Philosophy, recent

Why Everyone Values Freedom

On March 28, presidential candidate Bernie Sanders uploaded a video to YouTube entitled “Medicare for All Is about Freedom.” This may strike some viewers as an abuse of language. In a market system, a consumer can freely choose whether or not to pay Aetna or Blue Cross Blue Shield or no one for health insurance. In a single-payer system of Medicare for All, everyone with taxable income pays Medicare for health insurance—theirs and everyone else’s—whether or not any individual tax-payer wants to be part of that “All.” Such a system may serve many social goods. It may even save most individual taxpayers money. (If X is your current tax burden, Y is the current cost of your private health insurance plan, and Z is the cost of your tax burden after the implementation of Medicare for All, the question that matters for your bottom line is whether Z comes to a figure more or less than the combined cost of X and Y.) It may, however, be difficult for conservatives to understand the contention of many progressive thinkers—from Karl Marx to Amartya Sen—that the provision of these social goods enhances not just the welfare and equality of many individuals but their real freedom.

Conservative thinkers have argued that the provision of these benefits must surely come at a price of reduced personal freedom. Consider the following thought experiment. An oddly conscientious thief steals my car and leaves more money stacked in my driveway than I would have likely received had I put the car on sale. This, however, doesn’t detract from the objectionable involuntariness of the theft. More systematically, in his classic Anarchy, State and Utopia, the philosopher Robert Nozick adapted the thinking of classical liberals such as Locke and Kant to make the argument that only a libertarian “minimal state” can be justified. A state which appropriates private property to pay for social services, outside of developing the institutions of a minimal state providing security and the rule of law, is involved in a form of unjustifiable coercion. Effectively, state officials have decided that an individual’s liberty to use their property as they see fit can be superseded by the social goods which emerged from redistributive efforts. According to Nozick (at least at the time, given he shifted his political orientation), this is comparable to a form of benign slavery.

Our contention is that neither side of this debate is playing fast and loose with language. Instead, the two sides are separated by a sincere difference of opinion about how best to conceptualize freedom. This dispute about “freedom” isn’t new in American politics. In his book Before the Storm, the historian of conservativism Rick Perlstein points out that civil rights protestors and supporters of Republican Presidential candidate Barry Goldwater both chanted about freedom. They did so despite taking opposite positions on such crucial issues as the provisions of the Civil Rights Act of 1964 compelling private businesses to desegregate against the will of their owners. Even more dramatically, an anti-communist thumbing through the Collected Works of Karl Marx and Friedrich Engels for the first time might be startled to find that while Marx and Engels hardly ever talk about “justice” or “equality,” they do talk quite a bit about “freedom.”

So what’s the right way to understand freedom? We both have strong views on the semantic issue and its moral and political implications, but we won’t try to settle any of those arguments here. Instead, we hope to illuminate the difference between negative or formal freedom and positive or substantive freedom so that readers can better understand what the dispute is about in the first place.

The Conservative Approach to Freedom

The conception of formal freedom holds that freedom is best analyzed and understood in terms of property. This tradition has its roots in the philosophy of John Locke and comes to fruition in the work of twentieth century libertarian thinkers like Robert Nozick and Murray Rothbard. We have a right to do what we want with our own bodies and labor because we own ourselves. As Locke articulated in the Second Treatise on Government, when we mix our labor with the world around us, we acquire “external” property. Our rights to this property then need to be protected by a government, the primary duty of which is to ensure we can enjoy the fruits of our labor without coercion by others. In the best iterations of this approach, slavery, forced labor, and the forcible confiscation of the fruits of one’s labor are all considered violations of the laborer’s property rights. Indeed, some libertarian thinkers have gone so far as to suggest that all three violations are morally on a par.

Mainstream conservatives don’t go that far. They typically believe that freedom has to be balanced against other important values like tradition, stability, and social cohesion. This is frequently characterized as an “ordered liberty” approach to distributive justice and society, and receives its classic exposition in the work of Edmund Burke. Even so, a libertarian-like understanding of freedom is an important part of contemporary Anglo-American conservativism. Here’s Ronald Reagan in an interview with Reason magazine five years before he was elected President:

The basis of conservatism is a desire for less government interference or less centralized authority or more individual freedom and this is a pretty general description also of what libertarianism is.

Now, I can’t say that I will agree with all the things that the present group who call themselves Libertarians in the sense of a party say, because I think that like in any political movement there are shades, and there are libertarians who are almost over at the point of wanting no government at all or anarchy. I believe there are legitimate government functions…. We have government to insure [sic] that we don’t each one of us have to carry a club to defend ourselves. But again, I stand on my statement that I think that libertarianism and conservatism are travelling the same path.

If you think of freedom the way that Locke or Nozick or Rothbard or Reagan defined it, it might be natural to assume that the difference between the Left and the Right is that the Left’s core value is equality while the Right’s core value is liberty. (On this picture, we can imagine different twentieth and twenty-first century political factions claiming different parts of the slogan of the French Revolution, with the Right taking Liberté, the Left taking Egalité, and the center being left with fraternité.) And, indeed, this binary between freedom and equality has been invoked by conservative icons for centuries. Alexis de Tocqueville made it a central dynamic in his analysis of American society in Democracy in America. Max Weber consistently expressed concerns that modern bureaucratic society was engaged in a levelling effort which would minimize freedom. And Ayn Rand consistently observed that the push for any kind of equality was always a reaction by the unproductive against the affluence and success of superior men.

Perhaps the most well known analysis was given by the Austrian economist F.A. Hayek in his popular polemic, The Road to Serfdom. Written and published in the 1940s, as governments were expanding to fight fascist aggression, Hayek worried that this expansion would not retreat once the conflict ended. Instead, driven by well-meaning but misguided and controlling technocrats, the state would continue to expand under the auspices of securing a higher quality of life for all and rectifying unjustifiable inequalities. Unfortunately, because these technocrats do not truly understand the relationship between economic growth and liberty, they will cause ongoing damage and in fact generate declining standards of living for all. This will inevitably lead to the technocrats seizing more and more power to rectify the very problems they produced, eventually leading to a decline in freedom for all. This is why, in The Constitution of Liberty, Hayek argued that only a minimal state can both guarantee freedom and secure prosperity for most. While considerable inequalities will emerge in such a social context, many of them not predicated on merit but luck, this is preferable to the damage which would be caused by seeking greater equality.

In some respects though, framing the difference between the Right and the Left as a dispute about whether to prioritize freedom or equality can lead to significant misinterpretations. Any conservative or libertarian who reads deeply into the history of left-wing thought will be struck by the fact that advocates of redistribution of the society’s resources (and even of nationalization of the means of producing those resources) have always understood themselves as being primarily motivated by liberté. Major figures in progressive thought, from Rousseau down to Žižek today, have emphasized that the primary reason to reform society and engage in more egalitarian distributions of social goods is that it will enhance the freedom of all. So the difference between Left and Right is in some respects more about the kind of freedom we should seek to secure.

The Left’s Approach to Freedom

As leftists, this makes perfect sense to us. We believe that substantive (as opposed to merely formal) freedom is best served by a left-wing economic program. This is because freedom is not exclusively about non-coercion by government or other individuals, which is only part of a more complex whole. Freedom is also about how capable one is of making choices to pursue various life goals. Acute precarity or lack of resources, for instance, can severely limit freedom by curtailing the number of choices available to an individual. A bumper sticker sold by the Libertarian Party bears the slogan “Pro-Choice About Everything.” From our perspective, however, the Libertarian Party isn’t as meaningfully pro-choice as the socialist Left—even on the narrow issue of abortion. If a pregnant woman has the legal option to abort but is unable to raise a child in her financial circumstances, she has fewer meaningful choices than a woman who lives in a society with legal abortion and generously state-subsidized childcare.

In this vein, Amartya Sen has argued that freedom is not just about non-interference, but about the availability of meaningful choices. While negative freedom is certainly one important kind of freedom, is isn’t the only one. Even someone who feels the pull of the Lockean freedom championed by Reagan might see how, for example, the passage of the Americans with Disabilities Act in 1990 increased freedom in Sen’s sense. That said, a more conservative interlocutor might suspect equivocation. The stand-up comedian and libertarian podcaster Dave Smith, who recently debated one of the authors of this piece, put it this way: “We might describe the experience of flying in an airplane as being ‘free from the ground,’ but surely this doesn’t have much to do with the political meaning of ‘freedom.’”

