Maybe we can only fix one evil at a time.
The approach that rejects the rusty-tools dentist is also more likely to reject the offshored oppressive offshored (or quite frequently, domestic) labour, rather than binning all empathy looking at either, other similar situations, or worse, and shrugging it off with a "meh, not my problem".
The worldview you're expressing has absolutely no dignity.
Also I don't think we agree on the definition of dignity. In my eyes it's perfectly possible to die of disease or starvation with dignity. Otherwise you're implying that nature itself is bereft of it.
Lots of research into the cost vs. outcomes of healthcare in the US vs. other countries shows that its very wasteful. Heck there was an interview with an ex health insurance exec who admitted they created the narrative of healthcare being shitty in Canada to sway public support for privatized healthcare. I personally buy drugs that cost $1-2 in other countries, but $100+ without insurance in US. In most cases, state owned healthcare ends up being much cheaper - so perhaps a surgery that costs $200K to one person, would cost only $100K when funded by the state because they have MUCH more negotiating power. So in a sense, public healthcare makes the entire system more efficient.
If we took on your Darwinian model, then its a very simple negotiation - life-saving medicines or surgeries are worth infinity, because otherwise you die. So if you ever need either of those, the doctors will simply ask for every single dollar and asset you have in perpetuity, easy.
I don't. I think prices and wages ought to be privately negotiated between consumers and producers, and employees and employers respectively. I also think that people are no more entitled to goods, employment or services from other people than they are to romantic relationships, which clearly need to be consensual.
Healthcare in the US is extremely heavily regulated, that's why it's so expensive. The minimum quality of care is absurdly high. There's no budget option. If you want any medical care, you have to see a physician with an ridiculously expensive education, the supply of which has been artificially limited by regulatory capture.
This is all highly unethical. If you need a simple procedure, why can't someone with the equivalent of technician training do it for much cheaper? Again, this would be a consensual interaction between two parties, which is nobody's buiness but their own.
> If we took on your Darwinian model, then its a very simple negotiation - life-saving medicines or surgeries are worth infinity, because otherwise you die. So if you ever need either of those, the doctors will simply ask for every single dollar and asset you have in perpetuity, easy.
This just totally ignores the idea of competition. If some doctors are charging infinity, then others would realize they could capture market share by charging less than that. The veterenary comparison is very apt, why should human healthcare work any differently?
Healthcare for humans is just another service, it doesn't need to be a special category. There doesn't need to be an association whose membership is granted a monopoly on this service. In absence of regulation, private industry would self-organize into tiers based on demand. From the very lowest tier of service, to the highest. This what we see in countries without so much regulatory burden, and more market freedom, such as India or China.
More fundementally, there is no moral justification for any of it. Just because one person or group of people belive in empathy, or a particular modal of social order, doesn't give them the right to impose that on others who disagree.
But that's not the question we started with. To get back to the original question -
I still believe using better modeling to make health insurance or loans available only to those who barely need it is highly unethical. If we are staying stuck in the current model of insanely high sticker prices that are only affordable with insurance then i don't believe it's ethical to deprive people who need insurance - because in this current model, there is no easy free market alternative, only illness and death.
I (and most other people) believe people should be "entitled" to not be slaves to tyrants, to freedom of speech, to food/warmth/shelter, to basic utilities like running water and electricity. If we have a surplus of resources such that we COULD either give everyone healthcare or give a few people more money, why should society as a whole pick the latter?
Except I don't call that entitlement, its called progress. By your logic, we should not take for granted anything that wasn't' present at the birth of civilization such as not being mauled by a bear or freezing to death. Why should our standard for humanity as a whole be stagnation instead of progress? Does that benefit anyone? If your country was taken over by a dictator and you were forced at gunpoint to become a slave, would you prefer other countries to try to restore democracy, or would you prefer that they say "why should you be entitled to freedom?" and do nothing?
I think you are basically taking libertarianism and "not reaching into the pocket of strangers" to a crazy extreme. Yes, it is a virtue to be self sufficient. Charity and empathy are also virtues.
Yes I agree wholeheartedly. We should not take anything for granted, and perceive any improvements to our quality of life as things to be grateful for, not entitled to. We are all born naked and hungry. Everything we receive afterwards we get from other people, people who are not obligated to give us anything.
All of your examples of being forced into chains at gunpoint oppose the fundamental principle I'm advocating for: consent. Just because someone has something (say indoor heating), it doesn't entitle you to have the same thing. Just because others live comfortably, it doesn't mean you should as well. Just because you define "progress" a certain way, it doesn't give you the right to impose that definition on me, does it?
> Yes, it is a virtue to be self sufficient. Charity and empathy are also virtues.
Yes! Where we disagree is whether these virtues should be voluntary or compulsive. For all of history until recently, they were voluntary. We have NGOs and other organizations which operate on this model of voluntary charity. This is the only model that's ethical. What gives you the right to impose your virtues on others?
I understand you are libertarian and believe only in consent, i don't need that explained to me again. I'm talking about actual concrete next steps on a concrete situation (healthcare), not "imagine you could rebuild the entire world in an ideal fashion". Thats the question I really want you to answer.
More along the lines of the philosophical (but less important, pointless) debate - Consent is not so clear as you think it is. Why should I consent to your single-minded focus on consent as the only valid principle of organizing society overriding all other concerns of practicality? What if I view that as an imposition of your virtues on mine?
I strongly disagree that it's pointless to have an underlying philosophy that decisions are based on, quite the opposite in fact. I would say that having a consistent philosophy or set of principles is the most important thing when making any sort of decisions, especially in the administration of complex systems such as society.
To answer your second (very valid) question, the underlying assumption is that we are all more or less equal, and therefore neither of us has a right to impose anything on the other. The question I've asked that you've not answered is what is the source of your authority to decide what virtues I should live by? I'm not saying you have to live by mine, just that you lack the moral authority to make me live by yours.
The fact that I'm asking for a source of authority is just a fancy way of saying "why do you think you can impose on me and not expect me to resist with violence and subversion?"
In fact I have. In my estimation, if we adopted a model of interaction that emphasizes consent, the incapable and unfortunate among us would rely on charity to have their needs met, as they have for most of history. This seems much more ethical than to rely on force through taxation. It can't be compassionate to impose your idea of compassion onto other unwilling people.
It is also worth noting that as long as we consume goods made by people in conditions we don't tolerate domestically, we're being wildly hypocritical. All we've done is offshore the suffering, and in the process massively harm the environment shipping things to and from more lenient jurisdictions.
> In a world that worked so hard over centuries to create modern healthcare, we should only use it for people who barely need it. We may have literally figured out how to transplant organs and save lives, but nah its too expensive so why bother?
It should be reserved for those who can afford to pay for it. If you want a modern operating theatre, filled with expensive equipent and highly educated people, someone has to pay for it regardless of whether it's for yourself or for your horse. I'm only saying that the person who pays should do so consensually.
Likewise, if all you can afford is a street dentist with rusty tools, then I don't see from where one derives entitlement to anything else. As mentioned earlier, we already buy things made by people who live in such conditions, so the point is moot.
> Anyways, your worldview is fucked. Hope you think much more deeply about it. Or just grow old in the world you wish for, maybe one day you will need surgery, insurance will reject you, banks will not loan you the $200k it costs, and you will die for the sake of the algorithms and profit maximization.
This all may be, but I will be dying with my dignity intact, not greedily reaching into the pocket of a stranger, deluded into thinking I'm entitled to what's inside.