I feel obliged to point out that Socialdemocracy is working quite well in Europe and elsewhere and we owe it, among other stuff, free universal health care and paid vacations.
It’s not fair to say we ‘owe’ Socialdemocracy for free universal health care and paid vacations, because they aren’t so much effects of the system as they are fundamental tenets of the system. It’s much like saying we owe FreeMarketCapitalism for free markets—without these things we wouldn’t recognize it as socialism. Rather, the question is whether the marginal gain in things like quality of living are worth the marginal losses in things like autonomy. Universal health care is not an end in itself.
I dunno man, maybe it’s a confusion on my part, but universal health coverage for one thing seems like a good enough goal in and of tiself. Not specifically in the form of a State-sponsored organziation, but the fuction of everyone having the right to health treatments, of no-one being left to die just because they happen not to have a given amount of money at a given time, I think that, from a humanistic point of view, it’s sort of obvious that we should have it if we can pay for it.
Free universal health care is a good thing in itself; the question is whether or not that’s worth the costs of higher taxes and any bureaucratic inefficiencies that may exist.
Free universal health care is a good thing in itself
The healthcare isn’t actually “free”. It’s either paid for individually, collectively on a national level, or some intermediate level, e.g., insurance companies. The question is what the most efficient way to deliver it is?
Well, at least the bureaucratic inefficiencies are entirely incidental to the problem, and there’s no decisive evidence for corporate bureaucracies to be any better than public ones (I suspect partisanship gets in the way of finding out said evidence, as well as a slew of other variables), so that factor… doesn’t factor. As for the higher taxes… how much are you ready to pay so that, the day you catch some horrible disease, the public entity will be able to afford diverting enough of its resources to save you? What are you more afraid of, cancer and other potentially-fatal diseases that will eventually kill you, terrorism/invading armies/criminals/people trying to kill you, boredom...? What would be your priorities in assigning which proportion of the taxes you pay goes to funding what projects?
… Actually that might be a neat reform. Budget decision by a combination of individual budget assignments by every citizen…
Well, at least the bureaucratic inefficiencies are entirely incidental to the problem, and there’s no evidence for corporate bureaucracies to be any better than public ones, so that factor… doesn’t factor.
This claim is disputed, but I have negligible information either way.
As for the higher taxes… how much are you ready to pay so that, the day you catch some horrible disease, the public entity will be able to afford diverting enough of its resources to save you? What are you more afraid of, cancer and other potentially-fatal diseases that will eventually kill you, terrorism/invading armies/criminals/people trying to kill you, boredom...?
Personally, I say that universal health care would be worth the higher taxes. For any given person the answer depends on their utility function: the relative values assigned to freedom, avoidance of harm, happiness, life, fairness,etc.
… Actually that might be a neat reform. Budget decision by a combination of individual budget assignments by every citizen...
This sets off my Really Bad Idea alarm. I don’t trust the aggregate decisions of individual citizens to add up to any kind of sane budget relative to their CEV. (Note: the following sentences are American-centric.) Probably research would get massively under-funded. Defense would probably be funded less than it is now, but that might well put it closer to the optimal value if it forced some cost-effectiveness increases.
Basically, each person would assign all their taxes to whatever they thought was most important, thus prioritizing programs according to how many people pick them as first choice, regardless of how many dollars it takes to make a given one work. The same kind of math used to discuss different voting/electoral college variants would inform this, I think, but I’m too lazy to look it up. And of course, if too much freedom was allowed in deciding, all companies and most people would decide to allocate their money to themselves.
^Hm. That’d be some very near-sighted companies and people, don’t you think? The Defending Your Doorstep fallacy etc. etc. Still, with some education fo the public (“Dear viewers, THIS is what would happen if everyone decided all the money should go to the Army right after a terrorist attack”) and some patches (I can’t imagine why people would put all their money into whatever they think is most important, rather than distributing it in an order of priorities: usually people’s interests aren’t so clear cut that they put one cause at such priority that the others become negligible… but if they did do that, just add a rule that there’s only so much of your money you can dedicate to a specific type of endeavor and all endeavors related),.