We believe that the best way for the Left to meet this challenge—and, indeed, the way in which various historically important left-wing writers have met it—is to argue that a more expansive understanding of freedom is more relevant to political principles like freedom from coercion. If a boss tells an employee—especially an unskilled employee in a time of high unemployment—”go on a date with me or you’re fired,” this isn’t as coercive as “go on a date with me or I’ll kill you” and it might not even be as effectively coercive as “go on a date with me or I’ll tell everyone what you did,” but the degree of coercion is considerably greater than zero. If the employee is a member of a union, or even if they benefit from a national health insurance plan and so don’t have to worry about losing their insurance if they lose their job, then that degree is dialed down a notch or two.

The conception of freedom as a meaningful and practical freedom from domination by others is sometimes called the “republican theory of liberty.” (That’s “republican” as in the Roman Republic, not the GOP.) While Locke understood freedom as non-interference, thinkers in this “neo-Roman” tradition understand freedom as non-domination. Frank Lovett describes this tradition of interpreting the republicans of classical antiquity in an article for the Stanford Encyclopedia of Philosophy:

Undoubtedly, the classical republicans were committed to the importance of active political participation, civic virtue, combating corruption, and so forth. But rather than viewing these as intrinsically valuable components of a particular vision of the good life, these authors argued, they should instead be viewed as instrumentally useful tools for securing and preserving political liberty, understood as independence from arbitrary rule. Republicanism, on this view, has its roots not in an Aristotelian vision of the ancient Greek polis, but rather in Roman jurisprudence with its fundamental and categorical distinction between free men and citizens on the one hand, and dependent slaves on the other.

To use a standard example in this tradition, slaves beaten by their master every day are interfered with more than slaves whose master treats them more kindly. Even so, it’s implausible that the latter are more free.

As Quentin Skinner observed, Karl Marx’s critique of capitalism falls well within this “neo-Roman” tradition. (Indeed, from “wage slavery” to the idea of a temporary “dictatorship” of the proletariat, Roman political vocabulary looms large in Marx’s thought.) If most people born into a capitalist society lack the financial resources to start a business of their own (and most small businesses fail in their first year of operation), most people have little realistic choice but to go to work for others. Marx’s solution was to advocate the confiscation of businesses from their owners in favor of a system based on workers’ control of the means of production. Even many left-wing authors who stop short of that kind of radicalism—much as Ronald Reagan fell short of wanting to do away with all government in the name of non-interference—see the issue of working-class people being vulnerable to arbitrary rule on the job as a major concern.

Social democrats propose that this kind of domination can be usefully lessened with redistributive social programs that make workers less dependent on business-owners. (If the government provide tuition-free higher education at public universities, someone considering saying “no” to an unreasonable request from his boss doesn’t have to worry that they won’t be able to pay their children’s way through college. If Medicare for All has been instituted, they won’t have to worry about losing their health insurance. Given sufficiently worker-friendly labor laws, they may not even lose their job.) Whether such programs are worth the cost in government interference in the market depends not just on how we weigh the importance of freedom relative to other values but on how we understand the meaning of “freedom” in the first place.

 

Ben Burgis is the author of Give Them An Argument: Logic for the Left, which is available for pre-order from Amazon and Barnes & Noble. He’s also a regular on The Michael Brooks Show on Tuesday nights and he releases videos every Monday for the Zero Books YouTube channel. You can follow him on Twitter @benburgis

Matt McManus is currently Visiting Professor of Politics and International Relations at Tec de Monterrey. His forthcoming books are Overcoming False Necessity: Making Human Dignity Central to International Human Rights Law and What is Post-Modern Conservatism? He can be reached at garion9@yorku.ca or followed on Twitter @MattPolProf

Photo by Grant Ritchie on Unsplash

150 Comments

  1. Libertarian says

    The notion that if your boss presents you with a “coercive” choice of alternatives only laws can protect you ignores the basic premise of competitive free markets. Where they exist you can tell him to take his job and stuff it, and go work for one of his several competitors who will be glad to hire you just to gain the benefit in their competition with him of your vindictive and vengeful energy. This notion that only what you have in hand is real and “substantial” and that no alternatives can exist if this present rich person won’t deliver one essentially denies the existence and agency of all the other millions of fellow human beings with whom you exist in society. What you call “merely formal” freedom is what makes competitive free markets with all the opportunities they create possible. Start with formal freedom and you get substantive freedom. Sacrifice formal freedom on the alter of substantive freedom and you get market failure and economic stagnation.

    • David of Kirkland says

      Yes, though employers use contracts to prevent jumping ship to a competitor. Is that legal? Are we free to agree to work for employer 1 and agreeing you won’t work for any competing employers until a few years have passed?

    • Annoying_Peasant says

      This notion of the employee having the right to leave the job only makes sense if there are plenty of alternatives with a diverse array of wages/benefits. For the vast majority of working-class and lower-middle class people, wages and workplace conditions are standardized (much as they were for serfs and tenants in the feudal era). “Choice” is an illusion in this case, just as a libertarian would argue that the “choice” to leave a nation in response to its policies is also an illusion. Recognizing injustice and hierarchies does not imply the “agency-less” of the lower classes; if anything it is crucial to their collective empowerment to overcome said injustice.

      • Stephanie says

        David, If one of the legitimate roles of government is preventing the formation of monopolies that render the market uncompetitive, I think that reasoning can be extended to outlawing non-compete clauses in employee contracts. Since they are ubiquitous now, they essentially represent monopolizing individual labour, which should belong to the individual and not to the company. That is a more elegant solution than what the author proposes.

        AP, there are millions of job openings in the US, and plenty of funding available for retraining. The poor are already covered by Medicaid, and the average cost of health insurance is less than stoners spend on weed. The poor half of Americans pay no taxes. If you finish high school, get (any) job, and wait until you’re married and over 21 to have kids, you have only a 2% chance of staying in poverty, and a 75% chance of joining the middle class or higher. It’s astounding that under such favourable circumstances people still have the audacity to complain that they have no “choice.”

        You have the amazing fortune of only having the make the most obvious choices to turn out fine, but instead of following through, or teaching your kids to follow through, you focus on “injustice” and “hierarchies,” which accomplishes nothing but nursing resentment.

        • TMac says

          Stephanie and David — in the state where I practiced, non-compete clauses are generally unenforceable, and the penalties for trying to enforce one can be high. However, no law will protect a worker who doesn’t know about his right to object to such a caluse.

      • Barney Doran says

        And in that utopian world of all of us being employed by the government for the common good, just exactly what is your alternative employment choice when you tell your government employer to take the job and put it where it won’t see the light of day? Human nature is a bitch, and every attempt at communism and extreme socialism has proven it. ‘Soviet Man’ didn’t evolve and won’t evolve unless we all get well and permanently drugged.

    • One of the main reasons for the strength of Silicon Valley is that California doesn’t allow companies to enforce anti-compete clauses in their employment contracts. As long as you’re not stealing IP, working for competitors is fair game.

      All states should allow this freedom.

  2. Bob Johnson says

    Freedom is overrated. Over the last 60 years, we have suffered from an excess of freedom. People no longer feel constrained by the boundaries of religion, nation, and marriage. Monogamy and the welfare state have both broken down, and the poor and weak have suffered. Just look at rampant divorce, polyamory, junk television, social media addiction, opiod addiction, the offshoring and automation of industry, and rampant porn use. Hedonistic, libertine freedom serves the interests of an elite that wants no obligation

    St Augustine defined true freedom, which is the ability to regulate one’s appetites

    • David of Kirkland says

      Libertarians are fine with St. Augustine’s definition since it implies control over your own body, not forcing others to ensure another body is treated well. If your freedom requires my enslavement or other harms to me, then you are not speaking about your freedom at all, but your demands for improvement at my expense.
      Despite all those “bad things,” the society is in pretty good shape considering how little liberty and equal protection is done around the world.

    • Sean Michael Bearly says

      Bob, freedom may be overrated for you but not for others. If you allow freedom, then those like you who think there is too much freedom can impose whatever restrictions you want on your own life. Freedom does not require anyone to exercise it for themselves. Plenty of free people are in bondage to things or behaviors by their own choice. But when you use laws to take away freedom, everyone (with the usual exception of those in high places) loses.

