The only validity to your argument is that the insurance companines are more entitled to a chunk of your earnings than you are - more self-destructive than self-interested.

The only threat to private insurance is a strong public plan that has better pricing leverage to negotiate costs for services and prescriptions. As that leverage would benefit all consumers, including you, why would you oppose it? It would lower your private premiums and boost your private coverage.

If you're simply acting out of fear of creeping socialism, I'll count on you to turn down Medicare and Social Security when you qualify. Someone has to hold the line and stand on solid, individualist principles against any need or want - will it be you?

Harold, you are jumping too far forward. I am saying only that it is My job to decide if My company is a good deal. or whether or not an increase is in order. Nobody elses'.

The bill under discussion leaves you wide open to retain the provider of your choosing. It is up to you to decide if your provider treats you right.

There is still competition. The goal of your insurer is to give you as little as possible for the premiums you pay. Apart from any intervening ideologies, your goal is to get the most from your insurer for the premiums you pay. Somewhere in between, you strike a deal.

Are you saying that more coverage for less money would not be a better deal for you unless you decide that more for less is better? or, that your prices will be increased by greater consumer leverage in healthcare pricing or by universal coverage? or, is this simply a choice issue where one's choice of a public provider would undermine your choice of a private provider? or, do you think that a choosing a public option is a non-choice? If you decide that Medicare works for you, that's OK? What if we decide it works for all of us? Is that a legitimate choice?

What is it, exactly, what decision regarding the insurers, do you worry about losing? What choice do you believe is being taken from you? What are you trying not to change?

The timeframe bothers me in the extreme. It's timid, fearful, insufficient, and driven by suppliers.

Obama said single-payer was only an option if we are starting from scratch. I'm game.

I still think we need to avoid getting bogged down in the details of cost controls. Give us care, freeze the prices, divert all the money we're paying to private insurers, and then go to work negotiating costs and redesigning care to fit our needs.

The need for immediate, universal care is the highest need and the money is out there to fund it if we just redirect the spending. Even if it costs an extra $1 trillion over 10 years, I'll bet a few average citizens can find that much waste in the Federal budget every year.

"My companies' increases have been regular and reasonable. I want to help the poor get good health care with My taxes. I'm all set with mine though, leave me alone."

No.

That's like saying "I'm happy with the Mafia protection I'm getting right now. They're not killing me, they're only blackmailing and killing other people. Leave my Mafia alone."

No.

Charlie, please check out Wendell Potter on Bill Moyers' Journal.

I would add to Carla's comments that it's also like saying, "I'm happy with the unregulated mortgage-backed securities my hedge fund manager is selling me."

Charlie, very few insurance companies, if any, sell *only* substandard plans with high deductibles and no protections to individuals.  Something like 70-90% of plans sold by insurance companies would meet the theshhold if this regulation was in place today, since its based on the industry's own average.

These insurance companies will be able to take on new customers.  They won't be able to sell their least useful plans -- the ones where they're essentially taking people for a ride.  Right now, we have 50 different minimum standards -- each state has its own.  After the law is phased in, we'd have one.

I tend to think this is going way, way easy on the private for-profit insurance industry, but let's be clear -- private insurance is still going to make a boatload of money under this arrangement unless they're completely incompetent.

Charlie Reed..what insurance company are you working for?

I think I understand better, now. You are the only person I've heard about, including people who've worked with the same employer for over 20 years, who has had satisfactory insurance and constant coverage with the same insurer.

However, most people with insurance get it through employers and I have seen employers change plans and providers every few years. I've even seen union plans go bust. Each time providers and plans change, choices regarding care become more costly and physician choice is often lost.

It isn't simply the poor or unemployed without insurance that are being adversely affected by the system, it's the working middle-class. While I'm sure you like your insurer, I can guarantee that, unless you're using some organization out of the mainstream and unavailable to the rest of us, that they are underserving a majority of their policy holders.

The market regulations, crafted by the insurance industry, do not motivate control of medical costs, deprives those most in need of costly care beyond what personal income allows, and happily takes premiums from those least in need of care who, barring misfortune, could probably pay even less if they paid directly out of pocket. The system poorly allocates resources.

Make no mistake, unless you're with some very special organization and not employer-dependent for coverage, you could get a letter tomorrow, without any justification, that your insurer will no longer cover you, that your plan has changed and your physicians are no longer covered, or your costs will increase.

Charlie, health insurance in this country is a protection racket. For some reason, you're being protected while others are being abused unto death.

I'm afraid it seems to me that you are unwilling to educate yourself about the realities of the health insurance industry and how it has degenerated, along with other financial sectors, over the last several decades.

Too bad. Whether you understand or accept it, change will come. You may remain bewildered by it if you wish--your choice!

Has it even occurred to you to wonder why the healthcare everyone needs should be a profit-creating business?

