Friday, June 22, 2012

Socioeconomic Fairness: Two Views


Both liberals and conservatives want socioeconomic fairness but they approach it in very different ways due to different definitions of “fairness”.  I will argue that the philosophical and empirical force for socioeconomic fairness is on the side of conservatives, not liberals.
President Obama and many liberals have repeatedly said that the wealthy need to pay their "fair share" and pushed for certain policies in the name of fairness.  For instance, Obamacare, Gary Bauer (2012) wrote in his Politico article "'Obamacare': Fairness vs. Justice", concerning fairness and the Constitution:

Many conservatives and others have accused Obama, a former constitutional law instructor, of being profoundly ignorant of the Constitution.  But he may just believe that “fairness” supersedes constitutionality in the hierarchy of legal values. […] Obama has called access to free contraceptives and abortion-inducing drugs for all women a matter of “basic fairness” and a “core principle” that needs to be balanced against the constitutional rights to religious liberty and free speech.

Another example of liberal policies under the mantra of fairness is the House bill H.R. 4170, the Student Loan Forgiveness Act of 2012 introduced by Democrat Representative Hansen Clark.  This bill’s explicit purpose is:

To increase purchasing power, strengthen economic recovery, and restore fairness in financing higher education in the United States through student loan forgiveness, caps on interest rates on Federal student loans, and refinancing opportunities for private borrowers, and for other purposes. (emphasis added)

When it comes to socioeconomics, liberals define “fairness” and “justice” in terms of equality.  For liberals, socioeconomic inequality is a form of injustice; what’s fair and just that is everyone has their fair share of wealth or enough of it so that social justice is achieved.  Therefore, affirmative action, graduated (progressive) tax-scales, redistribution of wealth, single-payer healthcare, etc., are just because these are fair.
Regardless if individuals believe such things (e.g., redistribution of wealth or affirmative action) are unfair or violate their individual liberties, if these actions create or potentially create an egalitarian society, then those actions are justified because the interests of (liberal) society trumps all other considerations.  For liberals the collective (i.e., society) is more important than the individual because, in the context of American liberals, “fairness” is a higher-order ethical value than upholding the Constitution.
Turning to conservatism, first I will examine the philosophical side of the conservative position.
When it comes to fairness, conservatives define socioeconomic fairness upon the idea of a meritocracy, the idea that people get in life what they’ve earned by what their actions merit.  If there are individuals who work hard and become successful, then they are reaping what they have sown.  If there are individuals who are lazy and end up living in poverty due to their own laziness, then they too are reaping what they’ve sown.  Under a meritocracy there will be societal inequalities that no amount of government intervention can change or rectify.  Not everyone is equal in the sense that not everyone has the same talents, skill sets, work ethic, ambitions, dreams, etc.  Some will simply work harder and use their talent more in life than others.  This is self-evident.
Despite these inherent inequalities, social classes are necessarily fluid and dynamic simply given the nature of a meritocracy.  However, if someone is kept in their social class, especially the lower classes, simply due to race, gender, social class, or unwarranted discrimination, this is unfair, unjust, and unethical because such individuals aren’t able to earn what they’re actions merit.  Under these circumstances, government should intervene to rectify injustices, which explains why Republicans/conservatives have consistently voted affirmatively for various civil rights bills.
A necessary contrast point is that individual’s interests aren’t always trumped by egalitarian considerations.  Conservatives believe that upholding meritocratic practices is a higher-order ethical value than egalitarian fairness.  A small and limited government because individualism and individual liberties are essential for a fair and just society as Richard Stroup (1976) argued:

Restraints on government, however, are the key to freedom and fairness.  Few would dispute the need for restraints to maintain freedom, but the restraints on government are necessary for fairness as well.  Why?  Individuals are not equally endowed with effectiveness in market earnings, nor in the market for political influence. […]  Thus a government with the power to prevent arbitrary abuse of some people by others, but with sharply limited power to coerce others directly and in detail, is likely to provide maximum freedom, and hence maximum prosperity and fairness as well. (405-406)

I believe Stroup’s argument explains why American conservatives uphold and defend the Constitution because it necessarily limits the power of government, but it doesn’t weaken government to the point that it can’t maintain civil order and justice.
Many conservatives hold a view as presented by Charles Fried (1981):

If the situation of individuals depends on collective claims for contribution to the well-being of others, that situation is insecure and their liberty is threatened.  If the very definition or conception of what a person’s situation is depends on collective claims directed at collective goals, including collective goals about fair distribution, the distinctness of the concept of liberty is undermined.  To put the issues crudely at the outset, if everything about an individual—his person or his product—is available for redistribution, then individuals are not free.

