What about the needy?

TTI is known for its intellectuals. This is a place for thinkers to gather and exchange quotes, thoughts, or other topics that might not appeal to the average gamer.

What social concessions to the needy deserve?

Poll ended at Wed Jan 02, 2008 7:01 pm

Absolutely nothing, sink or swim.
10
50%
It’s a family affair –but not a responsibility of government, care for your own family.
2
10%
The family should be legally responsible, and the government should get involved only if there are no immediate family members available.
5
25%
The government should provide a complete safety net.
3
15%
 
Total votes: 20

Trilori
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Post by Trilori »

Oleksandr wrote:
Trilori wrote:The DIFFERENCE is IF you FORCE them to starve by cutting off EVERY food option available to them in a given enviornment then you are DELIBERATELY causing thus committing Genocide.
This is right, but you have to be careful with one option here.

What would you say to a person who claims that their only option is to get food from you?

Would you say that by refusing to give your food away you are morally responsible for their death?
Well that would be technically correct, since you (me) whomever holds control of the food. Whether or not you're morally responsible for their death depends on a civilized society or not in either cases when it comes to individual rights nope but from a civilized society yep.

so like someone said it really is based on whether the morals are being seen by a civilized or non civ society regardless of whether there is any civilized culture you are still not morally responsible for deaths in the eyes of individual rights but that isn't the case when it comes to society viewing the issue.
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Tolthar Lockbar
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Post by Tolthar Lockbar »

Trilori wrote:Well that would be technically correct, since you (me) whomever holds control of the food. Whether or not you're morally responsible for their death depends on a civilized society or not in either cases when it comes to individual rights nope but from a civilized society yep.

so like someone said it really is based on whether the morals are being seen by a civilized or non civ society regardless of whether there is any civilized culture you are still not morally responsible for deaths in the eyes of individual rights but that isn't the case when it comes to society viewing the issue.
So in a civilized society, you are saying individual rights can be discarded, when talking about morals?
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Trilori
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Post by Trilori »

Tolthar Lockbar wrote:
Trilori wrote:Well that would be technically correct, since you (me) whomever holds control of the food. Whether or not you're morally responsible for their death depends on a civilized society or not in either cases when it comes to individual rights nope but from a civilized society yep.

so like someone said it really is based on whether the morals are being seen by a civilized or non civ society regardless of whether there is any civilized culture you are still not morally responsible for deaths in the eyes of individual rights but that isn't the case when it comes to society viewing the issue.
So in a civilized society, you are saying individual rights can be discarded, when talking about morals?
stop twisting things, individual rights stay the same regardless of what kind of society you are in. The difference is moral views will change based on what society you are in and consequently your individual rights can be violated in a society that views it morally correct rather than morally wrong.
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Tolthar Lockbar
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Post by Tolthar Lockbar »

Morals are objective, not based on any social construct. To say that they change according to what society you are in is false. Now I admit that people think differently about morals but that does not make them right.

Individual rights must persist through any social construct for it to be morally good.
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Trilori
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Post by Trilori »

Tolthar Lockbar wrote:Morals are objective, not based on any social construct. To say that they change according to what society you are in is false. Now I admit that people think differently about morals but that does not make them right.

Individual rights must persist through any social construct for it to be morally good.
Morals seem to be consistent with what society says even if that means their way of thinking. I somewhat disagree, just because someone thinks that a particular moral is good doesn't necessarily make them right but they only see that in a subjective manner as far as they know they ARE right in their own eyes not necessarily in ours.
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Oleksandr
 
 

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Post by Oleksandr »

Trilori wrote:Morals seem to be consistent with what society says even if that means their way of thinking.
Do not accept the morality that is pushed on you.

Right morality really is objective, and that is the reason to spend time now to read Ayn Rand.

Morality as proposed by various societies are at best partly evil.
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"Objectivism is not only true, it is great! Why? Because of the volitional work a mind must have performed to reach for the first time so exalted a level of truth—and because of all the glorious effects such knowledge will have on man’s life, all the possibilities of action it opens up for the future." -- Leonard Peikoff
Trilori
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Post by Trilori »

you call aborting chinese baby girls partially evil? hell no! its BLACK EVIL!
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Raindrop
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Post by Raindrop »

Tolthar Lockbar wrote:You heard wrong. There health care is poop. Most their doctors are Indian who are under payed. There waits are horrible. Statics have shown that many more people die waiting for health care in Canada than in US.
I guess the book didn't look into Dutch/Belgium healthcare. Our waiting lists are much shorter than in the UK which is famous for the waiting lists.

