Ronin of the Spirit

Because reality is beautiful.

Health-care debate VII

Do we want to fix health care? Health care is a cross roads where health-care providers, health-care consumers, health-care insurers and government all meet up. I can not talk about reforming those things without getting into pretty serious conversation what government’s role in society is, and here is my “simple” answer…

Government has a legitimate monopoly on force. If the mafia says “Give us 30% of your paycheck, every paycheck, to spend on protecting you and if you don’t we will take your stuff and/or lock you up in a small room with highly abusive people,” we would call that a protection racket, a form of organized crime. The reason the government is allowed to do this, and other groups are not, is because the government has a legitimate monopoly on force.

Under normal circumstances, a person exposes themselves to force by contract. Your collectors have the right to take your stuff if you don’t pay because you signed a contract saying it was OK. The fact that you have many contractors to choose from and that you enter the contract of your free will, makes this type of force self regulating and legitimate.

Government, on the other hand has this right regardless of contract, and there is no competition. So, in the absence of voluntary contracts serving as a control to the force, freewill is expressed through democracy.

However, democracy requires a system in order to function well. The simple will of the majority for every government tasking would be disastrous, even it it were logistically feasible. Fifty-one percent could (and would) use their power over the government to use the government’s monopoly of force to seize the money and resources of the remaining 49%.

Also, the fact that the government has monopoly on force doesn’t mean the government is the best instrument to accomplish every job. Socialism basically means the rich pay more taxes and the money taken from the rich provides for the poor. In a totally socialist state, the government would make all economic decisions for the people. Historically, this works very poorly.

Americans, justifiably proud of their economy, often complain about socialist economic control. However, if people take the time to think, few people really want a totally capitalist society, in which the supply of anything is controlled only by market demand, and not by the government’s monopoly of force.

Prescriptions are a good example. In a totally capitalist society, people could buy whatever drugs they wanted. The supply of drugs would be controlled completely by the demand for them. However, we impose non-market control over drugs, denying people access to drugs regardless of their demand because, in this case, capitalism harms rather then helps society.

Why? Because capitalism is a means to an end and not an end to itself. Capitalism is great at providing a variety of products, and using competition to drive the price of those products down, but capitalism, like many tools, is without morals. It is neither good, nor bad; it just is. Sometimes we stop capitalism from working on moral grounds.

The military is another good example. Bill Gates pays about 15 million times more taxes than the average American. Yet, he receives exactly the same level of military protection as the homeless who live nearby. That is socialism at its most basic. Yet few Americans clamor to have the US military dismantled and replaced with competing mercenary bands. We turn capitalism off and utilize the government’s monopoly of force when it seems that taking unequally from all to provide equally to all is more moral than not. In a totally capitalist economy, the rich would have the best police, the best roads, the safest airplanes, just as in our current economy they have the best cars, the best houses, and the safest neighborhoods.

Morality is the test. The poor people in a police district get the exact same protection as the rich in the same district, flying first class is just as safe as flying other classes, and the military protects us all to the same degree regardless of income, because we have decided to tax those with money, to pay for a service for all.

The government has a responsibility to protect its citizens, thus everybody pays what the government thinks they are able, to receive the exact same level of military protection. This does not mean there is a universal right to military protection, for there is no such thing as a right to a service when no contract has been made; it simply means the government has a responsibility to provide the best military the people will fund.

Health-care is no different. The government has a responsibility to protect the lives of its citizens. If 50,000 people a year die in attacks, the government acts through the military. If 50,000 a year die in traffic accidents, the government acts through the Department of Transportation. If 50,000 a year die from inaccessible health-care…well then let’s not do a fucking thing because that would be socialism?

My. God. Obviously, morality calls for the limited suspension of capitalism in this case. France has the the highest value health-care on Earth. In a few other countries, people pay less but get far less (Chad for instance). In most other countries people pay far more and get a bit less. There are three keys: (1) There is a single payer (the government) for everything; (2) The book keeping is state of the art; (3) The doctors strike regularly.

It’s that simple. In response to the will of the people, the government sets price caps as low as possible. In response to the health care providers, the government raises price caps. Between the two, the providers get the incentive they need to stay in the market, and the people get what they need to be able to afford health care.

And it will not work in the U.S. for just as simple a reason – we lack the sort of democracy that allows it. In the U.S.’s single-member-district plurality representation, it’s all or nothing; 100% or 0%. That simply will not work for government price fixing. Let us suppose the Republicans side with the doctors, and the Democrats with the “more-for-less” voice of the people.

When the regime is Republican, the doctors will do well. When the regime is Democrat, the doctors will do poorly. In a society like France’s, the doctors will always win something, but never as much as they ask for…every year. The people will always win something but never as much as they ask for..every year. In the U.S., doctors will spend 4-8 years going broke followed by 4-8 years of getting paid. Though this averages out to the same thing, the fact is after 8 lean years, doctors will be leaving the field in droves. The profession of medicine cannot survive the zero sum game (0% or 100%) method of democracy; it needs proportional representation.

If we really want health-care reform, we need to partially socialize medicine. If we want that, and we want crops of new doctors to replace the retiring ones every year, we must have proportional democracy.

Proportional democracy, however, only works for large bodies of many representatives, like the House. For things like the Senate, or the Presidency, we still need to vote for one person. No matter how democratic the House, unless the Senate and the President are elected differently, we will have made huge change with no positive effects. The two-party system would still rule the executive branch and the Senate.