Now, I will examine the empirical side of the conservative position.
Liberals, especially Obama, have argued that economically America as founded never worked.  This claim is soundly proven false via empirical evidence.  Before the United States was founded, according to his autobiography Benjamin Franklin started out in the printing business and after much work and personal discipline he became rich, later to become one of the most influential individuals counted among the Founding Fathers.  After America’s founding, J.D. Rockefeller started out from “humble beginnings” but through diligence and determination, he became one of the richest individuals in US history.

Rockefeller soon impressed his employers with his seriousness and diligence.  He was very exacting and scrupulously honest.  For example, he would not write out a false bill of lading under any circumstances.  […] (For all this work, he was not well paid.  But whatever he was paid, he always gave to his Church and local charities.) […] Rockefeller was extremely hard working.  He traveled extensively, drumming up business throughout Ohio, and then would go to the banks and borrow large sums of money to handle the shipments.  This aggressive style built the business up every year.

Another example would be William Shatner who lost everything but now is wealthy, successful, and influential.  These are just a few examples.
However, when presented with empirical evidence showing that socioeconomic egalitarianism fails over the long-term liberals retreat to a priori ethical arguments for fairness.  To use single-payer healthcare as an example, Obamacare is touted as “fair”, but when examining single-payer healthcare systems we can see that have serious socioeconomic consequences.
According to Edmund Conway (2009) of The Telegraph states that healthcare costs are going to play a major factor in forecasts that the UK national debt could quadruple within the next few decades.  Thus the financial stability of the UK has been called into question.  Additionally, Canada, which has a similar system to the UK and considered fair, is looking to private sector solutions to their health care because their current health care system is bankrupting them.  I fail to see how bankrupting and/or putting the nation’s economy under severe strain is fair.
One socioeconomic worry that was brought to my attention by a liberal friend is that without a single-payer healthcare system, bankruptcies due to rise in medical costs will sky-rocket.  Therefore, we need single-payer healthcare to keep costs down.  This argument is empirically false.  For example, in Canada, in 2009 researchers Skinner and Rovere found that there was a higher percentage of medical-cost related bankruptcy in Canada than in the US.

Unlike the United States, Canada has a universal, single-payer, government-run, socialized health insurance system.  Advocates of socialized medicine argue that the mixed public-private health insurance system in the United States causes many Americans to become financially bankrupt, and that this would not occur if the US adopted the Canadian health system.  Following this logic, we should expect to observe a lower rate of personal bankruptcy in Canada than in the United States.  Yet the most recent data (2006 and 2007) shows that personal bankruptcy rates are actually higher in Canada (.30% for both years) than in the United States (.20% and .27%).  Research indicates that medical spending was only one of several contributing factors in 17 percent of US bankruptcies, and that medical debts accounted for only 12 to 13 percent of the total debts among American bankruptcy filers who cited medical debt as one of their reasons for bankruptcy. (1)

Skinner (2009) states:

Indeed, if we define medical bankruptcies the way Himmelstein and colleagues did for their study in the United States, we find such bankruptcies also occur in Canada.  Survey research commissioned by the Canadian government found that despite having a government-run health system, medical reasons (including uninsured expenses), were cited as the primary cause of bankruptcy by approximately 15 percent of bankrupt Canadian seniors (55 years of age and older).

Therefore, in contrast to single-payer systems based upon “fairness”, the United States’ healthcare system (despite its flaws), which is loosely based upon meritocratic principles, is fairer from a socioeconomic standpoint than many single-payer systems.
While the UK and Canada are only two examples concerning healthcare and I don’t want to commit the fallacy of composition, I fail to see how this data can be used as evidence for the “fairness” of liberal single-payer healthcare policies.  Liberals can use all of the a priori ethical arguments all they want for fairness, but those arguments are soundly defeated by empirical evidence.
Furthermore, socioeconomic egalitarianism only leads to economic destruction; this cannot be more plainly shown than the Grecian debt crisis, Spain's bankrupt green-energy programs, and the decline of the US economy under Obama’s liberal agenda with our out-of-control debt and record unemployment, despite all of the government spending on stimulus bills and green-energy jobs.
Conservatives have the philosophical and empirical advantage because meritocracies work both in theory and practice.  While meritocracies do have their issues, all one needs to do is examine liberal-run US states and countries to see the failure the liberal socioeconomic policies and see that accepting meritocratic socioeconomic policies are the most fair and just while rejecting the liberal premise that fairness and justice are contingent upon egalitarianism.

