Well, at least the bureaucratic inefficiencies are entirely incidental to the problem, and there’s no decisive evidence for corporate bureaucracies to be any better than public ones (I suspect partisanship gets in the way of finding out said evidence, as well as a slew of other variables), so that factor… doesn’t factor. As for the higher taxes… how much are you ready to pay so that, the day you catch some horrible disease, the public entity will be able to afford diverting enough of its resources to save you? What are you more afraid of, cancer and other potentially-fatal diseases that will eventually kill you, terrorism/invading armies/criminals/people trying to kill you, boredom...? What would be your priorities in assigning which proportion of the taxes you pay goes to funding what projects?
… Actually that might be a neat reform. Budget decision by a combination of individual budget assignments by every citizen…
Well, at least the bureaucratic inefficiencies are entirely incidental to the problem, and there’s no evidence for corporate bureaucracies to be any better than public ones, so that factor… doesn’t factor.
This claim is disputed, but I have negligible information either way.
As for the higher taxes… how much are you ready to pay so that, the day you catch some horrible disease, the public entity will be able to afford diverting enough of its resources to save you? What are you more afraid of, cancer and other potentially-fatal diseases that will eventually kill you, terrorism/invading armies/criminals/people trying to kill you, boredom...?
Personally, I say that universal health care would be worth the higher taxes. For any given person the answer depends on their utility function: the relative values assigned to freedom, avoidance of harm, happiness, life, fairness,etc.
… Actually that might be a neat reform. Budget decision by a combination of individual budget assignments by every citizen...
This sets off my Really Bad Idea alarm. I don’t trust the aggregate decisions of individual citizens to add up to any kind of sane budget relative to their CEV. (Note: the following sentences are American-centric.) Probably research would get massively under-funded. Defense would probably be funded less than it is now, but that might well put it closer to the optimal value if it forced some cost-effectiveness increases.
Basically, each person would assign all their taxes to whatever they thought was most important, thus prioritizing programs according to how many people pick them as first choice, regardless of how many dollars it takes to make a given one work. The same kind of math used to discuss different voting/electoral college variants would inform this, I think, but I’m too lazy to look it up. And of course, if too much freedom was allowed in deciding, all companies and most people would decide to allocate their money to themselves.
^Hm. That’d be some very near-sighted companies and people, don’t you think? The Defending Your Doorstep fallacy etc. etc. Still, with some education fo the public (“Dear viewers, THIS is what would happen if everyone decided all the money should go to the Army right after a terrorist attack”) and some patches (I can’t imagine why people would put all their money into whatever they think is most important, rather than distributing it in an order of priorities: usually people’s interests aren’t so clear cut that they put one cause at such priority that the others become negligible… but if they did do that, just add a rule that there’s only so much of your money you can dedicate to a specific type of endeavor and all endeavors related),.
This reminds me of Kino’s Journey and the very neat simplisty solutions people used to their problems. The main reason those solutions failed was because the involved people were incrediby dumb at using them. The Democracy episode almost broke my willing suspension of disbelief, as did the Telepathy one. Are you familair with that story?
Human rationality can be trained and improved, it’s not an innate feature. To do that is part of the entire point of this site.
I hope you enjoy it. It is very interesting. Beware of generalizing from fictional evidence… but fiction is sometimes all we have to explore certain hypotheticals...
What does this mean? In particular, what does “universal” mean?
It means that each person in the country would, if ey got sick, be able to receive affordable treatment. This is true in, for example, Great Britain, where the NHS pays for people’s medical care regardless of their wealth. It is not true in the United States, where people who cannot afford health insurance and do not have it provided by their employer go without needed treatments because they can’t afford them.
ETA: does someone think this definition is wrong? What’s another definition I’m missing?
How different are the ways a society would treat citizens and various other people not covered by a system, such as Americans? What about tourists?
Isn’t it true that Great Britain could provide better medical care if it diverted resources currently spent elsewhere? How are any other government expenditures and fungible things (like autonomy) ever justified if health could be improved with more of a focus on it?
Do you primarily value a right to medical care, or instead optimal health outcomes?