  3. Farris says

    The Left’s version is not freedom but free. Free income, housing and healthcare, ect… This definition of freedom is limitless. For instance man wife and child live in a free two bedroom house but now complain they lack not the freedom to have a larger family. Their free healthcare plan doesn’t cover nose jobs so they lack the same beauty choices and as such are unequal. They have free public transportation but lack the ability to determine and schedule their own travel. These so called freedoms come at a cost which others must be compelled to pay. Of course I guess one could argue the compelled are free to provide.
    Using the argument that freedom means choices, wouldn’t that mean that the resources of those paying for the benefits of others now have less resources and hence less choices? The left’s version of freedom is not for all but rather targeted to a preferred group and as such is not beneficial to all. The authors are not advocating freedom but rather equality of out come. The authors make several references to slavery. Does that include being coerced into working and providing for the benefit of others? Replacing the master with the government is not compassion, it is merely switching horses.

    • S. Cheung says

      Farris,
      your response is fairly stereotypical of the type I would expect from your ideological brethren. I imagine the authors should be bracing themselves for much more where that came from.

      But the “examples” in your first paragraph are all straw guys. People will not be asking to roll like the Kardashians, or going to see Rodeo Drive plastic surgeons. And if they did, common sense would prevail.

      “Hayek argued that only a minimal state can both guarantee freedom and secure prosperity for most. While considerable inequalities will emerge in such a social context, many of them not predicated on merit but luck, this is preferable to the damage which would be caused by seeking greater equality.”
      What we are talking about, in Bernie’s example, is a bigger safety net, such that if you have the misfortune of a major health crisis, you are not further saddled with a double whammy of losing your job and facing a mountain of debt. It’s freedom from a weight of circumstances that may not be of your own doing. Now, I do see the counter-argument about those who knowingly abuse their own health, and whether they should expect others to pick up the slack for their poor choices. But that’s a more nuanced refrain compared to “nose jobs”.

      I am all for equality of opportunity, rather than outcome. But what you consider an outcome (health without undue financial burden), I consider as opportunity from which you can go forth and be a productive (and tax-paying) member of society.

      • John says

        Cheung

        I wish people who think like you understood how simplistic and simple and easy to understand your point of view is. Everyone goes through it when you’re a teenager. Yet you continue to talk to people as if what you think is somehow sophisticated or elusive or on a higher level when it isn’t.

      • Farris says

        @S Cheung

        My arguments are not straw men. I see this mistaken claim frequently on response posts. I do not know if false claims of straw men result from a misunderstanding of the term or just groping for a counter argument. Straw man involves constructing an argument the other party didn’t make and the deconstructing those falsely attributed arguments. I simply extrapolated the authors ‘ argument out to what I consider a logical inevitability. I never claimed the authors made or claimed to be defending those extrapolations. One is free to disagree with whether or not the extrapolations are logical or realistic but they are not straw men.
        Stereotypical arguments tend to be correct, that is why they are often repeated. Amongst mathematicians four is the stereotypical answer to the question two plus two.
        The misunderstanding arises from the notion that employers are apt to abuse employees. Generally this is fundamentally untrue. One bad apple does not spoil the whole bunch. Employers desire productive workers as those workers maximize profits, the more productive the better. In order to attract productive workers the employer must provide incentives in either salary or benefits or chose to risk losing productive employees to competitors. In my opinion the authors do not believe that people are benevolent but rather see government as benevolent. Which I find odd since government is comprised of people. People will not generally watch their neighbors starve but rather will provide assistance. Witness the burning of Notre Dame within 24 hours over $900 million dollars raised. Coercing people to pay infringes upon the freedom of those compelled, especially when others dictate the manner and terms of assistance. Additionally the coercion is a disincentive for some to provide direct assistance. Therefore coercion should be limited as much as possible. No one is arguing against a safety net for the misfortunate but rather the debate concerns the most efficient and least coercive manner of providing for those needs.

        • Ray Andrews says

          @Farris

          “I simply extrapolated the authors ‘ argument out to what I consider a logical inevitability.”

          You are correct that you didn’t make straw men, but you did caricature, as you admit. But why the logical inevitability? There is noting inevitable about taking various social initiatives to the point of absurdity. In the same way, calls to cut back the size of government need not necessarily be taking to their absurd extreme, either. We are always on a slippery slope to hell in either direction. Sensible people advocate for sensible balance.

          “Amongst mathematicians four is the stereotypical answer to the question two plus two.”

          Since you’re being rigorous with your logic, the above is not a stereotype, it is a provable answer.

          “The misunderstanding arises from the notion that employers are apt to abuse employees.”

          You make the usual just-so story, which — like all just-so stories — sounds true. Alas it is not true. Employers are always apt to abuse employees. When there is a labor shortage that diminishes somewhat but it never goes away since fear of loosing one’s job is always a powerful un-freedom.

          “Coercing people to pay infringes upon the freedom of those compelled, especially when others dictate the manner and terms of assistance.”

          But that is true of all taxation. I am compelled to pay my municipal services tax. But in return I get water and sewer and garbage collection. It would be grossly inefficient for everyone in town to have to attend to their own water and sewer needs. All but the most fanatical libertarians understand this.

          ” No one is arguing against a safety net for the misfortunate but rather the debate concerns the most efficient and least coercive manner of providing for those needs.”

          Some are. But the only sure way to provide such services is via the government. The mega rich would like it to be via local charity. They like that because then they’d simply not have to contribute. As the Bible points out, avarice has no limits.

          • Farris says

            @Ray Andrews

            Nice to hear from you Ray.

            Employers hire employees because they need them. The employer can not deliver his goods and/or services without the employees.

            “….fear of loosing one’s job is always a powerful un-freedom.”

            Employers invest in employees not with just salary and benefits but with training. New employees are less efficient as they are learning while working. So if your statement above is true then the following statement is true: “fear of losing productive employees is a powerful unfreedom.” Yet employees move on to better opportunities, as is their right. Furthermore oppressive government mandates or taxes can result in job losses. Employers typically respond to minimum wage increases with layoffs. Who is responsible for that unfreedom? Both employer and employee require profit to make their relationship work. Profit is not a product of income but rather a result of cost savings.

          • Ray Andrews says

            @Farris

            And you sir:

            “….fear of loosing one’s job is always a powerful un-freedom.”

            Everything you say is perfectly true as just-so stories go. My objection is the same one I level at the Commies. Their just-so story is the most wonderful of all, and listening to it, one is hard pressed not to become a Commie. There is only one small problem and we both know what it is: it doesn’t work in the real world. It’s the same thing with the Free Market just-so story: it is wonderfully explanatory it’s just that in the real world things don’t work out so wonderfully. We in fact find that the huge power advantage that the boss has gives him an unfair advantage and ordinary, replaceable workers are often treated very poorly.

            You’re familiar with the Triangle Shirtwaist fire? It galvanized an entire society to change the way it looked at the Free Market. As you may know, even after the fire, the owners were unmoved and not sorry. Their staff had worked there voluntarily, and they were and had been free to move to another sweatshop, or to starve. As it is, a few score exercised their freedom to jump rather than burn to death, tho a few chose to burn. The whole country started to question the merits of this kind of freedom.

          • Farris says

            @Ray Andrews

            I can’t thank you enough for your response. By citing the 1911 Triangle Sweatshirt fire, you have helped me to corroborate a theory I have maintained for years. I have always claimed that the arguments of progressives are indicative of people still living in the beginning of the twentieth century. The days of the robber barons and no child labor laws have long since passed. Business and society has progressed since the good ‘ol bad days. I suggest we strive for policies beneficial to 2019, not 1911. Progressives continue to fight old fights, perhaps that is because they are out of new ideas, old codgers sitting around re-living old glories.

          • ga gamba says

            There is noting inevitable about taking various social initiatives to the point of absurdity.

            Though things may not be inevitable, stating that they may not be does not rule it out. They remain possible, perhaps even likely. All it takes as a catalyst is for a sufficiently large enough or influential enough group to make the appeal, and if Nassim Nicholas Taleb is correct, it could be as little as three per cent of population evenly distributed.

            In the ’70s, Phyllis Schlafly and the opponents of the equal rights amendment argued that inevitably restrooms would be made genderless. The progressives of the time waved that away as hysterical fear mongering. “It’ll never happen.” Who has been proved right?

            Ninety-two genders and growing upends the idea that absurdity is not a possible outcome. Of course, many of those claiming one of the new genders probably don’t deem their assertions absurd.

            The strategy of incrementalism and the success of its incessant nudges tells us the path in that direction is ongoing, though it may not be linear having to zig zag a bit.