Medicine and nursing used to be professions. "Free enterprise," unregulated capitalism and unrestrained greed have wreaked their havoc.

It is a shame.

Right now, you believe you're being treated well but your premium dollars, whatever their source, are subsidizing an abusive system of insurers. No matter how you see it, the facts are that your insurer and its way of conducting business has to be affected.

There is no isolated business relationship with a corporation. Your business with your insurer affects others. We are all involuntarily connected through the marketplace and through our systems.

I've always agreed with Pastor Niemoller:

"In Germany, they came first for the Communists, And I didn't speak up because I wasn't a Communist; And then they came for the trade unionists, And I didn't speak up because I wasn't a trade unionist; And then they came for the Jews, And I didn't speak up because I wasn't a Jew; And then... they came for me... And by that time there was no one left to speak up."

As moral creatures, it is crucial that we speak for others and we examine the effects that our actions and inactions have on others' lives. That includes our choices and business decisions.

Harold, Even Tim says 77% of people are satisfied with their coverage. I read 84%, either way I'm not the only one who wants to protect his families' situation.

Rather than attempt to rebut myself, I'll redirect one and all to Paul Krugman's excellent post over the weekend:

http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healthcare/

"

There are two strongly distinctive aspects of health care. One is that you don’t know when or whether you’ll need care — but if you do, the care can be extremely expensive. The big bucks are in triple coronary bypass surgery, not routine visits to the doctor’s office; and very, very few people can afford to pay major medical costs out of pocket.

"This tells you right away that health care can’t be sold like bread. It must be largely paid for by some kind of insurance. And this in turn means that someone other than the patient ends up making decisions about what to buy. Consumer choice is nonsense when it comes to health care. And you can’t just trust insurance companies either — they’re not in business for their health, or yours."

Tim Foley,
 The Krugman piece is flawed in many ways, but principally, a couple points:
1. Perhaps I would be more accurate to say that INSURANCE should be about like any other commodity. 
2. Yes, the need for health care is unpredictable and could be catastrophically expensive. A couple sub-points on this:
 a. Get the government completely out of health care and health insurance (except for minimal regulations dealing with transparency, ensuring no monopolies or collusion occurs, etc) and the cost of both will drop dramatically!!!  Both will behave much more like any other commodity.  Market mechanisms of competition, supply, demand, price equilibrium, etc. will result in more availability and lower prices. 
 b. If unpredictability and catastrophe are the triggers for government takeover (whether directly or by onerous regulation), then I assume that I should expect the government to insure my house, and my car.  After all, risks in these insurance areas can be just as unpredictable and catastrophic.  In fact, perhaps they should insure my job, insure my income, insure a comfortable retirement, insure my access to gasoline, insure my access to food, ...  There are lots of things critical to life for which we buy insurance.  Should the government be the insurer of each of these?  That is the logical next step.  Apparently, the only thing the government won't insure is our liberty. I thought there was something about that in our founding documents somewhere. 
 c. He does not explain why health care is expensive.  He simply accepts it as an unassailable fact. 
3. Our health insurance and medical care system is a creation of the Government.  Don't pretend that the choice is "the current ‘free market' system" vs Government control and regulation.  The current system could not be called ‘free market' by virtually any measure.  The current state of government regulation is such that it has thoroughly distorted the market resulting in high costs and high cost growth. It is an overregulated, bureaucratic mess!  The status quo cannot be defended. However, we must not "reform" the system by higher and higher doses of the same pathogen that has been killing it for decades.
 a. The free market seems to work every other commodity that is not regulated.  Why should health care and medical insurance be different?  There are medical markets which are subject to no or very little market distorting government regulation.  This includes the markets for purely elective medical procedures (those that are not covered by medical insurance), such as cosmetic surgery (stable prices despite a 6X increase in demand since early 1990s), $10 prescription drugs at Wal-Mart for a 90-day supply of 300 different generic prescriptions, the No Insurance Club, medical savings accounts, IVF and other fertility treatments, laser eye surgery, optometry, most dental care,etc.  In these, the (mostly) free market has worked very well, and continually driven the prices down.  Also, how about aspirin, cold medicine, tooth paste, knee braces, crutches, and the list goes on?  All are examples of free market for medical care.  When I had to pick a doctor for my daughters' braces (orthodontia is not covered by my, nor, I believe, almost anyone's insurance), I had many choices of doctors, much information about who was better than who, who charged what for each procedure or service, and so forth.
4. "Consumer choice is nonsense when it comes to health care" is an unsupported argument. Are we just supposed to accept this because Mr. Krugman says so?  Consumer choice might appear to be "nonsense" now because of the screwed up, inappropriately regulated market the government has created.  Unscrew the massive government interference, and more and more choices will become available.