This reminds me of Kino’s Journey and the very neat simplisty solutions people used to their problems. The main reason those solutions failed was because the involved people were incrediby dumb at using them. The Democracy episode almost broke my willing suspension of disbelief, as did the Telepathy one. Are you familair with that story?
Human rationality can be trained and improved, it’s not an innate feature. To do that is part of the entire point of this site.
I hope you enjoy it. It is very interesting. Beware of generalizing from fictional evidence… but fiction is sometimes all we have to explore certain hypotheticals...
What does this mean? In particular, what does “universal” mean?
It means that each person in the country would, if ey got sick, be able to receive affordable treatment. This is true in, for example, Great Britain, where the NHS pays for people’s medical care regardless of their wealth. It is not true in the United States, where people who cannot afford health insurance and do not have it provided by their employer go without needed treatments because they can’t afford them.
ETA: does someone think this definition is wrong? What’s another definition I’m missing?
How different are the ways a society would treat citizens and various other people not covered by a system, such as Americans? What about tourists?
Isn’t it true that Great Britain could provide better medical care if it diverted resources currently spent elsewhere? How are any other government expenditures and fungible things (like autonomy) ever justified if health could be improved with more of a focus on it?
Do you primarily value a right to medical care, or instead optimal health outcomes?
An intuition pump: What if a genie offered to, for free, provide medical care to all people in a society equivalent to that the American President gets, and a second genie, much better at medical care, offered even better average health outcomes for all people, with the caveat that he would randomly deny patients care (every patient would still have a better chance under the second genie, until the patient was rejected, of course). Both conditional on no other health care in the society, especially not for those denied care by the second genie. Which genie would you choose for the society? Under the first, health outcomes would be good and everyone would have a right to health care, under the second, health outcomes would be even better for every type of patient, but there would be no right to care and some people with curable diseases would be left to die.
If you would choose the first genie, your choice increases net suffering every person can expect.
If you would choose the second genie, then you’re making a prosaic claim about the efficiency of systems rather than a novel moral point about rights for disadvantaged people—a claim that must be vulnerable to evidence and can’t rightly be part of your utility function.
What if there were a third genie much like the one you chose, except the third genie could provide even better care to rich people. Would you prefer the third genie and the resulting inequality?
I prefer the genie which provides the maximum average utility* to the citizens, with the important note that utility is probably non-linear in health. The way I read your comment, that would appear to be the third. Also note that the cost of providing health care is an important factor in real life, because that money could also go to education. Basically, I do my best to vote like a rational consequentialist interested in everyone’s welfare.
*I am aware that both average and total utilitarianism have mathematical issues (repugnant conclusion etc), but they aren’t relevant here.
cost of providing health care is an important factor in real life, because that money could also go to...
OK, so when you say “Personally, I say that universal health care would be worth the higher taxes,” you are referring to internal resource distribution along state, national, voluntary, or other lines to achieve efficient aggregate outcomes by taking advantage of the principle of diminishing returns and taking from the rich and giving to the poor. You don’t believe in a right to care, or equal treatment for outgroup non-citizens elsewhere, or that it’s very important for treatment to be equal between elites and the poor. Not an unusual position, it’s potentially coherent, consistent, altruistic, and other good things.
I asked for clarification from your original “Personally, I say that universal health care would be worth the higher taxes,” because I think that phrasing is compatible with several other positions.
Well, at least the bureaucratic inefficiencies are entirely incidental to the problem, and there’s no evidence for corporate bureaucracies to be any better than public ones,
Corporations that develop excessive inefficiencies tend to go bankrupt. (Ok, sometimes they can get government bailouts or are otherwise propped up by the government, but that is another against government intervention.)
