I compare public responsibility for health to public responsibility for fire control.
Fires can wreak havoc upon many beyond the fire's point of origin. It's also unprofitable to run a fire department, so given the public benefit, the public foots the bill for keeping a fire department.
Health care isn't the same in that it can be a very profitable business, but because profits are tied to consumption of goods (e.g., medicine) and services (e.g., operations), the industry has incentives to promote overconsumption of both. Meanwhile, the health insurance industry has incentives to deny coverage as much as possible in the name of profit. You might think this would cause the health care industry to operate efficiently, but health care is complex and not easily overseen, and even if the health care industry ran efficiently, the health insurance industry would still have incentives to deny coverage past the efficient rate.
But the effects of letting people who genuinely need treatment go untreated are nevertheless much like fires. Not only does it stand an excellent chance of reducing their productivity and overall employment prospects, the consequences it can have for a family can likewise be disastrous. That doesn't do them any good and it certainly doesn't do our economy any good. So while the health industries might be quite profitable, the net benefit to society is considerably less than if the profit incentives were properly aligned to maximize health instead of consumption and lack of coverage.
But, you know, some folks just have to be sacrificed on the altar of the completely free market, in the name of their own good.
Somebody else's sickness has no effect on me in most cases. And in the ones in which it does, the CDC is there to help. Nobody would suggest that the government doesn't play an important role in protecting against epidemics, which is most analogous to your fire metaphor.
It's not up to the public to protect people from all of the bad things that can befall them. It's up to the public to ensure that people are not impeded when trying to help themselves.
Thus even most of us who are against public health care are in favor of reforms. Tort reforms, ending the perverse incentives.
Interestingly, most of our health problems in the U.S. seem to be due to political pressure caused by lobbying. Read In Defense of Food for a good review as to why our diet has shifted to where it is, and why it's almost certainly the problem. It illustrates that government cannot be counted on to ensure public health.
> Somebody else's sickness has no effect on me in most cases. And in the ones in which it does, the CDC is there to help. Nobody would suggest that the government doesn't play an important role in protecting against epidemics, which is most analogous to your fire metaphor.
In most cases, someone else's fire has no (direct) effect on you either, so I'm not sure what the relevance of that assertion is. Nor am I talking about the spread of disease, but rather the socioeconomic effects of having an untreated medical condition, which may not affect you very much, but which can have serious effects for a family and their ability to contribute to the economy. See Gladwell's The Moral-Hazard Myth: http://www.newyorker.com/archive/2005/08/29/050829fa_fact and Uninsured in America, a book which Gladwell cites in the article.
I'm also not sure how you got the impression that I think the public should "protect people from all of the bad things that can befall them." What I believe is that an entity capable of making a credible threat on the public's behalf must ensure that market incentives are properly aligned with the public good, when they are demonstrably not in alignment. That entity tends to be the government. If there's another entity that can do the job more effectively, that's great. I don't entertain any sort of dogma about the "proper" role of the government.
I don't see how tort reform counters the inefficiencies of the health industries.
And diet certainly is a problem. But I'm not sure how the fact that there is a cultural basis to many of our health problems bears upon the problem of misaligned market incentives in the health industry. No one is saying that government is the sole force in ensuring the public health. People who think the government might have a role to play typically don't think that individual judgment goes out the window.
If we didn't have fire departments, other people's fires would have direct effects on me. Hell, every time someone drops a cigarette in California hundreds lose their homes. That's not true of health insurance.
Tort reform and caps on payouts for malpractice suits are necessary. Every time someone wins a $50m suit because a doctor accidentally amputated their pinky, the costs are passed back onto the rest of us.
I'm all for aligning incentives, but that does not necessitate public health care.
I've been talking about indirect effects. Direct effects are what you injected into the conversation by way of talking about epidemics. You are indeed indirectly affected by the poor state of health care in this nation as a result of the lost economic productivity, and any cultural decline that can ensue. My analogy to fire control is simply to point out that we are affected by the well being of others.
Tort reform is a solution to a completely different problem than what I've been talking about, so again, I fail to see the relevance.
We clearly disagree on what would improve the public health, and our disagreement clearly stems from ideological differences which haven't surfaced here. That's fine, but nothing that we've been doing amounts to an actual debate over the issue in question.
Fires can wreak havoc upon many beyond the fire's point of origin. It's also unprofitable to run a fire department, so given the public benefit, the public foots the bill for keeping a fire department.
Health care isn't the same in that it can be a very profitable business, but because profits are tied to consumption of goods (e.g., medicine) and services (e.g., operations), the industry has incentives to promote overconsumption of both. Meanwhile, the health insurance industry has incentives to deny coverage as much as possible in the name of profit. You might think this would cause the health care industry to operate efficiently, but health care is complex and not easily overseen, and even if the health care industry ran efficiently, the health insurance industry would still have incentives to deny coverage past the efficient rate.
But the effects of letting people who genuinely need treatment go untreated are nevertheless much like fires. Not only does it stand an excellent chance of reducing their productivity and overall employment prospects, the consequences it can have for a family can likewise be disastrous. That doesn't do them any good and it certainly doesn't do our economy any good. So while the health industries might be quite profitable, the net benefit to society is considerably less than if the profit incentives were properly aligned to maximize health instead of consumption and lack of coverage.
But, you know, some folks just have to be sacrificed on the altar of the completely free market, in the name of their own good.