Obama health care ethics - a question

Good morning:

I am asking for some help with an Objectivist ethics question.

I recently discussed the Obama health plan with a group of very smart liberals and for the first time in awhile was stumped.

First thing to know is that I am a lifelong student of Objectivism and have read and studied about it as much or more than many others.

Here was the question – “You advocate that the only public good that the government should perform is for national defense. I ask you why? And then I ask you why is healthcare different from national defense?”

Leave aside their phrase of “public good” for a moment as it is not germane to the issue.

I answered the first part to their agreement, but had trouble with the second part.

I moved them through the Objectivist view of limited government, the difference between the initiation and retaliation of physical force. I included AR’s theory of government financing using a voluntary court fee or insurance system.

At the end, my liberal friends understood and agreed as follows:

The barring of physical force in society.

The justification of retaliation against those who initiate it.

The justification of granting a government a monopoly on that retaliation.

The proposed method of financing police and armies with the court system.

That citizens would enjoy the benefits of the police and army without cost.

The costs would be borne by those using the court system.

The discussion further described that in the Objectivist view no citizen could opt out of the police and army protection. But could opt out of the court system.

(Am I correct so, far?)

Their remaining question was why would an Objectivist delegate the retaliation of physical force and but not delegate the use of medical providers.

Let’s assume the liberals were willing to pay market salaries, etc to medical provides as well as to the police and army personnel. And that no medicals providers were forced in any way as were no police and army personnel.

And then they asked, in the police and army examples, citizens do not get to pick the individual persons assigned to protect them, why should they be able to pick their medical providers?

My usual rebuttals surround the theme that the government should protect rights (intangibles) and not provide materials items (medical care).

The liberals’ response went like “The police and army protect against physical enemies and health care providers protect against injury and disease enemies. What is the difference?”

In all the prior reading of AR’s non-fiction work and her Lexicon I have not found or understood a strong ethical argument about the limitation of limited government. The general theme I have read is along the lines of “the proper role of government is…”, but not a clear ethical explanation of what proper is and why this is so. (And yes, I do know some objectivist anarchists).

What I have read makes a case for retaliation of force as a limited government requirement, but does not make an ethical case about extending that to other services if all agree.

In other words in an Objectivist view –

“Why can the government provide the police and army and not the medical providers?”

Please assume that for this discussion, no coercion is present. If a group of people gather together and decide to form a government and that government is charged with the monopoly of the retaliation of physical force, could not that government be granted a monopoly on medical services?

I have revisited all the Objectivist material on the subject, but have not found what I need.

I hope I have been clear in this request and I hope some of you have the interest and time to help me.

Thank you.

Cameron Craig

Denver

Post 1

Wednesday, October 14, 2009 - 1:21pm

If this is true:

First thing to know is that I am a lifelong student of Objectivism and have read and studied about it as much or more than many others.

Then this shouldn't be a problem:

Here was the question – “You advocate that the only public good that the government should perform is for national defense. I ask you why? And then I ask you why is healthcare different from national defense?”

The difference is in defining "rights." There are "positive rights," and "negative rights."

They're actually trying to tell you that getting sick, or hurt, is a violation of your rights and anything that afflicts the body should be remedied by government force. We should wage war against anything that causes the body and mind harm, but they never want to explain why this is true, because they can't.

They're wrong, you know. No one has a right to a risk free life. No one has a right to perfect health, or to the means of perfect health, which would require the right to food, clothing, housing, heat, air conditioning, furniture, transportation, the skill and know-how of dozens (hundreds?) of individuals, entertainment, recreation, hobbies, etc. etc., etc., along with the right to any medical treatment required, and ending with, hopefully, happiness, but at the expense of everyone else. They're advocating positive rights.

When you think of everything that goes into living a good, healthy life the list is endless, but no one has a right to those things. They only have the right to pursue them, and that's what government is in place to protect. The freedom required to pursue the things that make your life worthwhile. Period.

Getting the flu, or breaking an arm falling from a dirt bike isn't a violation of your rights.

No one has a right "from" schizophrenia, depression, obesity, PMS, ADD, ADHD, autism, narcissism, chronic bullshit disorder, alcoholism, drug addiction, or chicken pox. All are free to seek treatment, but no one has a "right" to it.

