“These are just a few examples, illustrating the perception of cost. How much more would a family be able to afford healthcare, if they went without such things as televisions, cable, satellite, and $200/month cell phone bills? If healthcare is so important, why do such trivial items come first?”

This is exactly the argument that Theodore Dalrymple uses in dispelling the myth of a “poor” underclass in the Western world. The “poor” are not financially impoverished, at least not in historical terms. Go into the squalor of any inner city ghetto, and you’ll find almost everyone with cable TV and cell phones (not to mention the abuse of alcohol and tobacco, which costs thousands of dollars each year to keep up), yet living on junk food and barely feeding themselves.

Reducing out-of-pocket costs increases demand for medical care - more people go to the doctor more, for basic preventative care or more trivial health concerns (and NOT only “in case s**t happens”). At the same time, supply of medical services is reduced because medical personnel have to spend their time handling paperwork and complying with regulations. So the cost of medical care rises sharply.

Many people point to the dwindling supply and high costs as proof that we need universal health care, or that we’d be lost without Medicare and Medicaid. But the more the government involves itself with health care, the more the cost rises (because of attempts to recoup the costs of those who don’t pay, underpayments from Medicare, and simple supply and demand.)

It’s self-perpetuating because the more costs rise, the more people jump on the “free health insurance” gravy train, which makes costs rise exponentially. Normally responsible people now want to use it, because health costs have risen to where they KNOW the price is an unfair burden, so they have no reservations about taking full advantage of any freebies offered. Soon though, supply and quality just run out. There’s a rush to get while the getting’s good, and then, boom, there is no affordable health care available for ANYONE - except the wealthy elite (listen up, people who apparently hate wealthy elites.) The reason there is an outcry for universal health care is that health costs are now obviously unfair for EVERYONE, because all who pay are responsible for those that don’t - both in taxes AND in the disproportionate cost of their own medical care. It’s also self-perpetuating because most people seem to believe that the problems health care is riddled with are caused by greedy doctors, greedy insurance companies, greedy pharmaceutical companies, and greedy and restrictive HMOs - which makes them call for more government involvement - which is what started it in the first place.

“When Medicare was set up in 1965, the politicians projected its cost in 1990 to be $3 billion — which is equivalent to $12 billion when adjusted for inflation to 1990 dollars. The actual cost in 1990 was $98 billion — eight times as much.” — (Harry Browne, Why Government Doesn’t Work)

For people who are concerned about the poor, it’s very important to realize that even people who are covered by Medicare pay more than twice as much in out-of-pocket costs (after adjustment for inflation) than they did before Medicare existed. Prices rise to such an outrageous extent that the “help” provided by government is absolutely meaningless. It’s like being stabbed and then offered a Band-Aid.

A service provider answers to whoever is paying them, as you pointed out. With something like health care, it’s just dangerous to have your physician answering to someone other than you, the patient. Doctors should answer to patients.

Many people can’t give up on the idea of themselves as champions of the poor. That image of themselves becomes so important to them that it overshadows their concern about the actual well-being of the poor (and everyone else!).

People have the RIGHT to buy a big-screen TV or twenty cheeseburgers instead of health insurance, and they have the RIGHT to die because of that choice. But no one has the right to force me to protect others from the consequences of their choices - although I might be PERSUADED to do so - especially if it actually helped them out, and taught them to make better choices. But why would protection from consequences ever result in a lesson well-learned?

I hadn’t thought about it that way. That explains a lot. That’s why arguments based on liberty and freedom won’t change their minds. It doesn’t matter that universal health care erodes personal liberty, because the champions of the poor are concerned only with reducing economic inequity.

And when those champions are politicians, the only tool they have is government. So they try to use government to solve the world’s problems.

- It astounds me that the so many people seem to be caught up in the Universal Healthcare fanfare. Many of these people seem to confuse the word “Universal” with the word “free”. I think the average man-on-the-street who is in favor or Universal Healthcare would say it is a necessity because they cannot afford their own insurance or healthcare. I am not going to argue that case, as the author has already taken on that point. I am going to argue the simple math: Things That Cost Money = Money That Has To Be Collected/Paid. In all reality, Universal Healthcare would probably end up costing the uninsured more money than they pay now, simply due to the increase in the volume of people using said services. I have seen many coworkers/family members/friends go to the doctor for the most trivial things. Their reasoning is that they have health insurance and they pay for it, so they are going to use it. Imagine the drain on our healthcare system if every Tom, Dick, and Harry had the coverage to go to the hospital everytime they stubbed their toe?

