AG,

I feel our discussion has largely run its course and we are compelled now to agree to disagree with one another.  I have perhaps not outlined my position clearly however so I thought I would just summarize my disagreement with your position.

First, I am not convinced that a mixed public / private alternative (to the current public / private US system) is likely to result in better health outcomes as measured by quality, cost, efficiency, effective regulation and diversity of product offering. I'm convinced that the current problems in US healthcare today can be traced directly to government regulation and provision and that the solution is the removal of these distortions to free markets. 

Second and more importantly, I have a strong philosophical disagreement with government interference in choices that I believe ought to be left to the individual to decide in an environment of free market solutions. You have stated that you are willing to allow government involvement because of the importance of healthcare, an issue too important to be left to the individual in all cases. I understand from your posts that your preferred mechanism for government mandate is democratic process. Yet democratic or majority decisions have no moral validity in themselves. It would be immoral certainly to allow two Hutus to determine the fate of a single Tutsi, two men to decide the use of a woman's body to provide two extreme examples that disprove the moral validity of majoritarianism. 

So we are left to search for an alternative validity for government interference in healthcare. If government assumes a role in healthcare provision it necessarily violates the property of others in society. And so arises the question of whether the morality (if we are assume it to be such) of collectively provided healthcare for all exceeds the immorality (for which no assumption is required) of the violation of individual property rights? You take the position that it does. I hold the position that nothing moral can come of immorality. That's a philosophical discussion of its own. But let us assume that you are right and that healthcare is worth an exception. Do you honestly believe that this compromise will end with healthcare? Once the state is afforded the right to collective violence for collective good all manner of distortions and violations are not only possible but inevitable. There will be others like yourself who instead of, or perhaps in addition to healthcare, will afford the state a role in education, energy, agriculture, trade, industrial policy, competition policy, energy, eminent domain, conscription, immigration, emigration, employment, wage policy, technology, roads, railways, postage, haulage, shipping, employee unions, monopolies, oligopolies, judicial interference. Before long the government will be establishing taxpayer funded operations with names like the Australian Institute of Sports so that collective national pride can be raised when a taxpayer funded athlete wins gold at the Olympics after which she can revel in the populace's gratitude at a taxpayer funded ticker tape parade. Why stop there, why not use taxpayer money to pay to actually hold the Olympics? That way taxpayers can also pay for a minister of recreation and sports. When that minister retires with a generous tax payer funded pension the government might even apportion taxpayer money to dedicate a statue to that minister. After all there are some willing to make that sacrifice and there always will be. Even if state involvement in healthcare were valid, which I dispute, what cannot be disputed is that such a precedent will open a pandoras box of innumerable violations whose central premise of the primacy of collective good established with that precedent will be used as justification for ever more encroachments.

I feel our discussion has largely run its course and we are compelled now to agree to disagree with one another.  I have perhaps not outlined my position clearly however so I thought I would just summarize my disagreement with your position.

Fair enough, for the most part it has been a worthwhile discussion and I think that we have covered enough ground. I will respond to your summary this one last time though. 

First, I am not convinced that a mixed public / private alternative (to the current public / private US system) is likely to result in better health outcomes as measured by quality, cost, efficiency, effective regulation and diversity of product offering. I'm convinced that the current problems in US healthcare today can be traced directly to government regulation and provision and that the solution is the removal of these distortions to free markets. 

Second and more importantly, I have a strong philosophical disagreement with government interference in choices that I believe ought to be left to the individual to decide in an environment of free market solutions. You have stated that you are willing to allow government involvement because of the importance of healthcare, an issue too important to be left to the individual in all cases. I understand from your posts that your preferred mechanism for government mandate is democratic process. Yet democratic or majority decisions have no moral validity in themselves. It would be immoral certainly to allow two Hutus to determine the fate of a single Tutsi, two men to decide the use of a woman's body to provide two extreme examples that disprove the moral validity of majoritarianism. 

Well I partially agree in that I'm convinced that a lot of the current problems in US healthcare today can be traced to bad government regulation. However the fundamental fact is that in free markets some people are priced out and don't recieve the good or service that is being offered. On your standard supply/demand diagram this is represented by everybody on the demand curve to the right of and below where the curves intersect at the price.  

But I argue that in a free market there will be a very large variety of supply curves not a single aggregated one (I'm not a Keynesian). 

Yes, as I have just indicated I do consider healthcare to be too important to be left to the market alone and I do consider that the democratic process is the best alternative to individual choice in the US.  I underline the last point to highlight the fact that your example of Hutu's and Tutsi's really is as you describe it, extreme, and it is therefore not relevant to this argument.

The US healthcare outcome is already the result of the democratic process there. The healthcare industry would be incredibly different to today?s environment were markets free to determine outcomes.

The example of Rwanda is extreme but the argument remains valid and relevant. The welfare state is a means of forcible distribution from part of society to another. It is, to be blunt, democratic theft.

I disagree that democratic processes generally work for the greater good when collective decisions are made. Policies frequently emerge in democracies that are detrimental to the majority. Voters are ignorant of most of the issues on which they vote. Their behaviour is irrational in that they vote for policies that harm them. I see no evidence that collective decision making results in a desirable outcome. Given that most voters are usually very ignorant on any variety of political issues, there is no reason to assume that the collective decision making of those voters is likely to be the right outcome. H.L. Mencken once said that "democracy is the pathetic belief in the collective wisdom of individual ignorance." 

The key issue of modern policy making is economic policy. The public as a whole is charged with determining economic policy. It's my view as an economist that the issue that voters most misunderstand it is economics. Bias continually underlies policy making. Take Europe for example. Despite it being clear that above market prices creating unsellable surpluses, policies regulating labour prices have created massive unemployment. The conclusion necessarily is that the average voter does not understand the link between government set labour prices and unemployment. No less baffling is the fact that the very persons most negatively affected by such policies (the unemployed) are those who are most likely to vote for parties espousing those policies.

There is a serious anti-market bias amongst the general populace. Take FVJ for example. An intelligent poster who rails against free trade. Joseph Schumpeter, who was one of the greatest economic historians (English speakers such as yourself have a typical admiration for Smith although his ideas weren't particularly original), when discussing the general public spoke of "the ineradicable prejudice that every action intended to serve the profit interest must be anti-social by this fact alone." This comment is particularly prescient when we consider that today, government's all over the world, are playing to the base public's false understanding of economics in calling for new regulation. This despite government being responsible for the current crisis we are in which the origin is the policies that government enacted to control the last government inspired crisis in 2001.

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