But could opt out of the court system.

(Am I correct so, far?)

What? No! Unless you want to "opt out" of objective law, then good luck with that!

(Edited by Teresa Summerlee Isanhart on 10/14, 1:23pm)

(Edited by Teresa Summerlee Isanhart on 10/14, 1:29pm)

(Edited by Teresa Summerlee Isanhart on 10/14, 1:36pm)

Post 2

Wednesday, October 14, 2009 - 4:24pm

I would have to disagree that you know some Objectivist anarchists. It would be a lot like having a few triangular spheres laying around the house.

One of many differences between defense of rights and health care is that freedom from the initiation of force is a right while health care is a service. The Objectivist position on a single government is not a justification, its an explanation. A single government governing a geographical area is the only system that can work. There are no alternatives that can perform the function of defense.

Ethical government is essentially a reactive governor of force. It does nothing until there is an initiation of force at which point to eliminate or contain the threat, afterward arbitrating justice. Like an immune system it then becomes passive and everyone goes about their lives. The granting of favors under the guise of contrived positive rights with expropriated funds is essentially a proactive governor of force. The system put in place to protect the citizenry from initiation of force now initiates force against the citizenry.

Here are a few other glaring holes in your premises.

"The discussion further described that in the Objectivist view no citizen could opt out of the police and army protection. But could opt out of the court system.

(Am I correct so, far?)"

No, you are not. An entity designed to govern force within a region cannot be opted out of. Any entity that allowed opting out would be immediately neutered as criminals and contract breakers would be allowed to opt out of the law at will.

"Their remaining question was why would an Objectivist delegate the retaliation of physical force and but not delegate the use of medical providers."

This is difficult to address, as the premise is so distorted. Retaliation of physical force is delegation of an ethical action. I don't even know what you mean by delegating the use of medical providers. Taken literally it implies you tell someone they can go to the doctor for you. In the context of you question it appears that you believe medical providers are a public resource that everyone owns and has a right to and can delegate to control of. Insurance companys and hospitals don't mine medical providers from public land and then charge you for the use of your medical provider. They aren't public atms dispensing band aids and morphine. A medical provider is a human being who went through a great deal of effort to aquire the skill to care for life, and does so at personal risk for a living. No one owns him but himself and the mob can't "delegate" his use.

"And then they asked, in the police and army examples, citizens do not get to pick the individual persons assigned to protect them, why should they be able to pick their medical providers?"

Citizens do have a say in the army and police that protect them. They can change jurisdictions. An area can only have one absolute governor of force, so the only (peaceful) choices are to reside in that area or not and to change the government through established mechanisms. Medical care is a service that operates within the realm of economics, and is not based on rights or force, but trade of value. The question isn't why shouldn't they be allowed, but why should anyone be allowed to force them?

"My usual rebuttals surround the theme that the government should protect rights (intangibles) and not provide materials items (medical care)."

Medical care involves many intangibles, and there are scenarios where the military or police could ethically provide material items.

"The liberals’ response went like “The police and army protect against physical enemies and health care providers protect against injury and disease enemies. What is the difference?”"

A human enemy initiates force to strip you of your rights. A disease is a pathological process or deadly organism that is a part of life. A disease isn't your enemy, it just is. You have a right to be free of force, you do not have a right to be free of your natural environment.

"In all the prior reading of AR’s non-fiction work and her Lexicon I have not found or understood a strong ethical argument about the limitation of limited government. The general theme I have read is along the lines of “the proper role of government is…”, but not a clear ethical explanation of what proper is and why this is so. (And yes, I do know some objectivist anarchists"

Read again. I recapped some of it above, but its all right there in the books you claim to have read.

"What I have read makes a case for retaliation of force as a limited government requirement, but does not make an ethical case about extending that to other services if all agree"

Why would you need to make other services a government requirement, and thus a matter of force, if everyone agrees? Did everyone agree that the extra level of overhead, waste, and inefficiency would be neat to have? Like a golf handicap?

"Please assume that for this discussion, no coercion is present. If a group of people gather together and decide to form a government and that government is charged with the monopoly of the retaliation of physical force, could not that government be granted a monopoly on medical services?"

