Free riders are mostly a problem for countries without a public healthcare system, like the USA. See : I live in France. When I make money, some of it is taken away to fund healthcare, whether I like it or not. If I need healthcare, I’m certainly not a free rider. Now, if I were living in the USA, I could choose not to pay for an insurance (and I know, if only from reading this board, that some people do exactly that). Now, what is going to happen if I need healthcare? I won’t be left to die in a dark alley. I will receive it. At the expense of other tax payers (maybe I’ll have to pay for it eventually, but probably not if it’s costly enough and I don’t have much in the way of assets). That is free riding, and you do pay for it as an American citizen.
Now, I suspect that what you have in mind is people abusing from the system. But healthcare is precisely a service people are not likely to abuse from. If you hand out cars for free, plenty of people will take one even if they don’t really need one, or even have no use for one. On the other hand, you’d have a hard time signing me up for a free heart transplant I don’t need. Actually, it’s difficult enough to have people sign up for free preventive care (say free check-ups) that would benefit them, because most people don’t really enjoy seeing a doctor or going to an hospital when they feel fine.
Now, there might be some people abusing. Say, seeing their doctor every other day for no real reason at all. But, ignoring the fact that said doctor would probably have an issue with this behaviour, ignoring also the fact that this would be at worst a marginal expense in the grand scheme of things, do you somehow think that this would be an issue only when there’s a public healthcare system? Hmm… No. In your system, the same person would show up at the emergency room if she hadn’t a private insurance (at your expense as a taxpayer) or would also see her doctor if she had one (ultimately at your expense too if you have the same insurer).
Your “free rider” problem isn’t a problem that needs solving. Well…as I said, except if you don’t have an universal healthcare system, hence have people who choose not to pay for an insurance even though they could have afforded one. So, I’m going to throw back the question at you : since you don’t support an universal health care system, can you “point out to me how to solve the free-rider problem” ?
And more importantly, the existence of an extensive and functional health care system is precisely the reason why epidemics are mostly unheard of in first world countries. Remove it, and you’ll get again malaria and cholera outbreaks in short order.
People need help understanding the difference because it doesn’t exist.
Why is keeping somebody’s house from burning down the taxpayers’ job, while keeping somebody from dying from the resulting burns is the job of the individual?
Besides, we already have a form of government health care, in Medicare. I doubt my grandmother would have had her 90th birthday last week if not for Medicare. (And ANYONE who begrudes her that will have to deal will with ME. NOBODY messes with my Gramma.)
I was originally eligible for Medicaid after I got out of the hospital back in Feb. of 2007, until some of my bills (very few, though), were paid. Now most of my paycheck goes towards my meds. Why the HELL do you think I still live at home? When I got my job, I thought I’d finally be able to move out and on my own. Nope, no-can-do. And I’m not covered through work. I’m paying all of my medical expenses out of pocket.
Are there people who abuse the assistance program? Hell yes. But you’re going to have that no matter WHAT. I doubt if you had a program where everyone is covered that you’d have to worry about that so much-since we’d all be “free-riders”, so to speak.
This is the real issue. Not so much whether it’s a “right” in some quasi-religious sense of moralization, but the consequences of different policies, & what that means morally.
I think that with one or two exceptions, the reasons we require publicly funded police departments & consider them preferable to private security also apply to health care.
Having a single service provider means not having to check to see who has the account in an emergency. It also means that resources can be pooled collectively in one system. A tax funding system can be used to keep the basic services going; fee-for-service systems sometimes have to raise prices to keep operating, which lowers demand, & screws them up further.
Will there be rationing? Sure. But it’s an adaptable structure.
Now, if you object to those without funds being treated–as an immoral policy–fine, make that argument.
Well, one attraction of socialized medicine is that monetary costs can be be contained. Citizens don’t have to pay high premiums to a for-profit provider to get good emergency care & good dental. Also, the effects of market rationing don’t go completely out the window. The government isn’t going to spend the whole tax base on experimental liver-regeneration drugs when it has agricultural expenses, a military, etc.
So you’d accept extending Medicaid/Medicare coverage to everyone? Did you know that at present, not everyone qualifies for these? If you make to much & are not aged, you get jack unless a free clinic is lucky enough to have the funding to help you. Why not dump the age & income limits?
This is largely why I’m for single-payer UHC. I dislike the neither-fish-nor-flesh compromises that Americans end up with that don’t make a lot of sense from either side.
As a Deep Ecology moralist, I have twinges of quasi-Malthusian sympathies.
Excess population dying? All right!
On the other hand: Excess population taking out their rage at an unsympathetic system & an “unjust world” by poaching & undermining the commons? Unacceptable.
I live in a democracy, not an absolute monarchy. Even if I don’t believe in human rights as absolute, those with power are the populace, & they do so believe. I must stand for treating people decently so that they see the world as on their side rather than against them. Only in this way do I have hope that this country will defend the common natural resource base.
Too right. Fetishization of the Founding Fathers is daft. And I think a lot of those who go one about rights put words in the FF’s mouths.
A good working definition of ‘right’ that I’ve heard which seems to serve well for purposes of debates like this is: an automatic claim on the resources of others.
Public education, police protection, access to the courts – all of these fit that definition fairly well. Healthcare, minimum levels of housing, food – I think everyone agrees that these are certainly important, and they are to a certain degree a certain metric of evaluating societies… but there is more hesitancy when they are classified as “automatic claims” (ie, under any circumstances) on the resources of others. This is when things get dicy, and, as someone said before: the devil is in the details.
If I had a rebuttal to your post, I would have a plan with a reasonable chance of solving the problem. I would also have a fabulous job as Healthcare Czar.