Monday, December 5, 2011

Even If He Doesn't, Part I

I think that most people are familiar with the Biblical account of Shadrach, Meshach, and Abednego. But as a refresher: the Babylonian King Nebuchadnezzar set up a golden image of himself and commanded everyone to worship it whenever musicians began to play. Shadrach, Meshach, and Abednego were Israelites and to worship such an image was strictly forbidden, and thus they did not worship it. Nebuchadnezzar became furious, summoned Shadrach, Meshach, and Abednego to him and gave them an ultimatum; either worship the image or die. Daniel 3:13-18 states:

13 Furious with rage, Nebuchadnezzar summoned Shadrach, Meshach and Abednego. So these men were brought before the king, 14 and Nebuchadnezzar said to them, “Is it true, Shadrach, Meshach and Abednego, that you do not serve my gods or worship the image of gold I have set up? 15 Now when you hear the sound of the horn, flute, zither, lyre, harp, pipe and all kinds of music, if you are ready to fall down and worship the image I made, very good. But if you do not worship it, you will be thrown immediately into a blazing furnace. Then what god will be able to rescue you from my hand?” 16 Shadrach, Meshach and Abednego replied to him, “King Nebuchadnezzar, we do not need to defend ourselves before you in this matter. 17 If we are thrown into the blazing furnace, the God we serve is able to deliver us from it, and he will deliver us from Your Majesty’s hand. 18 But even if he does not, we want you to know, Your Majesty, that we will not serve your gods or worship the image of gold you have set up.”

What I want to focus on is the assertions found in verses 17 and 18: 17 If we are thrown into the blazing furnace, the God we serve is able to deliver us from it, and he will deliver us from Your Majesty’s hand. 18 But even if he does not, we want you to know, Your Majesty, that we will not serve your gods or worship the image of gold you have set up.”

Now I am going to transition into a topic that one may find strange but give me a moment to explain.

The Problem of Evil (POE) is a major philosophical and human objection to Christianity. Leibniz (2009) stated in his Theodicy[1]:

1. Having so settled the rights of faith and of reason as rather to place reason at the service of faith than in opposition to it, we shall see how they exercise these rights to support and harmonize what the light of nature and the light of revelation teach us of God and of man in relation to evil. The difficulties are distinguishable into two classes. The one kind springs from man's freedom, which appears incompatible with the divine nature; and nevertheless freedom is deemed necessary, in order that man may be deemed guilty and open to punishment. The other kind concerns the conduct of God, and seems to make him participate too much in the existence of evil, even though man be free and participate also therein. And this conduct appears contrary to the goodness, the holiness and the justice of God, since God co-operates in evil as well physical as moral, and co-operates in each of them both morally and physically; and since it seems that these evils are manifested in the order of nature as well as in that of grace, and in the future and eternal life as well as, nay, more than, in this transitory life. (Kindle Locations 1977-1984)

It has been objected through philosophical and human history that the existence of evil and the existence of God are utterly incompatible, and going further, the existence of evil shows one of two things:

1. God does not exist, or

2. God is not the God Christians claim He is.

I say this because there are many times whenever Christians ask God to remedy some evil in their life and nothing happens and this can call into question whether God is truly omnibenevolent (all-loving). Some, including myself, have asked for God to something and situation we ask for God to remedy gets worse instead of better. The question that must be asked then and something that is found in Shadrach, Meshach and Abednego’s answer:

Q. “Is God who He is even if He does not do what we ask in instances of evil?”

I will set aside (Q) for the moment. Examining (1) from above, consider the following argument presented by Tooley (2009)[2] that I will label as (T):

  1. If God exists, then God is omnipotent, omniscient, and morally perfect.
  2. If God is omnipotent, then God has the power to eliminate all evil.
  3. If God is omniscient, then God knows when evil exists.
  4. If God is morally perfect, then God has the desire to eliminate all evil.
  5. Evil exists.
  6. If evil exists and God exists, then either God doesn't have the power to eliminate all evil, or doesn't know when evil exists, or doesn't have the desire to eliminate all evil.
  7. Therefore, God doesn't exist.

