[ExI] Yet another health care debate

Damien Sullivan phoenix at ugcs.caltech.edu
Mon Sep 22 01:46:07 UTC 2008

On Sun, Sep 21, 2008 at 01:01:18PM -0700, Damien Sullivan wrote:
> On Sun, Sep 21, 2008 at 12:19:28PM -0700, Lee Corbin wrote:
> > Can you perhaps give me a hint of your thought on the following
> > questions. Why not have the government pay for all food? Isn't
> > food just as important (or perhaps vastly more important) than
> > medical care?  How about transportation, or perhaps electrical

Another take:
communism doesn't work because it assumes away the high-frequency bits
of human nature where we're greedy and looking out for ourselves,
friends, or family, and out to get stuff without working for it.

libertarianism doesn't work, or rather doesn't last, because it assumes
away the high-frequency bits of human nature where we like taking care
of each other *and* don't like being the only ones to take care of

More exactly, most people don't like seeing members of their in-group
die, especially preventably.  There's some flexibility here: who's in
our in-group, would we rather help our or avoid knowing that someone's
in need, will we hope that someone else will step in before we have to.
But when we're clearly the only ones who can, at low cost to ourselves,
keep someone else from dying, most of us will rise to the occasion.

The generalized version of this is that most of us don't like people
starving or dying due to lack of cheap medicine, even without the
thought that that might be us some day.  So we want people helped... but
we also don't want to be suckers, helping all the poor by ourselves.
Absent a really powerful social reputation system that can reward
charity, that means taxes, in this case a draft of the rich, or the

Thus public granaries, tithes to church charities, alms tax, welfare
systems.  Thus also, in the US, the mandate that emergency rooms can't
turn people away.  We don't have a pure free market in health care for
many reasons, but *that* is among the most fundamental.  When you're
sick, there's somewhere you can go that'll help you.

Thing is, giving food to the starving is pretty effective.  Giving
medicine to the sick... is actually kind of inefficient, compared to
preventing them from getting sick in the first place.  Once we accept
the moral committment to help the sick, it then becomes cheaper to
support the whole process, not just the endpoint.  Vaccines and checkups
and cancer screenings, rather than waiting for cancerous pneumonia
patients to stagger their way into ER.  Let alone dealing with people
using ER for their less urgent needs because they can't afford more
regular channels.

So the sensible economic choices are full universal health care, or
laissez faire and let them die on the streets.  And as far as human
nature goes, every well-off society today and many not so well off ones
has opted for not letting people die on the streets.  Every developed
country except the US has universal health care (modulo dental or
psych), and even the US has the ER mandate form of it.  Various
developing countries have universal care too and the trend is growing.
Expecting people to choose a laissez faire approach to health care or food
distribution seems about as in touch with reality as expecting
collectivized agriculture to be productive.

Of course, there's always a first time.  But that's the data so far.

-xx- Damien X-) 

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