        • @ Farris

          “My arguments are not straw men.”

          Your first comment is much more and worse. You completely and perhaps delibrately bastardize what Left sees in a Welfare system.

          Example: “Their free healthcare plan doesn’t cover nose jobs so they lack the same beauty choices and as such are unequal.”

          “Straw man involves constructing an argument the other party didn’t make”

          Yeah! So according to this, you were strawmanning.

          “Stereotypical arguments tend to be correct”

          Huh!? Why don’t you think this over and try to revise this stupidity.

          “Amongst mathematicians four is the stereotypical answer to the question two plus two.”

          Nope! Complete horseshit. Two plus two equals four is basic fact of reality. It is NOT a stereotypical answer – rather it is ALWAYS the case.

          “The misunderstanding arises from the notion that employers are apt to abuse employees. ”

          Employee and Employer have some divergent interests and this can lead to conflict.

          • Ray Andrews says

            @Farris

            “The days of the robber barons and no child labor laws have long since passed.”

            Fair enough. But you’d concede that those changes did not come about due to Free Market Forces? They came about due to Government Interference in the Marketplace? It’s inevitable that extreme examples get thrown around, they’re mostly used to try to make the other guy look like a fanatic, but at the same time we should be aware of all slippery slopes in all directions.

            I only say that Free Market Forces do not solve every problem and that sometimes Big Bad Government has a role to play. Standing as I do in the center, I can happily agree that there is such a thing as too much government but I can also say that there is such a thing as too little government. I don’t want the poor starving on the sidewalk, but neither do I want muligenerational lifetime welfare dependency. I like entrepreneurial capitalism, but I don’t like what happened in ’08. ‘Equality’ is not possible, nor is it even to be desired, but there is such a thing as too much concentration of wealth, too.

            Being in the center means living without a comforting just-so story, but we always have Kipling’s and IMHO they’re much more entertaining and they don’t screw the economy. It is deplorable for the government to not give a damn about the (working) poor, it is equally deplorable for the government to permit anyone to think that they are entitled to a free lunch forever. Sensible, rational people belong in the center. No?

        • S.Cheung says

          Farris,
          your “logical inevitabilities” (or more like extremes”) ARE arguments the author did not make. Are you not making an argument in listing those extremes? Was “nose jobs” not an attempt to argue against the defensibility of a “free healthcare plan”? You didn’t merely state that “free healthcare runs the potential risk of descending into the absurd, such as someone demanding a nose job for purely cosmetic reasons”; you ARGUED that some healthcare recipients might complain that lack of coverage for a nose job would constitute unequal treatment.

          You digressed into stuff unrelated to healthcare. So when you say this (“Coercing people to pay infringes upon the freedom of those compelled, especially when others dictate the manner and terms of assistance.”), that describes all taxation.

          “No one is arguing against a safety net for the misfortunate but rather the debate concerns the most efficient and least coercive manner of providing for those needs.”
          —so if you accept the need for a safety net with some common sense constraints, but universal healthcare is not the “most efficient” and “least coercive”, then what do you suggest instead?

          • Chuck37 says

            I think Farris has made good points, and a cursory reading of the resulting comments pretty much brings things back to status quo (in contradiction to the point the article was trying to make), that progressives are simply willing to sacrifice significantly more freedom to both help the unfortunate and (in my view) tilt the capitalist playing field in favor of “the little guy”. The left doesn’t define freedom differently, it just doesn’t care about it as much relative to other things.

        • AGPhillbin says

          @Farris,

          I’m not going to give a detailed answer to you remarks, as I see that others are taking up that task. But I will point out one part of your statement that strikes me as absurdly naive:

          “People will not generally watch their neighbors starve but rather will provide assistance. Witness the burning of Notre Dame within 24 hours over $900 million dollars raised.”

          Really? When was the last time you walked past someone begging in your neighborhood, or volunteered your time or gave money to provide housing or food for those in need? How well do you think most people know or care about their neighbors? More or less than they might care about the destruction of Mount Rushmore, the Washington Monument, or some other piece of architecrure or sculpture of equal significance to American national identity? The Cathedral of Notre Dame isn’t anyone’s “neighbor,” it is an inanimate object imbued with cultural significance. Comparing apples and oranges would be more plausible than this. Now, perhaps your view would be more realistic if most of us lived in close knit communities of the sort that our “free” economy tends to erode, but we don’t.

      • Mec B says

        Now I know that “nose job” does seem like a trivial matter that is ludicrous to majority of us but if we look beneath it, that is where the deeply troubling issue of Universal Health Care in the hands of “critical theorists” or intersectionalists can lead too. If as an example (and we are not far off mind you) the employer needs the applicant to look “instagram like” for the job, I can foresee that many people eager to take that job may require surgery to get the position. It is then logical to an intersectionalist to note the “inequality” that a bad nose may have to get the position and thus the government run health care has a duty to provide “equality of opportunity” for anyone who needs the surgery to have the opportunity to get the position.

        This is not to say that Universal health care is a bad thing. I really do appreciate my country’s UHC, but it is an endeavor that in the wrongs minds/lead by, can lead to a truly horrifying financial burden(using the nose job as an example). A well laid out plan takes time especially with regard to UHC.

        • David of Kirkland says

          The U.S. military MUST PAY for transgender surgeries, per the courts, but courts elsewhere will suggest the Feds can not pay for abortions, which SCOTUS declared an actual right (oddly of course).

        • Ray Andrews says

          @Mec B

          Yes. The is no question that it can get out of hand.

        • S. Cheung says

          Mec B,
          that is simply a variation of the slippery slope that Farris launched himself off of.

          One way to conceive of what universal healthcare might cover would be considering what is deemed medically necessary. Farris used “nose job” in the most derisive manner (or at least intended it to be received that way). But a “nose job” is a rhinoplasty, which can be cosmetic or reconstructive (such as after trauma, or cancer). It can also be external or internal (eg. deviated septum repair to correct a form of sleep disordered breathing). He intended it in the most ludicrous (insofar as universal healthcare is concerned) cosmetic sense, when in fact there are nose jobs that CAN be medically necessary.

          Now, for people whose ideology is that anyone making decisions about tax dollars besides themselves is unacceptable, letting doctors arbitrate what is or isn’t medically necessary for the purposes of tax dollars paying for a procedure is likely already a bridge too far. And that’s the way these discussions always go.

          You have UHC. Do you get a free nose-job to be instagram-ready if you so desired? If not, then maybe that kind of logic isn’t so inevitable after all.

      • David of Kirkland says

        @S. Cheung – That you suggest a little theft from one to give to another is okay is funny. Sure, your “common sense” might prevail, but why should it. If it’s okay to have X, why not X+1? How did you find the limit where X is okay, but X+1 is not?
        “I’ll just put the tip in…” doesn’t work.

        • Ray Andrews says

          @David of Kirkland

          Should the poor be entitled to walk down the street if they can’t prove that they paid enough tax to justify the privilege? Every public provision — roads, sewers, fire-brigade — involves the risk that someone will collect more than they pay. All these things involve a load-leveling or one might say ‘insurance’. Social benefits are no different. Mind, there can and should be limits to them, too.

        • S. Cheung says

          David,
          I could have been more precise. I used “common sense” as in “who in their right mind would seriously advocate public coverage of elective cosmetic surgery”. But you are certainly correct that you can’t codify or legislate common sense. So instead, as I mentioned to Mec above, one possible test would be “medical necessity”.

          Now, your next question might be how to best determine that. I don’t have an answer for you. I imagine it will involve doctors. Which will likely cause a subset of commentators here to resist giving up their tax dollars to the control by doctors in general, and in the case of nose jobs, plastic surgeons in particular, whose primary objective is to buy another Ferrari.

      • Jim Gorman says

        S.C. –> “People will not be asking to roll like the Kardashians, or going to see Rodeo Drive plastic surgeons. And if they did, common sense would prevail.”

        That is a large assumption on your part! Whose common sense and who will enforce it? If allowing one the freedom of choice is important then it would have no restriction. It’s human nature that some will choose whatever it is and some will not. Are you too young and/or sheltered to understand that?

        “What we are talking about, in Bernie’s example, is a bigger safety net, such that if you have the misfortune of a major health crisis, you are not further saddled with a double whammy of losing your job and facing a mountain of debt. “ Where do you get this from? I don’t remember Bernie’s plan guaranteeing your job nor keeping you out of debt. Have you considered taxes, monthly bills like water, food, electricity, loan payments. Again, are you too young and/or sheltered to understand that?