I do not believe that (T) (or (POE) for that matter) proves that God does not exist. First, the argument is logically valid but I contend that it is not logically sound because (T6) is false. Now, Christians cannot deny premises (1) through (5) but they can reject (T6). Allow me to introduce some logical symbolism from sentential logic. (T6) can be symbolized in the following way:

((e • g) → (~p v (~k v ~d))

A conditional such as (T6) is false if and only if the antecedent is true and its consequent is false. Therefore, the way to show (T6) false is to show that the consequence, (~p v (~k v ~d)), is false. So, consider the following truth-table:

P | Q | R | P v (Q v R)

0) T | T | T | T T

1) T | T | F | T T

2) T | F | T | T T

3) T | F | F | T F

4) F | T | T | T T

5) F | T | F | T T

6) F | F | T | T T

7) F | F | F | F F

The focus is on line (7). If P, Q, and R are false then the entire disjunct is false. With this in mind, returning to the consequence of (T6), (~p v ~k v ~d); if the Christian asserts p (God has the power to eliminate evil), k (God knows about all evil), and d (God has the desire to eliminate evil), then the disjunct is false given God’s divine attributes. Since for a Christian the antecedent of (T6), (e • g), is true, but the consequence is false, (T6) as a whole is a false premise. Therefore, (T) is logically unsound and can be rejected because in order for an argument to be logically sound the argument’s conclusion must follow from true premises, a condition (T) does not satisfy.

So, the existence of evil does not show that God does not exist. (Granted (T) is just one of the many arguments but I cannot possibly cover all of them.) But then comes the more pressing problem for Christians and is commonly pressed by objectors. Recalling the existence of evil shows one of two things:

1. God does not exist, or

2. God is not the God Christians claim He is.

Since (1) has been eliminated, what is a Christian to do with (2) in light of (POE)? I believe this is where most Christian struggle whenever it comes to (POE) because, as shown previously by rejecting (T6), Christians believe God has the power to eliminate evil, God knows about all evil, and God has the desire to eliminate evil and this is due to the fact that Christians claim that God is all-loving (omnibenevolent), all-powerful (omnipotent), all-knowledge (omniscient), and all-present (omnipresent).

However, the evidence (appears) runs contrary to what we believe, and what I mean by evidence is that Christians experience evil in their lives, asked God to do something about it, and sometimes nothing happens or the situation gets worse. This is contrary evidence is commonly used by objectors to undermine the beliefs Christians have concerning God and who He is.

A few examples. I have experience numerous times where I have asked God to remedy evil in my life or in other’s lives and nothing happens, and in some instances the situation only got worse. For example, whenever my Aunt Ginger cancer came back with a vengeance, there were numerous individuals praying that she would be healed, but it seems like the more we prayed the faster she deteriorated. Eventually she died. Or, my own life, I have battled numerous post-secondary skin infections due to my eczema. I have prayed to be healed in every instance but nothing happens; there is no supernatural intervention in the sense that the infection was healed without the aid of medicines. Every infection has required doctor’s visits, medications, etc.; it seems as if God is completely silent and I have to turn to the physical world for remedies.

Recalling (Q):

Q. “Is God who He is even if He does not do what we ask in instances of evil?”

Some have replied in the same fashion as Shadrach, Meshach, and Abednego who faced evil, and they answered (Q) with an emphatic, “Yes.” Essentially their answer was, “No matter what happens God is still God and has all of the attributes we ascribe to Him.” In the instance of Shadrach, Meshach, and Abednego, God did intervene and saved them from death.

But then comes the next objection: “So God remedies evil for some people and not others. Why is that the case? According to the evidence, God does not equally love everyone because if He did then He would answer everyone’s prayers, especially in instances of evil. There are even instances in the Bible where so-called Godly men and women were tortured, and killed, and there were others who were rescued from these evils. Care to explain why God picks and chooses?”

The only answer I have to this question is, “I don’t know; I’m not God.”

Unfortunately I doubt that this answer satisfies. Personally, it has not satisfied me in many cases.



[1] Leibniz, Wilhelm; Freiherr von Gottfried (2009). Theodicy Essays on the Goodness of God, the Freedom of Man and the Origin of Evil. Public Domain Books. Kindle Edition.

Wednesday, August 24, 2011

Adam's Responses to my "Responses."

I appreciate you taking the time to respond and your kind accolades.

I don't have much time, so I apologize that I can't offer a full rejoinder.

Kagas appears misguided, but I'll set that aside. I support the following views:

A: Homosexuals are persons and, so, deserve the same moral consideration that persons deserve. They are not afforded that same consideration when we fail to recognize (morally and legally) their committed and vowed relationships as we recognize those of heterosexuals.

B: Climate change is clearly the theory best supported by the evidence. That climate change is in large part due to human actions is best supported by the evidence.

C: Access to health care is a basic human right. A non-universal health care system offers unequal access to health care.

