[ExI] Health system, again

Lee Corbin lcorbin at rawbw.com
Sat Apr 12 13:03:18 UTC 2008

Stathis wrote

> On 09/04/2008, Lee Corbin <lcorbin at rawbw.com> wrote:
>> Yes, it's an extremely perverse use of the word "insurance" as
>>  a euphemism for "national or tax-funded health care system".
>>  (Hmm, I guess that is the phrase I should use since the "s"
>>  word arouses sensitivities in many.)
> Why, exactly?

Why what?  why the word choice is so bad? That's because
*insurance* should always be understood as a kind of bet:
you bet that something bad will happen to you, and a large
financial institution bets that it won't, and you both hope that
the deep-pocket company wins.

Damien also explained very well why the term should not
be used as a synonym for "national health care".

If you're wondering why I should avoid the "s" word, it's 
because for reasons unknown to me many people who
really do admit that Sweden, say, is more socialized (or
is closer to socialism) than is the U.S., but they have gone
on record as feeling insulted by use of the terms "socialistic"
and "socialism". It's an extremely complex issue just who
is bothered by what terms (I can't even fully explain why
I am bothered by some language issues and not others.)

> Because it's compulsory?

In principle, that's a big part of it. Free choice in general has
worked out so well whenever a society has been "ready" 
for it, i.e., when the freedom is able to be maintained without
immediately falling to some more practical and ruthless group
that takes advantage of it to push some anti-freedom agenda.
There are a number of free countries in the world who are
steadily being encroached upon by those who disagree that
the country should be free (or that people should live according
to secular laws that lay down a great deal of personal liberty),
and yet to take advantage of the country's freedoms to directly
go about undermining them.

> There are all sorts of commercial situations where (private)
> insurance is compulsory; for example, if you are the owner
> of a unit in an apartment building.

But if the *compulsion* (so-called) arises from you freely
choosing to live in such an apartment, instead of choosing
some other kind of dwelling (that is perhaps more expensive),
then that's one thing.  I choose to continue to live in a town-
house complex that has all sorts of rules about what we can
and cannot do to the exterior of our units. 

It's quite another when the entire nation applies force. It's
not at all easy to go live in another country, and worse, if
the country that is using force on you excessively, i.e., in
instances where substitutes would be available, then one
really is trapped. As I said before, the world's most 
advanced free societies should work to diminish the number
of regulations and laws that are compulsorily inflicted on the
population. (That does not mean getting rid of all laws, of

>> Oh, it's a difficult choice, all right. In any system of national,
>>  tax-funded medical care, there will end up being bureaucrats
>>  who make the hard decisions about who gets what expensive
>>  treatments. Do you really expect the son of a senator to be
>>  treated with the same lack of deference a typical semiretired
>>  software engineer would be?  There is a record of a certain
>>  baseball player---I forget who---who was put at the head of
>>  the list for some state or federally funded medical treatment
>>  a few years back. You'll never root out that kind of corruption.
> I guess it's possible, but the same sort of thing can happen if you're
> trying to book a restaurant table.

Not at all. Keep in mind that so long as not all the restaurants
are regulated by the government (which is steadily becoming
more and more not the case in California and perhaps America
in general), then you can always *freely choose* to take your
business elsewhere.

> In my personal experience over 16 years in the Australian
> public health system something like this has happened once,
> when hospital management requested that a relative of a
> famous person be reassessed after he was rejected for
> admission.

There is utterly no guarantee that the same would hold for
a far larger, much more diverse society with entirely different
government traditions. Cronyism and corruption have a much
longer history in the U.S. than in Australia if for no other 
reason the U.S. has a much longer history.

>>  I say let the contracts be written, literal, and binding (and
>>  strongly enforced by the government) between those who
>>  legitimately want insurance for whatever they're afraid of.
>>  And if you are unlucky enough to be born with a condition
>>  that *predictably* at age 40 will start to require $100,000
>>  or $10,000,000 treatments each month to overcome, well,
>>  better then to have been of economic utility to other
>>  people and have become rich.
> This is where universal insurance has an advantage, even if it is
> contracted out to a private insurer. The agreement is to insure the
> entire population of citizens, come what may.

That's still very misleading language, if you ask me. It's not
*insurance* at all!  It's simply a guarantee to all citizens that
their health problems will be "taken care of" by a nationally
tax funded (i.e. by force applied to citizens to compel them
to pay whether they want to opt out or not).

> BTW, there aren't any treatments costing $10,000,000 a
> month that have gone through any of the usual studies to
> show that they are of benefit, since there is no incentive for
> anyone to do such studies.

Perhaps not yet there aren't. But there could easily become
such treatments. Anyway, surely you got my point! Even at
$100,000 a month, some bureaucrat will end up having to
say "no" to some doctors and to some families. In the U.S.
at least, this is a huge incentive for corruption and favoritism.

It's just perfectly clear that on this issue there are some of us
who favor freedom over security, and some who do not. It's
really too bad that we have no countries of any size left in 
the world that are entirely free, in the sense that they compel
their citizens as little as did the U.S. of 1855.   So we can't
learn a thing from such non-existent examples.


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