# Why is socially provided universal healthcare 'better'? **URL:** \ **Category:** Great Debates\ **Created:** [February 8, 2012, 12:09pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181 "2012-02-08T12:09:40Z")\ **Posts on this page:** 20\ **Page:** 6
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [February 9, 2012, 4:59pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/101 "2012-02-09T16:59:32Z")
> [@bldysabba](#): > > I don’t see how I’ve shifted the goalpost one inch. You are narrowing the debate from your original post, which was far broader than your one-line restatement here. > [@](#): > > See, if you’d been reading any of my posts thus far, you’d know this is the question I want answered. In the VERY post that you’ve quoted, I have reiterated that this is the question that I want answered. Morality is subjective. I know your position, it was a rhetorical question. See the following posts for further discussion on that. > [@](#): > > Is there empirical evidence out there that makes the case for access to healthcare regardless of ability to pay? In terms of productivity, life outcomes etc. ? OK, in order to assess the evidence lets be clear on what is being asked here. You need to define what metrics are important to you and what sort of evidence would be acceptable. What does productivity mean? what is a “life outcome”. We have to define our terms. The two massively important metrics that are easy to get would be coverage and costs per head. Other we may consider could be practical accessibility. These may act as a decent proxy for productivity and life outcomes seeing as if you can’t get healthcare or it won’t cover you then of course those are going to be adversely affected. Can they be measured directly though? I’m not sure. Also, to allow for confounding factors you’d have to compare across broadly similar countries that operate the different systems. To do that we are once again driven to compare the first world countries, Europe and the USA. ---
**Author:** ![Gyrate](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gyrate/32/3588_2.png) [@Gyrate](https://boards.straightdope.com/u/Gyrate)\ **Post date:** [February 9, 2012, 5:02pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/102 "2012-02-09T17:02:26Z")
> [@bldysabba](#): > > Which monumental successes are you referring to? Please point me to them. So far, the most successful somewhat large system I’ve found is the Japanese one. All others, including the oldest one in Germany, cannot be regarded as unqualified successes. Neither can the Japanese one really, but there don’t seem to be any big points against it. If you want an unqualified success you’re not going to find one in either the public or private sector. But as I’ve already said, the NHS for all its failings is extremely good value for money and attempts to privatise it have been met with heavy public resistance. In fact, some of its worst failings were down to efforts under Thatcher and Major to outsource some of its support functions - most notably, privatising the cleaning services resulted in a marked decrease in cleanliness in hospital wards. > [@](#): > > And sure, the Indian bureaucracy is hella bad, but it’s improved in recent years. You know why they’ve improved? Because they’ve had a whole lot of areas in which they had no business being removed from their ambit. They no longer have power over everything that happens. It’s easier/possible for them to do the more limited jobs they have (which is their core job of governance), it is easier for their political masters to measure their performance, and they let the market mechanism step up and do the job. But you’re taking away the wrong message. The fact that the Indian government ran things badly doesn’t mean that all governments run things badly (or at least worse than the private sector). All it means is that the Indian government runs things badly. Letting “the market mechanism do its job” is what’s causing the problems in the US at the moment and is the reason vast numbers of people get no health care at all apart from minimal emergency care. > [@](#): > > I will reiterate once again. I am not ideologically opposed to universal healthcare. I don’t believe there is a moral argument to be made for it, as most posters here do. But that isn’t productive ground for debate. They can tell me I’m misanthropic, I can tell them they’re hypocrites who don’t know the realities of life in a poor country. It gets us nowhere. > > This was in the OP(although maybe it wasn’t clear enough), and I’ve just repeated it to **Novelty Bobble** in the post above, but is there an argument to be made, aside from the moral one, for equal access to healthcare regardless of ability to pay? > (tip of the hat to **Novelty Bobble** for the wording) Have you read _any_ of this thread? To quote one of **Novelty Bobble** ’s posts about the NHS as an example: > [@](#): > > it covers everyone equally, prioritises according to needs rather than means, covers all treatments that can show efficacy to a given standard, cannot refuse coverage due to existing conditions, is infinitely transferable, demands no input at all from non tax-payers, waives prescription costs for the vulnerable and chronically ill, it is cheaper that the USA system and should you wish to pay a little extra you can still go private and jump any queues (and for less than an equivalent US healthcare policy), it bankrupts no-one and doesn’t ask for credit cards. In short: it’s cheaper, more efficient, more effective, covers everyone, and doesn’t prohibit the free market from competing. Of course it’s not perfect but what is? ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [February 9, 2012, 5:02pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/103 "2012-02-09T17:02:59Z")
