Healthcare...is it a "good/service" or an inalienable "right"

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Income tax is a theft of property. Wages are property. An excise tax or tariff is are sources of revenue that are paid when engaging in an activity such as any sale or buying of a specific good, like alcohol or cigarettes. A toll on a bridge is a kind of this sort of tax. You choose to buy then pay the excise. Alternatively, you choose to sell your product in the country and you pay the tariff (Yay for foreigners helping keep our kids out of the factory). One you have a choice and the other you pay or you go to jail and then you still usually pay. It's not ethical (or moral).

Thanks for your clarification. I appreciate it. It does clarify your position, and does seem consistent.

What I noticed is that the taxes libertarians support are all regressive. See this article: 6 Ways to Fund Public Services in a Libertarian Republic

So, the article proposes six options: 1) Lottery, 2) Consumption tax (which includes excise tax you mentioned), 3) Voluntary tax, 4) Usage fees (which includes tolls you mentioned), 5) cooperatives (basically private health insurance would fit under here), and 6) government selling land to people.

I think this list--aside from the two you mentioned (#2 and #4)--is quite absurd, and really shows how a purely libertarian society is not workable. But, as I mentioned, these are all regressive taxes, which hit poor people the most: #1 the lottery is the equivalent of a tax on the poor, #2 and #4 hit the poor the hardest since these taxes are a much greater percentage of their wealth; taxing loaves of bread, etc. And only wealthier people benefit from #5 and especially #6 (with #6 being highly absurd).

As for #3--a voluntary tax--that one has this worrisome bit mentioned in the article:

In a community, town or city, a voluntary per person tax may be implemented. Services provided by the town such as fire and police services could only utilized by persons who had paid the tax. Those who choose not to would be left to fend for themselves, hire private services or depend on volunteer services.​

So, it really is as I said: in the purely libertarian world, if your house is burning down--and you didn't pay fire insurance--then they let it burn down. I think most reasonable human beings don't agree with this sort of ideology.

And the truth is that most human beings don't, which is why we treat a child who got hit by a car and comes to our ER even if he/she has no health insurance and can't afford to pay. (There are poorer countries where such people are told to "fend for themselves" and are denied entrance into the hospital.)

I like kids going to school - private school. If I had my way there would be no public education, but there it is - though that is a discussion for another day with plenty of nuanced points. To your point though, we could pay for public education with excise taxes and tariffs, if we really wanted. The situation is not either steal what is mine or kids work in a factory (zomgexclamationpoint). That's some kind of emotional appeal coupled to a clear logical fallacy.

Here's where libertarians really struggle. See, you are very uncomfortable telling it as it is, so you have to blur what you are saying. Clearly, you are saying that in your system, there would be no public education, and we'd be back to the same system where kids were working in factories.

Question: do you think banning child labor is legal, and do you think the government is justified in mandating child education?

So, you think consumption taxes and usage fees should be raised further to fund public education for children, or no? If yes, then why put such taxes that would hit the poor the hardest, and not take them from those who are blessed with more wealth? Is it not more ethical to take such taxes from those who can afford it, instead of placing taxes on bread and butter, which poor people need to survive?

This is not an emotional appeal. This is (bio)ethics. Do you believe this would be ethical?

I propose to you that the libertarian model is unethical and that one should instead approach the matter using the Veil of Ignorance proposed by ethicist John Rawles, wherein one creates a system based on a hypothetical situation of being behind a veil or wall of ignorance. In other words, "no one knows his place in society, his class position or social status; nor does he know his fortune in the distribution of natural assets and abilities, his intelligence and strength, and the like." In this thought experiment, you are going to be randomly assigned to someone in the world--or in this particular case, the country. You may be born as Bill Gates or alternatively you may be born as a poor black kid living in a slum. If one did indeed live behind this veil or wall of ignorance, then one would want to set up a society whereby the lowest person in society would have certain bare minimum floor, because one may indeed be assigned to such a person.

This is a much better way to think of things, behind this veil or wall of ignorance, than to think of things after one already has wealth and resources, as most all libertarians do. It is difficult to find a poor, struggling libertarian. This is, as I have said, a convenient position for someone with wealth and resources, and provides ideological and moral cover to what is, at the end of the day, unethical and immoral, i.e. quite literally letting poorer people die.

Taxing you is not the same as stealing from you, no matter how much one says otherwise.

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I'm a pure libertarian. Everyone should be responsible for their own choices, and society should not take money from one person to give goods/services free of charge to another.

That being said, a purely libertarian world would be anarchy. Government does play a role as a referee, and its role should be limited as follows:

1. Establish and enforce a legal system
2. Protect national borders
3. Public safety (police, firefighters, national guard, etc)
4. Basic infrastructure like roads.

Essentially the role of government should be to make sure people don't kill or steal from each other.
 
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Thanks for your clarification. I appreciate it. It does clarify your position, and does seem consistent.

What I noticed is that the taxes libertarians support are all regressive. See this article: 6 Ways to Fund Public Services in a Libertarian Republic

So, the article proposes six options: 1) Lottery, 2) Consumption tax (which includes excise tax you mentioned), 3) Voluntary tax, 4) Usage fees (which includes tolls you mentioned), 5) cooperatives (basically private health insurance would fit under here), and 6) government selling land to people.

I think this list--aside from the two you mentioned (#2 and #4)--is quite absurd, and really shows how a purely libertarian society is not workable. But, as I mentioned, these are all regressive taxes, which hit poor people the most: #1 the lottery is the equivalent of a tax on the poor, #2 and #4 hit the poor the hardest since these taxes are a much greater percentage of their wealth; taxing loaves of bread, etc. And only wealthier people benefit from #5 and especially #6 (with #6 being highly absurd).