Hi Mark--

Thanks for your comments.  I will say this sentence caught my eye.  "In fact, perhaps they should insure my job, insure my income, insure a comfortable retirement, insure my access to gasoline, insure my access to food"

Considering unemployment insurance has been in operation since the New Deal, Social Security as well, the price of gasoline is heavily subsidized by the federal government even before we start talking about indirect subsidization (a la military commitments), and that federal subsidies for agribusinesses is deliberately designed to keep the price of food, especially corn-based food, down... well, I don't quite know what to say.

For someone who doesn't know quite what to say, Tim, I think you said it superbly well.

And Mark, you may consider your health to be a commodity, but many of us do not feel that way about our own health, or the health of our loved ones.

Tim,

Well, after I hit the "Post Comment" button, I ralized the ones you mentioned weren't precisely the best examples, but I think you got my point.

Carla,

"And Mark, you may consider your health to be a commodity, but many of us do not feel that way about our own health, or the health of our loved ones."

Then you may participate in whatever twisted, contorted over-regulated, bastardized, over-priced, poorly functioning, rationed, waiting-line little communal helath insurance system of your own.  Just don't force the rest of us to participate in it as well.

Tim,

I would like to see such subsidies ended, especially the subsidy for ethanol - huge waste all the way around.  There is also no reason to subsidize any food production that I can see.  However, if essentiality is the justification for the government to be the sole provider of health insurance, then they should provide ALL essential items in life.  Health insurance pays for both catastrophic and routine health care.  I expect the government, then, to provide for my routine food consumption as well (I'm particularly fond of Italian cuisine).  Shall I expect the government deliveries of food on my doorstep soon?

I can appreciate these arguments far better than high-level statements. The one I agree with is the lack of a tax credit for individuals needing to purchase their own insurance. I would even take it to the point that I believe there is wage discrimination where corporations offer coverage but someone doesn't take it. It is not usually the case that the benefit not taken is then given as salary.

However, from an objectivist point of view, that's between the individual and employer and I shouldn't presume to be enforcing a right or obtaining justice by bringing the government into the mix for wage issues.

I am happy that I live in a State which sets higher standards for insurers thereby keeping some insurers and policies out of the market.

The marketplace, by virtue of size and scope, is no longer local and transparent to the degree that rational decisions can be made on all transactions. Further, a corporation's function is entirely impersonal.There is no link between the corporate goals of profit and acquisition and the sustenance of human life. They are means, not necessities, and not the only means, to attaining economic goals. They are tools, like hammers or cars. One doesn't negotiate with tools and, therefore, one should not be concerned with the regulation of corporate entities. If anything, one should be more concerned that these entities

We are not regulating commerce among individuals but commerce among individuals and corporate entities. If anything, such regulations guard the individual from a non-human agent and bureaucracy. Were we talking about the government exerting force against people in a transparent, common, and open marketplace, the conversation would be different. But such a marketplace has never existed beyond the village.

As to unearned benefit, the nature of our basic rights is that they are not earned, they are not economic issues. If you reject outright a right to life, then by all means you ought to withhold life-sustaining aid except where it pleases or benefits you. If you commodify life-sustaining aid, you commodify life and it is no longer a right. If you assert YOUR right and not OUR right, you denigrate those around you to something less than yourself.

By virtue of their status as human beings, deserving of civilized and social compassion and the right to life they possess, all are entitled to what you perceive as the "unearned" economic benefit of healing "extorted by force." Only a sociopath would walk past a person in need determined not to help unless some benefit could be extracted. Because our ties and the  marketplace are so much larger than the immediate community around us, the needs of others are not always laid out on our doorsteps. Often they are in remote areas we never see yet are affected by our actions.

Yes, help will have to come from you and me, from all of us. When we work it benefits ourselves, our families, our friends, our communities, our nation, our society. Our commerce and market decisions affect not only ourselves but others connected to us in the marketplace.

The only alternative is to dissolve the nation and the marketplace, the people, and all human ties - reduce us all, against nature, to independent and egocentric actors unconscious and unconcerned of the ramifications of our decsions beyond our own stomachs and/ or internal rationality. For that, you would need a planet of your own.

Harold,

 "However, from an objectivist point of view, that's between the individual and employer and I shouldn't presume to be enforcing a right or obtaining justice by bringing the government into the mix for wage issues."

I do agree that it is an issue between the employer and employee.  However, I wouldn't object to the Government requiring enough transparency to provide the employee all the information necessary to make a wise decision, but not limiting the consumer's options by prohibiting certain prodects or services.

"I am happy that I live in a State which sets higher standards for insurers thereby keeping some insurers and policies out of the market." 