Concerning A: Perhaps a compassionate person could deny A. Still, if you understand the issues involved, then you recognize that there is no good/reasonable/plausible argument to support the denial of A. Your training should show you that. Your compassion should help grasp the issue (but maybe that's just me).

Concerning B: You're right, compassion seems to play no role here. However, understanding (i) cogent vs. non-cogent inductive inferences, (ii) when to let one's skepticism subside, and (iii) the evidence offered on both sides of the debate should lead one to confirm B. Your training should show you that.

Concerning C: Perhaps a compassionate person could deny A. Still, if you understand the issues involved, then you recognize that there is no good/reasonable/plausible argument to support the denial of A. Your training should show you that. Your compassion should help grasp the issue (but maybe that's just me).

Now, more an C: You continue to misunderstand the issue. I did not claim that the health care systems in parts of Europe and Asia were capitalist. Rather, I claimed first that there are some countries in Europe and Asia who have the following attributes:
I: Capitalist economy
II: Universal health care.
Why do I point this out? To point out that it is not impossible to have both. And, since we should keep a capitalist economy, we should look at these other countries and understand their situation so that we can improve ours.

As I said, no system is perfect. But you should note that not all universal health care systems are the same. There are wait times that are similar to U.S. wait times (see Germany, for e.g.) and wait times that are better (see, e.g. Japan and Taiwan). So, just looking at Canada is not sufficient to raise this as a worry for all current forms of a universalized system.

Not all diseases are treatable at emergency rooms. Not all people who die are old. Your inability to find evidence of folks who have suffered and died due to their not being able to obtain medical insurance is strange. Also, it's not just people who are turned away but those who are responsible enough not to put further burdens on themselves or others by incurring debt for a treatment. For a start, see Frontline: Sick Around America; See Frontline: Sick Around the World.

The emergency center brings up an interesting problem for your position. Typically, folks think that 'socialized' health care means that they'll have to pay for others who either don't want to buy health care or who don't take care of themselves (either b/c they can't or don't want to, etc.). That's true, but it's also true that you already pay for these people. Health care costs (e.g. hospital fees, insurance premiums, etc.) are in large part made up by the cost of services rendered that were not paid for by the individual who received the service. So, the current system still supports free riders and many more than would plausibly exist under a universal system.

Also, you fail to adequately address the concern that people go bankrupt attempting to pay for medical services. First, Skinner et al do make a fallacious inference. They claim the following:

(F) If the view that U.S. adoption of universal health care will reduce bankruptcies primarily caused by lack of health insurance in the U.S. is true, then we should find fewer cases of bankruptcies in a country that has universal health care.

That's simply ridiculous. Of course there may be more bankruptcies. The question is whether there are more bankruptcies primarily caused by lack of health insurance in countries with universal health care. And, there can't be b/c everyone has health insurance in those countries.

It is just a fact that many go bankrupt primarily due to lack of health insurance, and a distressing one. Among other things, in a system like ours, this means your costs go up in more than just the medical arena. This also means that costs for businesses go up in more than just the medical arena.

That's right you've got to distribute wealth. Oh no! We should never distribute wealth, especially unevenly. That's just a silly claim. Wealth is distributed (unevenly) to pay for roads, sidewalks, schools, police, fire departments, parks, etc. Forcing certain folks to pay what the wealthiest pay or what the middle folks pay would simply destroy their opportunity to a good life. Forcing certain folks to pay only what the poorest have to pay would not allow us to afford those public things ultimately decreasing everyone's standard of living. It's just not practical. (And, if you look at Rawls and others we'll find that it's unjust as well...but maybe that's just the compassion speaking up again.)

So, we can't just point to the fact that something would require distribution (even or uneven) of wealth to show that it's unacceptable unless we can determine what it is about distribution that is impermissible.

The right-libertarians have some things to say here. That position seems completely untenable. And, as the left-libertarians have shown, taking up the positions advocated by right-libertarians to ground their views (property-rights-centered justice) is not incompatible with taxation and wealth distribution. Moreover, you're committed to the view that taxation is okay (so long as its a flat tax of some sort). But, taxing just is a method for collecting wealth that will be distributed to pay for stuff. So, you can't consistently maintain that wealth distribution is always impermissible.

So, you'll have to identify something else about universal health care that makes it impermissible. These claims about distribution are simply red-herrings.

Finally, Argument (R). The argument as I've said is a non-starter. So, it doesn't matter in our debate if that's a bad argument offered by some who don't realize this or do and use it anyway.