Answered above. If everyone is in agreement, why bring the governor of force into it? What use would force be in a 100% consenting population? Why combine monopolies on force and medical care unless your express purpose is to add force to medical care (and thus add coercion)?

Post 3

Wednesday, October 14, 2009 - 6:32pm

"Retaliation" is used against rights violators in possession of conscious intent. Pathogens don't have "intent." Dogs don't have criminal "intent" when they bite you. Food doesn't "intend" to make you fat. Cancer doesn't "intend" to kill you. Drugs don't "intend" to make you an addict. Bees don't "intend" to give you an allergic reaction, etc.

To echo Ryan's excellent observation, an environment can't violate your rights. Only other human beings can do that.

Honesty requires one to understand and deal with the nature of the entities involved. Your opponents want to deny the nature of every entity in reality, including you, a thinking, reasoning human being, in order to fashion an argument that sounds plausible, but just isn't. There's no substance to an intrinsic argument, so don't fall for them. To issue an intrinsic argument into law is crazy dangerous. If a law isn't based on the nature of the entity(ies) involved, it's sure to violate the rights of others in some way.

Post 4

Thursday, October 15, 2009 - 2:04pm

Hi Cameron, I believe Objectivism does not say necessarily that the government should have a monopoly on the use of retaliatory force, only that they should have the monopoly on the rules for using retaliatory force. In other words the system of due process should be uniform within a geographical area, and the means by which that retaliatory force can be carried out can come from different competing companies, as long as they all perform within the same established law. Anarchy would be defined as not having any objectively defined due process, and each competing agency or individual could come up with their own idea of what is justifiable force. But the problem with that is this is purely subjective, someone's idea of legitimate force could very well be immoral, and since no uniform law exists, there would be no mechanism to correct such an immoral action except civil war. And also if an action was moral, another competing faction may disagree, since there would be no agreed upon rule of law, and again carry out attacks against that competitor.

Post 5

Thursday, October 15, 2009 - 5:52pm

Hi Cameron,

Teresa, Ryan, and John all made good points. You may be wondering whether Rand herself made similar points. Here are 2 quotes from Rand's book, The Virtue of Selfishness, which will probably be helpful for you in understanding the true Objectivist position on this matter:

********************
The concept of a “right” pertains only to action—specifically, to freedom of action. It means freedom from physical compulsion, coercion or interference by other men.

Thus, for every individual, a right is the moral sanction of a positive—of his freedom to act on his own judgment, for his own goals, by his own voluntary, uncoerced choice. As to his neighbors, his rights impose no obligations on them except of a negative kind: to abstain from violating his rights.

The right to life is the source of all rights—and the right to property is their only implementation. Without property rights, no other rights are possible. Since man has to sustain his life by his own effort, the man who has no right to the product of his effort has no means to sustain his life. The man who produces while others dispose of his product, is a slave.

Bear in mind that the right to property is a right to action, like all the others: it is not the right to an object, but to the action and the consequences of producing or earning that object. It is not a guarantee that a man will earn any property, but only a guarantee that he will own it if he earns it. It is the right to gain, to keep, to use and to dispose of material values.
********************

Note:
The operative phrase above is: "rights impose no obligations ... except of a negative kind" (like Teresa and Ryan said).

********************
No man can have a right to impose an unchosen obligation, an unrewarded duty or an involuntary servitude on another man. There can be no such thing as “the right to enslave.”

A right does not include the material implementation of that right by other men; it includes only the freedom to earn that implementation by one’s own effort . . . .

The right to property means that a man has the right to take the economic actions necessary to earn property, to use it and to dispose of it; it does not mean that others must provide him with property.

The right of free speech means that a man has the right to express his ideas without danger of suppression, interference or punitive action by the government. It does not mean that others must provide him with a lecture hall, a radio station or a printing press through which to express his ideas.

Any undertaking that involves more than one man, requires the voluntary consent of every participant. Every one of them has the right to make his own decision, but none has the right to force his decision on the others.