This limited type of regulation is, arguably, more acceptable than some forms.  However, the same function can be provided by the free market.  There are myriad companies whose sole purpose is to audit, analyze, and rate firms in most industries and their products.  Think JD Powers, ANSI, ISO, UL, Better Homes and Gardens, AM Best, Moody's, S&P, and many more; all of which grew out of market demand for their services, not from government.    Particularly in the internet age, there is no shortage of solid information about for consumers.  The effect is that consumers know quickly, and in depth, about the companies, their products, and quality of service.

Harold,

- "As to unearned benefit...", "..right to life...", et al.,:

The government forcibly taking my property for use by another who has not earned it is theft and immoral, regardless of what it is for, except for the expense of basic protections and basic functions that government must provide.  I do not object to a right to life, which is the premise of your last three paragraphs, thus rendering your argument moot.  However, I shall expound:

I do object to me being * forced * to pay for the medical care for you or anyone else; or forced to pay for your food, transportation, house, etc.  Just because you have a right to life does not mean that I must be forced to preserve it.  You are entitled to life.  You are not, however, entitled to use my property to preserve your life.  Now I may CHOOSE to pay to preserve your life, but that is charity and is a choice that must remain free and MY prerogative, not be forced by the government.  Just because you have a right to property does not mean that I should be forced to pay for its maintenance and upkeep.  Should I be required to pay for reroofing your house?   Just because you have a right to liberty does not mean that I should be forced to pay the expenses associated with you pursuing those liberties.  So, NO, we are not entitled to the economic benefit of healing "extorted by force."

I'm sorry to alert you to reality, but EVERY product or service is a commodity, whether it is designed to preserve life or not.  So by definition it comes with a price, a certain supply and demand, a certain level of scarcity, a certain level of value to the consumer and the supplier.  You can pretend the reality is otherwise, but not for long.  Every pill, every doctor's visit, every MRI, every hospital stay, etc.; they all come at a cost, cannot be provided for free (someone pays for it).  So, in the entire history of the human race, no one has commoditized life-sustaining aid. It comes that way all by itself, by its very nature.  There's no way around it.  Those societies that tried to deny this reality all failed because of that denial.

In an unrestricted market, medical care and medical insurance are commodities that are available to all on a fair and reasonable basis.  There is no structural barrier to anyone procuring those goods.  That said, I don't necessarily have a problem with some form of assistance to the very poor.  However, it really should be much more market oriented than the current Medicaid and Medicare.   That could be as simple as assistance with their premiums for private insurance (and of course, unscrewing the current government created structural distortions in the insurance markets). 

"However, I wouldn't object to the Government requiring enough transparency to provide the employee all the information necessary to make a wise decision, but not limiting the consumer's options by prohibiting certain prodects or services."

Again, by objectivist standards, governmental requirement indicates enforcement and, therefore, is coercive. Though you would not mind the regulation, your employer might perceive it beneficial/ profitable not to disclose. Further, stockholders may see the benefit in concealment if it means higher returns. Concealment is not a lie, it is refusal to talk.

"There are myriad companies whose sole purpose is to audit, analyze, and rate firms in most industries and their products.  Think JD Powers, ANSI, ISO, UL, Better Homes and Gardens, AM Best, Moody's, S&P, and many more; all of which grew out of market demand for their services, not from government."

S&P failed to do anything about the creation of false wealth in the financial sector because it is aligned philosophically with those creating and profiting from the practice. That aside, given the issues with our delivery system, the analysis and rating of medical practices and insurers ought to be a lucrative business. Yet, profit has not motivated the formation of such an independent agency. That is a market failure.

"The insurance company is paid on a procedure by procedure basis, which provides an incentive to do more procedures, and thus, receive more revenue.  It very is hard for most customers to take their business elsewhere, so there is less incentive to provide value and good service.  The patient also has little to no incentive to self-limit the care he seeks, since his medical is all paid for through his premiums, except for small co-pays and deductibles.  This really disconnects the patient/consumer, from the money.  If the patient had to control some of that money, they would be more prone to seriously evaluate what services the seek, how often, etc.  No more ER visits for the sniffles."

It is not the insurers but the providers which bill procedure by procedure. It is more profitable for them to do so. The insurers have no motivation to make changes to this mode of operation since they, too, can profit by the same system. We already have a great deal of self-limiting, people are not seeking the needed care which they cannot afford. People making ER visits for sniffles conjures up an image of the Reaganite, mythical welfare-queen. It is not common or the norm. When someone needing common doctor's care shows up in the ER, that usually indicates a lack of means other than charity care not a conscious decision on the part of someone who can afford regular treatment.

If you were in the place of a provider or insurer, what objective motivation would you have to eschew profits by changing your system when there is no competing system? It isn't about competition among companies but of the lack of response to consumers whose bargaining power is diminished by the need for healthcare and the lack of alternatives.

You could say that there is a business opportunity to create alternative systems but the market has not brought this about.

"Do not limit the competition for the patient's medical insurance."