An intuition pump: What if a genie offered to, for free, provide medical care to all people in a society equivalent to that the American President gets, and a second genie, much better at medical care, offered even better average health outcomes for all people, with the caveat that he would randomly deny patients care (every patient would still have a better chance under the second genie, until the patient was rejected, of course). Both conditional on no other health care in the society, especially not for those denied care by the second genie. Which genie would you choose for the society? Under the first, health outcomes would be good and everyone would have a right to health care, under the second, health outcomes would be even better for every type of patient, but there would be no right to care and some people with curable diseases would be left to die.
If you would choose the first genie, your choice increases net suffering every person can expect.
If you would choose the second genie, then you’re making a prosaic claim about the efficiency of systems rather than a novel moral point about rights for disadvantaged people—a claim that must be vulnerable to evidence and can’t rightly be part of your utility function.
What if there were a third genie much like the one you chose, except the third genie could provide even better care to rich people. Would you prefer the third genie and the resulting inequality?
I prefer the genie which provides the maximum average utility* to the citizens, with the important note that utility is probably non-linear in health. The way I read your comment, that would appear to be the third. Also note that the cost of providing health care is an important factor in real life, because that money could also go to education. Basically, I do my best to vote like a rational consequentialist interested in everyone’s welfare.
*I am aware that both average and total utilitarianism have mathematical issues (repugnant conclusion etc), but they aren’t relevant here.
cost of providing health care is an important factor in real life, because that money could also go to...
OK, so when you say “Personally, I say that universal health care would be worth the higher taxes,” you are referring to internal resource distribution along state, national, voluntary, or other lines to achieve efficient aggregate outcomes by taking advantage of the principle of diminishing returns and taking from the rich and giving to the poor. You don’t believe in a right to care, or equal treatment for outgroup non-citizens elsewhere, or that it’s very important for treatment to be equal between elites and the poor. Not an unusual position, it’s potentially coherent, consistent, altruistic, and other good things.
I asked for clarification from your original “Personally, I say that universal health care would be worth the higher taxes,” because I think that phrasing is compatible with several other positions.
Well, at least the bureaucratic inefficiencies are entirely incidental to the problem, and there’s no evidence for corporate bureaucracies to be any better than public ones,
Corporations that develop excessive inefficiencies tend to go bankrupt. (Ok, sometimes they can get government bailouts or are otherwise propped up by the government, but that is another against government intervention.)
As for the higher taxes… how much are you ready to pay so that, the day you catch some horrible disease, the public entity will be able to afford diverting enough of its resources to save you?
Well, maybe if it wasn’t for the taxes I would be able to afford to pay for treatment myself. (Taxes are a zero-sum process, actually negative sum because of the inefficiencies.) If the idea is risk mitigation, then why not use a private insurance company?
Well, given that the government’s allledged goal is to provide the service while the private organization’s alledged goal is to make a profit, one would expect the State (I like to call the organization the State or the Adminsitration: the Government should simply mean whoever the current team of politically appointed president/minister/cabinet are, rather than the entire bureaucracy) to be less likely to “weasel out of” paying for your treatment, a risk I (in complete and utter subjectivity and in the here and now) deem more frightening (and frustrating) than the disease itself.
And yes, risk mitigation is always negative sum, that’s kind of a thermodynamic requisite.
one would expect the State (...) to be less likely to “weasel out of” paying for your treatment,
Well, since the ministry of health’s budget is finite, whereas the potential amount of money that could be spent on everyone’s treatment isn’t, the state very quickly discovers that is too needs to find ways to weasel out of paying for treatment.
And yes, risk mitigation is always negative sum, that’s kind of a thermodynamic requisite.
And the more layers of bureaucracy involved, the more negative sum it is.
1.You mean they incur in the exact same kind of legal practices as private groups, with the same frequency? Given the difference in position, methodolgy and resourses, I doubt it, but I don’t have any evidence pointing to either side about the behavior of Universal Health Coverage systems. I’d need time to ask a few people and find a few sources.