There is no such thing as “a right to a job”—there is only the right of free trade, that is: a man’s right to take a job if another man chooses to hire him. There is no “right to a home,” only the right of free trade: the right to build a home or to buy it. There are no “rights to a ‘fair’ wage or a ‘fair’ price” if no one chooses to pay it, to hire a man or to buy his product. There are no “rights of consumers” to milk, shoes, movies or champagne if no producers choose to manufacture such items (there is only the right to manufacture them oneself). There are no “rights” of special groups, there are no “rights of farmers, of workers, of businessmen, of employees, of employers, of the old, of the young, of the unborn.” There are only the Rights of Man—rights possessed by every individual man and by all men as individuals.
********************

You can view these quotes online here and here.

Ed

Post 6

Thursday, October 15, 2009 - 7:27pm

We try to maximize things provided in the free market and minimize the number of things provided through socialist/communist means (taxes). Military and police forces, and the legislative and judicial branches of government simply can't be done in the free market because that would contradict the basic definition and function of the government.

Medical services can be provided in the free market. Socializing medical services worsens the lives of citizens who do not force others to live for their sake. I don't care enough about people who are so unproductive that they cannot afford to sustain their health in the free market... I'd rather they were dead then force someone to pay for their medical services.

Post 7

Friday, October 16, 2009 - 1:51am

Dean's comment brought something else to mind. Even if the healthcare and physical well being of everyone was an overriding concern It still wouldn't be reasonable to implement socialization of those services. The nature of syphoning off the productive capacity of an industry and impeding its worker's rights serves to diminish future production and innovation. Socialism uproots the tree so that everyone might have access to the fruit, but pays no thought to tomorrow's planting. The limits of charity (the fruit that falls from the tree freely) are all that the system can tolerate without problems. The free market was already providing the services as cheaply and abundantly as could be managed, with a near constant improvement in price and supply. Socialism isn't only morally wrong due to rights violations it isn't even practical. The socialist cannot even achieve his own goals by his own policies.

Post 8

Friday, October 16, 2009 - 2:11am

The preceding thoughts and references are good.

CR Craig, the phrase public good can mean simply good for the public, but it has another sense, an economic one. In this latter sense, the concept of a public good is crucial to the issue. A public good, in the economic sense is a good that is non-rival and non-excludable. The benefit of the security provided by national defense can be had by me and everyone else in country all at once; one resident enjoying that benefit does not preclude another resident from simultaneous enjoyment of that benefit. That is the non-rival characteristic of a public good. The circumstance that residents not paying for the benefit of the national defense cannot be excluded from enjoyment of that benefit is the characteristic of non-excludability of a public good.

