I actually meant that as a genuine question without meaning to discuss it but..
We believe that almost everything the government does, it does poorly
There is definitely some truth in that in a general sense. But it seems to me that it is really a technical side issue in this particular case. The efficiency costs/gains are debatable. Even if you think you see an answer, it's marginal. It largely depends on what you consider the 'output' of a healthcare system. If you take traditional public health indicators such as life expectancy at birth, rates of various avoidable deaths & such, as the output of healthcare systems, private health systems are generally 'less efficient.'
What I mean to suggest with the above line is that a lot of practical pieces of general world views & rules of thumb (Government should not provide services because it is inefficient) are taken to specific contexts regardless of their validity in these cases.
That's why I always find it very hard to believe that anti public health arguments are truly decided on technical grounds. This is a moral not a technical issue.
We believe that health care is not a right but a privilege.
I'm not sure if you were being sarcastic. But it does seem closer to the point. In other words, I have no duty to ensure you have healthcare. I have a duty to ensure you are not murdered, but not that you don't die from diabetes.
If you take what seems to be a current debate in US politics, it seems very fundamental & moral rather then technical: Assume the responsibility or try to enable more healthcare without assuming the responsibility.
I think most would probably agree that regardless of the tax regime & regardless of price of medical care (within possible levels), some people will be left without. Many people in fact.
Short of assuming responsibility for health, you are debating ways of getting the number of uninsured from 17% to 12% or 10% or some moral equivalent. Some people will be left out. But that's ok because they chose that or made a dumb mistake or had a fighting chance.
I don't think it's safe to measure various health care systems against each other. The prevailing theories these days seem to suggest that most of the problems are due to lifestyle. Diet, pollution, obesity, exercise levels, etc. all play a major part as well, and those have little to do with the health system. So I don't think it's safe to say that publicly funded health systems would work as well here as they do elsewhere.
Also, I always try to resolve arguments on practical grounds first. For instance, I feel that moral stances on drug laws are irrelevant, because the facts show that drug laws don't stop drug use, cause violent crime and many deaths of dealers/distributors, policemen and civilians. So even if you accept that drug use is immoral, just like with alcohol before it the laws still should not be on the books.
A law that has almost entirely negative effects is not a good law no matter what the moral justification.
I don't think it's safe to measure various health care systems against each other
OK. How about measuring various health care systems against themselves? What I am putting forward is that given that we are talking about improvement in the types of metrics used to compare health care systems, the US system would improve it's output by being public to an extent.
Various implementations are possible from direct government ownership of hospitals to means-tested health care subsidies & everything in between. Obviously crappy implementation has the ability to make things worse. But within the realm of the currently probable, steps taken in that direction would probably lead to an improved result.
But again, that's a purely technical line of argument. I think that in this case the rule of thumb economic liberalism is wrong. I'm reasonable happy to let economists bash that one out. But I do think that in the absense of an overwhelming victory for one of the practical debates, the moral argument here is very strong.
practical grounds
That's an area worthy of discussion in itself. Even if you do believe that drug use is deeply immoral, but see that the consequences of prohibition on are so severe, it'd be very rational to let it slide. But then, I wonder what I would think if I did understand drug use to be deeply immoral in the same sense as rape or murder is immoral. Would I allow legalised rape if the long term if the consequences of prohibiting it were as severe as the drug case. I dn't know how to answer that. (*Most would say no to a purely utilitarian approach http://www.nysun.com/arts/putting-practice-into-ethics/69595...)
For me that particular issue is all about practical. It's hard for me to see any justification for drug prohibition on moral grounds, just the opposite. It's an infringement on liberties. So there have to be net benefit reasons. But I would consider the flipside. In Australia (where I live) Alcohol & gambling are legal. Certain communities (usually extremely remote communities) here have severe social problems linked to abuse of these. Very severe. Some have decided that Alcohol prohibition (like dry counties in the states) are necessary to get the situation under control.
Even though I think individuals should have the right to consume alcohol, in these circumstances the prohibition creates large net gain for the community. I'm OK with that.
I think even in the case of rape, practical grounds matter. If making it illegal didn't decrease the amount of rapes but increased violence and furthered the profits of organized crime families, why would one make it illegal? You'd simply have to attack the problem from another angle, as we should be doing (but aren't) with drugs.