As for the higher taxes… how much are you ready to pay so that, the day you catch some horrible disease, the public entity will be able to afford diverting enough of its resources to save you?
Well, maybe if it wasn’t for the taxes I would be able to afford to pay for treatment myself. (Taxes are a zero-sum process, actually negative sum because of the inefficiencies.) If the idea is risk mitigation, then why not use a private insurance company?
Well, given that the government’s allledged goal is to provide the service while the private organization’s alledged goal is to make a profit, one would expect the State (I like to call the organization the State or the Adminsitration: the Government should simply mean whoever the current team of politically appointed president/minister/cabinet are, rather than the entire bureaucracy) to be less likely to “weasel out of” paying for your treatment, a risk I (in complete and utter subjectivity and in the here and now) deem more frightening (and frustrating) than the disease itself.
And yes, risk mitigation is always negative sum, that’s kind of a thermodynamic requisite.
one would expect the State (...) to be less likely to “weasel out of” paying for your treatment,
Well, since the ministry of health’s budget is finite, whereas the potential amount of money that could be spent on everyone’s treatment isn’t, the state very quickly discovers that is too needs to find ways to weasel out of paying for treatment.
And yes, risk mitigation is always negative sum, that’s kind of a thermodynamic requisite.
And the more layers of bureaucracy involved, the more negative sum it is.
1.You mean they incur in the exact same kind of legal practices as private groups, with the same frequency? Given the difference in position, methodolgy and resourses, I doubt it, but I don’t have any evidence pointing to either side about the behavior of Universal Health Coverage systems. I’d need time to ask a few people and find a few sources.
2.I don’t think it’s a matter of “layers” so much as one of how those layers are organized. The exact same amount of people can have productivity outputs that are radically different in function of the algorythms used to organize their work. Your post seems to imply that State services have more bureaucratic layers than public ones. I’d think that’d be something to decide case by case, but I wouldn’t say it’s a foregone conclusion: private insurances are infamous for being bureauratic hells too. Ones deliberately designed to mislead and confuse unhappy clients, at that.
This conversation appears to not have incorporated the very strong evidence that higher health care spending does lead to improved health outcomes.
Personally I’d reform the American system in one of two ways- either privatize health care completely so that cost of using a health care provider is directly connected to the decision to use health care OR turn the whole thing over to the state and ration care (alternatively you could do the latter for basic health care and than let individuals purchase anything above that). What we have now leaves health care consumption decisions up to individuals but collectivizes costs—which is obviously a recipe for inflating an industry well above its utility.
I have left it ambiguous on purpose. What this means specifically depends on the means available at any given time.
IDEALLY: Universal means everyone should have a right to as much health service as is necessary for their bodies and minds functioning as well as it can, if they ask for it. That would include education, coaching, and sports, among many others. And nobody should ever be allowed to die if they don’t want to and there’s any way of preventing it.
Between “leaving anyone to die because they don’t have the money or assets to pay for their treatment”[your question puzzles me, what part of this scenario don’t you understand] and “spending all our country’s budget on progressively changing the organs of seventy-year-.olds”, there’s a lot of intermediate points. The touchy problem is deciding how much we want to pay for, and how, and who pays it for whom, No matter how you cut the cake, given our current state of development, at some point you have to say X person dies in spite of their will because either they can’t afford to live or because his can’t”. So, are you* going to deny that seventy-year-old their new organs?
So, are you going to deny that seventy-year-old their new organs?
Yes, unless there is nobody else that can use them. If my watching of House tells me anything it is standard practice to prioritize by this kind of criteria.