Indeed, the default model the GOP uses to attack UHC is the UK’s NHS, precisely becasue it is the furthest removed from the USA model. In fact, it’s the only one without any kind of personal insurance component, I believe. The fact that no one in mainstream US politics is considering anything remotely like the UK model seems to not be relevant, the fact is it’s SOCIALIZED MEDICINE! ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [February 9, 2012, 5:05pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/104 "2012-02-09T17:05:11Z")
> [@thelabdude](#): > > What about money back to the parents whose kids learn nothing? Bush got a law saying kids must learn. Now Obama is letting the states that failed to get off. > > I want health care that works better than our public schools. If the US peels back the cost of healthcare to 12% GDP (from approaching 20%) - as it would do under UHC, the USA can afford anything it likes. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 9, 2012, 5:06pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/105 "2012-02-09T17:06:50Z")
> [@Bozuit](#): > > Why do we all pay taxes for roads when we don’t all use them equally? Should we pay more for police if we need them more often? Wow. You really blindsided me with that. Sheesh. Read my posts. Law and order and infrastructure are clearly defined public or quasi-public goods. The case for government/social provision is clear cut. [QUOTE=SciFiSam] Correct me if I’m wrong, but you’re advocating a system with no insurance at all, where people just pay out of pocket for their medical expenses? Except some basic healthcare for children. [/QUOTE] My personal position is that basic healthcare should be provided for children(on the grounds that it is a quasi public good) and the very poor(on moral grounds, because especially in India, there is nothing close to equality of opportunity). And I’m not necessarily saying no insurance at all. If a market for health insurance can stand on its own merit (without being tied to mandated universal coverage, or perhaps employer provision of health insurance as it seems to be in the US) then I have absolutely nothing against it. It’s just the nature of the healthcare insurance business that makes me think it isn’t all likely that such a market will function. Aside from that, yes, out of pocket medical expenditure. ---
**Author:** ![gatorslap](https://avatars.discourse-cdn.com/v4/letter/g/bb73d2/32.png) [@gatorslap](https://boards.straightdope.com/u/gatorslap)\ **Post date:** [February 9, 2012, 5:13pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/106 "2012-02-09T17:13:14Z")
> [@amanset](#): > > As a Brit, I do find it amusing that you’ve concentrated on the Scandinavian systems. Because frankly the Swedish (not sure about the other bits of Scandinavia) system is slightly closer to the US idea than the much more socialist British system. Namely, in the UK you just turn up and get treated. In Sweden you have to pay, although unlike the US it is capped at 900 SEK/year. The charges recently changed so I’m not sure, but I think an Akuten/ER/A&E/Casualty visit costs 300 SEK. Google tells me 900 SEK is about $135. That’s chump change. ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [February 9, 2012, 5:14pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/107 "2012-02-09T17:14:53Z")
A couple of quick points worth making here. Firstly, though there may have been some evolution of this thread so far, and the typical misunderstandings inherent in internet discussion, bldysabba has been engaging in a genuine way. (that isn’t a backhanded compliment BTW, so many of these threads end up badly) That makes a refreshing change. And there are very important questions to ask, even if we are unlikely to come an agreement on the answers. Secondly, it may be that bldysabba’s question really _is_ and _needs to be_ narrower than we appreciate. If the moral argument is not up for discussion then perhaps it only really makes sense to think of how this applies to India and the specific challenges of free-market vs UHC in that context. In which case…I’m at a loss as I don’t know. Just something or everyone to chew over anyhow. ---
**Author:** ![Gyrate](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gyrate/32/3588_2.png) [@Gyrate](https://boards.straightdope.com/u/Gyrate)\ **Post date:** [February 9, 2012, 5:25pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/108 "2012-02-09T17:25:00Z")
> [@Novelty\_Bobble](#): > > Secondly, it may be that bldysabba’s question really _is_ and _needs to be_ narrower than we appreciate. If the moral argument is not up for discussion then perhaps it only really makes sense to think of how this applies to India and the specific challenges of free-market vs UHC in that context. In which case…I’m at a loss as I don’t know. > > Just something or everyone to chew over anyhow. But the best healthcare system for the US (or other first-world countries) is a different argument than the best healthcare system for India. If we’re talking specifically about India then that’s a whole other ball of wax ---