        Socialists never sit down and do a expansive project plan of what could take place with their solutions. Unexpected consequences reign supreme. This is why socialists ALWAYS end up with bigger and bigger government and more and more intrusiveness into everyone’s life. Every time you turn a corner, you will see another outcome that is unjust for someone. Until you have leveled outcomes for EACH INDIVIDUAL there will always be another problem for government to solve. Everyone will end up with a government shadow telling them each and every second how to live their life. Lastly, are you too young and/or sheltered to understand that?

        • Ray Andrews says

          @Jim Gorman

          Are you too young and/or sheltered to understand that when the government gets out of hand — either too stingy or too profligate — we have an election. Last election just yesterday up here in Canada saw conservatives returned to power in Alberta after a brief love-in with the socialists.

          • Saw file says

            @Ray A.
            The NDP gaining a term in power in Alberta wasn’t a “love-in with the socialists.” (other than Edmonton). It was simply the byproduct of the then split of the Right vote.
            The only ones more surprised with the results than the conservatives were the dippers themselves.

        • S. Cheung says

          Jim,
          it must be that “common sense” is less common than I thought. Numerous examples of that just on this thread. So as I said above, replace with “medical necessity”.

          I’m actually just old enough and traveled enough to know what common sense is. Apparently not shared by everyone.

          ” I don’t remember Bernie’s plan guaranteeing your job nor keeping you out of debt.”
          —and I didn’t say it did either. But if your medically necessary surgery was free, maybe you don’t need to sell your house, or something to that effect. I think the point can be made without being completely literal about it, don’t you? And yes, there are other expenses. And “common sense” (there’s that concept again) tells me that free healthcare doesn’t mean the same thing as free everything. Your results may vary. But maybe if you’re not facing a 100k medical bill, you might more easily manage water, food, etc. Ok, you’re right, the swimming pool may have to go, and the Maybach may have to be repo’d. I am old enough to realize life involves very painful choices…sob….oh but the backseat of that Maybach must be the size of a swimming pool though…and the leather must be ooohhh sooo fine…

          “Socialists”— I don’t think that word means what you think it means. I haven’t seen any mention of a managed or centrally controlled economy. I think you’re conflating “social welfare”, which is a common affliction around here.

          I have had the good fortune to not have suffered any catastrophic health event thus far. But I am old enough and empathetic enough, and have a brain enough, to not need direct experience to realize the folly of “every man for himself” in an arena as fragile as your health. Clearly, that concept eludes you, and folks like you.

          • Jim Gorman says

            SC –> I too am old enough to recognize that when politicians talk about “social welfare” that it is a prescription for a never ending government provided basket of “free” things that soon expand past the “safety net” idea. Socialism doesn’t necessarily require the government “own” the means of production, as long as they regulate production so closely that the same result occurs. That is what we have going on today in so many industries. The government keeps looking for “problems” to solve and interferes in every part of business and private lives. That is socialism to me.

          • S. Cheung says

            Jim,
            You’re doing the same thing as Farris. Things don’t have to be “logical extreme” to the point of absurdity, every single time. I think there is a common sense middle ground somewhere btw “none” and “never-ending”. If your mind is closed to that as a possibility, then this is no different from what was discussed on the IDW thread ie. you can’t even have a good-faith discussion.

            Your definition of “socialism” is fine if you want but it has nothing to do with healthcare unless you somehow equate healthcare with production. That in itself is on that slippery slope towards absurdity.

      • Ray Andrews says

        @S. Cheung

        Well said sir. They have to take the thing to an absurdity every time.

        • Stephanie says

          My mother actually did convince the socialist health care system to pay for her nose job in the 1970s. She lied and said she was getting bullied for her big Jew nose and that it was thus necessary for her mental health that it be fixed.

          Farris didn’t make any strawman arguments. The natural consequences of this line of thinking might sound absurd and unrealistic, but people already are successfully making those claims. You’d think with all the crazy things people are claiming as their “right” in the news, Farris’ examples would be conservative.

          I think the distinction between “freedom” and “free” accurately describes the distinction between right and left. There is no limiting principle on how much “free” things you are entitled to, so by necessity it will trend to greater entitlement as people become used to what they already receive for free. The nature of progressivism is that it must continue to progress: there can be no final state, or the movement ceases to exist.

          • Saw file says

            @Stephanie
            Your example it absolutely believable.
            I know three women who received unnecessary cosmetic breast augmentation through manipulation of the UHC system by making it a psychological (self esteem) issue.

        • S.Cheung says

          Ray,
          don’t I know it. Precisely what I meant by “stereotypical of the type I would expect from your ideological brethren”. And I wasn’t referring to arithmetic.
          BTW,still trying to apply those lessons you taught me. Some days harder than others, or so it seems…

          • Ray Andrews says

            @S.Cheung

            “BTW,still trying to apply those lessons you taught me. Some days harder than others, or so it seems…”

            You’re batting 400 bro. And the fact is that we are winning this hands down. We can demonstrate the virtues of economic moderation, what guys like Jim (pardon me sir) have is the endless recitation that you and me must one day hoist the Red Flag over the Capitol. All they have is their warnings of Armageddon if we deviate from The Free Market by one inch. Baloney! If the government needs a liposuction — and that’s entirely probable — then give it a liposuction. E will point out, correctly, how difficult that might be. Fine then, it’s going to hurt. Too damn bad. Meanwhile taxing billionaires will no doubt cause them no end of suffering. Too damn bad.

            Speaking of the Red Flag, AOC and company probably do want to hoist it, and the libertarians want a return to John Wayne’s Wild West and each of them generates the other. Moderation used to be a virtue, what happened?

          • S. Cheung says

            Ray,
            I’ve learned to avoid using “common sense” moving forward, at least with this crowd. Gotta read the room. But you’d think one can logically conceive of a position that’s somewhere btw AOC and a John Wayne flick.

            I agree with Olson’s general gist of excessive bureaucratic fat and waste. So let’s cut that where we can. But some level of medically necessary healthcare doesn’t have to be a free-market luxury to me.

            And I still love that trickle down business. Gates and Buffett choose to give their money away, and good on them. I doubt it would be an existential hardship for others in their percentile neck of the woods if they “had to” to some extent, perhaps more than they do now, without crippling investment.

    • Ray Andrews says

      @Farris

      “Does that include being coerced into working and providing for the benefit of others?”

      Yes, if you are a young man and your nation declares war — almost always to advance the agendas of your nation’s power elites — those same elites take it as a matter of course that you will be coerced into killing and dying for their sakes. Mind, their own sons will receive exemptions naturally. But let not those same young men suppose that the elites owe them anything in return, that would be socialism.

      • Farris says

        @Ray Andrews

        So you would oppose conscripting the man but not his property?

        • Ray Andrews says

          @Farris

          I’d just see the whole show for what it is. There are compulsions in any society and we should not pick and choose the ones we like and the ones that don’t suit us. To oversimplify for effect I think that FDR did the right thing by not letting starvation correct the labor surplus during the Great Depression and he also did the right thing drafting those same men who received government assistance off to die on Iwo Jima. To the extent that the state giveth, the state has the right to taketh away.

      • K. Dershem says

        The “taxes = theft” argument fails to acknowledge that society makes wealth production possible. Taxes are the price we pay for the privilege of living in a civilization that provides us with opportunities to lead meaningful lives. Libertarians seem to define humans as atomistic individuals who engage in voluntary transactions with other individuals — the only obligations we have the ones to which we freely consent. I disagree. Although liberty is an important value, it’s not the only value that matters. Humans are embedded in relationships with family members, friends, acquaintances, co-workers and fellow citizens. To a significant degree, these relationships constitute our identity and establish moral obligations. Obviously, our obligations to our loved ones are far stronger than those to strangers who live in the same city, state/province, or country, but obligations to people with whom we share a society are nevertheless real. If voluntary charity was sufficient to ensure that our fellow citizens have their basic needs met, a tax-funded social safety net may be unnecessary. However, libertarians themselves provide evidence that people are fundamentally self-interested. Many government programs are bloated and inefficient, and can provide perverse incentives that lead to unintended consequences. In my view, this provides a reason to improve those systems, not to eliminate them and leave people to fend for themselves.

        • Stephanie says

          K, there are other ways to organise joint ventures in society other than taxation. I think the libertarian preference would be that projects benefiting a broad range of people (roads, hospitals, ect) be organised at the local level and funded on an equitable, voluntary basis by the people who want to see it done.