Resources are limited and medical demand is not. The medical response time if the President of the United States gets shot is less for than if anyone else gets shot. It’s not possible to give everyone as much health protection as the president. So it’s not a scenario. I can imagine each person as being the only person on earth with such care, and I can imagine imagining a single hypothetical world has each person with that level of care, but I can’t actually imagine it.
there’s a lot of intermediate points
That indicates that no argument about the type of thing to be done will be based on a difference in kind. It won’t resemble saying that we should switch from what happens at present to “no-one being left to die just because they happen not to have a given amount of money”. We currently allow some people to die based on rationing, and you are literally proposing the impossible to connote that you would prefer a different rationing system, but then you get tripped up when sometimes speaking as if the proposal is literally possible.
deciding how much we want to pay for
Declaring that someone has a right is declaring one’s willingness to help that person get something from others over their protests. We currently allow multimillionaires, and we allow them to spend all their money trying to discover a cure for their child’s rare or unique disease, and we allow people to drive in populated areas.
We allow people to spend money in sub-optimal ways. Resources being limited means that not every disease gets the same attention. Allowing people to drive in populated areas is implicitly valuing the fun and convenience of some people driving over the actuarially inevitable death and carnage to un-consenting pedestrians.
What this means specifically depends on the means available at any given time.
I don’t understand how you want to ration or limit people, in an ideal world, because you have proposed the literally impossible as a way of gesturing towards a different rationing system (infinitely) short of that ideal and (as far as I can see) not different in kind than any other system.
By analogy, you don’t describe what you mean when you declare “infinity” a number preferable to 1206. Do you mean that any number higher than 1206 is equally good? Do you mean that every number is better than its predecessor, no matter what? Since you probably don’t, then...what number do you mean? Approximately?
I can perhaps get an idea of the function if you tell me some points of x (resources) and y (what you are proposing).
Your post confuses me a lot: I am being entirely honest about this, there seem to be illusions of transparency and (un)common priors. The only part I feel capable of responding to is the first: I can perfectly imagine every human being having as much medical care as the chief of the wealthiest most powerful organization in the world, in an FAI-regimented society. For a given value of “imagining”, of course: I have a vague idea of nanomachines in the bloodstream, implants, etc. I basically expect human bodies to be self-sufficient in taking care of themsleves, and able to acquire and use the necessary raw materials with ease, including being able to medically operate on themselves. The rare cases will be left to the rare specialist, and I expect everyone to be able to take care of the more common problems their bodies and minds may encounter.
As for the rest of your post:
What are people’s rationing optimixation functions? Is it possible to get an entire society to agree to a single one, for a given value of “agree”? Or is it that people don’t have a consistent optimization function, and that it’s not so much a matter of some things being valued over others as a matter of tradition and sheer thoughtless inertia? Yes, I know I am answering questions with questions, but that’s all I got right now.
Your post confuses me a lot: I am being entirely honest about this, there seem to be illusions of transparency
Thank you for leading with that.
In an FAI-regimented society
This seems to sidestep the limited resources issue, making your argument not clearly apply outside of that context.
Let me give an example outside of health to discuss the resources issue. I have read that when a guy tried to make a nuclear power source in his garage from clock parts, government agents swooped in very soon after it started emitting radiation—presumably there are people monitoring for that, with field agents ever-ready to pursue leads. This means that, for some 911 calls where the nuclear team would be the first to the scene, we allow the normal police to handle it, even at the risk of people’s lives. If that isn’t the case, imagine a world in which it were so, and in which it would be easy to tell that the police would be slower than the nuke guys (who don’t even leave their stations most days). I think having such an institution would be worthwhile, even at the cost of crimes in progress being responded to slower.
Similarly, I think many things would be worth diverting resources from better policing, such as health—and from health to other things, such as better policing, and from both to fun, privacy, autonomy, and so forth. I’m only referring to a world in which resources are limited.
It is possible that there is a society wealthy enough to ensure very good health care for those it can influence by eliminating all choice about what to eat, mandating exercise, eliminating privacy to enforce those things, etc. It’s not obvious to me that it’s always the right choice to optimize health or that that would be best for the hypothetical society.