Health care is not a public good in the economic sense. That is not to say that health care is not a good thing for every individual. I cannot remember just now which essay it was, but there is one by Rand, during the debate over Medicare, in which she stressed, “Yes, medical care for the elderly is a good thing, however . . . .”

~~~~~~~~~~~~~~~~
PS

I see now it was in the 1963 essay “Collectivized Ethics” (VoS).

Rand there addresses the common pattern of “advocacy of some grand scale public goal, without regard to context, costs or means. Out of context, such a goal can usually be shown to be desirable . . . .”

“‘Medicare’ is an example of such a project. ‘Isn’t it desirable that the aged should have medical care in times of illness?’ its advocates clamor. Considered out of context, the answer would be: yes, it is desirable. Who would have a reason to say no? And it is at this point that the mental process of a collectivized brain are cut off: the rest is fog. Only the desire remains in his sight—it’s the good, isn’t it? . . ..”

(Edited by Stephen Boydstun on 10/16, 5:41am)

Post 9

Friday, October 16, 2009 - 4:27am

And here's another link. See the quote from "The Pull Peddlers", as it has relevance to whether the notion of government-provided medical services could ever be considered valid.

Ed

Post 10

Tuesday, October 20, 2009 - 10:46pm

Craig asks the following questions:

“You advocate that the only public good that the government should perform is for national defense. I ask you why? And then I ask you why is healthcare different from national defense?”

I moved them through the Objectivist view of limited government, the difference between the initiation and retaliation of physical force. I included AR’s theory of government financing using a voluntary court fee or insurance system.

At the end, my liberal friends understood and agreed as follows:

The barring of physical force in society.
The justification of retaliation against those who initiate it.
The justification of granting a government a monopoly on that retaliation.
The proposed method of financing police and armies with the court system.
That citizens would enjoy the benefits of the police and army without cost.
The costs would be borne by those using the court system.

If your "liberal friends" agreed with all of this, then it is difficult for me to see how they could still call themselves "liberal" in the leftist sense of that term. Liberals believe that everyone has a "right" to health care, and that taxpayers can be forced to subsidize it.

The discussion further described that in the Objectivist view no citizen could opt out of the police and army protection. But could opt out of the court system.

I don't know what you mean by "opt out." In the Objectivist view of government, there is no coercion, no initiation of force, so there is nothing to opt out of, unless you're talking about opting out of an obligation to abide by the law and to respect people's rights. In that case, of course, no one has a right to "opt out" of an obligation to respect the rights of others.

Their remaining question was why would an Objectivist delegate the retaliation of physical force and but not delegate the use of medical providers.

By "delegating" the retaliation of physical force to the government, one is simply delegating the right to administer one's own version of justice. Each individual cannot dispense his own version of justice without society's degenerating into civil war. No such risk is present with private providers of medical services.

Let’s assume the liberals were willing to pay market salaries, etc to medical provides as well as to the police and army personnel. And that no medicals providers were forced in any way as were no police and army personnel.

How can you determine "market salaries" without a competitive market in which prices are determined by supply and demand? The answer is, you can't.

And then they asked, in the police and army examples, citizens do not get to pick the individual persons assigned to protect them, why should they be able to pick their medical providers?

Actually, as John Armaos points out, citizens would be able to hire police services to protect their lives and property from criminal assault. Even now there are private security guards and private police agencies. What citizens wouldn't get to pick are the laws, rules and regulations governing the retaliatory use of force. As for national defense, it too would be voluntarily provided, so the people serving in the armed forces would be self selected. Anyone who wanted to would be free to join the military, if qualified, and become a soldier.

My usual rebuttals surround the theme that the government should protect rights (intangibles) and not provide materials items (medical care). The liberals’ response went like “The police and army protect against physical enemies and health care providers protect against injury and disease enemies. What is the difference?”

There wouldn't really be any difference between hiring private police or security services and hiring private doctors and medical providers. The only difference is that the army as an agent of national defense would be protecting not people as individual clients or customers but rather an entire geographical area. That doesn't mean that people couldn't pay voluntarily for the kind of armed forces that they thought would be the most effective.

In all the prior reading of AR’s non-fiction work and her Lexicon I have not found or understood a strong ethical argument about the limitation of limited government. The general theme I have read is along the lines of “the proper role of government is…”, but not a clear ethical explanation of what proper is and why this is so. (And yes, I do know some objectivist anarchists).

Well, what is meant by "limited government" is a government that is limited to the protection of individual rights. Liberals don't believe in individual rights and don't believe in protecting them. A government must be limited to the protection of individual rights; otherwise it will be violating those rights, and there can be no right to violate rights, as that is a contradiction in terms.

What I have read makes a case for retaliation of force as a limited government requirement, but does not make an ethical case about extending that to other services if all agree.

Well, if all agree to form a voluntary collective or commune and share the expense of medical care or other services, they would certainly have the right to do that, but it would not be the most efficient use of their resources, because it would lack the virtues of a competitive price system that is governed by the laws supply and demand and is therefore able to avoid surpluses and shortages.

In other words in an Objectivist view –

“Why can the government provide the police and army and not the medical providers?”

Because everything other than the administration of a uniform system of laws that is based on individual rights is handled better by private providers. Obviously, not everyone can be allowed to enforce his own set of laws, as that would degenerate into anarchy and civil war.

Please assume that for this discussion, no coercion is present. If a group of people gather together and decide to form a government and that government is charged with the monopoly of the retaliation of physical force, could not that government be granted a monopoly on medical services?

By a "monopoly on the retaliation of physical force" is meant a monopoly on law and criminal justice. Such a monopoly is necessary to avoid civil war. But there is no requirement that other kinds of services cannot be privately provided. You certainly wouldn't want a monopoly on medical services with only certain people being allowed to dispense health care, any more than you would want a monopoly on postal service with only certain people being allowed to deliver mail. What you want is a free market of competing providers, just so long as they're not competing in the enforcement of different brands of justice.

Post 11

Wednesday, October 21, 2009 - 10:02am