          You’re right that people are selfish by nature, which is why such a system would only work if we had religious institutions inculcating a sense of virtue that compels people to charity. The welfare state and taxation destroy the motivation for charity. Think of a typical response to beggars: I pay into social services ready to provide for you, why are you bothering me instead of using them? When someone is begging for money to pay medical expenses in a country with universal coverage, it leads to strong suspicion that they are lying.

          If we knew for a fact that the government wasn’t going to help these people (or kids with cancer, or disabled vets, ect), how much more responsibility would we feel for helping them personally? The rich generally donate huge quantities of wealth to charity; how much more would they donate if they weren’t taxed at 37%? How much more efficiently could the money be spent if people could choose where their money goes, instead of throwing it into the most inefficient bureaucracies?

          Maybe the ship has already sailed and the welfare state has taught us to accept massive wealth confiscation and ignore the suffering of those around as the State’s problem. Maybe our charitable impulse and connection to our community has been severed and cannot be rebuilt. But I don’t think it is fair to ignore the possibility we can avoid the progressive slide towards ever-greater government control and rebuild our social fabric. The challenge is that it requires a rise in personal virtue and a simultaneous roll-back of government mandate, a transformation that seems unlikely in a time of rising entitlement.

          • Ray Andrews says

            @Stephanie

            “on an equitable, voluntary basis by the people who want to see it done”

            So those of us who want a sewer system will pitch in and pay for it, and those who don’t won’t then? And if I didn’t help pay for them, can I walk down the road? How many miles?

            “The welfare state and taxation destroy the motivation for charity.”

            There is some truth in that, but how much? Show us a graph of taxation vs. charity. and lets see. Besides the ‘welfare state’ is simply charity organized on the highest level. I like it that beggars do have access to services and thus I feel less impulse to be pan handled on the street.

          • K. Dershem says

            Stephanie, I don’t have a great deal of faith in the generosity of the rich.

            *In an article in The Atlantic this month, author Ken Stern details the charitable divide between the income classes. The author of “With Charity for All: Why Charities Are Failing and a Better Way to Give,” writes that in 2011, Americans with earnings in the top 20% of income levels contributed, on average, 1.3% of their income to charity. Those at the bottom 20% donated 3.2% of their cash to charity—more than double of what their more-wealthy counterparts donated.

            What’s more, Stern says those at the bottom income levels often do not itemize their tax returns, so they aren’t taking advantage of the charitable tax deduction.

            Caroline Preston, senior reporter at The Chronicle of Philanthropy, says as people accumulate more wealth they tend to become more insulated and set apart from others, making them potentially less aware of others’ needs and struggles ….

            Ken Berger, president and CEO of Charity Navigator, a nonprofit evaluator, says “When it comes to the rich, the big areas of donation are the arts, universities and sometimes health-care organizations,” Berger says. “That is not to say they don’t give to other causes as well. With the poor, they tend to lean towards human services, direct service organizations that are focused on serving the poor. It’s how you define charity because some don’t see a hospital or museum as a charity, but they need donations to operate.”

            Preston says it’s harder for social services organizations to garner support from wealthy donors. “The super wealthy, billionaires of the world give to universities, cultural organizations and higher-education institutions,” she says. “For anti-poverty and development-relief organizations, it’s just harder to get on the radar of these wealthy donors.”*

            https://www.foxbusiness.com/features/poor-middle-class-and-rich-who-gives-and-who-doesnt

            If your hypothesis that lower tax rates result in greater generosity is true, then wealthy people who derive most of their income from capital gains (which is taxed at a much lower rate than paid work) should be more charitable than those who receive a salary.

          • Ray Andrews says

            @K. Dershem

            ” so they aren’t taking advantage of the charitable tax deduction”

            When PBS tries to give me a mug after I donate I tell them I’m making a gift, not a purchase and they can keep their mug. I’ve never made a deduction in my taxes due to charity once, and I find the idea distasteful. Grubby proletarian that I am.

  4. Closed Range says

    My impression of the article is that overall, it was rather shallow, and simply reiterates the mainstream centre left view on the differences between right and left. It doesn’t really go beyond the standard examples, and I still feel that this view doesn’t challenge itself enough when it comes to matching this view with the facts of history. Before elaborating further, I want to also point out that the analogy of the thief leaving cash behind is so ludicrous that it weakens the argument above it on the economies of scale achievable in a welfare state – it would improve the article to remove that analogy altogether.

    Where I think the first main limitation of the article is that it fails to try to really assess if the facts show that these notions of freedom discussed can be correctly attributed to the right or left, or if in fact our notions of freedom are coming from older currents related to the Enlightenment. For instance, slavery was abolished throughout the British empire in 1833 largely as the result of a religious campaign involving Quakers, Evangelicals, along lines of reason related to Christian notions of charity and empathy (check up William Wilberforce). This occured before any “left” ever appeared as a political movement. The fact that the left has occasionally borrowed the conception of freedom as absence of coercion from earlier movements and applied it in other situations doesn’t justify putting under a section of “The Left’s Approach to Freedom”; would it not be more historically accurate to describe this concept of freedom as an “Enlightened Christian” approach? To use a leftist term, that’s a case of appropriation. I also certainly don’t get how the authors try to connect this notion of freedom to the Roman Empire, that bit of the article was confused…

    The second main weakness of the article in trying to characterise left and right wing notions of freedom is that the authors forgot to consider any instances where these political factions don’t live up to their claimed notions of freedom. You learn more about a movement’s core through what they do, and not what they say. The fact that Marx used the word freedom a lot doesn’t really prove that the left cares about freedom. Of course one can cite the crucial examples of left-wing dictatorships of the past and present, but even within (supposed) western democracies, the modern left is deeply hostile to freedom, even as a notion of absence of coercion – a more accurate view of the present day left’s attitude to freedom is to be found in another article here on Quillette, namely https://quillette.com/2019/04/16/why-are-women-under-represented-in-physics/

    I think ultimately it is this missing aspect of the article which makes the panglossian title of “Why Everyone Values Freedom” sadly untrue.

    • John says

      Closed range

      The reason it seems shallow is because it is. The self delusion of the self-important “intellectual center left“ is that their worldview is somehow rigorous or sophisticated when it’s really quite simple and narrow. This shows up in their inability to truly understand the points of view that they don’t agree with. They cannot articulate what they don’t agree with and because they’re limited by their view of the world. Thus they don’t really understand it. They think they understand it based on a cartoon of reality.

  5. For a more in-depth view of the disagreements between the opposing negative and positive views of liberty, I think it would be wise to read Isaiah Berlin’s “Two Concepts of Liberty”.

  6. peanut gallery says

    Booooooring. I’m not that opposed to the idea of Health Care for All (though some definition of terms may be in order.) My problem is that the author and people like him seem completely uninterested in investigating why the current system is messed up. Slapping on HCFA now would be like putting a bandage on a festering wound. You can’t even elucidate what the current problem is, how can you claim to have the solution? The array if issues are multitude. In summary here are a few big ones, the over-arching theme being “US healthcare is nothing resembling a free market and I think a freer market would help solve a lot of issues and allow implementing a social healthcare system on top of THAT to be more successful”

    The “insurance” we have now is nothing like real insurance that I have on my car, which I feel like is a decent value for what I get. My Health insurance is a greedy middle man that exacerbates bloat and takes a share of all medical expenses and helps inflate the cost of everything. I could just be required to save the amount I pay each year in HC and be good to go. Yet someone one started requiring me to pay. I’m sure insurance companies hated the ACA.

    The US has a shortage of Doctors for no good reasons and we have totally allowed pharmacy to become completely dysfunctional and the free market had nothing to do with it.

    Also, the US debt is a real problem. Nothing lasts forever. New Democrats will wail and gnash their teeth about the “future populations” affected by Global Warming, but seem to have no concern for the absolutely certain economic devastation if we ever stop being able to maintain our charade of wealth. I guess starving and disaffected children of US citizens isn’t that interesting. Call me a “conservative” I guess… Just do whatever Paul Krugman suggests, he’s a great economist and social commentator.

    • Jim Gorman says

      P.G. –> I think you meant, “Just do whatever Paul Krugman suggests, he’s a great economist and social commentator.” AND DO THE OPPOSITE.