Insurers have had the chance to compete with each other for clients but don't seem to offer real care choices. The fee-for-service system can be had for a price, that's the only model offered. Is that real competition?

"The government forcibly taking my property for use by another who has not earned it is theft and immoral, regardless of what it is for, except for the expense of basic protections and basic functions that government must provide... Just because you have a right to liberty does not mean that I should be forced to pay the expenses associated with you pursuing those liberties."

However, you would expect your liberty to own property to be protected by the government? In other words, I must pay to protect your property even if I determine it is immoral or against my interest to do so? The basic protections and functions of the government are associated costs paid by all for us to pursue our liberties without impinging on the liberties of others. Where have you drawn your line on this issue and why are others' boundaries less valid?

I find it disturbing that you would ascribe a moral dimension to earnings that you would not ascribe to social relationships. That is not to say that you are not personally charitable or kindly but that these are optional qualities, not moral imperatives, the lack of which does not carry the stigma of criminality or moral condemnation. Aboriginal societies provide evidence that earnings and property do not exist by nature. Social relationships, duty toward one another in caring and compassionate ways, if only among small groups, are natural.

If I find such social relationships superior to property or earnings, should I not advocate to place them in a superior position as you would earnings and property? It is simply deciding that the products and imperatives of social interaction are superior to the products and imperatives of ego. One cannot commodify morality, compassion, charity, love, or duty - the service of healing, of medicine, proceeds not from the desire to earn and profit but from the desire to be moral, compassionate, and charitable.

To think of a commodity as something that naturally occurs is to view of the current economy as something independent of us stemming from an evolutionary process of its own. We create the economy and the market, the set of rules and conventions, by which we obtain the things we need and want. Neither the methods nor the measures are absolute and timeless. You talk as if we are creatures of the economy rather than economic creatures.

I would place property and earnings not as rights but among the rules and conventions created to best allocate resources and serve our greater needs and keep our baser natures, through reward, in check

"Just because you have a right to life does not mean that I must be forced to preserve it.  You are entitled to life.  You are not, however, entitled to use my property to preserve your life."

The right to life is not an abstraction, no rights are. If one is without the means, for whatever reason, to exercise and sustain life, then that right is abrogated unless sustenance is unconditionally provided. I say unconditionally because a right is not purchased by transaction or acquired by the grace of others. If one must bargain for basic necessities or rely on the amoral feelings of someone's personal charity, then that life is placed in an inferior position to the life of the selling or subjectively charitable party. This doesn't mean that every personal preference or advantage ought to be granted unearned but it does mean that some set of basics, including healthcare, is essential to the dignity and sanctity of life as a right.

 The defense and protection of possessions should never take precedence over the protection and defense of life.

Harold,

You have given me so many things to respond to that I suspect I will not get to them all, even though I'd love to. I have so little time and a big project due tomorrow, so it may take a couple days.

Let's start here, and in no particular order of importance:

" S&P failed to do anything about the creation of false wealth in the financial sector ..."

See my earlier post responding to Carla on this.

"...the analysis and rating of medical practices and insurers ought to be a lucrative business. Yet, profit has not motivated the formation of such an independent agency. That is a market failure."

Market failure?

http://www.healthgrades.com/

http://www.pressganey.com/

http://www.ambest.com/

http://www.healthinsight.org/performance/hosp_rankings/hospitals.html

http://www.ratemds.com

http://www.jdpower.com/healthcare

http://www.netdoc.com/option,com_netdoc/task,display_hospital_list/year,2008/Itemid,127/

...and these are just a few I've found, a couple of which I'm familiar with. This does not include the various accreditation services hospitals and other providers must use just in order to open their doors and be seen as quality providers in the consumer's mind. Would you go to a doctor who was not accredited in his or her specialty? Aren't such accreditations at least a basic, initial testament to the providers' quality?

"It is not the insurers but the providers which bill procedure by procedure. It is more profitable for them to do so."

They bill that way because that is how they are paid. 

"When someone needing common doctor's care shows up in the ER, that usually indicates a lack of means other than charity care not a conscious decision on the part of someone who can afford regular treatment."

It truly sounds like you have never, ever spent any consequential amount of time in an ER.  My wife (an RN) has worked in ERs for 20 years.  I get to hear all the stories every week about just the cases you say are not the norm.

"If you were in the place of a provider or insurer, what objective motivation would you have to eschew profits by changing your system when there is no competing system?" 

Consumers in control of where they will choose to spend their health care dollars will provide the incentive to continually improve services, and excellence.  This would be true both when choosing a doctor and choosing an insurance provider.

Harold,

"It isn't about competition among companies but of the lack of response to consumers whose bargaining power is diminished by the need for healthcare and the lack of alternatives."