As for #3--a voluntary tax--that one has this worrisome bit mentioned in the article:

In a community, town or city, a voluntary per person tax may be implemented. Services provided by the town such as fire and police services could only utilized by persons who had paid the tax. Those who choose not to would be left to fend for themselves, hire private services or depend on volunteer services.​

So, it really is as I said: in the purely libertarian world, if your house is burning down--and you didn't pay fire insurance--then they let it burn down. I think most reasonable human beings don't agree with this sort of ideology.

And the truth is that most human beings don't, which is why we treat a child who got hit by a car and comes to our ER even if he/she has no health insurance and can't afford to pay. (There are poorer countries where such people are told to "fend for themselves" and are denied entrance into the hospital.)

A consumption tax isn't regressive. The rich would still pay more in taxes when they spend more money. I'll beg the question on the rest. Even if they are regressive, that isn't a legitimate reason to take what mine because you think you can use it somewhere else. You can exempt food.

We haven't been talking about fire departments. And I've never suggested they shouldn't be funded. Nor have I suggested that a child not get treated in an ED.

You seem to think you know who you are talking to, but you don't. I wouldn't make assumptions. But that is just me. YMMV.

Here's where libertarians really struggle. See, you are very uncomfortable telling it as it is, so you have to blur what you are saying. Clearly, you are saying that in your system, there would be no public education, and we'd be back to the same system where kids were working in factories.

Question: do you think banning child labor is legal, and do you think the government is justified in mandating child education?

So, you think consumption taxes and usage fees should be raised further to fund public education for children, or no? If yes, then why put such taxes that would hit the poor the hardest, and not take them from those who are blessed with more wealth? Is it not more ethical to take such taxes from those who can afford it, instead of placing taxes on bread and butter, which poor people need to survive?

This is not an emotional appeal. This is (bio)ethics. Do you believe this would be ethical?

I propose to you that the libertarian model is unethical and that one should instead approach the matter using the Veil of Ignorance proposed by ethicist John Rawles, wherein one creates a system based on a hypothetical situation of being behind a veil or wall of ignorance. In other words, "no one knows his place in society, his class position or social status; nor does he know his fortune in the distribution of natural assets and abilities, his intelligence and strength, and the like." In this thought experiment, you are going to be randomly assigned to someone in the world--or in this particular case, the country. You may be born as Bill Gates or alternatively you may be born as a poor black kid living in a slum. If one did indeed live behind this veil or wall of ignorance, then one would want to set up a society whereby the lowest person in society would have certain bare minimum floor, because one may indeed be assigned to such a person.

This is a much better way to think of things, behind this veil or wall of ignorance, than to think of things after one already has wealth and resources, as most all libertarians do. It is difficult to find a poor, struggling libertarian. This is, as I have said, a convenient position for someone with wealth and resources, and provides ideological and moral cover to what is, at the end of the day, unethical and immoral, i.e. quite literally letting poorer people die.

I'm not uncomfortable telling it as it is. I'd prefer to see private education which is really neither here not there - I was simply trying to better articulate my position to a question you asked in a dishonest way. Though that isn't the model we have. I prefer children in school. So the schools need to be paid for. They can be paid for with taxes that don't steal. That and that only was my point. You did make an emotional fallacious appeal because it's a false dichotomy. There is no "take my money by theft and give it school or kids just have to be in factories *cue the muted trombones* wah wah wahhh" It's a stupid an incorrect argument. It like asking me if I want it in the mouth or the ass, when I have many, many options to take neither. It's also intellectually dishonest.

Again. Consumption taxes are not regressive. The rich spend more money and will pay more taxes. You exempt food and then no one is forgoing bread or butter.

Also. Not a libertarian. You assume too much. I am merely talking about an system of taxation that doesn't steal. It matters little if you have the best of intentions for my stolen money or if you think I can afford to have my money stolen. It's still stealing. Quit apologizing for an immoral act.
 
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JDH71 - Thank you for giving your side of the argument. I think this conversation has gotten too heated, and we've both provided our respective sides. It would not behoove me or us to go round and round, I think you can agree. This is the thing about political debates--or perhaps debates in general--nobody (or hardly anybody) ever changes their position!

Also, apologies if I caused any offense.

Cheers!
 
JDH71 - Thank you for giving your side of the argument. I think this conversation has gotten too heated, and we've both provided our respective sides. It would not behoove me or us to go round and round, I think you can agree. This is the thing about political debates--or perhaps debates in general--nobody (or hardly anybody) ever changes their position!

Also, apologies if I caused any offense.

Cheers!

We're cool.

Though, I think to be fair it wasn't close to being heated until you created the false dilemma and then proceeded to tell me I was being chicken **** about my answer.

I'm a big believer in a social contract. I like national defense, medicare, social security, roads, fire departments, police, and . . . even schools! They need to be paid for. I don't disagree with that at all, nor do I feel bad for ending any sentences in prepositions. I'm suggesting a better way to pay for things.

If you're to believe the psychological literature (and there is some evidence suggesting most of it is unreproducible nonsense) then being jerks on the internet is more likely to make sure your opponent stays entrenched in their position, which is why I do my best these days not to be. I know what an olive branch looks like one it's offered, and we can agree to disagree.
 
We're cool.

Though, I think to be fair it wasn't close to being heated until you created the false dilemma and then proceeded to tell me I was being chicken **** about my answer.