And i don't think it's weird that more people die waiting for health care in Canada than the US. Since in the US when you know you're not insured you might aswell stay home and die there than in a waiting room.
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Tolthar Lockbar
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Post by Tolthar Lockbar »

Raindrop wrote:
Tolthar Lockbar wrote:You heard wrong. There health care is poop. Most their doctors are Indian who are under payed. There waits are horrible. Statics have shown that many more people die waiting for health care in Canada than in US.
I guess the book didn't look into Dutch/Belgium healthcare. Our waiting lists are much shorter than in the UK which is famous for the waiting lists.

And i don't think it's weird that more people die waiting for health care in Canada than the US. Since in the US when you know you're not insured you might aswell stay home and die there than in a waiting room.
Yes, if you can not earn the money for the health care, you should be left at the mercy of voluntary charity. It should NOT be taken by force through means of taxation. I know this means that said person without insurance and money might die, but I do not care. I have no moral responsibility to those who can not afford health coverage and the government has no right to provide it out of my pocket!
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musashi
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Post by musashi »

Tolthar Lockbar wrote:Yes, if you can not earn the money for the health care, you should be left at the mercy of voluntary charity. It should NOT be taken by force through means of taxation.
Ding, Ding, Ding, Ding, Ding, Ding….

You just said the secret word – Charity ! [ala Groucho Marx – the funny Marx]

I think you’ve hit the nail on the head. In a world where the government does not get involved in responding to the needy, charity must rise up as the sole address. Charles Dickens fantastically described the type of world you get when social need is addressed by charity. The word pictures he painted were bleak. There was crime brought about by necessity. There was abandonment. There was debt peonage. There was generational poverty. All good stuff to start your motivational engine, at least Horatio Alger thought so.
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Tolthar Lockbar
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Post by Tolthar Lockbar »

Do not get me wrong though, I am not saying that someone is responsible for someone else's life (without some special personal connection), but that charity should work for one's own good. Also, as Olex mentioned, the wealth of the nation would be so much greater if there was a separation of government and economy; that, charity would not be a sacrifice by any means. Think of how much charity Bill Gates gives out -- that amount of money to him is nothing. Now think if there were 100s of people as rich as bill gates. That is the greater amount of charity that one would see.
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musashi
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Post by musashi »

Onkar Ghate wrote:The following op-ed was published on June 11 at Businessweek.com at http://www.businessweek.com/debateroom/ ... healt.html

No Right to "Free" Health Care

By Onkar Ghate

The cause of the U.S. health-care mess is governmental interference. The solution, therefore, is not more governmental control, whether via nationalized medical insurance or a government takeover of medicine.

Health insurance costs so much today because the government, on the premise that there exists a "right" to health care at someone else's expense, has promised Americans a free lunch. When a person can consume medical services without needing to consider how to pay for them--Medicare, Medicaid, or the individual's employer will foot the bill--demand skyrockets. The $2,000 elective liver test he or she would have forgone in favor of a better place to live suddenly becomes a necessity when its cost seems to add up to $0.

As the expense of providing "free" health care erupts accordingly, the government tries to control costs by clamping down on the providers of health care. A massive net of regulations descends on doctors, nurses, insurers, and drug companies. As more of their endeavors are rendered unprofitable, drug companies produce fewer drugs, and insurers limit their policies or exit the industry.

Doctors and nurses, now buried in paperwork and faced with the endless, unjust task of appeasing government regulators, find their love for their work dissipating. They cut their hours or leave the profession. Many young people decide never to enter those fields in the first place.

What happens when demand skyrockets and supply is restricted? The price of medicine explodes. What was once to serve as a free lunch for everyone becomes lunch for no one.

The solution? Remove all controls. Recognize each citizen's right and responsibility to pay for his or her own health care, and return to insurers the entrepreneurial freedom to come up with innovative products.

True freedom would bring health care into the reach of the average U.S. citizen again--just as it has done for other goods and services, such as computers, cell phones, and food.

Dr. Onkar Ghate is a senior fellow at the Ayn Rand Institute.
This press release just came out, and I though it would be good to add it to the thread.

This doesn’t make sense to me. He is basically saying pay for medicine as you go. I see several problems with this approach first it excludes everyone that lacks the capacity to pay. If you are ill or dying, what businessman-doctor is going to extend credit? If you only have a small sum, and the scope of your condition worsens do they kick you to the curb? Doesn’t this approach just create a beggar’s colony right at the doors of every hospital?