Considering the principle of diminishing returns, there’s no plausible way of describing people’s preferences such that all effort should be put towards better health. we don’t have to be able to describe them perfectly to say that being forced to eat only the healthiest foods does not comport with them—ask any child told to eat vegetables before desert.
It’s not fair to say we ‘owe’ Socialdemocracy for free universal health care and paid vacations, because they aren’t so much effects of the system as they are fundamental tenets of the system. It’s much like saying we owe FreeMarketCapitalism for free markets—without these things we wouldn’t recognize it as socialism. Rather, the question is whether the marginal gain in things like quality of living are worth the marginal losses in things like autonomy. Universal health care is not an end in itself.
I dunno man, maybe it’s a confusion on my part, but universal health coverage for one thing seems like a good enough goal in and of tiself. Not specifically in the form of a State-sponsored organziation, but the fuction of everyone having the right to health treatments, of no-one being left to die just because they happen not to have a given amount of money at a given time, I think that, from a humanistic point of view, it’s sort of obvious that we should have it if we can pay for it.
Free universal health care is a good thing in itself; the question is whether or not that’s worth the costs of higher taxes and any bureaucratic inefficiencies that may exist.
The healthcare isn’t actually “free”. It’s either paid for individually, collectively on a national level, or some intermediate level, e.g., insurance companies. The question is what the most efficient way to deliver it is?
Well, at least the bureaucratic inefficiencies are entirely incidental to the problem, and there’s no decisive evidence for corporate bureaucracies to be any better than public ones (I suspect partisanship gets in the way of finding out said evidence, as well as a slew of other variables), so that factor… doesn’t factor. As for the higher taxes… how much are you ready to pay so that, the day you catch some horrible disease, the public entity will be able to afford diverting enough of its resources to save you? What are you more afraid of, cancer and other potentially-fatal diseases that will eventually kill you, terrorism/invading armies/criminals/people trying to kill you, boredom...? What would be your priorities in assigning which proportion of the taxes you pay goes to funding what projects?
… Actually that might be a neat reform. Budget decision by a combination of individual budget assignments by every citizen…
This claim is disputed, but I have negligible information either way.
Personally, I say that universal health care would be worth the higher taxes. For any given person the answer depends on their utility function: the relative values assigned to freedom, avoidance of harm, happiness, life, fairness,etc.
This sets off my Really Bad Idea alarm. I don’t trust the aggregate decisions of individual citizens to add up to any kind of sane budget relative to their CEV. (Note: the following sentences are American-centric.) Probably research would get massively under-funded. Defense would probably be funded less than it is now, but that might well put it closer to the optimal value if it forced some cost-effectiveness increases.
Basically, each person would assign all their taxes to whatever they thought was most important, thus prioritizing programs according to how many people pick them as first choice, regardless of how many dollars it takes to make a given one work. The same kind of math used to discuss different voting/electoral college variants would inform this, I think, but I’m too lazy to look it up. And of course, if too much freedom was allowed in deciding, all companies and most people would decide to allocate their money to themselves.
^Hm. That’d be some very near-sighted companies and people, don’t you think? The Defending Your Doorstep fallacy etc. etc. Still, with some education fo the public (“Dear viewers, THIS is what would happen if everyone decided all the money should go to the Army right after a terrorist attack”) and some patches (I can’t imagine why people would put all their money into whatever they think is most important, rather than distributing it in an order of priorities: usually people’s interests aren’t so clear cut that they put one cause at such priority that the others become negligible… but if they did do that, just add a rule that there’s only so much of your money you can dedicate to a specific type of endeavor and all endeavors related),.
This reminds me of Kino’s Journey and the very neat simplisty solutions people used to their problems. The main reason those solutions failed was because the involved people were incrediby dumb at using them. The Democracy episode almost broke my willing suspension of disbelief, as did the Telepathy one. Are you familair with that story?
Re your 1st paragraph: you have a much higher opinion of human rationality than myself. I hope you’re right, but I doubt it.
