Laurence B., I couldn’t agree with you more. Do you realize that the phrase, “There’s no such thing as a free lunch,” is much more broad in meaning than the strictly monetary connotation that is placed upon it? Time, health and dignity are just a few of the external, opportunity costs involved in making American life so convenient. Consumer reluctance (including employers as labor consumers) to pay a dime more for the entire cost of production simply transfer those costs to others.

“Find a better job” is akin to asking a physician to “treat more patients” when uninsured patients are unable or unwilling to pay for medical procedures. The cost is simply pushed onto someone else. Whether someone has chosen or was chosen for a particular job, someone else receives a benefit from that labor along with the worker. Supply and demand has created a great deal of low paying jobs with many benefits to consumers. Relevance of labor is irrelevant when discussing supply and demand. We demand cheap products, and then bitch when asked to pay for the healthcare of the many that help make our demands possible?

What do you do when you have to choose between saving a pedophile doctor, and a fat pizza boy? I wish life were so simple as you all have made it. According to the American legal system, you better have a damn good reason for not saving either of them.

Asking someone to pay for your healthcare really isn’t that different than asking someone to provide for your consumer wants for a wage that doesn’t sustain their life. Government , taxation, and regulation imposed through the democratic process is probably the most civilized way to solve this particular problem. You may not feel that everyone deserves healthcare, but can you understand why everyone wants it? We aren’t that different.

Where is the free market incentive for insurers to reduce healthcare costs for anyone? Affordable healthcare makes insurance unmarketable.

I believe your theory should explicitly include political correctness. As you and others have noted, few Americans would reject the proposition that “All Americans should have equal access to health care.” I believe an equally small percentage of the population would affirm publicly the proposition that “Wealth should determine access to health care quality and innovation.” Yet, I am quite confident that all of us would affirm the proposition that “If I or my family needs health care not accessible through public or private insurance and I can afford to pay for it, I should be able to purchase it.”

Personally, I would not affirm the first two of these propositions to make myself feel better. My conscience is not so easily assuaged. I might affirm these propositions because I support them at least in the abstract, or perhaps because I do not want to invite the wrath or scorn of friends or colleagues who would attack me for being realistic (as I discuss further below) and honest with myself (i.e., to be politically correct). All of us would affirm the last of my three propositions because, in truth, we are motivated fundamentally by self-interest (in this case more particularly self-preservation).

There is another reason that I and others might affirm the first two of these propositions that I think bears a bit of elaboration. Many of us, especially those of us who have thought about the issue of health care more deeply than is typical for mass media, might affirm these propositions because we know them to be futile. In other words, we may believe that a legal declaration of the right to equality in health care would be limited by practical constraints such as economics, capitalism, selfishness or limitations on the resources of healt care collectivism enforcement officials.

In considering this possibility, we can refer to past battles in this country over “equality.” The meaning and justification for equality, in the U.S. at least, has evolved and undoubtedly will continue to evolve. Before various amendments to the Constitution and Supreme Court decisions, equality was limited to white men of certain religions. Thankfully, we have evolved our law well beyond this limitation, but limitations remain and some of those limitations (such as the geographic and economic limitations discussed in some comments with regard to education) undermine the potential of the constitutional rights granted or affirmed in those amendments and Supreme Court cases.

Health care is no different in my view. Whether or not we individually believe truly in equal access to health care, equal access to health care is no more achievable than has been equal access to education, housing, or anything else, if by equal access we mean that everyone is entitled to the best or to no more than a governmentally defined level of quality or quantity. No successful nation has achieved such perfect equality (except perhaps the idyllic Federation of Planets from Star Trek), and no nation of limited resources ever can. Those who have more resources always will find ways to acquire better health care more quickly, conveniently, and comfortably.

One final point on your post. Collectivizing health care not only is impractical it is counter-productive. The quality of health care in our country, and probably world-wide, is a result in substantial part of innovation in technology, technique, education, pharmacology, and many other fields. Innovation occurs for many reasons but one of the dominant reasons is economic gain — wealth for the individuals and companies who conceive, refine, test, and reduce to working form innovations. Suppressing the power of our country’s wealthier citizens to purchase better health care services and technology inevitably would suppress innovation in health care and, therefore, retard the pace of improvements that ultimately the wealthy and not so wealthy will enjoy.

Political expediency and correctness should be recognized for the obstacles they are to improving the lives of everyone. If reality and practicality prevailed, or even had modest influence, we could establish workable systems of health care and education and many other essential services that would deliver better quality, more quickly, and more efficiently. Regrettably, reality and practicality do not win political elections.

I just read Richters “Picture of a Socialistic Future”. It really gets John’s point across. Satire at its best by taking an agrument to its logical conclusion. To bad Americans are not taught to do that starting in middle school.

The best line I have read is a bumper sticker my CEO has on his car “If you think medical care is expensive now, wait until it’s free”

It is interesting that no English conservative or Tory can say the NHS is bad institution. Some people have the attitude that slavery was not such a bad thing. So attitudes are the evolution of thinks and make a difference , like justice or human rights.

To equate the color of shoes with health care seems like you may be lost in your philosophy text book.

Is the NHS getting better or worse over the years. I would imagine it is better by most benchmarks.

Remember NHS was done in 1947 ..when UK was very economically depressed and in some ways to save money and yet cover the entire population– even foreigners. UK asked for loans and we declined to help after WWII.

Regardless of all the critiques, it was a very progress step forward in human history. I am not an expert on this NHS but I did spent time studying GP services and the geriatric service. The geriatric system in UK set standards for geriatric care in USA and around the world for 40 years or so.

They invented it. ! We are still trying to recreate the geriatric models from UK now amd we have not been very successful to create such a quality system in USA. Primary care was weak in some ways, but it has been improved. It must be remembered that their system .. by choice . is cheap.!! 8-10% vs our 17% of GNP.

I also agree with Devon. “Equal access” sounds great. And because health care includes the risk of immediate death, it’s easy to rationalize a single payer system.

I’ve been doing my own reading about collectivism, and I think it is partly genetic. It’s partly learned behavior. It’s also in style right now. Back in prehistoric times, we had to cooperate or else we starved. But society has evolved, and we now have the possibility of being self-sufficient (via earning our own wages through a capitalistic system and trading them for goods/services that satisfy our needs).

This is, of course, horrifying to some people, both because they fear being unable to take care of their own needs and they feel beholden to others who might not make it in the free market.

I think collectivism is, at heart, fear. Fear of the unknown, fear of independence, and fear of being without a “community” to bail you out.

And there’s nothing more frightening than being sick and not knowing what to do. It’s in those times that “equal access” seems so appealing to so many people who fear the unknown and lack the tools to invent better solutions than stealing someone else’s property.

That’s my theory, anyway.