People who say "health care should be free."
They don't really mean free, generally -- they understand that doctors and nurses need to make a living too, that big buildings and fancy machines that go ping! don't pay for themselves, and that even if medicines cost only the value of the raw materials that would be something -- but they have a deeply rooted feeling that all that stuff should be paid for by someone else.
And saying "free" when you mean "paid for by someone else" is massively intellectually dishonest. It's an attempt to shift the dialogue to fantasy-land, where dialysis machines fall from the sky and ambulances run on happy thoughts, where doctors are all handsome and tall and privately wealthy and nurses are all married to them. It's just as bad as any other political lie.
If you believe that healthcare should be provided to all people without condition, you need to state who should do the providing. And, at least in your own mind, you should have a sense of how that entity could pay for said healthcare -- again, it's not free, though the system in the USA is awash in money that could certainly be allotted in different ways. Also, "the government will stop spending money on things I personally dislike" is not a rational, reasonable system of funding.
"Free" is not an argument; it's an attempt to deflect attention from the fact that you don't have an argument. If you believe it, get an argument.
13 comments:
I'm confused - healthcare *is* free, isn't it? In the same way that schools are free or roads are free - it's paid for by the government out of tax revenues.
Um, sorry, ignore that last comment - for some reason I thought you were here in the UK.
WOW! Great rant. I totally agree. There's no such thing as a free lunch. Where's Heinlein when we need him...
Arnold: Even in the UK, the government has to get the money to pay for healthcare from somewhere -- as you say, presumably taxes. And every pound spent on healthcare is a pound that can't be spent elsewhere -- on housing, the military, roads, corrupt loans to friends of government officials, or any of the other million things governments spend money on. So it's not "free" -- each person in the UK paid some amount of tax, out of which some proportion went to healthcare.
My point really is "I'm not paying for it" is not the same as "free," especially when it's something that clearly does cost a lot of money in aggregate for the society.
Michael: I'm not necessarily against a single payer system --I'd have to see the details -- and I've had a growing discomfort with the idea of for-profit healthcare (in which company executives will, inevitably, get bonuses for denying people care).
But I really don't like dishonest arguments about what is "free."
Mr. Wheeler supports single payer healthcare?
It's nice to know that at least one Rockefeller Republican still exists (unless you count Mr. Scalzi).
Pretty soon he'll start talking about banning those pesky handguns.
For a lot of people, health care appears to be free. Their employer pays for it and they have no idea that the employer pays less in salary to make up for it.
I think this could be filed under the same mindset that causes the tradegy of the commons?
Brad: I think you're right; for a lot of people, "I don't pay for it directly" is the same as "free."
I've noticed many employers are making more noise lately about "total compensation" of regular employees -- sending out packets explaining exactly how much that specific employee costs the company, including company contributions to healthcare, 401(k)s, and so on. Maybe those will help with that perception, but I'm a cynic as usual.
I saw a number a while back, can't remember where, that something like 25% of the people believe that if the federal government needs more money, it only needs to print more at the mint. They don't understand that it's their tax money that is spent (plus deficit spending). That's a level of hardcore ignorance that's hard to reason with.
"free at the point of use"
Problem solved.
Free at the point of use is a nice idea, and that is what most advocates of single payer programs want.
My wife badly cut her finger yesterday, so I had to reacquiant myself with our benefits. There is a $15 copay for walking through the door. For us, $15 is easy. When I had physical therapy, I spent $90 or so on copays over six weeks. That is a lot of money for someone on a tight budget. Of course, getting a plan without copays costs me $200+ a month as opposed to $15 a month my current plan does.
I think that the real answer is I should buy shares an insurance companies.
As someone born and bred in the UK, the idea of free (at point of use) healthcare is perfectly natural to me, and A Good Thing to boot.
I know healthcare seems to be a hot topic in the US at the moment, and one (kind of) related thing I've not seen adressed is education. Unless there are proportionately a hell of a lot more kids in private education in the US than the UK, presumably a lot of the "why should I contribute to someone else's healtchcare?" types are quite happy to accept someone else paying for their kids' schooling. Like I say, I'm not a US citizen and perhaps I'm missing something, but I don't see how these viewpoints can be reconciled. Thoughts?
Dan: I'm not sure the precise system in the UK, but, in most of the US, the public schools are run by the local jurisdiction (not even state or county-level, generally -- the town/city/village level). And, because of that, you see people with children often choosing to move to a town with "good schools" (which generally also means "higher taxes"), and, on the other side, people without children -- and particularly older people -- moving to places with bad schools (not specifically, but because the taxes are lower).
There's also the recent growth area of "age-restricted developments," which are condo communities (usually) in which no one younger than 50 is allowed to live. Towns like them because they provide tax revenue without causing additional spending for schools (any extra spending for fire or police protection is peanuts). Old people like them, because taxes tend to be low, and they don't have to deal with other people's kids being young and all that.
And the problem is never "someone else is paying for me" -- it's always "I'm paying for someone else." People often object to their tax money being used for things they don't like -- for some folks it's military spending, for others it's "excessive" school spending.
(Where I live, school budgets come up for a popular vote annually -- and, in many towns, are regularly voted down.)
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