One of Dr Ghate’s points was that if people were fully and totally responsible for paying for their medical expenses, somehow they would know and avoid all the factors that negatively impact their health. The truth is we are painfully unaware of the majority of factors that harm our health. What causes cancer? What causes glaucoma? And even if I did know that say a common social practice (how about smoking) was causing me harm, how could I go about protecting my health without abridging the rights of all people that are made happy by smoking.

Dr. Ghate blames government for the inefficiencies is US medicine. Clearly there is a huge and wasteful bureaucracy in US healthcare, but most of that bureaucracy is created by private industry not the government. Overall Dr. Ghate’s position seems unworkable to me. Am I missing something?
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Petter Sandstad
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Post by Petter Sandstad »

Ghate does not say how it is to be payed, only that the customer is the one to pay. This can offcourse be done through an insurance, as he must himself think judging by : "return to insurers the entrepreneurial freedom to come up with innovative products.".

The op-ed seems to focus on two points. First, that free health care leads to a much higher demand for health care. Second, that this leads to government trying to reduce costs through regulations and paper-work -- which makes it more difficult for the health care business to do its job (i.e. supply is restricted). By making health care private, Ghate is saying that the supply would increase, while demand would decrease. I don't think Ghate is arguing that if ti were private people would avoid getting ill.
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musashi
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Post by musashi »

Petter Sandstad wrote:The op-ed seems to focus on two points. First, that free health care leads to a much higher demand for health care.
I absolutely agree with you and Mr. Ghate on this point. Whenever you subsidize something, the unseen hand of the market ensures that you will receive more of that item. If you subsidize milk, you will end up with a surplus of milk and cheese. Prices decline. And it is possible that a perishable commodity like this could spoil.

It this case the subsidy does not seem like complete bad thing. Yes you would have higher consumption of healthcare, but what does that mean? Does it mean you’d have a healthier population? Does it mean that per capita GDP would increase as a result? Does this imply that there is a potential for an economic multiplier effect by fostering a healthier population?
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Outsider
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Post by Outsider »

It seems that some people here determine what is moral or not based on feelings.
One example is to give the argument that something is uncivil as the justification for why it should not be done.
However, this is circular logic; How do you determine what is "civil" or not? by what you have persuaded yourself that it good or bad. But how did you persuade yourself of what is good or bad? By relying on your gut feeling. But is gut feeling a good way of arriving at conclusions? No it isn't. A gut feeling can only serve as a good start, something to investigate further, but not something to rely on without further thinking.

So when asked about why something is just, try to give the answer from a logical chain of thoughts.
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Post by musashi »