Fair enough. Sorry about that last part.
 
It's not a right.

Yes, the system isn't working as currently designed. Anyone who thinks the fix is easy doesn't understand the problem.

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That doesn't make it a right, it makes it an entitlement.

Drop a man into the middle of nowhere. He has a "right" to whatever he gets there. Freedom to move, speak, believe. Freedom to defend himself. What is missing?? Is a freedom to have someone else do something else for him. Hell, he doesn't even have a right to be "healthy" - the germs be everywhere and he could fall out of a tree at any time. How could he then have any sort of concept of a "right" to "healthcare". The notion is preposterous and defies rational thought.

How did you even end up here? Are you just wandering around each forum looking for a thread to post politics in?
 
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Even the government doesn't have that right.

Though it does have a right to collect certain taxes. Not all tax is theft. Excise tax and tariff all day. Fund what you want. Threatening to put someone in jail if they don't hand over their stuff is extortion and theft.

Oh really
Thomas_Hobbes_(portrait).jpg

JohnLocke.png


Two old men ready to throw down some social contract whoopass.
 
I'm willing to guess Med students turn from overall liberal to overall conservative once the clock starts ticking and those loans they've been living on for 4 years start coming due. Easy to argue for all these "rights" when you aren't paying for them.

The PSLF should have some impact on changing that general transition from being quite as pronounced. Forgiving $300,000 without a tax hit could restore faith in the system for some.
 
Thanks for your clarification. I appreciate it. It does clarify your position, and does seem consistent.

What I noticed is that the taxes libertarians support are all regressive. See this article: 6 Ways to Fund Public Services in a Libertarian Republic

So, the article proposes six options: 1) Lottery, 2) Consumption tax (which includes excise tax you mentioned), 3) Voluntary tax, 4) Usage fees (which includes tolls you mentioned), 5) cooperatives (basically private health insurance would fit under here), and 6) government selling land to people.

I think this list--aside from the two you mentioned (#2 and #4)--is quite absurd, and really shows how a purely libertarian society is not workable. But, as I mentioned, these are all regressive taxes, which hit poor people the most: #1 the lottery is the equivalent of a tax on the poor, #2 and #4 hit the poor the hardest since these taxes are a much greater percentage of their wealth; taxing loaves of bread, etc. And only wealthier people benefit from #5 and especially #6 (with #6 being highly absurd).

As for #3--a voluntary tax--that one has this worrisome bit mentioned in the article:

In a community, town or city, a voluntary per person tax may be implemented. Services provided by the town such as fire and police services could only utilized by persons who had paid the tax. Those who choose not to would be left to fend for themselves, hire private services or depend on volunteer services.​

So, it really is as I said: in the purely libertarian world, if your house is burning down--and you didn't pay fire insurance--then they let it burn down. I think most reasonable human beings don't agree with this sort of ideology.

And the truth is that most human beings don't, which is why we treat a child who got hit by a car and comes to our ER even if he/she has no health insurance and can't afford to pay. (There are poorer countries where such people are told to "fend for themselves" and are denied entrance into the hospital.)



Here's where libertarians really struggle. See, you are very uncomfortable telling it as it is, so you have to blur what you are saying. Clearly, you are saying that in your system, there would be no public education, and we'd be back to the same system where kids were working in factories.

Question: do you think banning child labor is legal, and do you think the government is justified in mandating child education?

So, you think consumption taxes and usage fees should be raised further to fund public education for children, or no? If yes, then why put such taxes that would hit the poor the hardest, and not take them from those who are blessed with more wealth? Is it not more ethical to take such taxes from those who can afford it, instead of placing taxes on bread and butter, which poor people need to survive?

This is not an emotional appeal. This is (bio)ethics. Do you believe this would be ethical?

I propose to you that the libertarian model is unethical and that one should instead approach the matter using the Veil of Ignorance proposed by ethicist John Rawles, wherein one creates a system based on a hypothetical situation of being behind a veil or wall of ignorance. In other words, "no one knows his place in society, his class position or social status; nor does he know his fortune in the distribution of natural assets and abilities, his intelligence and strength, and the like." In this thought experiment, you are going to be randomly assigned to someone in the world--or in this particular case, the country. You may be born as Bill Gates or alternatively you may be born as a poor black kid living in a slum. If one did indeed live behind this veil or wall of ignorance, then one would want to set up a society whereby the lowest person in society would have certain bare minimum floor, because one may indeed be assigned to such a person.

This is a much better way to think of things, behind this veil or wall of ignorance, than to think of things after one already has wealth and resources, as most all libertarians do. It is difficult to find a poor, struggling libertarian. This is, as I have said, a convenient position for someone with wealth and resources, and provides ideological and moral cover to what is, at the end of the day, unethical and immoral, i.e. quite literally letting poorer people die.

Taxing you is not the same as stealing from you, no matter how much one says otherwise.
I like the veil of ignorance as an exercise in evaluating my personal behavior to others (basically a golden rulr situation). It doesn't grant me rights to take someone's items to give to someone else. To reference your earlier reply, government can't do it either with any more morality than i can. As government gets its power from the people it can't get a power from me that I don't have...I can't vote for theft and and justify it morally because "the govt did it"
 
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To answer your other questions Angry Birds, no we don't need public school. Mine was a joke and even in college I learned more from khan academy on youtube than most professors. Those who want knowledge can find it other ways.
 
