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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: puborectalis who wrote (17426)	4/29/2010 10:49:15 AM
From: longnshort	Read Replies (1) \| Respond to of 42652

no it doesn't those people die young, it's pople who exercise that cost the systems more, sprains, broken bones, knee replacements, hip replacements. They live into their 80s gatting all kinds of operations. My dad smoked, die of a heart attck in 10 minutes cost to the system zero. My mom never smoked and exercised all the time, she's 86, 15-25 operations later cost to the system ?? 5 million

To: puborectalis who wrote (17426)	4/29/2010 11:05:04 AM
From: TimF	Respond to of 42652

The Nanny State Two-Step Ben Adler at TAPped writes: This clearly expresses a fundamental tenet of conservative/libertarian thinking: that engaging in risky behavior with serious social costs is an entitlement. People who are injured by metal bats, or fall ill from smoking or fatty food, cost the rest of us money. We pay their emergency room bill, their Medicare bills or their Social Security disablity insurance. Only someone willing to forgo those benefits should have the right to also opt out of public health laws like those passed by the New York City Council, or pre-existing ones requiring that motorcyclists wear helmets and drivers wear seat belts. But Beston, like all conservatives, makes no serious suggestion about offering such an option in our society (much less explaining how it would be practically possible.) Instead he merely sneers at the New York City government's efforts to lower the costs that he, like all other taxpayers, will ultimately bear (and that, should rising health costs force the government to raise taxes, Beston and City Journal would surely bray against as well). Ah, man, you’re so close: That’s exactly why many of us object to having the public take on such responsibilities in the first place. Behold the weird alchemical powers of public subsidy: You start with a paradigm case of a self regarding act—choosing to engage in risk behaviors with your own body—which traditional liberal principles would place outside the sphere of state regulation as a core component of personal autonomy. But throw some public funds into the mix and—Abracadabra!—what had been the exercise of an individual right is transformed into the “imposition” of a cost on society. No behavior is so private that you can’t regulate or ban it, so long as you’re willing to subsidize it first! Ben does at least seem to give a nod toward the idea that we can’t unilaterally revoke rights by suggesting people ought to have an option: Accept restrictions on risky behavior or forego public money. (Actually, you could get very much the same effect by announcing certain sorts of injuries and ailments—fractures from skiing or whatnot—just aren’t going to be covered.) That’s makes sense to me, but I doubt Ben would actually endorse the outcome. The effect is that the people who have no need to avail themselves of (say) Medicaid go on eating and drinking and smoking and playing as they please, while the poorest are heavily regimented. Come to think of it, you know what costs a lot of public money? When poor people have children. And surely only right wing loonies think having sex “is an entitlement” when it incurs “serious social costs.” Still, at least in this scenario everyone would have a choice. It would avoid the repugnant implication that our generosity gives us the right to restrict people’s freedoms just automatically. But few people like the idea of creating this kind of caste system of rights, or of making too explicit in practice what is always transparent in the arguments for such rules: That it’s really just the poor who are the targets of paternalistic measures. So instead of enacting uncomfortably unequal restrictions that would actually make sense in light of the arguments used to justify them, we engage in the ultimate form of leveling down: We restrict everyone’s liberty, even when many or most people impose no public cost when they exercise it. The law, in its magnificent equality, forbids the rich as well as the poor from burdening the public coffers by consuming transfats, smoking, or playing baseball with metal bats. Update: Replying to a similar critique, Ben makes the sort of response that accidentally confirms exactly how creepy his position is. On the suggestion that his own principle would endorse regulation of private sexual behavior on public health grounds, Ben essentially responds: “Well, that would be awfully impractical and hard to monitor without lots of intrusions.” This should be unsettling—it’s a little like arguing that of course we can’t carve up the homeless for spare organs, because we’d get blood on our nice new slacks. Fine, what if it wasn’t inconvenient? What if we had a pinpoint search technology that would automatically register all and only the risky behaviors we wanted to prohibit? Pace Ben, I don’t mean this as a “slippery slope” argument, in that I’m not primarily arguing that there’s grave danger of our actually going this route in the future. Rather, I’m suggesting that if you have an argument on which the only reason we’re not collectively entitled to regulate this most intimate realm in order to save a few bucks is that it would be a big hassle… there’s probably something wrong with your argument. Ben does at least nod in the direction of suggesting that who you sleep with is more central to (most) people’s identity and autonomy than what they eat or smoke. And that’s plausible enough in general—though presumably there are people for whom that’s reversed—but it’s also precisely the kind of judgment that it would be better to avoid having to render publicly when possible. The whole point of a broad sphere of autonomy—drawn around the body, for instance—is that it allows individuals to rank the importance of these kinds of competing goods for themselves, rather than subordinating their judgment to Ben’s assessment of which exercises of liberty are sufficiently important to be due deference. juliansanchez.com

To: puborectalis who wrote (17426)	4/29/2010 11:06:25 AM
From: Lane3	1 Recommendation Read Replies (1) \| Respond to of 42652

Obesity causes unnecessary expense to the nation in health dollars....... True. if we can impact cigarettes we can impact fatty foods. This suggests that fatty foods are the cause of obesity. Perhaps that's not what you intended. Nonetheless, until the causes and treatment of obesity are better appreciated, it's not constructive to employ public policy to impact obesity, if then.