Of course there are gray areas. What if rape laws decreased rape by 10%, but increased other forms of violent crime double that?
But in general, if a law's overwhelming result is negative, like our drug and gambling prohibitions, there's no point to them no matter how moral they may be. The money and effort would be much better spent on prevention and rehabilitation.
Unless your communities that are so afflicted are much different than ours, I expect prohibition won't work much better for you than it does for us. People are going to get what they want. Demand for vices seems to be inelastic the world over.
I think even in the case of rape, practical grounds matter.
People disagree with you instinctively. It seems that we have Deontological tendencies by nature. Mostly people do not find utilitarian arguments compelling. You have to weight the scales very far in favour of utility before people will violate a principle.
the dry communities
It's an extreme case. These are mostly very small very isolated (like 2 days drive to a store) communities. Generally self imposed by direct democracy or community elders/leaders. I don't know if it works. I don't know if it helps. But that is besides what I was saying. Assuming it's a net gain, I approve.
*It's interesting that we arrived here from the public health care questions. I'm actually surprised that someone open to a 100% practical outcome argument would be so against public healthcare. I expected more fundamental objections: despite the net loss..
This is an area with some experiments actually. Peter Sinegr seems to be involved in a lot of them. He's a famous(ish) utilitarian. Considered pretty extreme.
Actually, you can almost use his moral prescriptions as a what happens when you take your above reasoning to the extreme.
Anyway, most people are instinctive deontologists. From the above link:
"the minority of subjects who did consider that it would be right to push the stranger off the footbridge {Right from a utilitarian/net-good perspective} took longer to reach their judgment, and had more activity in the parts of their brains associated with cognitive activity, than those who said that it would be wrong to push the stranger off the footbridge{Right from a deontological perspecitve}"
You seem to be a good example. Instinctively/emotionally a deontologist, rationally a utilitarian. A torn man. (;
Most of us are remarkably similar regardless of race, religion, nationality, education etc. are like that.
I think that those who go with a utilitarian approach think harder about the decision, but that might be just because it makes the decision harder. You need to work out consequences. It's a stretch to say it makes it smarter.
But when you get right down to the root of your stack of 'whys,' you generally hit a principle at some stage. When your trying to rationalise morals, that is. Even Bentham the old time 'extremist' utilitarian had 'the principle of equal consideration.'
Your Constitution & other fundamental documents that you sited earlier are essentially principals (held to be self evident, no?). If you are going to try & rationalise your ethics, most strategies can be deciding on what level to define you principles, define them somehow then apply. Most people instinctively do it at the same sort of level as the law. Some mostly pretty bookish characters go to a slightly higher level.
In that respect, the US founding documents (which I am always surprised to hear quoted & treated in the way that they are) conform to that. Confucius as an example goes to a slightly lower level.
We believe that almost everything the government does, it does poorly
There is definitely some truth in that in a general sense. But it seems to me that it is really a technical side issue in this particular case. The efficiency costs/gains are debatable. Even if you think you see an answer, it's marginal. It largely depends on what you consider the 'output' of a healthcare system. If you take traditional public health indicators such as life expectancy at birth, rates of various avoidable deaths & such, as the output of healthcare systems, private health systems are generally 'less efficient.'
What I mean to suggest with the above line is that a lot of practical pieces of general world views & rules of thumb (Government should not provide services because it is inefficient) are taken to specific contexts regardless of their validity in these cases.
That's why I always find it very hard to believe that anti public health arguments are truly decided on technical grounds. This is a moral not a technical issue.
We believe that health care is not a right but a privilege.
I'm not sure if you were being sarcastic. But it does seem closer to the point. In other words, I have no duty to ensure you have healthcare. I have a duty to ensure you are not murdered, but not that you don't die from diabetes.
If you take what seems to be a current debate in US politics, it seems very fundamental & moral rather then technical: Assume the responsibility or try to enable more healthcare without assuming the responsibility.
I think most would probably agree that regardless of the tax regime & regardless of price of medical care (within possible levels), some people will be left without. Many people in fact.
Short of assuming responsibility for health, you are debating ways of getting the number of uninsured from 17% to 12% or 10% or some moral equivalent. Some people will be left out. But that's ok because they chose that or made a dumb mistake or had a fighting chance.