I like the veil of ignorance as an exercise in evaluating my personal behavior to others (basically a golden rulr situation). It doesn't grant me rights to take someone's items to give to someone else. To reference your earlier reply, government can't do it either with any more morality than i can. As government gets its power from the people it can't get a power from me that I don't have...I can't vote for theft and and justify it morally because "the govt did it"

I think this is a fundamental difference. You keep equating taxes with stealing, which is an interesting viewpoint. But, that's just it: it's a viewpoint. If you open the dictionary and look up the word "tax," you won't see the word "steal" in it. Why not? Because they are two different things.

To answer your other questions Angry Birds, no we don't need public school. Mine was a joke and even in college I learned more from khan academy on youtube than most professors. Those who want knowledge can find it other ways.

I think this answer adequately shows what I perceive to be the unethical nature of your view. Public school is what allows young kids from poor neighborhoods to get an education and go to college in order to break the cycle of poverty. The fact that some of these schools are "a joke" is a reflection of the fact that this country spends too little on education, resulting in a mediocre educational system compared to other Western countries. In other words, the argument that they are "a joke" is more of a reason to support increasing funds to education than to argue for getting rid of the Department of Education (as Ron/Rand Paul argue for). This is clearly leaving the realm of reasonableness.

But again, I thank you for your clarity, which does clearly show the weakness of the libertarian position. Most people will be appalled by your idea of getting rid of public education for children, as not everyone can afford private schools. (In fact, most people *can't* afford private schools.) For the record, I attended public schools my entire life, and they offered me an amazing education, one which allowed me to attend elite universities and be in the profession I am in now. So, public schools *can* be good, if we support them adequately.

Also, I don't think YouTube and Wikipedia--as great as they are--are a good substitute for formal education. Do you think we can skip medical school as well, and just learn everything off of EmCrit and YouTube videos, which are admittedly of high quality?
 
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But again, I thank you for your clarity, which does clearly show the weakness of the libertarian position. Most people will be appalled by your idea of getting rid of public education for children, as not everyone can afford private schools. (In fact, most people *can't* afford private schools.) For the record, I attended public schools my entire life, and they offered me an amazing education, one which allowed me to attend elite universities and be in the profession I am in now. So, public schools *can* be good, if we support them adequately.

Also, I don't think YouTube and Wikipedia--as great as they are--are a good substitute for formal education. Do you think we can skip medical school as well, and just learn everything off of EmCrit and YouTube videos, which are admittedly of high quality?
The number of people appalled with a concept has nothing to do with it's merit/morality. And the fallacy that simply spending more on public education would make it better is simply not true.
 
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That's so horrible.

what's horrible is choosing not to buy the coverage and then being shocked when you don't get the service.....that's how insurance works, you pay up front in case something happens. I can't total my car and then call state farm to get a policy
 
To take my stuff? No. To tax. Yes. One should not be the same.

Government was created to protect life, liberty, and the pursuit of property... but they charge you for it. Hobbes says you give them some portion of your liberty. Locke says you give them some portion of your property. I do believe their combined life works are the basis of all western political thought, and particularly all American political heritage. Now to be fair... while something akin to income tax existed in the time they were writing, I dont think anything akin to it existed in the colonies when the founders adopted the policies of those two blokes.

Its rather picking and choosing to be about social contracts and not be about income tax since it was a delineated part of both of their key works. It may not be the lasting legacy of either of them, but its still key to both of their political theories and key to social contract government. But thats a side conversation and we are moving farther away from the actual point.

and REALLY... I really just posted so that I had an excuse to post angry Hobbes and disappointed Locke. (forgot about Francis Bacon. He's too hippie dippie for me)
 
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Government was created to protect life, liberty, and the pursuit of property... but they charge you for it. Hobbes says you give them some portion of your liberty. Locke says you give them some portion of your property. I do believe their combined life works are the basis of all western political thought, and particularly all American political heritage. Now to be fair... while something akin to income tax existed in the time they were writing, I dont think anything akin to it existed in the colonies when the founders adopted the policies of those two blokes.

Its rather picking and choosing to be about social contracts and not be about income tax since it was a delineated part of both of their key works. It may not be the lasting legacy of either of them, but its still key to both of their political theories and key to social contract government. But thats a side conversation and we are moving farther away from the actual point.

and REALLY... I really just posted so that I had an excuse to post angry Hobbes and disappointed Locke. (forgot about Francis Bacon. He's too hippie dippie for me)

Can't be right about everything. Even Hobbes and Locke.

I'll pay your taxes. But don't pretend when you have come for my income with men with guns as threat if I don't give it up that it is some kind right action. It isn't.
 
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Can't be right about everything. Even Hobbes and Locke.

I'll pay your taxes. But don't pretend when you have come for my income with men with guns as threat if I don't give it up that it is some kind right action. It isn't.

Its not. I agree. Its a business transaction. One enforced by men with guns that you in some tiny way funded but dont have loyalty to you (the government is a cruel fickle bitch)
 
what's horrible is choosing not to buy the coverage and then being shocked when you don't get the service.....that's how insurance works, you pay up front in case something happens. I can't total my car and then call state farm to get a policy

See, sometimes it really seems that conservatives/libertarians are devoid of a heart. It is different than a car. It is a person's home--literally the roof over their heads--with all of their life belongings inside of it. The family will often have kids and now they will be on the streets. Surely you see something "horrible" in homeless kids. (I try to see if there is a heart beating at all in there by mentioning children, since I know no human compassion is to be given toward people above the age of eighteen.)

As for car insurance, the government *forces* people to buy car insurance, even penalizing them if they don't. This is done for their own good, and this *force* might be considered "theft" under your definition.