**Author:** ![SciFiSam](https://avatars.discourse-cdn.com/v4/letter/s/47e85d/32.png) [@SciFiSam](https://boards.straightdope.com/u/SciFiSam)\ **Post date:** [February 9, 2012, 5:26pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/109 "2012-02-09T17:26:42Z")
> [@bldysabba](#): > > Wow. You really blindsided me with that. Sheesh. Read my posts. Law and order and infrastructure are clearly defined public or quasi-public goods. The case for government/social provision is clear cut. > > My personal position is that basic healthcare should be provided for children(on the grounds that it is a quasi public good) and the very poor(on moral grounds, because especially in India, there is nothing close to equality of opportunity). And I’m not necessarily saying no insurance at all. If a market for health insurance can stand on its own merit (without being tied to mandated universal coverage, or perhaps employer provision of health insurance as it seems to be in the US) then I have absolutely nothing against it. It’s just the nature of the healthcare insurance business that makes me think it isn’t all likely that such a market will function. Aside from that, yes, out of pocket medical expenditure. I’m pretty sure having most people pay medical expenses out of pocket would result in a lot more unnecessary deaths and disabilities, widows and orphaned kids, beggars and street crime. Like you have in India, actually, in comparison to the UK. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [February 9, 2012, 5:39pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/110 "2012-02-09T17:39:48Z")
> [@bldysabba](#): > > Heh. Just in this thread you’ve had people allege racism will play a role in UHC. I’ve been to Scandinavia and lived there for a couple of months. Even there you can often hear people complain about immigrants who move there, and immediately start mooching off ‘their’ generous welfare state. Ah, see, in Spain one of the pieces of data that gets reported every month is variation in the amount of “people actively contributing to our UHC system” - when the chunk of variation linked to immigration is significant (be it up or down, the implosion of the construction bubble led many people to return home sooner than they’d planned to), that gets reported, as does data on m:f ratio, temp vs perm vs self-employed and others. There have been some people here who’ve tried to play the “they’re coming here to mooch off our SS!” key, but it’s broken, since “they” contribute to that SS; there have been some cases of immigrants trying to abuse things by getting expensive surgery to relatives who would never be considered dependents under Spanish law (no, you can’t claim your mother’s second cousin as a dependent!) but it’s been very rare. Mind you, it’s possible that part that “oh noes they’re mooching!” key is broken is that Spain has been an emigrant or passer-by country through much of the 19th and 20th century; finding a Spaniard who does not have at least one group of second cousins (or closer) living abroad is actually rare. We do know that when we go abroad to work we pay taxes wherever, we do know that when people come here to work they do pay taxes here. The corruption of the Indian system and racism are two issues which are separate of whether UHC is better than job-dependent or uninsured medicine. They can affect each other, but if corruption was a reason to say “government can’t ever do [insert job here] because ours is corrupt”, there’s several dozen countries where the government shouldn’t even be allowed to paint roads… does that mean no government should be allowed to paint roads? ---
**Author:** ![Kearsen](https://avatars.discourse-cdn.com/v4/letter/k/82dd89/32.png) [@Kearsen](https://boards.straightdope.com/u/Kearsen)\ **Post date:** [February 9, 2012, 5:43pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/111 "2012-02-09T17:43:29Z")
> [@Great\_Antibob](#): > > The day care part doesn’t exist, but don’t the other two exist in some related form? > > For low income families, there’s certainly housing assistance and WIC. > > At least it’s universally provided in the same sense there’s universal health care in the form of emergency rooms, so there’s a societal recognition that food and shelter should be provided for all children, at least, even if the quality of the aid may or may not be all that high. True enough, although I wasn’t really married to any of the terms I used. My point was that you could effectively argue that any and everything should be paid for ‘by the government’ which is essentially socialism Running health care for all shouldn’t even be a twinkling in governments eye. Now if you want to legislate the way private insurers have to operate, I’ll listen. The fastest way to a man’s heart is his stomach. Do things for the relatively poor (or people who could conceive themselves as poor) and you endear yourselves to them for a time. This is what politics of late has become. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [February 9, 2012, 5:46pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/112 "2012-02-09T17:46:04Z")
> [@Kearsen](#): > > Running health care for all shouldn’t even be a twinkling in governments eye. Now if you want to legislate the way private insurers have to operate, I’ll listen. _Why_? Can you actually come up with a plausible reason why government shouldn’t run healthcare, other than “waaah! It’s socialism!”? ---
**Author:** ![Kearsen](https://avatars.discourse-cdn.com/v4/letter/k/82dd89/32.png) [@Kearsen](https://boards.straightdope.com/u/Kearsen)\ **Post date:** [February 9, 2012, 5:52pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/113 "2012-02-09T17:52:14Z")
> [@Really\_Not\_All\_That\_Bright](#): > > _Why_? Can you actually come up with a plausible reason why government shouldn’t run healthcare, other than “waaah! It’s socialism!”? It’s unaffordable (currently) As an aside, it is my belief that our government should not be in the delivery of any service. Was that free enough of waaah? ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [February 9, 2012, 6:00pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/114 "2012-02-09T18:00:43Z")
Your beliefs are irrelevant. “It’s not good because I don’t like it” is effectively a circular argument. As far as “unaffordability”, feel free to peruse the numbers I posted on the first page of this thread. What is “unaffordable” about a system which would cover every citizen for a fifth of the cost of covering 75% of them? ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [February 9, 2012, 6:04pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/115 "2012-02-09T18:04:47Z")