Their diminished bargaining power in medical insurance is largely due to the limits built into the current system.  Those with insurance through their employer usually only have a few choices (I, for example, can choose from among 2 plans);  very little choice if the plans offered dish out poor service.  Those who must buy private insurance as an individual on the open market do not get the benefit of the large tax break that the big employers do.  Thus, their net health insurance expense is much larger which is going to limit their choices, simply for affordability reasons.  Furthermore, states limit the number of companies that can sell insurance in their state. 

They have few alternatives for insurance providers, a larger set of alternatives for providers since there are often many doctors available on a given plan.

"You could say that there is a business opportunity to create alternative systems but the market has not brought this about."

It has in small examples like Mayo, Cleveland Clinic, etc.  Additionally, current laws and regulations often limit the flexibility providers have to provide innovative business models.

"Insurers have had the chance to compete with each other for clients but don't seem to offer real care choices. The fee-for-service system can be had for a price, that's the only model offered. Is that real competition?"

Again, I believe that the current statutory and regulatory structure determines much about how the industry operates and makes innovation difficult with respect to insurance.

"However, you would expect your liberty to own property to be protected by the government? In other words, I must pay to protect your property even if I determine it is immoral or against my interest to do so? The basic protections and functions of the government are associated costs paid by all for us to pursue our liberties without impinging on the liberties of others. Where have you drawn your line on this issue and why are others' boundaries less valid?"

I acknowledged that basic government protection of our rights is necessary.  Admittedly, I draw that line pretty far to the libertarian side of the spectrum.  Protect the borders and prosecute people who violate my or your rights.  That is a pretty minimalist position.  SO I expect some sort of competent national armed forces of at least a sound defensive nature. I expect police forces who can respond competently to a break in at my house, or a life and death situation.  I don't expect them to protect me from bruising my knee in my yard, or from a tree falling on my house and threatening my life, or from accumulating cholesterol in my arteries.  I certainly don't expect the government to provide me health insurance or medical care, or life insurance, or car insurance, or breakfast cereal.... at least not until I become completely indigent, and even then, I'm not sure I would want to move from being a citizen of the nation to a subject of the state.

Mark, you say "...even then, I'm not sure I would want to move from being a citizen of the nation to a subject of the state."

There is a marvelous moment in the film "SiCKO" in which a French government official is viewing about 500,000 of his compatriots demonstrating in the Paris streets. He turns to the American cameraman and comments wryly to the camera: "You know, in America the people are afraid of the government. In France, the government is afraid of the people."

I think it is clear that the French consider themselves to be citizens of their nation, and they expect their government to work for THEM. That's called democracy.

So Mark Anonymous, which would you prefer? 

Carla,

      SiCKO? .....  Seriously?

Anyway, of course you know that I choose liberty.  The quote you cite appears to be inspired by the Thomas Jefferson quote: "When the people fear the government, there is tyranny. When the government fears the people, there is liberty". 

So, if we take the quote from the movie on its face, then the implication is that we (Americans) live under tyranny (at least, relative to the French).  If you accept that to be true, then why, in Heaven's name, would we want to move toward even greater tyranny?  If we give the government more money and power, including power over the most intimate, personal decisions we make in our lives, have we not moved toward greater tyranny and far less liberty?

If Jefferson was articulating a truth in hs quote, then we should be doing all we can to gird ourselves against every excess by the government.

While I am not an authority on French government/politics/society, it is generally true that the government of France has more power over the lives of its citizens than does the US government over our lives; it leans much (?) more toward socialism.  The more power and control the government has over our lives, the closer we move to being subjects rather than free citizens.   Whether or not the French "...consider themselves to be citizens of their nation"  is one thing.  Whether they really are is another.  The populations under tyranny are more subjects than citizens, and those under much more limited governments are more citizens than subjects.

"...and they expect their government to work for THEM ..."

As to whether the government actually works for us, or would work for us in the case of socialized medicine, well, the evidence that it does or would is slim indeed.

It is actually the case that the French have more power over their own government, because they know who is in charge--they are.

Americans are so cowed we won't rally in the streets for our own interests.

And yes, SiCKO. Seriously, have you seen it, Mark Anonymous?

BTW, Mark Anonymous, I suggest that as a service to humanity, you visit some European and Scandinavian countries to explain to the people there how tyrannized they are by having excellent universal healthcare, tuition-free university education, and none of the dire poverty that characterizes our inner cities and many of our rural areas. I'm sure they will see the error of their ways and immediately renounce their "socialistic" forms of representative democracy in favor of Mark Anonymous' free market ideology.

Carla Rautenberg,

            It appears that your post is addressed to me because it directly addresses points that I made.  However, it is a very odd and confusing thing, because it is directly addressed to someone named "Mark Anonymous", a most peculiar name.  I don't know who that is, so I am afraid that it would be far too presumptive of me to offer a direct response on his behalf.   