I wouldn't have a problem with *forcing* people to pay the fire brigade fee, but if their house is actively burning down, one is ethically obligated to put the fire out. No questions asked. Anything less is immoral... just like when a gang member is shot and arrives in my ER without health insurance of any kind, I am ethically bound to treat him to the best of my abilities, no questions asked. This is the ethical thing to do.

The number of people appalled with a concept has nothing to do with it's merit/morality. And the fallacy that simply spending more on public education would make it better is simply not true.

You seem to use the word "fallacy" a lot, without seeming to understand the concept at all. I never claimed that "simply spending more on public education would make it better." Did I? Did you see that written? Rather, my argument is that many public schools are heavily underfunded and cannot improve significantly without more funding. Teachers need salaries, and less money to go around means less teachers and larger class sizes, which means worse schools. Less money means less after school activities and programs, etc., see where this is going?

Do you understand the difference between these two statements? Seriously, please look into "fallacies" before claiming it repeatedly.

Likewise, I did not claim that the number of people appalled with a concept necessitates it being immoral. Rather, I was pointing out that I had adequately "exposed" the flaws of libertarian ideology for most neutral third party persons, and that this was my objective, which I succeeded in doing. In your world, kids who can't afford private schools can't get a formal education and must instead rely on YouTube. In your world, if a person's house burns down, you let it burn down. So, if someone does not have health insurance (or car insurance either!) and arrives in your ER after a massive car crash, then we don't treat them, right? Yes, I'm sorry, your ideology is immoral.
 
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I wouldn't have a problem with *forcing* people to pay the fire brigade fee, but if their house is actively burning down, one is ethically obligated to put the fire out. No questions asked. Anything less is immoral... just like when a gang member is shot and arrives in my ER without health insurance of any kind, I am ethically bound to treat him to the best of my abilities, no questions asked. This is the ethical thing to do.
This issue here isn't the morality. It's the precedent. If they arrive and say, "shucks, guess we should put this guys fire out even though he didn't pay", then guess what happens. Next year nobody pays, the firemen are out of jobs, and every house is at risk of fire.
 
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See, sometimes it really seems that conservatives/libertarians are devoid of a heart. It is different than a car. It is a person's home--literally the roof over their heads--with all of their life belongings inside of it. The family will often have kids and now they will be on the streets. Surely you see something "horrible" in homeless kids. (I try to see if there is a heart beating at all in there by mentioning children, since I know no human compassion is to be given toward people above the age of eighteen.)

As for car insurance, the government *forces* people to buy car insurance, even penalizing them if they don't. This is done for their own good, and this *force* might be considered "theft" under your definition.

I wouldn't have a problem with *forcing* people to pay the fire brigade fee, but if their house is actively burning down, one is ethically obligated to put the fire out. No questions asked. Anything less is immoral... just like when a gang member is shot and arrives in my ER without health insurance of any kind, I am ethically bound to treat him to the best of my abilities, no questions asked. This is the ethical thing to do.



You seem to use the word "fallacy" a lot, without seeming to understand the concept at all. I never claimed that "simply spending more on public education would make it better." Did I? Did you see that written? Rather, my argument is that many public schools are heavily underfunded and cannot improve significantly without more funding. Teachers need salaries, and less money to go around means less teachers and larger class sizes, which means worse schools. Less money means less after school activities and programs, etc., see where this is going?

Do you understand the difference between these two statements? Seriously, please look into "fallacies" before claiming it repeatedly.

Likewise, I did not claim that the number of people appalled with a concept necessitates it being immoral. Rather, I was pointing out that I had adequately "exposed" the flaws of libertarian ideology for most neutral third party persons, and that this was my objective, which I succeeded in doing. In your world, kids who can't afford private schools can't get a formal education and must instead rely on YouTube. In your world, if a person's house burns down, you let it burn down. So, if someone does not have health insurance (or car insurance either!) and arrives in your ER after a massive car crash, then we don't treat them, right? Yes, I'm sorry, your ideology is immoral.
You aren't ethically bound to treat people regardless of payment, you are legally bound by emtala. Your premise implies all the dentists are unethical for not offering free treatment, or all the opthalmologists, etc...

And yes, when people don't pay for a service and no one has volunteered to donate it to them....they don't get the service.

The argument about schools is poorly structured. Your whole argument is they need more money... they don't need more money.
 
Its not. I agree. Its a business transaction. One enforced by men with guns that you in some tiny way funded but dont have loyalty to you (the government is a cruel fickle bitch)

No it isn't. It's theft. A social contract isn't some kind of utilitarian suicide pact. You need to respect people's property.
 
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No it isn't. It's theft. A social contract isn't some kind of utilitarian suicide pact. You need to respect people's property.

Eh. Agree to disagree. The idea of how a government like this would work was founded on the idea that your choice was give up property to the government or leave and enter anarchy; potentially becoming an enemy of the state if they then felt that your property was worth taking 100% by force, rather than 40%. And at its time, this was an extremely literal option, you could opt out and take your chances. Will modern government allow you to leave and become an anarchic city-state of your house an front lawn? No. Probably not. But they also dont collect taxes with armed guards any more either. So the classical interpretation may not always apply any longer, but it is where the government draws its justification from.
 
This issue here isn't the morality. It's the precedent. If they arrive and say, "shucks, guess we should put this guys fire out even though he didn't pay", then guess what happens. Next year nobody pays, the firemen are out of jobs, and every house is at risk of fire.