    • Ray Andrews says

      @peanut gallery

      ” I guess starving and disaffected children of US citizens isn’t that interesting. Call me a “conservative” I guess”

      More like a paleo-socialist or a classic liberal or a sane centrist.

      • Peter from Oz says

        No, a conservative or a Tory. Pragmatic with a respect for tradition and a distrust of plans.
        As Dr Johnson once said, government schemes of improvement are laughable things. That’s usually because government is more interested in increasing bureaucracy and budget than it is about actually making things better.
        Government has long since become a way for politicians to find new things to do, even if they don’t need doing. The classic example of this is man made climate change, which has been invented and sustained by those with an interest in bureaucracy and rent seeking.
        Sinistra delenda est

  7. asdf says

    We have limited resources.

    To procure the resources I need to live, tradeoffs are necessary. For instance, I have to trade my time for money (a job). Let’s say I need $Z of goods to live.

    If the government taxes $X from me, and provides me with resources worth $Y, and $Y < $X, then I now have to trade even more of my time to earn $Z + ($X – $Y) instead of just $Z. That extra time I had to trade away is a loss of my freedom.

    Socialist will often claim something like $Y > $X. However, I am skeptical based on past experience. In those cases where $Y > $X I don’t have a problem, but on the margin that rarely seems to be the case.

    • E. Olson says

      asdf – $Y > $X is the case for 50+% of the US population that pays little or nothing in taxes and received much welfare and other government goodies by virtue of being “poor”. Thus we are in danger of losing our democracy when the 50+% “takers” vote themselves ever more “free stuff” from the “makers” who pay almost all the taxes and buy almost all the government bonds that finance the deficits.

      • asdf says

        Lots of rich people get more from the government then they give. As do lots of professionals. Why do you think the teachers union votes D?

        A lots of relatively poor people pay more than they get. Would you say the law enforcement they receive or the education they get is as valuable as what taxes they do pay? Is the fact that the government monopoly in these areas drowns out alternative low cost providers good for their quality of life? Just because the government spends $15k/pupil doesn’t mean these people get $15k worth of value. They may only be paying $5k in taxes for “$15K” worth of services that are, to them, worth less then the $5k they paid.

        • E. Olson says

          There certainly is welfare to the middle and upper-classes, but very few of the truly wealthy pay less taxes than they receive in direct government goodies. I also certainly agree that the value received from public education, law enforcement, and other government services is often not worth the price paid by taxpayers, which is why I support nearly all efforts to drain the swamp and shut down public sector unions.

      • Farris says

        @E Olson

        “When the people find that they can vote themselves money that will herald the end of the republic.”

        Benjamin Franklin

    • S. Cheung says

      asdf,
      what you net would actually be Z-X+Y. For low income people, as EO says where X is nearly zero, that sum is likely >Z. For you, and most people with the time and energy to comment here, that sum is possibly/probably <Z. But that then assumes that you would only work enough to satisfy Z, and nothing more. And/or that you would consider the accumulation of sums >Z to be a loss of freedom, just as the work you would need to perform to receive a sum >Z is a loss of freedom.

      The fact that you could even conceive of a possibility where Y>X makes me assume you’re not one of the rabid libertarians here. And you’re not arguing that X should be zero. And I readily agree that the reality of a bloated bureaucracy is inefficiency and waste. It just seems to be that the application of the concept needs improvement, but that’s not a call to throw baby out with bathwater.

      • asdf says

        Even if your net tax bill was zero (which it is for nobody, because even those with zero federal income taxes usually pay SS, property taxes, etc) its still possible for the government services you receive in return to have a negative value.

        Let’s say, for instance, that government education went away. My guess is that the market would rush in to provide a now highly demanded service. There would also be lots of economics of scale that don’t exist in the private education world today. Price would come down and diversity of options would go up. And I don’t just mean in instructional quality, lots of people with access to “good schools” today are terrified by their ideological content.

        It may well be that the absence of “free” education could mean that some superior alternative would spring up at a relatively low price point which provides so much greater value that its worth more utility to people than “free” education.

        The truth is we don’t know, because it’s an impossible counterfactual to test. But it’s not clear to me that government is a net win ever for people paying $0 federal income tax.

        • S.Cheung says

          Asdf,
          That could be an argument against ANY public-funding of anything. Let competition determine the quality, and the cost. But that ignores society’s interest in having a bare minimum of education among its citizens; or of public sanitation; or in the case here, public/general health. And that bare minimum is targeting society’s have-nots. The rich always have had, and will always have, the option of purchasing a more premium service.

          What better economy of scale is there than a single payer that does its thing for everybody? And if your principles worked, why did public works and services get started anyway?

          • asdf says

            Single Payer probably won’t drive down costs in America. Single payer was really good at keeping cost trend 1-2% lower in the 70s/80s, which really add up over decades. That’s when you got a big gap open up between the USA and Europe. If you implemented single payer tomorrow, its not like the government could ram through 50% cost reductions.

            And a lot of the best performing healthcare sectors in the world aren’t single payer. Many people mix up “universal coverage” with “single payer”.

            I would guess providing the bare minimum anything would cost a lot less than now. Education, for instance, is three times as expensive in real per capita terms over the last few decades and I’m not seeing some improvement in quality.

            What’s the bare minimum? Who defines it?

            Instead of making the THEORETICAL case for there existing some instance where government might be more efficient, do the actual work of going case by case and asking if the data holds up as to whether it is more efficient.

          • S. Cheung says

            Asdf,
            Most western first world countries, if not all, have some form of public payer universal healthcare system, often augmented by a private pay option. To my knowledge, hard outcomes like mortality or life expectancy is no better here. What’s worse here is cost. If we want to see a cost inefficient system, in terms of money spent per unit outcome obtained, we can simply look in mirror. So government doesn’t even need to be more efficient; being less inefficient with our health expenditures now would already be a good step forward.

            Single payer is a form of universal coverage. I think the principle of HCFA is the universality, not necessarily the single payer bit.

            But I agree that “bare minimum” needs to be defined, as does “medical necessity “ that I alluded to earlier.

          • Craig Willms says

            S.Cheung
            Single payer isn’t the issue, It’s government control of something extremely complicated and chalk full of value judgments – like health care. Building roads and bridges and really nice parks is something governments can do well. Running a complicated business like health care is not. They are clearly failing at running public schools efficiently regardless of of how poor the results are, and they are poor.

            So prattle on about single payer, that’s just one small part of the issue. Medicare-for-all is just the next step after ObamaCare (which was designed to fail) on the road to complete government control (ala NHS) of the American healthcare system and disaster.

  8. peanut gallery says

    “And only in America do we want the system to force us to do the right thing so we can take the credit. ”

    The idea that people should help is other is correct. Contracting it out to a faceless .gov organ that has a 99.9% chance of being wasteful and and corrupt is not the answer. We would need a cultural revolution however, so perhaps I am the hopeless utopian here.

    • David of Kirkland says

      Charity is fine. Robin Hood should be left as a myth, not a coercive, centrally planned reality. There’s no end to the notion of “the common good” if it means you can take from one to benefit others.

    • Ray Andrews says

      @peanut gallery

      “Contracting it out to a faceless .gov organ that has a 99.9% chance of being wasteful and and corrupt is not the answer.”

      People repeat this trope so often than it becomes a mantra. History has shown us many lean, mean, fast, efficient bureaucracies. Within living memory a German friend of mine recalls a bureaucracy that was as crack as a division of stormtroopers. My Dad recalled the day when civil servants signed letters: “Your humble servant …” I’ve seen statistics to the effect that the American civil service was very efficient back in the day. Nuts, I used to belong to one of E’s ‘bloated civil service unions’ and work for the government, and I can assure him that most of us want to do the right thing.

      • peanut gallery says

        @Ray Generally, I think the bureaucracy in the US has just gotten too big. I think there’s a limit to just how many people can be managed. It’s best to spread the government power out not up. Or don’t give the government more power, give more people more power. If that makes sense. The consolidation of power in the presidency only makes the power of politics more valuable to the corrupt and unscrupulous.

        Technically, the American people DO have the power to change things now, but not the cultural will. I don’t think there’s an easy solution.

        As an engineer, I like to get right at the surest solutions. Right now, HCFA won’t really solve our problems and will just make it messier. No argument for “forcing doctors into ‘slavery’ or whatever are necessary.

        • Ray Andrews says

          @peanut gallery

          “I think the bureaucracy in the US has just gotten too big.”