Harold (this might address some of Lauren Serven's questions/assertions, as well),

"I find it disturbing that you would ascribe a moral dimension to earnings that you would not ascribe to social relationships. That is not to say that you are not personally charitable or kindly but that these are optional qualities, not moral imperatives, the lack of which does not carry the stigma of criminality or moral condemnation."

You assume too much.  I don't see how anything I've said should imply that I give more moral weight to the right to property than I do to social relationships.  I assume that by the broad term "social relationships", you mean to include actions such as charity to the less fortunate among us, including providing health care to them, or helping them pay for their medical bills or insurance, or food, etc.  If so, then I say there is no evidence in my writings here that I place more or less moral value on those things than on property rights, simply because I have not yet written about those other things here.  That said, compassion, love, charity (pick your virtues) are personal imperatives and not governmental or collective ones.  I have a right to property and it is immoral for another to unjustly take my property.  It may also be immoral for me to choose to keep all of my property in the face of a person in need.  But again, that is a personal moral imperative and should rightly be a decision reserved to me, not the government. 

Now you will likely assert (maybe you have here and I haven't gotten to it yet) that since in a democracy we vote for certain officeholders and, by extension, arguably, the social welfare/poverty relief policies they enact into law, then aren't we consenting to use our tax dollars for charity and, thus, fulfilling the personal moral imperative to be charitable?  The answer is "NO".  In this case, you are helping the poor by coercing those who would otherwise make another moral choice.   "Forced charity" is an oxymoron.  There is also the problem of the government deciding what "charity" is.  This is a "governmental judgment" that may not agree with the personal moral judgment of the coerced.  Additionally, the government is the least efficient distributor of "charitable" aid that I can imagine.  Shouldn't I be allowed to exercise my moral choice to be charitable by doing it directly, or through a foundation of my choosing that is extremely efficient and targets the charitable causes that MY moral judgment requires?

"Aboriginal societies provide evidence that earnings and property do not exist by nature.

Social relationships, duty toward one another in caring and compassionate ways, if only among small groups, are natural."

OK.  How far did those societies progress?  Yes, I know. We could get into a long philosophical discussion of the definition of "progress".

"If I find such social relationships superior to property or earnings, should I not advocate to place them in a superior position as you would earnings and property?"

You can ‘advocate' all you want, but you would be wrong.

"It is simply deciding that the products and imperatives of social interaction are superior to the products and imperatives of ego."

You may make that decision and act upon it, but again, it is a personal moral choice.  Imposing it on others is removing their moral choice.

"One cannot commodify morality, compassion, charity, love, or duty - the service of healing, of medicine, proceeds not from the desire to earn and profit but from the desire to be moral, compassionate, and charitable."

I agree that we cannot, and ought not (don't know how you would) commoditize all/most virtues.  However, the physical manifestation of those virtues is a physical item or a service.  In this case we are talking about health care or medical insurance.  I may wish to provide it free to the patient, but because those products and services are scarce, to one degree or another, they are by definition, commodities, and they will cost somebody something to provide them to the patient.  These are the facts of the real world.  Everything one hopes to provide a patient (other than hugs, prayers, good wishes, etc.) is a commodity.  One of the main problems that I believe many have in discussing this, and similar issues is that they deny or do not realize this reality. 

"To think of a commodity as something that naturally occurs is to view of the current economy as something independent of us stemming from an evolutionary process of its own."

A commodity occurs as the product of our demand and its relative scarcity.

"We create the economy and the market, the set of rules and conventions, by which we obtain the things we need and want. Neither the methods nor the measures are absolute and timeless. You talk as if we are creatures of the economy rather than economic creatures."

I'm not sure what you mean by "creatures of the economy", but I will say that we are subject to the laws of economics, and the more we choose to ignore them, the more peril we are in. 

"I would place property and earnings not as rights but among the rules and conventions created to best allocate resources and serve our greater needs and keep our baser natures, through reward, in check."

Then you do not believe that property is a natural right.  You also disagree with the Declaration of Independence and the Constitution regarding this issue. 

"Just because you have a right to life does not mean that I must be forced to preserve it.  You are entitled to life.  You are not, however, entitled to use my property to preserve your life."

"If one is without the means, for whatever reason, to exercise and sustain life, then that right is abrogated unless sustenance is unconditionally provided."

How so?  Just because I may not be able to sustain my own life does not mean that I have abrogated my right to it.  Of course, the opportunities for me to obtain sustenance should not be unduly restricted.  By this, I mean I should not be unduly restricted from properly acquiring the resources/wealth necessary to obtain sustenance.  My employment opportunities should not be restricted unduly, my access to charities should not be unduly restricted, etc.

"I say unconditionally because a right is not purchased by transaction or acquired by the grace of others."

Agreed, but that does not eliminate the laws of the physical world and of economics.

