[odorousrex]

How does a national health care system (say such as Canada or UK) encroach on personal freedom? (Short of say the obvious...increased taxes for you.)

I've found a lot of "opponents" of universal healthcare actually support a safety net for less fortunate people - they just don't want to pay for it. This is a perfectly valid reason, but I wouldn't call it encroaching on personal freedom, so I'm curious as to how else you see it affecting liberty?

[gowld]

Taxes are quite clearly an infringement of personal freedom. Government-run healthcare removes (or greatly reduces) the choice of care from the open market and puts it in the government's control. You can't operate or patronize a medical service provider that is insolvent because the government offers a subsidized alternative service.

There are tradeoffs, and well spent taxes can open up opportunities otherwise precluded, NHS might be better than a private alternative, but in the cost/benefit analysis, the costs really do exist.

[joppy]

Government-run healthcare does not always reduce the choice of care, it can do the opposite! In Australia, many medical services are subsidised by the government, meaning many of them (for example, a visit to a GP) can be free. However, a GP is still free to claim this money from the government, while still charging extra on top of that. The end result is that people who can’t afford health insurance still get health care, while people who can afford to pick and choose quality of care can still do so, and at a reduced cost.

I’m not saying Australia has it right in every way, I’m just saying that universal health care doesn’t need to restrict your choice of care.

[crumbshot]

I don't see how taxes are an infringement of personal freedom, could you elaborate?

[roenxi]

It's a slightly roundabout set of links that tends to become very clear to people paying >40% of their income in taxes. First, some setup:

The base case is I think the world needs to change, so I spend 8 hours changing it for the better.

The extended case is other people notice I am making the world better, and want to pitch in. We've got this great indirection system in money to allow that to happen with a highly abstract measure of 'resources' so even if they don't know how to contribute personally they can signal how important my work is to others.

Now, there are respectable schools of thought that believe something like (a) there are people who do not have the capacity to meaningfully contribute resources or (b) initial control of raw resources is more impactful than human endeavor. They employ taxes to change how resources are distributed.

And now, the freedom angle:

Without government tax, if I work for 8 hours I can presumably provide for myself in about 2-3 because modern production is so efficient, and then I get 5 hours to reshape the world into something I want to live in. With government tax, the split is basically 2-3 for me, 2-3 for the government, 3 for changing the world to taste. This is effectively a loss of liberty, because now I have half the control over how the world changes.

That isn't particularly profound, it is just how taxes work. But one of the points of money is abstracting direct work for contributing. In a sense, this is the same as labouring directly on a government project for 2-3 hours, and that would be slavery. Obviously taxes aren't slavery because they aren't mandatory (don't want to pay taxes, don't work) but the parallel is there for reducing liberty.

[crumbshot]

Interesting argument, though I think this could also support the claim that paying taxes increases personal liberty. By having a portion of income paid into the commons for the general benefit of society, this means you don't have to work directly on such government-led projects, giving you increased freedom in where you apply your labour.

[SturgeonsLaw]

I think you're being a bit idealistic to assume that people would generally spend their excess resources shaping the world for the better.

Instead, we seem to see a lot of people spending those resources on shiny toys to make their own lives a little better, and in some cases, spending those resources to ensure that they get more resources in the future, at the expense of others.

[MikeHolman]

The problem is that most people act selfishly with that "5 to reshape the world into something you want to live in". The world they want to live in has them lazing on a beach, not providing healthcare for the masses.

[stcredzero]

The world they want to live in has them lazing on a beach

Far better places to play with a LASER than on a beach.

[stcredzero]

they just don't want to pay for it. This is a perfectly valid reason, but I wouldn't call it encroaching on personal freedom, so I'm curious as to how else you see it affecting liberty?

For one thing, why are you so insistent that I'm an opponent of health care reform. (Subjectively speaking, there's this sour stickyness of you assuming things inside my head around that. If you are, please, don't. You would be wasting our time and energy with that.) I voted for Obama the 1st time in large part because of health care reform. That said, I've since changed my mind. The individual mandate in Obamacare is too big an encroachment on individual freedom.

Big government agencies tend to encroach on individual freedom because they tend to accrue de facto then de jure power. Would anyone dispute that the IRS has considerable power, enough to create some potential for abuse? (Not saying we should get rid of them, however.)

As far as individual freedom goes generally, watching the events of the past several years, including those around "activists," and big tech companies, has made me a lot more concerned about individual freedom. A lot of people seem to be paying lip service to concepts like Freedom of Speech and Due Process, but then putting wide ranging things into effect which interfere with or abrogate those rights, though they are not technically illegal. (yet)

[ncallaway]

> For one thing, why are you so insistent that I'm an opponent of health care reform

I think the assumptions others may have made because you've largely described what you don't want.

Do you have suggestions or thoughts for what an effective system is? What is the system that you do want?

[stcredzero]

I'd like for people on both sides of the aisle to come together and design a system which tries to prioritize both dignified almost-total coverage and individual autonomy. Probably not the answer you were looking for, but thanks for asking the question. I think I've clarified to myself how I'm to vote.

[monocasa]

Obamacare was both sides of the aisle coming together. It's a repackaged version of the proposed Republican 1993 HEART Act (including the individual mandate).

[jonfw]

What? Obamacare didn't receive a single republican vote

[germinalphrase]

True - but that is completely independent from the fact that the ACA was the Republican healthcare reform model (see Romneycare). The Republican Party went completely at war against President Obama regardless of whether or not he was proposing solutions they explicitly supported (in the past) or actively designed.

[CydeWeys]

You keep talking about personal freedom and autonomy. How exactly are you using those in a healthcare context? No one has ever proposed a system that forces adults into getting treatment against their will.

Are you instead talking about being forced to pay for a healthcare system, either directly or indirectly through taxes? Because in that case, then yeah, obviously it would need to be paid for. The alternative is not having it at all. And we already don't have a system where people who can't afford healthcare are denied treatment and forced to die, and such a system is untenable according to our modern society's morals anyway.

I agree with the others; you're using wishy-washy words without clarifying exactly what you're proposing, or even explaining how alternatives to the existing types of systems are possible at all.

[specialist]

Our respective positions have almost zero overlap, but I appreciate that you've articulated and shared yours.

I have and continue to spend a lot of time on healthcare. Despite 15 years of grinding, I feel like I barely understand what's going, and am continually surprised. For example, I totally didn't foresee hospital consolidation tipping the balance of power back to them (from insurers), begetting the scourge of surprise billing.

The best, and perhaps only, label for our current system is confusopoly (h/t Scott Adams).

In your travels, all that I ask, given your desire for bipartisan bonhomie, is while you read reform proposals (from policy wonks), please note who is participating in the conversation, and who isn't.