2.I don’t think it’s a matter of “layers” so much as one of how those layers are organized. The exact same amount of people can have productivity outputs that are radically different in function of the algorythms used to organize their work. Your post seems to imply that State services have more bureaucratic layers than public ones. I’d think that’d be something to decide case by case, but I wouldn’t say it’s a foregone conclusion: private insurances are infamous for being bureauratic hells too. Ones deliberately designed to mislead and confuse unhappy clients, at that.
Well, at least the bureaucratic inefficiencies are entirely incidental to the problem, and there’s no decisive evidence for corporate bureaucracies to be any better than public ones (I suspect partisanship gets in the way of finding out said evidence, as well as a slew of other variables), so that factor… doesn’t factor. As for the higher taxes… how much are you ready to pay so that, the day you catch some horrible disease, the public entity will be able to afford diverting enough of its resources to save you? What are you more afraid of, cancer and other potentially-fatal diseases that will eventually kill you, terrorism/invading armies/criminals/people trying to kill you, boredom...? What would be your priorities in assigning which proportion of the taxes you pay goes to funding what projects?
… Actually that might be a neat reform. Budget decision by a combination of individual budget assignments by every citizen…
This claim is disputed, but I have negligible information either way.
Personally, I say that universal health care would be worth the higher taxes. For any given person the answer depends on their utility function: the relative values assigned to freedom, avoidance of harm, happiness, life, fairness,etc.
This sets off my Really Bad Idea alarm. I don’t trust the aggregate decisions of individual citizens to add up to any kind of sane budget relative to their CEV. (Note: the following sentences are American-centric.) Probably research would get massively under-funded. Defense would probably be funded less than it is now, but that might well put it closer to the optimal value if it forced some cost-effectiveness increases.
Basically, each person would assign all their taxes to whatever they thought was most important, thus prioritizing programs according to how many people pick them as first choice, regardless of how many dollars it takes to make a given one work. The same kind of math used to discuss different voting/electoral college variants would inform this, I think, but I’m too lazy to look it up. And of course, if too much freedom was allowed in deciding, all companies and most people would decide to allocate their money to themselves.
^Hm. That’d be some very near-sighted companies and people, don’t you think? The Defending Your Doorstep fallacy etc. etc. Still, with some education fo the public (“Dear viewers, THIS is what would happen if everyone decided all the money should go to the Army right after a terrorist attack”) and some patches (I can’t imagine why people would put all their money into whatever they think is most important, rather than distributing it in an order of priorities: usually people’s interests aren’t so clear cut that they put one cause at such priority that the others become negligible… but if they did do that, just add a rule that there’s only so much of your money you can dedicate to a specific type of endeavor and all endeavors related),.
This reminds me of Kino’s Journey and the very neat simplisty solutions people used to their problems. The main reason those solutions failed was because the involved people were incrediby dumb at using them. The Democracy episode almost broke my willing suspension of disbelief, as did the Telepathy one. Are you familair with that story?
Re your 1st paragraph: you have a much higher opinion of human rationality than myself. I hope you’re right, but I doubt it.
Re your second paragraph: I am currently watching Kino’s Journey, and will respond later. Thanks for the reference, it sounds interesting.
Human rationality can be trained and improved, it’s not an innate feature. To do that is part of the entire point of this site.
I hope you enjoy it. It is very interesting. Beware of generalizing from fictional evidence… but fiction is sometimes all we have to explore certain hypotheticals...
True. Individual budget allocation would be a bad idea in present day America, but it wouldn’t be a bad idea everywhere and for all time.
What does this mean? In particular, what does “universal” mean?
It means that each person in the country would, if ey got sick, be able to receive affordable treatment. This is true in, for example, Great Britain, where the NHS pays for people’s medical care regardless of their wealth. It is not true in the United States, where people who cannot afford health insurance and do not have it provided by their employer go without needed treatments because they can’t afford them.
ETA: does someone think this definition is wrong? What’s another definition I’m missing?
How different are the ways a society would treat citizens and various other people not covered by a system, such as Americans? What about tourists?
Isn’t it true that Great Britain could provide better medical care if it diverted resources currently spent elsewhere? How are any other government expenditures and fungible things (like autonomy) ever justified if health could be improved with more of a focus on it?
Do you primarily value a right to medical care, or instead optimal health outcomes?