(thanks for listening to my garbage. take care)

Tuesday, August 23, 2011

Responses

Just as a warning, this is long.

As a caveat, I had been working on some responses to some critiques and objections that my friend, Adam Thompson, had leveled against some of my previous posts. I must give him acknowledgment where it is due because I believe on some points his objections are correct. And to be fair and honest, Adam’s philosophical sophistication and prowess is far superior to my own (ergo, why’s he’s one of the leading and most respected UNL philosophy TA’s). So while I’m sure I sound like a Chihuahua nipping at the heels, I’ll go ahead and nip. So, one of Adam’s critiques:

“First, once again the logic is incorrect. A conditional is false if and only if the consequent of the conditional is false while the antecedent is true.”

This is reference to the conditional:

If x is compassionate, then x will support the liberal agenda.” (c a)

I said:

I believe this conditional is false because I believe its consequences to be false and in logic if the consequence is false, then the whole conditional is false.

I’ll take that rebuke, because my above statement is very false. I know what I was meaning to say but I did not spell out the necessary and sufficient conditions for the falsity of a conditional correctly.

So, to be absolutely clear about my position, I hold that one can be compassionate, i.e., the antecedent c is true, even though they don’t support the liberal agenda and that is why I hold the consequent a as false and, therefore, the whole conditional false.

Adam said didn’t know what I meant when I said, “liberal agenda.” Good point; the concept of the “liberal agenda” is rather ambiguous and unclear, and if there’s one thing that we who were trained in the analytic tradition of philosophy require is clarity. What is the liberal agenda? [1] While I can’t give any sort of necessary or sufficient conditions, I’ll just give some examples of positions many liberals hold. (Yes Socrates, I haven’t said what the liberal agenda is.) Phil Valentine (2008) writes:

Steve Kangas, a devoted liberal, was a political journalist for the Internet site Votelink out of Boulder, Colorado. […] Kangas wrote that liberalism believes in collectivism… while conservatives believes in individualism. Liberals are for democracy, while conservatives are for constitutionalism. […] He says liberals believe in pacifism, while conservatives believe in armed deference… Kangas goes on to explain that liberals believe in ‘progressive taxes, anti-poverty spending, and other forms of regulation.’ He says they view ‘the runaway profits of the rich—especially in the later stages of wealth accumulation—as undeserved, so redistributing them among the workers who produced them is necessary to prevent exploitation.’” (214-215)

Let’s not forget global warming or call it climate change, save the polar bears, say have you, I don’t care.

While I don’t want to make a hasty generalization and say that all who call themselves “liberal” believe and/or support all of what Kangas does, but for the most part from what I have observed and heard from friends, acquaintances, media-types, and politicians who call themselves liberal, they have expressed support for some (if not all) views very similar to what Kangas espouses. So, that’s what I’m calling the “liberal agenda,” and one can reject this agenda and still be compassionate. (No doubt I’m going to be criticized for this. Guess I’ll have to write a post on this subject.)

To Adam’s criticism concerning my label of socialized medicine in Europe, there are scholars in the medical community, both in the US and in Europe, that say that England has socialized medicine,[2] as well as in Canada.[3] And, I had a boss who is a neutralized citizen from England and he said that England has socialized medicine. However, after doing some digging, the terms socialized medicine and the more commonly used universal health care are used synonymously, especially here in the US, whereas in Europe, universal health care is commonly used.[4] So, I’ll just use the term “universal health care” since it’s what Europeans commonly use.

Be that as it may, under a universal health care system, the government is a primary administer of medical care. Therefore, to say that England, which has universal health care, has a capitalistic health care system is puzzling to me. In England, the government controls/administers 90% of the health care and the private sector only controls/administers 10%, which is more aligned with universal health care system, not a capitalistic system.

The definition of Capitalism[5], call it (C), is:

: an economic system characterized by private or corporate ownership of capital goods, by investments that are determined by private decision, and by prices, production, and the distribution of goods that are determined mainly by competition in a free market

The health care system in England, the NHS, doesn’t satisfy (C) because under a capitalistic system, the private sector would administer and distribute most (if not all) of the health care.

So, the health care question, “Is health care in the US high?” Yes. “Do I want a health care system like that of Europe or Canada?” No, and here’s why.