Or next year everyone pays because John Miller learned his lesson about being a cheapskate, and we are capable of learning by proxy.
 
Eh. Agree to disagree. The idea of how a government like this would work was founded on the idea that your choice was give up property to the government or leave and enter anarchy; potentially becoming an enemy of the state if they then felt that your property was worth taking 100% by force, rather than 40%. And at its time, this was an extremely literal option, you could opt out and take your chances. Will modern government allow you to leave and become an anarchic city-state of your house an front lawn? No. Probably not. But they also dont collect taxes with armed guards any more either. So the classical interpretation may not always apply any longer, but it is where the government draws its justification from.
Try not paying.....they absolutely will send people with guns

Or next year everyone pays because John Miller learned his lesson about being a cheapskate, and we are capable of learning by proxy.

I would suggest that John Miller did learn his lesson and it's likely a few neighbors did as well
 
I would suggest that John Miller did learn his lesson and it's likely a few neighbors did as well
Not sure who this John Miller cat is, but the woman who owned the house didn't learn from it happening in the same county the year before.
 
Eh. Agree to disagree. The idea of how a government like this would work was founded on the idea that your choice was give up property to the government or leave and enter anarchy; potentially becoming an enemy of the state if they then felt that your property was worth taking 100% by force, rather than 40%. And at its time, this was an extremely literal option, you could opt out and take your chances. Will modern government allow you to leave and become an anarchic city-state of your house an front lawn? No. Probably not. But they also dont collect taxes with armed guards any more either. So the classical interpretation may not always apply any longer, but it is where the government draws its justification from.

The founding of *our* government was based on a tax system that was respective of someone's property. I think it's crap weasel to hide behind Hobbes and Locke who yes did influence our founders and double down on confiscation when our government's founders clearly rejected that and ran quite well for a long time without it. And could again.
 
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The founding of *our* government was based on a tax system that was respective of someone's property. I think it's crap weasel to hide behind Hobbes and Locke who yes did influence our founders and double down on confiscation when our government's founders clearly rejected that and ran quite well for a long time without it. And could again.

There would literally be no US government the way we see it without them. The ideas for it simply did not exist. And given the heavy referencing to those two that were done during the continental congress and in theyears preceeding it.... its a bit much to dismiss them and completely wrong to say they rejected it when they were plaigarising it just a few years beforehand. Though we did start without an income tax, something I already agreed to earlier.
 
The federal government decided long ago that access to emergency services was a "right". We are legally mandated to provide professional services for patients who will never pay us, and I'd say the vast majority of us would do this even if we weren't required.

I am happy to help self-pay patients in whatever way I can. Does not bother me at all. I very rarely if ever run into any issue getting appropriate follow up for my self-pay patients.

The problem with this massive government way of thinking, ie: "Healthcare is a right." is that, to the population, it doesn't mean, "The treatment of childhood leukemia is a right" it means "Every futile procedure that has ever been done to any wealthy person must be performed on me regardless of its efficacy or my ability to pay." Access to insulin, antibiotic coverage for pneumonia/UTIs, basic OB services, most will agree people should have despite ability to pay. Politically it is always focused on rare scenarios such as MAB treatments, liver/pancreas/heart transplants, etc in order to increase the size of the government and self-serve politicians.

Getting a $500k procedure that may extend your life by 6 months is not a right.

Like GeneralVeers said, the role of the federal government should be to protect our borders, establish basic laws to protect the constitutional rights of the citizens of the US, provide national security, foreign diplomacy, and maintain an infrastructure (which is really just part of national defense..)

Everything else can be provided by State governments. That's the beauty of the USA, the states are supposed to have power to govern individually, and if you don't like your state, you can move to another one while remaining a US citizen.
 
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Why can't I opt out of social security and Medicare? Theoretically I'm paying into it in order to pay my bills after age 65. It was never designed as a system to pay for the costs of others. Conveniently when both were created, the average life expectancy was below 70, so in general the amount paid in by each individual was less than was paid out.

We can fix both programs by capping payouts based on the amount you've paid in. An opt-out option should exist entirely. I put away 54K per year in a SEP-IRA. Over my working life that will equate to a retirement of $3-5 million. Why do I still need to pay into social security???
 
The PSLF should have some impact on changing that general transition from being quite as pronounced. Forgiving $300,000 without a tax hit could restore faith in the system for some.

Thats true but the sacrifice in a lot of those positions you make less money than you would out on the market. Personally I would rather make more money and pay my own loans off.
 
You aren't ethically bound to treat people regardless of payment, you are legally bound by emtala.

Can you quote a single bioethicist who argues this?

There is a difference between ethical and legal obligation, and the former is a stronger obligation upon you than the latter.

Kindly refer to Beauchamp and Childress and the moral obligation to rescue the drowning person as it is applied to medical care. This will also clarify this part for you:

Your premise implies all the dentists are unethical for not offering free treatment, or all the opthalmologists, etc...

Once again a mischaracterization of my argument. Please refer to the drowning person argument and you will see the difference between emergency care and non-emergent dental work.

Allow me to clarify for you. You are ethically obligated to care for the patient if:

1) The patient will likely suffer serious injury or death.

2) The physician's help is needed to avert this harm.

3) You, as a physician, are capable of averting this harm.

4) There is a reasonable chance of success.

5) In acting, the physician will not sustain serious risks or harms.

6) The patient's benefit will outweigh the risks or harms sustained by the physician.​

I fear that you are severely lacking in bioethics education, even if your technical training is top notch. We are not mechanics like you make us out to be. Ours is a noble profession afforded a position of respect exactly because of this ethical code we must follow.