An intuition pump: What if a genie offered to, for free, provide medical care to all people in a society equivalent to that the American President gets, and a second genie, much better at medical care, offered even better average health outcomes for all people, with the caveat that he would randomly deny patients care (every patient would still have a better chance under the second genie, until the patient was rejected, of course). Both conditional on no other health care in the society, especially not for those denied care by the second genie. Which genie would you choose for the society? Under the first, health outcomes would be good and everyone would have a right to health care, under the second, health outcomes would be even better for every type of patient, but there would be no right to care and some people with curable diseases would be left to die.
If you would choose the first genie, your choice increases net suffering every person can expect.
If you would choose the second genie, then you’re making a prosaic claim about the efficiency of systems rather than a novel moral point about rights for disadvantaged people—a claim that must be vulnerable to evidence and can’t rightly be part of your utility function.
What if there were a third genie much like the one you chose, except the third genie could provide even better care to rich people. Would you prefer the third genie and the resulting inequality?
I prefer the genie which provides the maximum average utility* to the citizens, with the important note that utility is probably non-linear in health. The way I read your comment, that would appear to be the third. Also note that the cost of providing health care is an important factor in real life, because that money could also go to education. Basically, I do my best to vote like a rational consequentialist interested in everyone’s welfare.
*I am aware that both average and total utilitarianism have mathematical issues (repugnant conclusion etc), but they aren’t relevant here.
OK, so when you say “Personally, I say that universal health care would be worth the higher taxes,” you are referring to internal resource distribution along state, national, voluntary, or other lines to achieve efficient aggregate outcomes by taking advantage of the principle of diminishing returns and taking from the rich and giving to the poor. You don’t believe in a right to care, or equal treatment for outgroup non-citizens elsewhere, or that it’s very important for treatment to be equal between elites and the poor. Not an unusual position, it’s potentially coherent, consistent, altruistic, and other good things.
I asked for clarification from your original “Personally, I say that universal health care would be worth the higher taxes,” because I think that phrasing is compatible with several other positions.
Corporations that develop excessive inefficiencies tend to go bankrupt. (Ok, sometimes they can get government bailouts or are otherwise propped up by the government, but that is another against government intervention.)
Not if all their competitors are also inefficient.
I don’t see a corporate world which has spawned works like the Dilbert comics as inside critiques as a compelling example of a race to the top.
The advertising would get very tiresome, but probably not bad enough to oppose the idea for that reason.
Well, maybe if it wasn’t for the taxes I would be able to afford to pay for treatment myself. (Taxes are a zero-sum process, actually negative sum because of the inefficiencies.) If the idea is risk mitigation, then why not use a private insurance company?
Well, given that the government’s allledged goal is to provide the service while the private organization’s alledged goal is to make a profit, one would expect the State (I like to call the organization the State or the Adminsitration: the Government should simply mean whoever the current team of politically appointed president/minister/cabinet are, rather than the entire bureaucracy) to be less likely to “weasel out of” paying for your treatment, a risk I (in complete and utter subjectivity and in the here and now) deem more frightening (and frustrating) than the disease itself.
And yes, risk mitigation is always negative sum, that’s kind of a thermodynamic requisite.
Well, since the ministry of health’s budget is finite, whereas the potential amount of money that could be spent on everyone’s treatment isn’t, the state very quickly discovers that is too needs to find ways to weasel out of paying for treatment.
And the more layers of bureaucracy involved, the more negative sum it is.
1.You mean they incur in the exact same kind of legal practices as private groups, with the same frequency? Given the difference in position, methodolgy and resourses, I doubt it, but I don’t have any evidence pointing to either side about the behavior of Universal Health Coverage systems. I’d need time to ask a few people and find a few sources.
2.I don’t think it’s a matter of “layers” so much as one of how those layers are organized. The exact same amount of people can have productivity outputs that are radically different in function of the algorythms used to organize their work. Your post seems to imply that State services have more bureaucratic layers than public ones. I’d think that’d be something to decide case by case, but I wouldn’t say it’s a foregone conclusion: private insurances are infamous for being bureauratic hells too. Ones deliberately designed to mislead and confuse unhappy clients, at that.