[From Rick Marken (940904.2230)]
Bill Leach (940904.10:37 EST) --
Me:
it seems to me that you are controlling for something other than "best
health care for all". I think you are controlling for a perception of
the government being out of it; as long as that perception is under
control (which it seems to be now) then I don't think it would matter
if
Bill:
I am not sure what to say to this. It appears to me to be a "personal
attack" veiled in PCT terminology.
I am really sorry. This was a poor way to say what I meant. I was
guessing that you might be controlling for something other than what I
define as "best health care for all", not that you didn't want the best
health care for all. I know you do. I was just suggesting that "govenment
non-involvement" might be a more important aspect of this perception
to you than it is to me.
Maybe it would be better to phrase this in terms of means and ends.
Let's assume that we are both talking about the same perceptual
variable when we talk about "quality of health care". Let's also assume
that we both have precisely the same reference level for this variable --
we both want to see the quality of health care as "pretty darn high".
What I would like to know is this; suppose that, by some miracle (or
tragedy), a single payer health care system were implented in the US
and, after some time, we noticed that our perception of the quality of
health care (which for both of us had been at "pretty darn crappy") were
approaching our reference of "pretty darn good". Would you then be able
to live with this system (while it was working) or would there be a problem
for you because the system itself is of a type that moves another
perception (of degree of government involvement in anyuthing, for
example) away from it's reference? I can tell you that, if a completely
free, competitive, private approach to health care was as effective, simple
and cheap as the single payer systems that seem to work so well everywhere
else, I'd have no problem with it at all.
A serious problem with any such discussions (that Bill pointed out
rather nicely) is that all such "complex" matters are not binary in
nature (that is there is not an absolute right and an absolute wrong).
Yes, perceptions of health care quality and government involvement
vary over quite a range; they are not binary. Very important. I have
serious difficulties with recognizing this sometimes and I'm trying to
keep this in mind. It is very helpful to notice that perceptions are
not just one way or the other, right or wrong, left to right, idiotic
or sublime. There is always a continuum.
I also sense, rightly or wrongly a strong bias in your postings.
True. And I am trying to get above it. Life is complex. I know that.
We need then, I think, compelling evidence that a proposal to force or
restrict the freedom to control for an individual is actually in that
individual's best interest.
I think the fear of dictatorship can blind one to the virtues of
community. For me, it seems rather easy to tell the difference between
a dictatorial, forced restriction on freedom (the kind that seems to be the
obsessive fear of the far right) and forced restriction based on broad
agreements (we are "forced" to pay taxes, obey the speed limit, etc). As I
said before, the degree to which force must be used is probably a good
measure of how "agreed to" anything is. Clearly, the Soviet system was
less agreed to than ours. But it seems to me that the reasonable fear of
dictatorship should not prevent people from trying to cooperate;
community is too powerful to be abandoned entirely. The perception of
"community" is a continuum, right? I think people in this society have been
controlling way too far towardd the "individualism" end of that continuum,
with unfortunate consequences (like the quality of health care) for
many individuals. It would be terrible to force community on people but,
for me, it seems just as terribe to avoid teaching the enormous possibilities
of voluntary community. That is the aspect of education that is lacking
-- sorely -- in this community of individualists called the USA -- I think.
Best
Rick.