Surgeons even have an ethical obligation to render service to HIV patients, despite the added risk of contagion, secondary to needle prick.

And yes, when people don't pay for a service and no one has volunteered to donate it to them....they don't get the service.

Do you recognize any ethical code as a physician?

The argument about schools is poorly structured. Your whole argument is they need more money... they don't need more money.

No, it is not. Do you deny that public schools are heavily underfunded, which affects their ability to provide a quality education?
 
Can you quote a single bioethicist who argues this?

There is a difference between ethical and legal obligation, and the former is a stronger obligation upon you than the latter.

Kindly refer to Beauchamp and Childress and the moral obligation to rescue the drowning person as it is applied to medical care. This will also clarify this part for you:

Once again a mischaracterization of my argument. Please refer to the drowning person argument and you will see the difference between emergency care and non-emergent dental work.

Allow me to clarify for you. You are ethically obligated to care for the patient if:

1) The patient will likely suffer serious injury or death.

2) The physician's help is needed to avert this harm.

3) You, as a physician, are capable of averting this harm.

4) There is a reasonable chance of success.

5) In acting, the physician will not sustain serious risks or harms.

6) The patient's benefit will outweigh the risks or harms sustained by the physician.​

I fear that you are severely lacking in bioethics education, even if your technical training is top notch. We are not mechanics like you make us out to be. Ours is a noble profession afforded a position of respect exactly because of this ethical code we must follow.

Surgeons even have an ethical obligation to render service to HIV patients, despite the added risk of contagion, secondary to needle prick.

Do you recognize any ethical code as a physician?
You are welcome to voluntarily adopt a personal code that says you will treat anyone regardless of them paying you. I reject two things in relation to this. First, it's not remotely something you can claim if just to thrust upon the rest of the profession. Second, I don't believe you. If your paycheck stops coming in, you will walk from your post in the ED. You don't believe that you have to treat anyone regardless of payment. You absolutely demand payment...you just don't necessarily demand that payment from the patient. You absolutely expect that payment to materialize from the rest of society. Your stance isn't selfless, it's just demanding your money from a different source. You may let a few patients slip through the cracks, but you wouldn't show up if no one paid you because your services are not a right that other people can claim.

My ethical code as a professional is to be honest and skilled. My personal ethics/code about charity are my own and aren't relevant to people having an ability to demand my services without compensation. I will deal with the legal environment I end up in, but that doesn't make the laws I'm subject to following moral in any way


No, it is not. Do you deny that public schools are heavily underfunded, which affects their ability to provide a quality education?

I absolutely deny that public schools are underfunded. They are a cluster of waste and inefficiency. Offer a full voucher system and just watch them try to compete on equal footing with private industry.
 
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There would literally be no US government the way we see it without them. The ideas for it simply did not exist. And given the heavy referencing to those two that were done during the continental congress and in theyears preceeding it.... its a bit much to dismiss them and completely wrong to say they rejected it when they were plaigarising it just a few years beforehand. Though we did start without an income tax, something I already agreed to earlier.

I didn't dismiss them completely. All I said was they were wrong about theft. Our founders saw this.
 
Once again a mischaracterization of my argument. Please refer to the drowning person argument and you will see the difference between emergency care and non-emergent dental work.

Allow me to clarify for you. You are ethically obligated to care for the patient if:

1) The patient will likely suffer serious injury or death.

2) The physician's help is needed to avert this harm.

3) You, as a physician, are capable of averting this harm.

4) There is a reasonable chance of success.

5) In acting, the physician will not sustain serious risks or harms.

6) The patient's benefit will outweigh the risks or harms sustained by the physician.​

By your logic if people know that I'm a physician, then can just turn up at my front door an I have an obligation to treat them. To do otherwise would be unethical and would make me a terrible human being.

This is why healthcare cannot be a right. It allows other people to steal and take advantage of the production of goods and service from another.
 
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By your logic if people know that I'm a physician, then can just turn up at my front door an I have an obligation to treat them. To do otherwise would be unethical and would make me a terrible human being.

No, this is not correct. However, if a person happened to sustain cardiopulmonary arrest outside your door, you would be expected to come to her rescue if the conditions I outlined above are met, i.e. your failure to intervene would result in harm/death, you have a good chance of success, etc.

Further, there is some complexity here. You must provide care if you are the only one who can do so. However, if someone else can adequately do the job and agrees to do it, then this discharges you of your responsibility. So, if EMS arrives on the scene and takes over, your ethical obligation is over.

Ethics is different than law. Ethics are meant to be at a higher standard than the law, which is the bare minimum. If, for example, the zombie apocalypse occurs, and the government collapses and there is complete anarchy--even then your ethical obligation to provide medical care would exist, if the conditions I outlined are met. This is a part of being a physician, and upholding the ethical code of a physician.

Again, you are not a mechanic. You are part of a noble profession. This, by the way, is part of the social contract between physicians and society--which you benefit from and obtain all your life earnings and prestige from. From the AMA Journal of Ethics:

The obligations of physicians necessary to sustain the contract were understood and passed on by respected role models. For its part, society understood what it wanted from those responsible for the care of the sick. Societal obligations were present, but less clear. Society granted physicians status, respect, autonomy in practice, the privilege of self-regulation, and financial rewards on the expectation that physicians would be competent, altruistic, moral, and would address the health care needs of individual patients and society [6]. This "arrangement" remains the essence of the social contract [between physicians and patients].
It is because of this understanding that the government protects your livelihood, punishing anyone who would dare practice your craft without a medical license, i.e. quacks. This is why you are not competing with witch doctors.