For these, we need a Condorcet vote. In this system, the voter rank candidates, and the overall winner gets the seat. This breaks the back of the two-party system and puts the President and the Senate in the same democratic boat as the House.

Without these, any attempt at health-care reform is so much verbal masturbation.


September 27, 2009 Posted by | atheism, Christianity, Government, Politics, Religion, Science, skepticism, Uncategorized | , , , , , , , , | Leave a comment

Health Care Debate VI

So, one of the things I thought about as I was siting in my car seat, either watching barriers shoot (by far to close) or stuck in traffic, was the American health care system.

In post five, I said health care is a real problem in the US and needs a solution. A gave a solution, but it was so cursory as to be nearly comic. (Like a three step process to getting the moon: 1. Build rocket, 2. Load up and launch. 3. Land on moon.) I wanted to go into detail, but I simply don’t have the time it would take to write a book about it. Here is my less summarized than before, but still highly summarized problem. (The solution in the next blog.)

I’ve come to think, after much reflection, that problem is not health care. The problem is Americans. We have the 2nd most expensive socialized health-care per capita GDP on earth, yet it covers only a 1/3 of our citizens. We have the 1st most expensive private care per capita GDP on earth, yet have the lowest age of mortality and highest infant mortality in the western world. We have highest medical costs, bar none, on earth, yet the leading cause of death cancer caused by tobacco and heart disease due to diet and inactivity. We have all of this…and yet at least half of Americans don’t think there isn’t a problem.

Most Americans are stupid. We have only two possible causes for any undesirable behavior: internal and external. I find the idea that Americans are genetically inferior to people of other nations ridiculous, so that just leaves external. What could be acting from the outside in of whole nation to make Americans so politically stupid?

Let me pause for a moment, to say that I love my country. It’s not a perfect place, but I love it worts and all. I’m not so naive to believe that the election of single black man to the highest office in the land eliminates racism. I see private, quietly expressed racism nearly everyday I am work. The fact remains however, only three generations from one of the most homicidal racial slave systems on earth, a black man as president is a good step. It doesn’t solve inner city poverty. It doesn’t change the fact that schools with mostly black kids get a fraction the funding as schools with mostly white kids, but you will not see an outcast on the Diet of Japan, or Jew as the president of Egypt in three generations. America, ultimately, does many thing better then any other nation on earth.

But in the American democracy, there is a corrosive element that eats away at the will of the people constantly. It’s called the two party system.. In turn, the two party system is what causes this uniquely American stupidity.

I could go on about how two party systems prevent any real change (which they do), or why the left and right of the Communist party in China represent more choice of ideals then the Democrat and Republican party (which they do) but thats not the important part. No matter how bad the collusion between our politically parties, or between those in power and those with money is, democracy has an amazing power to right such wrongs, and in a way the people support. While the US does have systemic problems, the existing system has the capacity for self correction…but it’s only as good as the people voting.

The two party system putrefies the minds of the people. It reduces every discussion of shade and color of meaning into single binary choice of black or white. It turns every attempt at discussion into a cosmic battle of good and evil, characterized by a double false dichotomy. “False dichotomy” in argument refers to painting a bleak picture of you opponent’s viewpoint to make yours look better by comparison. In the two party system, both the viewpoints provided are absurd. One side is the bastion of all freedom, happiness, and light, the other a hotbed of evil, conspiratorial lies, and ill will. One side is God, the other side is Satan. 100% or 0%, with no in betweens.

In that environment, there can be no discussion, no debate, only people screaming slogans. The two party system is often defended with the statement “Well, it’s a good system, because it tells both sides of the story.” That single statement shows the mental atrophy that a two party system exacerbates: the idea that all meaningful thoughts on a subject can reduced to two viewpoints. Obviously it’s better then a single party system, but thats damning with faint praise. (Two steps removed from anarchy! Go team!)

Such simplicity is seductive. You don’t need to worry about how or why. You don’t need to think. You just need to know which of a pathetic two options you choose. This brain rot affects other things besides politics. Auto accident policy is the same. Pretend you are going down a road and the person in front of you slams on the breaks to turn right. You hit their car. It is 100% your fault. Why? Yes you were following to close, but couldn’t it be even a few per cent the other drivers fault breaking irresponsibly? (Which is how most traffic law is set up in Europe.)

The first step in my little “How to fix health-care” post was “Tort reform”. The 0%/100% fault system rears it’s ugly head hear as well. If you have a pool in your back yard, it must have fence of certain opacity and height, because it is an “attractive nuisance”. You must do this, because if someone gets into your pool without it, you are 100% at fault and they are 0%. That’s stupid. At the same time, the law was put into place to right the wrong of people putting things very dangerous to children in their yards with no protection whatsoever, an environment where the pool owner had 0% fault and small child was 100% at fault.

The real answer to tort reform is a society that recognizes partial fault. I think a two party system trains peoples minds to be incapable of functioning in the gray areas that make up real life. The real cause of the American health-care failure, is Americans incapacity for rational thought, followed by an inability to turn rational thought into rational policy.

September 27, 2009 Posted by | atheism, Christianity, Government, Politics, Religion, skepticism, Uncategorized | , , , , , , | 2 Comments