack of understanding vis-a-vis free marktes and his mis-interpretation of his own ignorance on top of that.
"" and the fact that it’s contradicted by the experience of every other democracy in the world.""

The experience of democracy shows that free markets don't work, eh? Really?

Mr. Berman, muirgeo, it is your democracy that ensures that free markets don't work because of the guaranteed interference democracy allows the beggars to bring to the results of the free market, they vote themselves wealth redistribution by imposing high taxes on the ambitious and productive, discourage invention and innorvation with the threat of those taxes and regulations, and drive the wealth creators to areas not in the democracy's control (over seas to cheaper labor and lower taxes).

Then Mr. Berman's closing paragraph, health care is not a commodity but a necessity. Realy?

I draw breath in order to get oxygen. I can't think of a single other thing that can not be considered a commodity, even water. Unlike my breath, my water source and intake can be controlled without actual physical interference with the workings of my body. Same with food, clothing, housing, health care, etc., all those things I must earn. Any doctor is in the same situation I am. He must, in order to provide for himself, charge for his services and his services can only be a commodity. Even if one wants to play semantics with the word commodity, the reality is the same. Health care is provided by someone who needs to charge so that he can stay alive, thrive, and continue to provide services.

But, then I am not writing to the vast majority of participants here, I guess I am just writing to those few socialist evangelicals that don't get it and never will.

Randy October 9, 2007 at 12:07 pm

I would like to go on record as opposed to the idea of boycotting Muirgeo. That's what the "progressives" do on their blogs when they run out of insults. Muirgeo is perfecting his argument by seeking out counter arguments. I see nothing wrong with that. I do expect that he will eventually realize that what he believes to be universal moral principles are not universal at all. If he should learn that lesson here, then something "good" will have been accomplished. But to those who have had their fill of playing the foil, by all means, ignore away.

vidyohs October 9, 2007 at 12:24 pm

I agree, Randy, except for one thing and that is that he is not here to learn, he is here to teach. Converting muirgeo to reason and rational is a task much like it would have been to convert Martin Luther to Wikka. An extremely long shot at the very best. I would say Cafe Hayek is more in the nature of an assignment given him by his socialist church Bishop. "Go yee forth muirgeo and disrupt what you can as best you can!" LOL

That being said, IMHO he has earned to the right to direct and blunt responses. I see no need to treat him gentle, with kid gloves, so as not to offend him and make his eventual conversion impossible….cause I know that isn't going to happen.

He is typical, and obvious, of so many I run into on other blogs and discussion links.

Randy October 9, 2007 at 12:35 pm

By the way, Muirgeo, there is no such thing as a natural right. There is only power. Those who speak of a right to healthcare are really speaking of the power to take it and hold it. Taking it will be easy. This is a Democracy. Holding it… not so much… tanstaafl and all that.

Randy October 9, 2007 at 12:40 pm

Vidyohs,

Agreed – no need for kid gloves, and that Muirgeo is not here to learn. But I think that he will learn. If nothing else, as he weaves through the mine fields he will learn that his idealistic vision of the future will contain mine fields – whether he likes them or not.

Daniel October 9, 2007 at 1:23 pm

"IF A and C and G are the same, then why not let G decide what church A and C go to?dave smith

See the United States Constitution, Amendment I"

I work for a institution that is run by an order of the Catholic Church. Though it goes against the beliefs of the church, state law requires that all health insurance policies include payments for abortion. The church has taken this law to court and lost. Muirgeo, is there still separation of church and state?

muirgeo October 9, 2007 at 1:36 pm

Good point Daniel. I think it's time to take away the tax exempt status of churches and use the proceeds to fund national health care…abortions included…and medical marijuana (loosely defined of course).

Randy October 9, 2007 at 1:55 pm

Or… we could just take away the right of the progressives to use the power of the state to enforce their ideology and thus return to a truly level playing field. Removing the tax exempt status of non-progressive churches just gives the church of progressivism an even greater advantage.

Randy October 9, 2007 at 2:08 pm

It would be interesting to see the Progressives try to take on the Catholics and Baptists directly though… to have us a good old fashioned religious war right here in the US of A. Strangely enough, as an Atheist I think I would have to side with the Catholics and Baptists – just to maintain a balance of power.

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