The waiting for medical care and treatment is a very serious problem in Canada and they have a form of universal health care.[6]

[7]

These figures are not as good as the figures here in America.[8] Furthermore, every time I’ve been to the emergency room for asthma and eczema problems, or my wife, or my son, the care was immediate without a wait.[9] Compare this to Canada’s 4 to 10+ hour wait, depending upon what care you require.[10] Concerning the emergency room, if I had to wait 10+ hours to get into the emergency room to get treated for an asthma attack, I would have likely died from suffocation.[11] But we’re told that here in the US, our care sucks, unequal, unfair, etc. I don’t see how waiting 10+ hours for an asthma attack is ‘equal’ or even ‘fair’ whenever someone’s life in the balance, especially in my case whenever minutes mattered. One could object to say, “Your case is extreme; they wouldn’t let you die.” Maybe, but I’m just going off straight numbers from the Canadian websites that calculate emergency room wait times. I’m playing on going to Canada and have an asthma attack just to find out how long I’ll have to wait in the emergency room.

Concerning long term care, with my Aunt (who unfortunately died from cancer) whenever she was initially diagnosed with cancer, she was in for scans and tests in a matter of days and found out she had stage 3 breast cancer, and treatments began shortly thereafter. They never asked about how she was going to pay or anything like that. If she had been made to wait more than 2 or 3 months as is the case in Canada, she would have been at stage 4 and died shortly thereafter. Now, I don’t see any compassionate in this, nor do I see that as ‘fair.’

Adam argued:

I don't see how anyone could reasonably think that that is too high a price to pay to (a) keep people from dying simply b/c they couldn't afford health care, (b) keep people from going bankrupt attempting to pay for normal health care, etc. No one in those countries faces either of these worries, and the large majority wouldn't change this to keep prices open to the market and let people decide whether to purchase health care.

Let’s address (a) really quick. The last time I checked people aren’t being allowed to die in the US simply because they don’t have the money to pay for care. If someone walks into an emergency room in the US, by law they can’t be turned away. Nor do I hear stories of the elderly being kicked out of hospital beds because they can’t afford it. It’s simply not true that there’s a serious problem of people dying in the US simply because can’t afford health care. I find no empirical evidence to support (a). If there is some, I could not find it.

I’m sure there are people who go untreated or undiagnosed because they believe they can’t afford it in the US. Ok, but I would argue that this sort of thing happens in every health care system in the world, and is not isolated to the US health care system simply because we don’t have universal health care. On the contrary, as I pointed in one of my earlier posts:

If the health care system in the UK, for example, is so great and wonderful, then it is hard to see why residences of the UK are pulling their teeth because they can’t find dentists.[12] Additionally, Canada, which has a similar system to the UK, is looking to private sector solutions to their health care because their current health care system is bankrupting them and the care stinks.[13]

Moving to (b), the bankruptcy worry. In 2001, 28% of bankruptcies were said to be caused by medical bills.[14] In 2005, research came out that two-thirds, or about 67%, of the bankruptcies in the US was due to health related costs.[15] However, the research that produced these figures has been called into question. In 2009, research found that there was a higher percentage of medical-cost related bankruptcy in Canada than in the US.

Unlike the United States, Canada has a universal, single-payer, government-run, socialized health insurance system. Advocates of socialized medicine argue that the mixed public-private health insurance system in the United States causes many Americans to become financially bankrupt, and that this would not occur if the US adopted the Canadian health system. Following this logic, we should expect to observe a lower rate of personal bankruptcy in Canada than in the United States. Yet the most recent data (2006 and 2007) shows that personal bankruptcy rates are actually higher in Canada (.30% for both years) than in the United States (.20% and .27%). Research indicates that medical spending was only one of several contributing factors in 17 percent of US bankruptcies, and that medical debts accounted for only 12 to 13 percent of the total debts among American bankruptcy filers who cited medical debt as one of their reasons for bankruptcy. (Skinner and Rovere 2009, 1)[16]

Skinner (2009) states:

Indeed, if we define medical bankruptcies the way Himmelstein and colleagues did for their study in the United States, we find such bankruptcies also occur in Canada. Survey research[17] commissioned by the Canadian government found that despite having a government-run health system, medical reasons (including uninsured expenses), were cited as the primary cause of bankruptcy by approximately 15 percent of bankrupt Canadian seniors (55 years of age and older).[18]

All I could find were stats on Canada I think because Canada specifically researched this phenomenon, but I think that will do. So, the empirical evidence shows two things:

1. There are far more causes of bankruptcy than medical expenses in both Canada and US.

2. If the stats are correct (which I see no reason to doubt them), bankruptcy is just as a much a problem in universal health care system than it is in the US.

Therefore,

3. Adam’s claim concerning bankruptcy that “….No one in those countries faces either of these worries,” is false.

So, Adam’s premise was that if I were reasonable then I wouldn’t support a system health care with such high costs to the customer and result in bankruptcy.