"If one must bargain for basic necessities or rely on the amoral feelings of someone's personal charity, then that life is placed in an inferior position to the life of the selling or subjectively charitable party."

Bargaining for the basic necessities is an unavoidable reality!  I need food to live.  There is only so much food in the world.  Therefore, it comes at a price, or through charity, in which case it comes at a price to the giver.

"The defense and protection of possessions should never take precedence over the protection and defense of life."

I believe I agree with that as a general moral truth.  

Carla,

Yes, they were a problem because of the structural set-up; they were paid by the sellers of the products they were rating.  Of course, this was freely knowable and known and would be an element of any risk evaluation for an investor.  Caution should have been the order of the day for any investor in these securities.  Of course, the danger of the securities was masked by their very structure and the backing (essentially, insurance) of the federal government through the GSEs.  So I'm not sure it is fair to blame those rating agencies much.

Finally, in most situations, the rating agency is NOT paid by the firm being examined, and where they do pay a fee to get their certification audit/assessment, they do not pay for results.  They simply pay for the expenses associated with conducting the audits.

Just as a consumer should understand the product or service he is buying, if he or she is relying on a rating agency, how that agency works should be understood.  I know that ever time I read an evaluation in Consumer Reports, the very clearly explain their methodology.

Carla,

"Mark, why are you afraid to post your full name with your comments?"

Frankly, I've had a couple bad experiences.  Granted, they were on local (home town newspaper) blogs, but it became clear that there are some real crazies who regular some blog sites, and once they find our who you are and where you live, they can be rough on your life.  So, a little anonymity is my going in policy.  It's nothing personal against any other participants.  I hope that the quality of my contributions to these blogs is sufficient, without disclosing my ful name. 

Lauren Serven

"You are very articulate and obviously bright. I am venturing either a degree in Law or business or both."

Thank you for the compliment.  Trust me, there are many times I'm not so articulate.  No law degree.  I'd hope a lawyer could put forward an argument much better than I have thus far.  BA in History, MS in Management.  I've had some regular exposure to the law, though, in my work. 

"Where we would be as a civilization without co-operation and generosity? And isn't our collective system of governance an opportunity to help each other and thereby strengthen ourselves as a people? "

Parhaps.  But that does not mean that less government would mean less cooperation or generosity.  In fact there may be more.  Government sometimes provides incentives for people to be less generous.  For example, people tend to be less generous in terms of giving to charity if they are lead to believe that "the government's got it covered" through, say, welfare, Medicaid, etc.  When we had far less government, I believe there was plenty of "opportunity to help each other" and to "strengthen ourselves as a people".

"... but I sense in your opinions a certain lack of concern about your fellow man."

That is a bad assumption.  I'm quite concerned about my fellow man.  I simply did not speak of it in my earlier posts because I did not believe it was pertinent to the points I was making.  I believe that I can understand how a person might wonder, though, since it was left unsaid.  I believe that my concern for my fellow man, though, is a personal moral issue, and not a matter for the government.  As I said in one of these posts, coerced charity is an oxymoron.  Furthermore, more help can be delivered to more people through a robust, vibrant economy.  It has always proven to be the best solution to raise more people out of poverty.  The gaps can, and should rightly be filled through the existing, and quite effective, charities that serve the needs of the less fortunate much more effectively than the Government.  I can make sure my charitable giving is delivered much more effectively by giving to my local United Way chapter, or church, or local Red Cross, etc.

"And your assumption that those who see government's role as different from yours as the equivalent of protecting you from bruising your knee in your yard is down right offensive. Why do you assume that others are lazy good for nothing whiney mouthed wimps who want Uncle Sam to take care of the most minor details of their lives? "

Evidence, Ma'am, evidence.  Medicare, Medicaid, social security, welfare, food stamps, Government cheese, unemployment insurance, subsidies, bailouts,  and many other programs to solve seemingly every little concern that we should be taking care of on our own.  Of course, I know that not every person who receives the benefit of Government largesse is a lazy bum, many are.  Furthermore, these programs seem to breed their own consumers in many quarters. 

As Harold so eloquently stated in previous posts, "one cannot commodify morality, compassion, charity, love or duty". Mark, as Harold also states you "talk as if we are creatures of the economy rather than economic creatures". Question is Mark, are you smart enough to know this difference?"

As I responded to Harold (please see that post for more) I have not espouse the commoditization of the mentioned virtues, simply recognized that the exercise of those virtues usually can only be manifest through commodities (particularly in the case of the exercise of compassion through the delivery of medical care), and that a lot of folks in the debate - including here on this blog site -  seem to ignore the reality of this fact.  And if one bases their argument on a demonstrably false assumption, the argument necessarily fails. 

"...you "talk as if we are creatures of the economy rather than economic creatures".

Aren't we both?