Re your second paragraph: I am currently watching Kino’s Journey, and will respond later. Thanks for the reference, it sounds interesting.
Human rationality can be trained and improved, it’s not an innate feature. To do that is part of the entire point of this site.
I hope you enjoy it. It is very interesting. Beware of generalizing from fictional evidence… but fiction is sometimes all we have to explore certain hypotheticals...
True. Individual budget allocation would be a bad idea in present day America, but it wouldn’t be a bad idea everywhere and for all time.
What does this mean? In particular, what does “universal” mean?
It means that each person in the country would, if ey got sick, be able to receive affordable treatment. This is true in, for example, Great Britain, where the NHS pays for people’s medical care regardless of their wealth. It is not true in the United States, where people who cannot afford health insurance and do not have it provided by their employer go without needed treatments because they can’t afford them.
ETA: does someone think this definition is wrong? What’s another definition I’m missing?
How different are the ways a society would treat citizens and various other people not covered by a system, such as Americans? What about tourists?
Isn’t it true that Great Britain could provide better medical care if it diverted resources currently spent elsewhere? How are any other government expenditures and fungible things (like autonomy) ever justified if health could be improved with more of a focus on it?
Do you primarily value a right to medical care, or instead optimal health outcomes?
An intuition pump: What if a genie offered to, for free, provide medical care to all people in a society equivalent to that the American President gets, and a second genie, much better at medical care, offered even better average health outcomes for all people, with the caveat that he would randomly deny patients care (every patient would still have a better chance under the second genie, until the patient was rejected, of course). Both conditional on no other health care in the society, especially not for those denied care by the second genie. Which genie would you choose for the society? Under the first, health outcomes would be good and everyone would have a right to health care, under the second, health outcomes would be even better for every type of patient, but there would be no right to care and some people with curable diseases would be left to die.
If you would choose the first genie, your choice increases net suffering every person can expect.
If you would choose the second genie, then you’re making a prosaic claim about the efficiency of systems rather than a novel moral point about rights for disadvantaged people—a claim that must be vulnerable to evidence and can’t rightly be part of your utility function.
What if there were a third genie much like the one you chose, except the third genie could provide even better care to rich people. Would you prefer the third genie and the resulting inequality?
I prefer the genie which provides the maximum average utility* to the citizens, with the important note that utility is probably non-linear in health. The way I read your comment, that would appear to be the third. Also note that the cost of providing health care is an important factor in real life, because that money could also go to education. Basically, I do my best to vote like a rational consequentialist interested in everyone’s welfare.
*I am aware that both average and total utilitarianism have mathematical issues (repugnant conclusion etc), but they aren’t relevant here.
OK, so when you say “Personally, I say that universal health care would be worth the higher taxes,” you are referring to internal resource distribution along state, national, voluntary, or other lines to achieve efficient aggregate outcomes by taking advantage of the principle of diminishing returns and taking from the rich and giving to the poor. You don’t believe in a right to care, or equal treatment for outgroup non-citizens elsewhere, or that it’s very important for treatment to be equal between elites and the poor. Not an unusual position, it’s potentially coherent, consistent, altruistic, and other good things.
I asked for clarification from your original “Personally, I say that universal health care would be worth the higher taxes,” because I think that phrasing is compatible with several other positions.
Corporations that develop excessive inefficiencies tend to go bankrupt. (Ok, sometimes they can get government bailouts or are otherwise propped up by the government, but that is another against government intervention.)
Not if all their competitors are also inefficient.
I don’t see a corporate world which has spawned works like the Dilbert comics as inside critiques as a compelling example of a race to the top.
The advertising would get very tiresome, but probably not bad enough to oppose the idea for that reason.
Well, maybe if it wasn’t for the taxes I would be able to afford to pay for treatment myself. (Taxes are a zero-sum process, actually negative sum because of the inefficiencies.) If the idea is risk mitigation, then why not use a private insurance company?