> [@Kearsen](#): > > Running health care for all shouldn’t even be a twinkling in governments eye. Now if you want to legislate the way private insurers have to operate, I’ll listen. shouldn’t? what a strange choice of words. Surely you want your government to be making the most efficient use of your tax dollars. Why would you reject a solution out of hand even when it has proven to be better than your current system and decidely not a stepping stone to socialism (note…the UK has become _less_ socialist since the inception of the NHS, not more). I think we are back to that previously mentioned gut reaction. I don’t think your opposition to UHC is based on a rational argument and I’m not sure what evidence would convince you otherwise. As for legislation, how about fixing a maximum policy price, mandating a minimum coverage, getting rid of lifetime limits, setting a maximum deductable for all, specifying exemptions for those on welfare and other vulnerable groups, setting up an independent clinical body to judge which treatments go to whom, taking away the insurance company’s ability to refuse coverage…? Those would get you on the road to a fair system and wouldn’t stop those that can pay more getting better and quicker treatment. Everyone is happy (apart from the health insurance companies) ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [February 9, 2012, 6:06pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/116 "2012-02-09T18:06:31Z")
> [@Kearsen](#): > > As an aside, it is my belief that our government should not be in the delivery of any service. So no roads, schools, army, police, judiciary, fire departments, government…etc. ---
**Author:** ![Great\_Antibob](https://avatars.discourse-cdn.com/v4/letter/g/e47c2d/32.png) [@Great\_Antibob](https://boards.straightdope.com/u/Great_Antibob)\ **Post date:** [February 9, 2012, 6:14pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/117 "2012-02-09T18:14:57Z")
> [@Kearsen](#): > > It’s unaffordable (currently) > > As an aside, it is my belief that our government should not be in the delivery of any service. It appears (from other posts as well) that it’s the second part that’s your main concern. That’s fine, from a philosophical POV. But claiming it’s unaffordable is rather bizarre. We have several examples of nationalized health care systems which provide US equivalent health care at significantly reduced prices. And several examples of other services government can provide at significantly lower cost (roads, policing, fire departments, militaries, schools, infrastructure, among others). While there may be a philosophical debate about whether government _ **should** _ provide public services or not, there’s not much of a debate that government can provide several services much more efficiently than private industry can. ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [February 9, 2012, 6:22pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/118 "2012-02-09T18:22:03Z")
It’s unamerican right? No one quite knows why or how but it’s unamerican, perhaps like John Wayne was a True Amercian and Malboro the smoke of True Men. ---
**Author:** ![gatorslap](https://avatars.discourse-cdn.com/v4/letter/g/bb73d2/32.png) [@gatorslap](https://boards.straightdope.com/u/gatorslap)\ **Post date:** [February 9, 2012, 6:36pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/119 "2012-02-09T18:36:24Z")
I don’t understand why people refer to the government “running” health care. The government doesn’t have to _run_ care, it just has to pay for it. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [February 9, 2012, 7:28pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/120 "2012-02-09T19:28:27Z")
> [@bldysabba](#): > > I am not at all questioning the value of insurance in general, for which your statements are valid. It’s perfectly true that insurance fulfills a particular demand i.e smooth out the impact of expensive, potentially low probability events. In most areas where insurance is needed (accident, theft etc.), a market mechanism (with reasonable regulation) has proved sufficient to fulfill the demand for insurance. Health insurance however tends to work very imperfectly(if at all) because there is massive potential for market failure through adverse selection (theoretically, and with good empirical basis for for it as well). This is why it isn’t a case of people simply smoothing out spiky risks by paying annual amounts. To prevent this market failure, lots of people(including on this thread) recommend that everybody be mandated to purchase health insurance(or that taxpayers pay healthcare costs. It works out to something similar). There are a few other reasons why car insurance is different. Though the purchase of car insurance is required in the US, there is a pretty low cap on payouts except in very unusual situations where someone is injured. Plus, for most incidents, if a guy didn’t buy car insurance and totals his car, that is his tough luck. Medical ethics - and the law - require treatment of the guy dying in your waiting room money or not. Willingness to pay medical insurance is a lot higher also, given that your life is at stake. > [@](#): > > It is to the benefit of only the insurance companies and those more susceptible to health problems to force health insurance markets to function this way. But you often don’t know who is more susceptible to health problems. Smokers are, and they get charged more. I’m 60 and have spent exactly one night in a hospital my entire life (not counting when I was born) but it turned out I have a heart condition. > [@](#): > > My contention is that there is no reason to believe that it is to the net benefit of society