Two points. First, in Canada, which has universal health care, again, has a higher medical-rate bankruptcy rates than the US according to the stats. So, even under universal health care, the bankruptcy problem isn’t solved.

Secondly, I’ll grant Adam’s argument for the sake of argument. If Adam’s premise holds true, I fail to see how one could support ObamaCare since health care costs are forecasted to rise for everyone. ObamaCare is a form of universal health care[19] and according to studies, produced by both conservatives and non-conservatives alike, ObamaCare will raise health care costs[20]. So if supporting our current cost of health care is unreasonable given the prices right now and the possibility of bankruptcy, I see it equally unreasonable to support ObamaCare since health care costs are going to go up thus increasing the possibility of individuals declaring bankruptcy, especially given the bankruptcy stats from Canada.

Now, one response could be, “Even if the costs do go up, the increases won’t be felt by those in the middle and lower classes because under universal health care, the government will pay for their care. But in the current system, middle and lower classes are directly affected by the high costs of health care. Therefore, universal health care is fairer.”

How are these costs going to be covered? Using England as an example, the rich are taxed at a much higher rate in order to pay for the costs. For example, a study in England found the following:

Access to the NHS is universal, free at the point of use (except for some copayments for services such as dentistry), and determined on the basis of medical need. In principle, therefore, the burden of financing the NHS is distributed unequally, with a bias against the rich, whereas the NHS's benefits are distributed equally to those in equal medical need. While the NHS is the main health care provider for the vast majority of the population, there also is a relatively small private health care sector (approximately 10 percent of the market) for which consumption as in any private market is determined on the basis of price and income (Tapay and Colombo 2004). (Faden et al., 2009, 791)[21]

In other words, England progressive taxation, even more so than here in the US. Now I believe we could to brass tacks of this debate, and the word is “distribution.” In order to pay for ObamaCare, Obama, Democrats, and Liberals argued and argue that the rich need to be taxed more.[22] In 2009, concerning taxing the rich, Obama said: “These folks can afford it. They were rich back in the ‘90s,’ he said. ‘It’s not like suddenly they’re going to have to go to the poorhouse. But what that does is it allows us to pay for health care reform for a lot of people.’”[23]

We’ve really come full tilt now, to my post “The Rich and Taxation.” There I presented argument (R):

1. If the rich aren’t struggling to make ends meet, then they can afford to pay more in taxes.

2. If the rich can afford to pay more in taxes, then they should pay more in taxes.

Therefore,

3. If the rich aren’t struggling to make ends meet, then they should pay more in taxes.

Adam argued that this is not an “enlightened” view. I agree that it is not but the argument is what it is, and I’ve heard argued by some of the political left, not in these exact words, but (R) is true to the spirit of the argument.[24] I argued that the argument is not sound due to premise (R2) because there is a false implication that “‘can’ implies ‘should’” which does not follow. I’m glad that Adam and I can agree that “can” does not necessarily imply “should.”[25] So, even if we grant that the rich can pay for higher tax rates, it doesn’t follow that they should.

With all this being said, I’m going to leave this post as is and then return later to addressing issues of taxation and fairness. That subject in of itself is a huge subject and one that I would like to dedicate some significant time and research.



[2] Weiner (1987) http://www.jstor.org/stable/3349946

Gottfried (1989) http://www.jstor.org/stable/4315916

[4] http://www.healthpaconline.net/universal-health-care.htm Now, admittedly, philosophers will say that these terms aren’t synonymous since synonymy requires that the terms be substitutable in a sentence salva veritate, but to everyday common folk, the terms are used synonymously.

[9] Yes I was asked if I had insurance but that is for billing purposes, not for screening out patents, and I have yet to find evidence of people being denied medical treatment simply because they didn’t have insurance.

[11] This is not the only problem that universal health care faces. For more see Ken Boyd (2011): http://www.amazon.com/Socialized-Medicine-Italy-Experience-ebook/dp/B005DVFWYA/ref=sr_1_1?s=digital-text&ie=UTF8&qid=1313964109&sr=1-1

[25] Now, if “ought” and “should” are synonymous in ethical contexts as Adam correctly pointed out, then I believe we can infer that not only does “‘ought’ implies ‘can’” but that “‘should” implies ‘can’” in an ethical context as well. So, if you should tell the truth, then you can (or as the ability) tell the truth. But clearly “can” does not imply “ought.” Therefore, (R2) is false because even if the antecedent is true, its consequent would be false.