John Rawls, why not free health care system

MaxManus

Hey, I'm reading about rawls in Kymlicka Contemporary Political Philosophy: An Introduction and it says that Rawls did not favour a free health care system. Does anyone know why? It strikes me as odd that you would design a society such that economic inequality is only allowed if it favours the least well of and not at the same time not give at least some compensation to the sick people.

russ_watters

I don't kbow, but did it have anything to do with the fact that without slaves, healthcare can't be "free"?

Ryan_m_b

I'm pretty sure he means universal/socialised healthcare where the state ensures that everyone has access to healthcare through either directly paying for it or heavy regulation/control of insurance.

As for why not it's something that always has baffled me coming from the UK where universal healthcare is a given. Reasons I've heard against such things include not wanting to pay for other people or wanting to encourage competition (both things that I don't agree with).

Mech_Engineer

There's no such thing as a free lunch. Either you pay for your healthcare directly, or you pay taxes (or insurance premiums) and those payments are used to pay for your healthcare.

In the case of paying insurance premiums (or taxes) your helathcare costs are basically averaged with everyone else's, so it's a good deal if you're above average in healthcare costs, but you get screwed if you're below average in costs. Insurance premiums do usually reflect your overall costs (some people pay more based on certain conditions).

One way or another the healthcare workers need to be paid, so when people demand "free healthcare for all" they usually haven't thought it through appropriately.

russ_watters

Yes, I'm sure. It just irritates me and I think is informative. It baffles me that it would baffle you: surely you are aware that it is a relatively new idea? It also baffles me that a new and radical idea is often simply taken as self-evident; without theoretical development.

To the OP: a google suggests he never discussed healthcare. Did you misread? Do you have a reference?

Ryan_m_b

Who said anything about self-evident? I am aware of the age of the NHS and the history of socialised healthcare. What baffles me is why anyone would be against the principle, I understand the counter arguments but one has never struck me as being particularly convincing.

Greg Bernhardt

I'm not sure people argue the principle, but rather the practicality.

Ryan_m_b

Most people may argue the practicality but I've met people who argue the principle as well, with rather sickening rationale.

Greg Bernhardt

My first "not deep" thought is that if the US moves to a true socialized health care, I'd want tobacco, alcohol, cheeseburgers and tootsie pops banned. I'd want helmets mandatory for bikers. This would just be the start. I have absolutely zero problem paying towards a child needing a cancer treatment or any other reasonable medical scenario. There is a part of me however that pauses when asked to help pay for someone's very poor decision. I know it's an impossible line to draw, but there are really terrible decisions being made all the time and I'm not sure I want to pay for them. Does that make me a bad person, I don't know.

Ryan_m_b

(Emphasis mine) Indeed it is a hard line to draw. One might argue that people partaking in extreme sports bring it on themselves when they have accidents or people who eat poorly because they can't afford good food might get caught in the system. If an insurance based universal system was implemented this could be tailored to the patient's needs/behaviours.

Personally I wouldn't advocate this however I like it how it is now in the UK where self-inflicted puts you at a low priority and bans you from certain procedures unless you change e.g. liver transplants for alcoholics.

MaxManus

My refference is Kymlicka p 70-72

micromass

Of course, health care is never free. People always pay for it in taxes. But socialized health care is not a bad idea at all.
I personally believe that each person has the right on cheap health care and cheap education. It makes sense that the people who are well off in society would pay for the people who are less lucky.

As for the practicality of it all. Socialized health care exists in many european countries and it works fine. So I don't see any real reason why it shouldn't work in the US.

Greg Bernhardt

That sounds interesting, but I could see it being full of fraud.

Well off people are just lucky? :) Why should I pay for a meth dealer's heath insurance? Is he just unlucky?

I think there are plenty of interesting debate points to be made. I am not smart enough to properly engage. However, one thing is we have more illegals than most european countries have citizens.

Everyone should have affordable heath insurance. Does that mean the only option is to socialize the industry? Are there no other options?

micromass

Not all of them are lucky, of course. But a lot depends on luck, sure.

Let's say you are born in a poor family with not many opportunities. Chances are larger that your education won't be good and that you will end up in poverty.
Poverty is a turning wheel, once you're in it, it's very hard to get out of it.

And yes, meth dealers can be considered unlucky. If you're raised in an environment where criminality is normal, then you won't have the norms and values we have. That doesn't excuse criminality, but it makes it more understandable.

I also don't think it's a wise idea to equate criminals with poor people. Most poor people are honest and hardworking people.

Ryan_m_b

Broadly one gets rich through a combination of accident of birth, profits from labour of other workers and hard work. No one of them is necessary: you could be born in the most poverty stricken area and work your way to 1% status, likewise you could be born into a rich land owning family and never work a day in your life. Social policies IMO are important to address the first two of the three. How this plays in to state provided medicine is to ensure that there is a justifiable reason for spending taxes on health care for all.

Greg Bernhardt

I understand that very well. I think more money should go into parenting and education. That is where the wheel will be stopped, not health care.

I never did. I simply said I hesitate to pay for people when they make very poor decisions. Income doesn't enter into the equation for me.

Ryan_m_b

Arguably I would say that if you have achieved that goal (actually I would replace affordable with cheap/negligible concern) you've probably instituted some pretty social policies anyway so you could argue you have an indirect social health care system