I am still actively thinking about this question. And the other day Paul Hsieh, MD posted an Op/Ed through the ARI institute. I sent him the question by e-mail, and he was kind enough to provide a detailed response. I’ve posted it here to extend the conversation. His reply is very much in-line with what Tolthar has written on this subject.
on 9/19/07 Musashi replied wrote:Mr. Hsieh, thank you for your detailed reply. You've given me many additional references than I had before. I will use them to get a better understanding of this topic. The topic is important to me for several reasons. I am enamored with the concept of Objectivism, but struggle with some hard questions in its application (this being one).
I will post your reply (without your e-mail address) in its entirety on the Taggart Transdimensional (TTI) forums. These forums are connected with an online massive Multi-player game (Eve) that creates a virtual world, economy and markets. TTI is an organization of Objectivist attempting apply the concepts of Objectivism to governance.
I do appreciate your reply greatly, if I could summarize the three mechanisms that would address the medically needy in an Objectivist world are;
  • Private charity
  • Deregulation
  • Private insurance
In the "pre medical insurance" world we had two of these three salivations. We have a portrait of life during this period from descriptions in literature. I’ve read many of these authors Upton Sinclair & Charles Dickens come to my mind now. I am not sure I would choose to live in those worlds, even with unfettered liberty.
I work in the medical device industry (currently building a continuous glucose monitor for people with diabetes). Looking back at the Food and Drug Act of 1938 and the regulations that followed, I’d have to say on par that regulation has greatly improved the quality and availability of healthcare.
In our forums, the concept of gift giving has been attacked based on the tenant of equal trade between men. Many of the people I correspond with consider the acceptor of a gift as a person doing harm to themselves, by accepting the un-reciprocated service of another. And the giver of a gift to a degree an enabler re-enforcing the destructive behavior of another person. The concept of charity appears to be in conflict with the principles of Objectivism (another hard issue that a struggle with).
As private insurance goes, left completely un-regulated, it seems to me that an insurance company would always seek to maximize profit, maximize revenue and minimize costs (even to the point of denial of service).
I do thank you for your reply. You have given me a much deeper explanation than I had previously. And the references will help me to gain an even deeper understanding. I hope that through this research that I can gain a different perspective on the free market and medical care. I am grateful for your time.
on 9/18/07 Paul Hsieh, MD wrote wrote: Dear [Musashi]:
That's an excellent question. When I've discussed this topic with patients and fellow doctors, it's clear that one of the major reasons driving the political push for government-run medicine in America is precisely the fear that ordinary people might not be able to get the care they needed if they were unlucky enough to experience a serious accident or illness. Given the way costs are rising, I can understand their concerns.
Since I don't believe that it's the proper role of government to guarantee health care to people in those circumstances (since that violates the individual rights of the taxpayers who are forced to foot the bill), the short answer is private charity.
Americans have traditionally been very generous towards others, particularly when they've experienced tragedies through no fault of there own. The outpouring of giving for victims whenever there's been a major natural disaster (or a man-made catastrophe such as 9/11), is evidence of that fact. As a doctors, I've waived my fee many times over the years for patients in tight financial straits with whom I sympathize, and the same is true for nearly every other doctor I know.
But the key is that the charity is *voluntary*. I donate to numerous charities because such giving accords with my rational values. I don't view someone else's misfortune or need as an automatic moral claim upon my life and wealth. And the recipient understands that any assistance he gets from me a *gift*, not something he is owed by "right". All the patients to whom I've given free care recognize that and are appreciative of that fact; in turn, I get to see good done for people whom I consider worthy recipients.
Also, please bear in mind that a large part of the skyrocketing costs of medical care is due to bad government policies. Onerous FDA rules jack up the prices of drugs and medical devices unnecessarily. Government mandates and red tape increase the price of insurance policies. Laws that force emergency rooms to provide charity care to all comers, even if those with obviously bogus complaints and who are just seeking to get a free meal and a free dose of narcotics drive up hospital costs for everyone else. If these bad government policies were reversed, health care would be much cheaper for everyone, and there would be a lot fewer needy people that would have to depend on charity care.
Numerous other free-market reforms (such as allowing Health Savings Accounts, insurance deregulations to allow companies to offer high-deductible, low premium catastrophic care, etc.) would go a long way towards reducing health care costs for everyone. Health insurance should be like other forms of insurance - basically, it pays for the rare but expensive catastrophes. For instance, my car insurance covers me in case it gets totaled in an accident, but I pay for my regular oil changes. Similarly, my homeowner's insurance protects me in case of a fire or a flood, but I cover the regular utility bills. Catastrophic health insurance would cover the bad illnesses, whereas the Health Savings Accounts would allow people to budget and pay for the routine expenses.
(John Stossel of ABC News has a good article on Health Savings Accounts at: http://abcnews.go.com/2020/Stossel/Stor ... 579&page=1)
If you are interested in learning more about some practical concrete steps in that direction, I'd recommend the book, "The Cure: How Capitalism Can Save American Health Care", by Dr. David Gratzer. Dr. Gratzer is a physician who has practiced in both Canada and the US and he has many good suggestions on how to move the American health care system in the right direction.
http://www.amazon.com/Cure-Capitalism-S ... 594031533/