Well, given that the government’s allledged goal is to provide the service while the private organization’s alledged goal is to make a profit, one would expect the State (I like to call the organization the State or the Adminsitration: the Government should simply mean whoever the current team of politically appointed president/minister/cabinet are, rather than the entire bureaucracy) to be less likely to “weasel out of” paying for your treatment, a risk I (in complete and utter subjectivity and in the here and now) deem more frightening (and frustrating) than the disease itself.
And yes, risk mitigation is always negative sum, that’s kind of a thermodynamic requisite.
Well, since the ministry of health’s budget is finite, whereas the potential amount of money that could be spent on everyone’s treatment isn’t, the state very quickly discovers that is too needs to find ways to weasel out of paying for treatment.
And the more layers of bureaucracy involved, the more negative sum it is.
1.You mean they incur in the exact same kind of legal practices as private groups, with the same frequency? Given the difference in position, methodolgy and resourses, I doubt it, but I don’t have any evidence pointing to either side about the behavior of Universal Health Coverage systems. I’d need time to ask a few people and find a few sources.
2.I don’t think it’s a matter of “layers” so much as one of how those layers are organized. The exact same amount of people can have productivity outputs that are radically different in function of the algorythms used to organize their work. Your post seems to imply that State services have more bureaucratic layers than public ones. I’d think that’d be something to decide case by case, but I wouldn’t say it’s a foregone conclusion: private insurances are infamous for being bureauratic hells too. Ones deliberately designed to mislead and confuse unhappy clients, at that.
This conversation appears to not have incorporated the very strong evidence that higher health care spending does lead to improved health outcomes.
Personally I’d reform the American system in one of two ways- either privatize health care completely so that cost of using a health care provider is directly connected to the decision to use health care OR turn the whole thing over to the state and ration care (alternatively you could do the latter for basic health care and than let individuals purchase anything above that). What we have now leaves health care consumption decisions up to individuals but collectivizes costs—which is obviously a recipe for inflating an industry well above its utility.
At what margin? Using randomized procedures?
http://www.overcomingbias.com/2009/01/free-medicine-no-help-for-ghanaian-kids.html
http://www.overcomingbias.com/2007/05/rand_health_ins.html
http://www.overcomingbias.com/2011/07/the-oregon-health-insurance-experiment.html
This instance of that conversation.
What does this mean?
What does this mean?
What does this mean?
I have left it ambiguous on purpose. What this means specifically depends on the means available at any given time.
IDEALLY: Universal means everyone should have a right to as much health service as is necessary for their bodies and minds functioning as well as it can, if they ask for it. That would include education, coaching, and sports, among many others. And nobody should ever be allowed to die if they don’t want to and there’s any way of preventing it.
Between “leaving anyone to die because they don’t have the money or assets to pay for their treatment”[your question puzzles me, what part of this scenario don’t you understand] and “spending all our country’s budget on progressively changing the organs of seventy-year-.olds”, there’s a lot of intermediate points. The touchy problem is deciding how much we want to pay for, and how, and who pays it for whom, No matter how you cut the cake, given our current state of development, at some point you have to say X person dies in spite of their will because either they can’t afford to live or because his can’t”. So, are you* going to deny that seventy-year-old their new organs?
Yes, it’s amazing how many bad decisions are made because it’s heartbreaking to just say no.
More like it’s potentially corrupting, but yeah, that too.
Yes, unless there is nobody else that can use them. If my watching of House tells me anything it is standard practice to prioritize by this kind of criteria.
I like this answer, if only for emotional reasons :). I also think the vast majority of seventy-years-old would be compelled by this argument.
Resources are limited and medical demand is not. The medical response time if the President of the United States gets shot is less for than if anyone else gets shot. It’s not possible to give everyone as much health protection as the president. So it’s not a scenario. I can imagine each person as being the only person on earth with such care, and I can imagine imagining a single hypothetical world has each person with that level of care, but I can’t actually imagine it.
