Paul Craig Roberts on Obamacare

[DSpencer]

Re: Paul Craig Roberts on Obamacare

I'd be happy to.

First, there is an important difference between providing basic healthcare to our citizens and providing food, shelter and clothing to the entire world. I do not support free healthcare for all but, rather, basic health insurance provided at taxpayer expense via a single payer. I have no objection to individuals purchasing additional coverage with their own money. So we are talking about a limited program paid for by all citizens which provides a benefit for all citizens. This is no different than national security, except that we are defending against the invasion of bacteria, viruses and accidental trauma to our physical body, rather than the invasion of a foreign army to our territory.

Second, taxes are not theft and one cannot separate his ability to make an income from the society in which the income is made. Taxes are the cost of living in our society. Absent that society --- which is the accumulated capital, culture, customs, laws, and knowledge of 300+ million Americans and their ancestors --- it would be virtually impossible for his to earn anything like the wealth he has earned in a civilized country. People who believe otherwise are living in a dream state, not in the real world.

Third, even for libertarians there is a good reason to use "force" to pay for everybody's healthcare. Unlike food, clothing and housing, there is no legal obligation of a grocer, clothing store or homeowner to provide food, clothing or housing to anybody who needs it. None. That is not true of medical care. Today, no hospital can turn down a needy patient, and we all pay for that care either through taxes or increased charges to those who have insurance. In short, Obamacare is about personal responsibility --- requiring everybody who already has a right to emergency care to pay for that care by becoming insured and taking more responsibilty for maintaining their own health.

I am open to changing my mind about this just as soon as we dissolve all government everywhere and see what happens. If after a reasonable test period the libertarian ideal is magically reached and nobody forces me to pay taxes for the myriad of other government programs I'll never need or want, I'll be happy to stop asking for any sort of collective healthcare. Until then, I'll just go along with every other developed country in the world and suggest that some sort of universal care is no more difficult than the 40 hour work week once appeared to be.

First off, I appreciate the response. Even though I have somewhat different views, you always provide thoughtful and polite responses.

A couple of my thoughts:

1. It's not really fair to say that this or any program is paid for by ALL citizens. While in some sense nearly everyone pays taxes, there are millions who are net recipients. If someone pays 1 dollar in taxes but receives 10 from the government, I don't think it's fair to say they are contributing.

2. How do you define "basic healthcare" or a "limited program". Speaking only for myself, I'd be willing to compromise on a safety net program that provides vaccines, antibiotics, lifesaving treatment for traumatic injuries and maybe a few other services. However, when we are talking about organ transplants, joint replacements, and dramatic life extension procedures for the elderly, I don't consider that part of national security by any stretch of the imagination.

3. Obamacare does NOT require everybody who already has a right to emergency care to pay for that care. It EXPANDS medicaid coverage. It subsidizes coverage for people up to 400% of the federal poverty level. Federal programs and subsidies do not count as paying for your own care or taking responsibility for your own health in any way. You can't get blood from a turnip. If people can't afford the care they receive, someone else pays for it. The question is only who. I concede that in some circumstances it will force people to buy insurance and that this may cover them for services that would otherwise stiff the hospital. Taxes and increased charges for those with insurance are the primary methods that Obamacare uses to pay for what it does - even more than before.

4. I'm not making the claim that all taxes are theft. I'm just asking where the line gets drawn when the option exists to take someone's money to save or improve someone else's life/health.

5. I'm also not pushing for anarchy. I don't think that fairly represents any claim I've made in this thread. I still think America is the best country in the world. I don't think we became that way by following what every other developed country did with regard to its government. I don't think we should start now.

[Munger]

Re: Paul Craig Roberts on Obamacare

Let's strip your post of the rhetoric and boil it down to the essence, shall we?

... There is no special case where free markets don't operate effectively ...

Demonstrably false. You are either ignorant or willfully living in a fantasy land. There is no debate to be had with you until you educate yourself on how markets actually work.

[Raz]

Re: Paul Craig Roberts on Obamacare

Let's strip your post of the rhetoric and boil it down to the essence, shall we?



Demonstrably false. You are either ignorant or willfully living in a fantasy land. There is no debate to be had with you until you educate yourself on how markets actually work.

Wow. Did you have pickle juice with your breakfast? That's the way to transform a conversation into a brawl.

And I actually agree that there are some situations where a free market doesn't work - like shopping for doctors or reasonably priced care when one is bleeding or in cardiac arrest.

[Ghent12]

Re: Paul Craig Roberts on Obamacare

Let's strip your post of the rhetoric and boil it down to the essence, shall we?



Demonstrably false. You are either ignorant or willfully living in a fantasy land. There is no debate to be had with you until you educate yourself on how markets actually work.

Markets work via price discovery. Market participants often seek to skew the interaction in their favor via political means (meaning they use the government to protect them or weaken others). It is up to the body politic to resist temptations to help one group over another so that we may make the most of scarce (i.e. all) resources.

Raz seems to think that you can't price shop while in cardiac arrest. This is pretty much true, but that is taking a microcosm of health care, emergency services, and applying it broadly to the whole industry. The reality is that it does take a lot of resources to respond quickly enough to save a life in many emergency cases such as cardiac arrest, arterial bleeding, and etc. Those resources are not free, and must be compensated for. If you want to cap what a hospital or paramedic can charge, then that is not a discussion worth having because price caps, when effective, invariably and always lead to a mismatch between supply and demand.

If you want to make the case that government should absorb some/all of the cost of emergency services, then that is a discussion that merits attention. However, let's not pretend that humans will stop being humans. The more cost the government absorbs, the less realistic the outlay of those services will be. Does a town of 1,000 people need 100 ambulances on standby? If that town is politically connected or the hometown of a senator, then it will be taken care of. A politician can always argue that there aren't enough resources to save lives because that will always be true until we reach parity between first responders and citizens (meaning 1 paramedic per citizen), hence there is a reduced tendency to realistically allocate resources in the most efficient way. Do not pretend for a moment that government-provided resources are inherently free or even efficient enough to be worthwhile. That must be proven continuously.

The plain fact is that we have an extraordinarily chained and constrained market in health care as to make it a farce. Do you really think our current health care industry operates under free market principles? Do you think you can do better than the "for profit" 'free market' hospitals that dot the country? Try to open a hospital in any given city or state to compete with the existing hospitals there and see what happens. Good luck getting your CON.