At a more fundamental level, Dr. Leonard Peikoff covered the central philosophical issue nicely in his article, "Health Care Is Not A Right', which can be found on the FIRM website at: http://www.WeStandFIRM.org/docs/Peikoff-01.html.
Here's an excerpt that relates directly to your question:
Peikoff wrote: Some of you may ask here: But can people afford health care on their own? Even leaving aside the present government-inflated medical prices, the answer is: Certainly people can afford it. Where do you think the money is coming from right now to pay for it all -- where does the government get its fabled unlimited money? Government is not a productive organization; it has no source of wealth other than confiscation of the citizens' wealth, through taxation, deficit financing or the like.
But, you may say, isn't it the "rich" who are really paying the costs of medical care now -- the rich, not the broad bulk of the people? As has been proved time and again, there are not enough rich anywhere to make a dent in the government's costs; it is the vast middle class in the U.S. that is the only source of the kind of money that national programs like government health care require. A simple example of this is the fact that all of these new programs rest squarely on the backs not of Big Business, but of small businessmen who are struggling in today's economy merely to stay alive and in existence. Under any socialized regime, it is the "little people" who do most of the paying for it -- under the senseless pretext that "the people" can't afford such and such, so the government must take over. If the people of a country truly couldn't afford a certain service -- as e.g. in Somalia -- neither, for that very reason, could any government in that country afford it, either.
Some people can't afford medical care in the U.S. But they are necessarily a small minority in a free or even semi-free country. If they were the majority, the country would be an utter bankrupt and could not even think of a national medical program. As to this small minority, in a free country they have to rely solely on private, voluntary charity. Yes, charity, the kindness of the doctors or of the better off -- charity, not right, i.e. not their right to the lives or work of others. And such charity, I may say, was always forthcoming in the past in America. The advocates of Medicaid and Medicare under LBJ did not claim that the poor or old in the '60's got bad care; they claimed that it was an affront for anyone to have to depend on charity.
But the fact is: You don't abolish charity by calling it something else. If a person is getting health care for nothing, simply because he is breathing, he is still getting charity, whether or not any politician, lobbyist or activist calls it a "right." To call it a Right when the recipient did not earn it is merely to compound the evil. It is charity still -- though now extorted by criminal tactics of force, while hiding under a dishonest name.
If someone were to establish a charity for decent ordinary people who have come down with rare but expensive medical conditions through no fault of their own, I bet there would be no shortage of donors in America willing to contribute. (Such a charity would exclude alcoholics who have destroyed their own livers through years of heavy drinking, etc.)
Another good source on the broader topic of caring for the needy in a free society can be found in Ayn Rand's essay, "Collectivized Ethics" in her book, "The Virtue of Selfishness". I can't quote the whole thing here, but if you haven't read that essay before (or if you haven't had a chance to re-read it in a while), I'd recommend taking a look. Here is an excerpt:
Rand wrote: ...Objectivists will often hear a question such as: "What will be done about the poor or the handicapped in a free society?"
The altruist-collectivist premise, implicit in that question, is that men are "their brothers' keepers" and that the misfortune of some is a mortgage on others. The questioner is ignoring or evading the basic premises of Objectivist ethics and is attempting to switch the discussion onto his own collectivist base. Observe that he does not ask: "*Should* anything be done?" but: "*What* will be done?" -- as if the collectivist premise had been tacitly accepted and all that remains is a discussion of the means to implement it.
Once, when Barbara Branden was asked by a student: "What will happen to the poor in an Objectivist society?" -- she answered: "If *you* want to help them, you will not be stopped."
There's much more in the essay, including an excellent discussion of Medicare and helping the needy. It's very thought provoking essay because she cuts to the philosophical heart of the issue in a way that (at least for me) was not obvious when I first read it.
I hope this helps, [Musashi]!
You have my permission to forward this e-mail to others or to post it onto any discussion forum, as long as the contents are not altered or edited.
All the best,
Paul Hsieh, MD
Freedom and Individual Rights in Medicine: http://www.WeStandFIRM.org
On 9/17/07, Musashi wrote wrote: Mr. Hsieh
As an Objectivist, I struggle with the concept of a single payer medical care system. Obviously a single payer system is totally incongruent with Objectivism. No man should be made a slave to another man.
My problem comes with medical necessity, what happens when you need it and can't afford it? Is the short answer that you suffer or die because you can't provide for yourself?
Some friends have suggested that doctors and hospital could enter the financing markets. But is someone with meta-static cancer a worthy credit risk?
How does medicine work in an Objectivist world?
What happens to the needy?
From my personal experience, yes socialization of medicine has many problems (from standards of care, to rationing, and bureaucratic largess and corruption). But as it is now in the US, we have a growing population without access to healthcare. And the mechanisms of the current US system utterly destroy the finances of entire families based upon a single catastrophic medical event. The current system is almost like a lottery for debt peonage.
PS. We have discussed this topic at length on the Taggart Transdimensional forums. If it is alright with you, I'd like to post any reply you can make on these forums.
Last edited by musashi on Wed Sep 19, 2007 7:58 pm, edited 1 time in total.
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Oleksandr
 
 

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Post by Oleksandr »

Wow, very cool, Musashi. I'll be reading this post.

A nice addition to TTI forums. :D
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