[MD] Privatised medicine? No thanks

[Ben Golden]

[Arlo]
But, like I said, no matter the World Health Org report, or the figures
provided in comparison, or NEJM articles and studies... for me the issue is
simple, who lives and who dies should not be decided by wealth.

[Ben]
I think this point is key, as it suggests that this discussion is focussing 
on the wrong topic--specific pieces of data--when there's a more fundamental 
disagreement at hand.  I imagine that Platt could make a somewhat opposite 
claim--it's not individual news stories or studies that make him support 
privatized health care; it's the fact he sees public health care as an 
infringement or property rights and an inefficient institution.

Your premise is that life and death should not be decided by wealth.  I 
disagree, though I know at one point I would have agreed.  Allow me to 
attempt to explain what changed my mind.

For starters, wealth's effect on life expectancy extends beyond the realm of 
health care.  Poor people tend to work riskier jobs.  They live in more 
dangerous neighborhoods.  Often, they eat less healthy foods.  So the tie 
between wealth and life expectancy would continue even if health care was 
allotted with no regard to wealth.  I recall reading studies showing that 
even when they have equal health care packages, poor people tend to receive 
worse care--they don't pester their doctors enough; they don't know the 
right questions to ask, etc.  So my feeling is that if you wanted to 
eliminate the link between wealth and life expectancy, you'd have to 
eliminate wealth inequality altogether.

The problem I have with left-wing arguments is that they focus too much on 
inequality and not enough on poverty.  Poverty is a problem.  Poverty kills 
people and leads people to live horrible lives.  But poverty is not caused 
by the wealth of others; it has existed throughout mankind.  If you could 
eliminate wealth inequality in medieval France, you'd still incredible 
poverty by any modern standards.  Life expectancy even of French nobles was 
considerably lower than that of poor Americans today.

There are two ways to combat poverty; one is to redistribute wealth within a 
society and the other is to create greater wealth.  The problem is that 
these two objectives often conflict.  Redistributing wealth requires raising 
tax rates.  Higher tax rates create a reduced incentive for innovation and 
hard work.  The Canadian policy of preventing rich people from buying more 
health care--which your position seems to support--reduces the incentive on 
Canadians to work hard or to choose particularly demanding jobs.

My position is not as extreme as Platt's; I support some amount of wealth 
redistribution, ideally through an Earned Income Tax Credit.  But I don't 
think we can, or should, arrive at a situation where wealth does not affect 
life expectancy.  I'm more interested in seeing poor people live longer than 
I am in seeing a narrowing of the gap between rich and poor's life spans.

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