That indicates that no argument about the type of thing to be done will be based on a difference in kind. It won’t resemble saying that we should switch from what happens at present to “no-one being left to die just because they happen not to have a given amount of money”. We currently allow some people to die based on rationing, and you are literally proposing the impossible to connote that you would prefer a different rationing system, but then you get tripped up when sometimes speaking as if the proposal is literally possible.
Declaring that someone has a right is declaring one’s willingness to help that person get something from others over their protests. We currently allow multimillionaires, and we allow them to spend all their money trying to discover a cure for their child’s rare or unique disease, and we allow people to drive in populated areas.
We allow people to spend money in sub-optimal ways. Resources being limited means that not every disease gets the same attention. Allowing people to drive in populated areas is implicitly valuing the fun and convenience of some people driving over the actuarially inevitable death and carnage to un-consenting pedestrians.
I don’t understand how you want to ration or limit people, in an ideal world, because you have proposed the literally impossible as a way of gesturing towards a different rationing system (infinitely) short of that ideal and (as far as I can see) not different in kind than any other system.
By analogy, you don’t describe what you mean when you declare “infinity” a number preferable to 1206. Do you mean that any number higher than 1206 is equally good? Do you mean that every number is better than its predecessor, no matter what? Since you probably don’t, then...what number do you mean? Approximately?
I can perhaps get an idea of the function if you tell me some points of x (resources) and y (what you are proposing).
Not quite. ER doctor.
Your post confuses me a lot: I am being entirely honest about this, there seem to be illusions of transparency and (un)common priors. The only part I feel capable of responding to is the first: I can perfectly imagine every human being having as much medical care as the chief of the wealthiest most powerful organization in the world, in an FAI-regimented society. For a given value of “imagining”, of course: I have a vague idea of nanomachines in the bloodstream, implants, etc. I basically expect human bodies to be self-sufficient in taking care of themsleves, and able to acquire and use the necessary raw materials with ease, including being able to medically operate on themselves. The rare cases will be left to the rare specialist, and I expect everyone to be able to take care of the more common problems their bodies and minds may encounter.
As for the rest of your post:
What are people’s rationing optimixation functions? Is it possible to get an entire society to agree to a single one, for a given value of “agree”? Or is it that people don’t have a consistent optimization function, and that it’s not so much a matter of some things being valued over others as a matter of tradition and sheer thoughtless inertia? Yes, I know I am answering questions with questions, but that’s all I got right now.
Thank you for leading with that.
This seems to sidestep the limited resources issue, making your argument not clearly apply outside of that context.
Let me give an example outside of health to discuss the resources issue. I have read that when a guy tried to make a nuclear power source in his garage from clock parts, government agents swooped in very soon after it started emitting radiation—presumably there are people monitoring for that, with field agents ever-ready to pursue leads. This means that, for some 911 calls where the nuclear team would be the first to the scene, we allow the normal police to handle it, even at the risk of people’s lives. If that isn’t the case, imagine a world in which it were so, and in which it would be easy to tell that the police would be slower than the nuke guys (who don’t even leave their stations most days). I think having such an institution would be worthwhile, even at the cost of crimes in progress being responded to slower.
Similarly, I think many things would be worth diverting resources from better policing, such as health—and from health to other things, such as better policing, and from both to fun, privacy, autonomy, and so forth. I’m only referring to a world in which resources are limited.
It is possible that there is a society wealthy enough to ensure very good health care for those it can influence by eliminating all choice about what to eat, mandating exercise, eliminating privacy to enforce those things, etc. It’s not obvious to me that it’s always the right choice to optimize health or that that would be best for the hypothetical society.
Considering the principle of diminishing returns, there’s no plausible way of describing people’s preferences such that all effort should be put towards better health. we don’t have to be able to describe them perfectly to say that being forced to eat only the healthiest foods does not comport with them—ask any child told to eat vegetables before desert.