if everybody is forced to buy health insurance. It perpetuates a model that cannot function because of deep, inherent flaws and prevents a more efficient model from emerging. UHC appears to provide better outcomes for less money than the current US mostly free market system. How is that not a net benefit to society? > [@](#): > > In the case of publicly provided healthcare my objections are a tad more strident. Governments in general will almost invariably perform inefficiently and are not incentivised to improve. Healthcare in particular is an area that needs to be fairly and impartially regulated because of big asymmetries of information between provider and patient. If you hand over service delivery to the regulator (by making government responsible for delivery of healthcare) you’re setting yourself up for a very expensive failure. There are several models of UHC, from NHS in Great Britain to private but single payer plans in lots of other places. The single payer plan we have in the US, Medicare, is very efficient. > [@](#): > > People don’t have a natural ‘right’ to anything. We collectively agree and bestow upon ourselves those rights we think will make our society a more productive, a fitter, more harmonious place. Some rights tend to be more useful for this purpose than others even if they both purport to achieve the same objective. The ‘right’ to have a say in the selection of those who rule over you, the ‘right’ to freely criticise, and the ‘right’ to hold private property are rights that have worked more effectively to produce stable, functioning societies than has the ‘right’ to healthcare, ‘right’ to education, and ‘right’ to food(My country has these last three in place btw. They’re utter hogwash and do far more damage to all three things than good). Without a right to life none of those other rights means a lot. > [@](#): > > While I suspect this will make you judge me, I won’t react to your high horse until you get on it 🙂 - Yes I do believe it is perfectly moral to let someone die if they don’t have the money for treatment. If they don’t have the money for treatment, somebody’s time and effort has to go to treat them. What gives them a claim on somebody else’s time and effort? You wouldn’t think a strong person has any claim on someone else’s time, effort and expertise because they can take it by virtue of their strength. Why do you think the sick person has a claim on someone else’s time and effort because they can demand it by virtue of their illness? (This is not a rhetorical question. It can have good answers beyond just ‘It is moral’, and it is in hope of finding a satisfactory one that I have started the thread) The reason I asked the question is that it is impossible to discuss this unless you understand basic premises. Now, members of society have a claim to others time for many things. We have a military to protect our life and our freedom. We have police who risk their lives to protect our lives and property. In both these cases society extracts money from its members (by force as an extremist anti-taxer would say) to pay for this. UHC is not all that different. Cops don’t protect only those people who can afford them - why should doctors? > [@](#): > > Why on earth would properly working markets exclude people with high expected costs? Properly working markets would love people with high expected costs, as long as they can pay for them. (Unless you’re talking insurance markets, about which my views are already laid out above. I don’t think health insurance markets can work very well and positively do not think that forcing everyone to buy health insurance is a good way of making them work) Of course we are talking about insurance. Price a car model out of my budget, I don’t buy it, and the market works fine. Price a cancer treatment out of my budget and I either bankrupt myself to live or I die. Slight difference there. As I said, rational economic actors will only buy insurance when the expected value is in the range of the cost. There if fuzziness about uncertainty of the actual expected value and the profit of the insurers. Insurance companies will only sell insurance to those they can make a profit on. If our expected values were constant throughout our life, there would be no issue. But the expected value of insurance is a lot lower for a young person than an old person. Let the young people out of the market and the price for the older person skyrockets. In fact this very thing is happening in California. As insurance prices go up, more and more people drop out of the market leaving fewer and fewer people in - people characterized by having high expected costs. This caused the insurance companies to request massive rate increases. It turns out they had a minor arithmetic problem, but the market will inevitably result in this kind of problem. My father-in-law is 95. His group insurance just kicked him out because he is the last surviving member of the group. Do you think he could get health insurance which is any way affordable without Medicare - which is mandated, by the way. > [@](#): > > I don’t have to spend any money on health insurance. My opposition stems purely from the fact that I think universalisation / socialisation of health care is the wrong way of addressing a problem. As a solution it springs from a sentimental approach to the issue which in the long run leads to higher inefficiencies and greater damage to the very people it is intended to help. Do you have any evidence that UHC damages people? I’ve seen various counts on the number of people in the US who died unnecessarily because of lack of access to health care. I think that is more of a social cost than raising the taxes on the rich slightly, but maybe I’m just being sentimental. 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