This understanding is also why the government and society allows us physicians to (within certain bounds) regulate ourselves. This fact is also why we are considered professionals.
 
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No, this is not correct. However, if a person happened to sustain cardiopulmonary arrest outside your door, you would be expected to come to her rescue if the conditions I outlined above are met, i.e. your failure to intervene would result in harm/death, you have a good chance of success, etc.

When would you ever reasonably have a good chance resuscitating someone who sustains cardiac arrest outside your door? They already died, how could your failure to intervene harm them?
 
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When would you ever reasonably have a good chance rescusitating someone who sustains cardiac arrest outside your door? They already died, how could your failure to intervene harm them?

This is partially correct. However, in this case, there would be very little harm or risk to the physician, and the potential benefit to the patient is very great--and so that particular condition (i.e. reasonable good chance of success) would be considerably weakened, and I think the ethical obligation would still hold. This is particularly true since the potential benefit is contingent on time... The more time that elapses, the more the patient's chances plummet. So, the best chance of success is immediately, necessitating you to act.

But, I was just illustrating a point, and one can think of some other condition in which this condition would also be met... for example, a patient with spontaneous pneumothorax and you have an EMS bag lying around (like I and many other ER doc's have) with something to needle her with.

In any case, the point is not the specific case (which I may not have done a good job of illustrating), but the general idea. The classic example is the person who is drowning. If you know how to swim, and the risk to you is low, then you are ethically obligated to act to save the person. This is then translated to the medical profession.

Taking the drowning example... If there was a lifeguard on duty, then your ethical obligation would be discharged. Further, if someone who wasn't supposed to be in the pool was drowning--or who didn't pay the entrance fee or the fee for the lifeguard--then the lifeguard would still be ethically obligated to save the drowning person.
 
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You are delusional sorry to say. Why would you think that people won't take advantage of our "ethical" duties? Moreover, if health care becomes a right, theoretically you could be violating laws and or civilly liable for infringing on people's "rights" if you refuse to give them even minor care.
 
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You are delusional sorry to say.

This is Bioethics 101. A good starting point would be to read Beauchamp and Childress, if you are interested.

Why would you think that people won't take advantage of our "ethical" duties?

Please give an example. I already responded to your previous post. Kindly reread.

Moreover, if health care becomes a right, theoretically you could be violating laws and or civilly liable for infringing on people's "rights" if you refuse to give them even minor care.

Lots of fuzzy lines here. First, as I said before, there is a difference between ethics and law. Law is the bare minimum that is demanded of you. Ethics is what your profession expects of you.

If someone asks you about something minor--something non-emergent without any risk of serious injury, imminent loss of limb or life, etc.--then you are not ethically obligated to provide care, especially if there is a more appropriate place to refer the patient to. For example, if someone comes to your door, knowing that you are a physician, and complains of stubbing her toe, then you can refer her to the ER, urgent care, PCP's office, etc. This is different than the examples cited above.

So, no--for multiple reasons--you are not violating laws or civilly liable for infringing on people's "rights" if you refuse to give them even minor care.
 
No, this is not correct. However, if a person happened to sustain cardiopulmonary arrest outside your door, you would be expected to come to her rescue if the conditions I outlined above are met, i.e. your failure to intervene would result in harm/death, you have a good chance of success, etc.

Further, there is some complexity here. You must provide care if you are the only one who can do so. However, if someone else can adequately do the job and agrees to do it, then this discharges you of your responsibility. So, if EMS arrives on the scene and takes over, your ethical obligation is over.

Ethics is different than law. Ethics are meant to be at a higher standard than the law, which is the bare minimum. If, for example, the zombie apocalypse occurs, and the government collapses and there is complete anarchy--even then your ethical obligation to provide medical care would exist, if the conditions I outlined are met. This is a part of being a physician, and upholding the ethical code of a physician.

Again, you are not a mechanic. You are part of a noble profession. This, by the way, is part of the social contract between physicians and society--which you benefit from and obtain all your life earnings and prestige from. From the AMA Journal of Ethics:

The obligations of physicians necessary to sustain the contract were understood and passed on by respected role models. For its part, society understood what it wanted from those responsible for the care of the sick. Societal obligations were present, but less clear. Society granted physicians status, respect, autonomy in practice, the privilege of self-regulation, and financial rewards on the expectation that physicians would be competent, altruistic, moral, and would address the health care needs of individual patients and society [6]. This "arrangement" remains the essence of the social contract [between physicians and patients].
It is because of this understanding that the government protects your livelihood, punishing anyone who would dare practice your craft without a medical license, i.e. quacks. This is why you are not competing with witch doctors.

This understanding is also why the government and society allows us physicians to (within certain bounds) regulate ourselves. This fact is also why we are considered professionals.
The AMA doesn't get to make ethical decisions for me after they supported the ACA.
 
Ethics is what your profession expects of you.
You know that there are people dying right this minute because of substandard care. And yet you do nothing for them.
I don't see your lack of 24/7, Mother Theresa style life as being unethical. But you see my demand to feed my family as unethical. It's a spectrum.
 
The AMA doesn't get to make ethical decisions for me after they supported the ACA.

Well that's simply not true if you plan to practice in the US. The AMAs code of ethics is a legal standard. Aka, you can be sued for actions which do not comply with it of there is damage to a patient even if your actions are otherwise defensible.

If you don't like that, change it. The AMA is currently accepting open comments from the Internet on this exact document.
 
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