[extropy-chat] Who Gets Expensive Treatments Under Socialism? (was Cryonics is the only option?)

Anders Sandberg asa at nada.kth.se
Mon Apr 16 08:52:49 UTC 2007

Lee Corbin wrote:
> But if money doesn't decide, who does, and how?  Is it assumed that
> the "waiting list" works well enough where you live?  In the U.S.
> there have been cases IIRC where famous baseball players have
> gone to the head of the list;   and I cannot believe that people
> who are less connected (like me) could possibly stand the same
> chance as people who are well-connected (like powerful politicians).
> Does this problem seem to come up in countries with even more
> socialized medicine than we have in the U.S.?

Sweden has a very socialized health care system (with very good reputation
abroad and factually, but like all European health care systems it is
regarded as inefficient, bad and on the verge of collapse by all swedes).
The official line is of course that everybody is equal in the waiting
list, but a few years ago the social democrat prime minister Göran Persson
got to the head of the hip replacement queue suspiciously quick. That
raised a lot of bad blood, and actually having to wait would probably have
helped his party.

In practice it all depends on how your employer handles health insurance;
if you have a good employer you will get treatment much faster - usually
done by the state health care, but you end up in a far shorter queue. And
if you have enough money you can go to one of the few private clinics (or
abroad). So in practice, getting treatment is dependent on wealth. And
high taxation of course means less spare private money to spend on private
health projects like cryonics.

There was also an interesting study I read about Canadian health care that
showed that despite putting rich and poor into the same system the richer
got more referrals to experts and better treatment. The reason seems to be
that they are simply better at talking to the doctor and asking for what
they want.

Then again, there are always health differentials between more well-off
and less well-off even when treatment is exactly alike. Just knowing you
are ahead of many others seems to be good for health (or conversely,
knowing you are far down on the ladder may stress people out). Given how
easily humans set up social hierarchies even when there is no material or
formal need to, this is something that is very hard to eradicate. Maybe we
should give the worst off SSRIs to improve their social dominance?

Tse, W. S. and A. J. Bond (2002). "Serotonergic intervention affects both
social dominance and affiliative behaviour." Psychopharmacology 161:

Tse, W. S. and A. J. Bond (2003 ). "Reboxetine promotes social bonding in
healthy volunteers." J Psychopharmacology 17(2): 189-195.

Anders Sandberg,
Oxford Uehiro Centre for Practical Ethics
Philosophy Faculty of Oxford University

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