- “On the other hand, members of Congress have completely free access to care at National Naval, where the quality of care couldn’t be better.” It is very hard for me to take an article (or website) seriously when it attempts to make an objective argument with a subjective observation. Do the doctors at National Naval give you hugs and kisses and make you hot chocolate? Well, then it COULD be better, couldn’t it? How silly.

- My car insurance argument and Chris Rock quote made it in there! This pleases me greatly.

I specifically don’t like the fact that health insurance is often tied to employment and I suspect that is one reason a chunk of the 43.6 Americans you mention (oh, did you really mean 43.6 million ? )don’t have insurance. It isn’t because they are so poor, it is because they’ve lost their job, or between jobs, or they’re self-employed or under-employed, etc.

Secondly, I’m not so sure we can compare car insurance to health insurance. Car insurance is mandatory, but only liability, for when you hurt someone else with your car. Comprehensive and collision insurance is not required, so I don’t think the two types of insurance are analogous. Further, we have the choice not to drive if we cannot afford car insurance, but we really don’t have the choice to not live if we don’t have health insurance.

It’s convenient to dismiss them as people who don’t really care, but that’s intellectually dishonest. We may think they are gravely mistaken, and that their proposed solutions will actually cause more harm than good, but that doesn’t make them wholly concerned with their image to the detriment of others. It’s more likely that they are genuinely trying to help the underprivileged. We can at least grant that they are sincere in their efforts, rather than painting them as self-absorbed monsters concerned only with their own feelings.

For example, as I posted on my blog a couple weeks ago, these are some other “leftist” ideals that have at their core a “feel good” vs. “do good” philosophy:

- the death penalty (as John Lott’s new book, Freedomnomics, points out, studies have shown that each execution saves on average about 18 potential murder victims): it feels good to not execute people, so the left is against it.

- Welfare (Theodore Dalrymple is one of the best at dissecting the falsehoods rampant in the left’s support of welfare): don’t think I have to explain this one, seems like most readers on this site would probably agree.

- Ethanol (not nearly a right vs. left issue, as many people have fallen for this one, but it does have its roots in environmental extremism): turns out, ethanol creates more pollution than it eliminates. But it feels good to avoid using evil oil.

- Save Darfur and the ONE Campaign against Poverty (again, good ideas on the face of them that don’t fit neatly into left/right boxes, yet both movements are generally led by left-leaning people): Neither actually do anything. In the case of Darfur, all this hand-wringing and online petitioning hasn’t done a thing, when what we really needed was some carpet bombing. With the ONE campaign, millions of dollars have been sent to African countries only to be stolen and misused by the corrupt government. But it feels good (and takes little energy) to throw money at a problem.

- Anthropogenic Global Warming solutions (plenty of left and right people are concerned about this issue, but the hysteria began from the environMENTAL left): leaving aside the debate of if AGW actually exists, the solutions put forth thus far have run from silly (Sheryl Crow’s “One square of toilet paper per visit” idea) to absurd (Kyoto Protocol would lower the Earth’s temp by .1 degree in 50 years, but would completely decimate the developed world’s economies). But it feels good to think little ol’ me could do something to save the world from imploding, exploding, or melting.

OK, I see what you’re driving at. You’re not accusing them of intentionally making irresponsible decisions just to feel good. You’re saying that they experience the world emotionally. The poor need health care, so the emotional response is to give it to them. Right and wrong are based more on emotionally satisfying a person’s wants than on an unforgiving standard of individual property rights.

So the fact that universal health care erodes individual liberties is irrelevant, because rigid adherence to concepts of individual freedom is less important than empathy. The most important thing is that the government should offer help to those in need. In other words, security and safety from a cruel world is more important than the abstract concept called freedom.

In one sense, I can see the allure of that idea. After all, what good is an absolute right to life, liberty, and property if I’m dead. I’d trade a lot to extend my life. When I’m dead, what good is a government that protects my rights? Maybe I’d have been better off with one that protected my life.

Sorry, it just sounds like a crazy idea for me :)…