          Now that’s a reasonable thing to say. But the extremists here will always talk about in inevitable slide into Maoism or to 99.9% waste.

          “I don’t think there’s an easy solution.”

          Me either. But just-so stories of why my libertarian or free-market or socialist paradise has all the answers is not it. Steph thinks that if the town decides it might want a water system then folks will gather round the town hall and throw a few bucks into a hat and it will get done. Presumably if you didn’t pay in, then the pipes don’t go to your house but if someone who did pay moves in, then they have to rip up the roads again to bring in the pipes but rip them out again if he moves away. Really?

          I honestly wish we could run social experiments. Let’s have a Libertyville somewhere run on fundamentalist libertarian principles — no taxes, no police no public words. Galt’s Gultch. Some other country where capitalism is absolutely unfettered and taxes are charged as so many dollars per head, rich or poor. No need to run the socialist paradise experiment tho because it’s been done dozens of times already with nearly the same result each time. And then there’s good old centrism, which every liberal democracy in fact practiced and most still do and which in point of fact created the most prosperous societies the world will ever see. But which most folks see to want to destroy. Me, I’d say it sure needs a tuneup but I’d rather keep it than junk it.

  9. Daniel V says

    So single payor healthcare is bad because giving a poor man is freedom to choose to treat his cancer to try to continue living is less important than ensuring a rich man has the freedom to die of their cancer?

    Nobody has a choice when it comes to the majority of health care issues. No one can choose to get sick and no one can reasonably choose to not seek care without being suicidal. The freedom to choose the bullet when a gun is pressed against your head is not freedom.

    • Kevin Herman says

      Single payor is bad because goverment bureaucrats, and not doctors, frequently decide who gets treated. Doctors get paid less and when you get paid less you are frequently quite less enthusiastic about the whole thing in general. The truly poor already have medicaid which is awful but not more awful then what single payer will be for everyone.

      • David of Kirkland says

        Liberty suggests you shouldn’t be limited to a doctor’s decision, but that you are an adult who can think and act for himself about himself. Giving doctors authority over you is a mistake, of course one enacted by force of government.

    • David of Kirkland says

      Disease is not imposed by others. You have no right to everlasting life, nor to an illness and injury free one.
      A century ago, there was no treatment at any price for cancer. Was there just no right then? Was this right created as soon as treatments were created? The government will now just pay for any treatment anybody creates and another suggests they need? There’s no end to medical services, being created on a daily basis around the world. Go figure if you think you’re simply entitled to them all because someone else created it.

      • Erik says

        I would suggest you google “environmental disease” and read about epidemiology or epigenetics. Disease can very well be caused by others.

  10. Lightning Rose says

    Has anybody bothered to ask why seemingly the entire population is “sick” to begin with? Maybe it’s our manufactured diet of hog fattening chow which is having the predictable effect. So the pharma-bros ratcheted the allowed “normal” number ever lower; the most ridiculous is that high blood pressure is now considered to be anything over 110/70! I’ve known one person in my life with a BP that low, and he’s a lifetime elite athlete. So the goal is plainly everyone under doctors’ orders, all the time, with “normal” being everyone on multiple, expensive meds. The goal is not a CURE for illness, it’s “maintenance” of chronic conditions or, heaven help me, medical interventions for this new piece of Orwell-speak, “wellness.” Sorry, if you need a Rx to be “well,” by definition you’re NOT. Don’t get me started on lack of evidence-basis in every direction. Most of the common “study says” epidemiology data-dredging is a JOKE.

    The quickest, easiest back door for totalitarian control to enter is the nanny state, “for your own good, dear.” They’ve been ramping this up for 40 years; it’s called “population medicine,” or in the livestock trade, “HERD medicine.” As in wear your monitor so we know how many steps you take, can control what you eat, spy on how much you sleep and what your job satisfaction level is. We can tell if you’re “happy” by your cortisol levels, dear. We can tell if you’re pulling your weight.
    Try foiling this, you malcontent, and we’ll medicate you “happy” and compliant to the Soylent Green Feedlot’s Central Planning. Here’s your microchip! Is it any coincidence the left has in the past two decades elevated public, performative “health” to its most conspicuous “virtue signal?”

    BTW, when you’re in your 80’s, you’ll be denied care and instead be prescribed a Culling Pill–to take of your own free will, of course!

    • Kevin Herman says

      People run for the hills from socialized medicine when they are told about the wait times and rationing that occurs. Unfortunately the media and elites do there best to keep the public in the dark about those aspects of single payer government run healthcare. People actually think they’ll get the same amount of treatment they get now under private insurance. They don’t understand that the older they get the less treatment they’ll get. Good luck Grandmom with that stage four cancer you’ll be dead in six months or less. Most people don’t have the time to get informed sadly so I feel like we will have single payer eventually hopefully after I die. (im in my early 40’s). Regardless I’ll fight that so called freedom to my death.

      • Lightning Rose says

        Talk to someone who’s dealt with the NHS in England. There’s a reason Mick Jagger came to the US for his recent heart procedure.

        • John says

          Re heart procedures, most are self-induced by what people put in their mouths by eating the atrocious standard American diet, the major ingredients of which are produced by industries that in one way or another receive massive government subsidies.

          And many even most could even be unnecessary with the condition being cured by a radical change in their diet.
          Such is the well documented argument of the eminent heart surgeon Steven Gundry in his books The Plant Paradox, and The Longevity Paradox.

      • Daniel V says

        If grandmom had stage four cancer she’d be treated immediately. And yes this does mean she’d be treated before someone without a life threatening illness even if they had the money to pay for quicker service. I’m sorry to say you’re the one being kept in the dark about single payor systems because nothing you’re saying is entirely true.

        Do doctors get paid less? Yes they do and often they have to retire with millions instead of tens of millions. Are wait times long? For something non life threatening absolutely because as more serious issues some in they get to go first.

        Ultimately the system is extremely egalitarian and everyone gets the exact same treatment.

        • Stephanie says

          If grandma is ill, she gets pressured into signing a do-not-resuscitate at 9pm while she’s alone and high on painkillers.

          If you have a non-urgent but extremely painful condition, you’re looking at months to years before it’s your turn for treatment. The wealthy can afford to go private, whether in-province or by doing the procedure in the US. The system is not equitable in practice because you cannot coerce away market forces.

          Story came out this week that the elderly are going blind in the UK because they were waitlisted too long for cataract surgery. And forget about getting treatment if you’ve got a mysterious condition: the UK will pull the plug on you even if you can arrange treatment in another country on your own dime. Can’t have that kind of threat to the reputation of your socialised system!

      • OleK says

        Yup, wait times…but those advocating for Medicare for All need to know why. They need to know about Medicare reimbursement for doctors (and that many doctors offices have gone out of business due to lower Medicare reimbursement). They need to know that if many more people suddenly have healthcare access, where will this capacity come from (ie wait times)? New hospitals and new doctors don’t appear overnight. Medical School loans that doctors have won’t suddenly disappear. And what about resulting mass unemployment by those in insurance companies, periphery industries, drug companies, etc?

    • John says

      An essay on the transcend.org website titled the Big Vaccine Cartel and Its Wholly Owned Subsidiaries by Gary Kohls MD is very much about how big Pharma creates and controls the sickness industry and all of its fake “for your own” good medicines, ALL of which have negative side effects.

  11. peanut gallery says

    I don’t think “everyone” values “freedom” either. It’s clearly untrue around the globe. The concept is pretty new in human history. I don’t think everyone is totally convinced. People tend to gravitate towards a Great Leader (Mao/Lenin) or Daddy Figure (FDR/Trump) to solve all their problems.

    • David of Kirkland says

      Just look at the never-ending creation of laws around the world (as if all the crimes have yet to be discovered) to know that coercion is the norm.
      People think children are under the authority of parents. Students under teachers. Employees under employers. All under the authority of cities, counties, states, feds, etc. All religions are based on the notion of authority.
      “There ought to be a law…”

    • Stephanie says

      It seems to me people like the idea of freedom but not so much the reality. Actual freedom is arduous and terrifying. Freedom means the freedom to starve, after all.

      Domestication feels safer, and for evolutionary reasons we gravitate towards seeking safety and prosperity under the leadership of a strong man. Once that is secured, it seems we then seek the care of a strong woman.

  12. MrJD says

    The authors’ sophistry is nothing new. It’s the same old argument over whether the Left actually wants to turn America into Venezuela, with the Leftists saying “no, that’s not the outcome we want” and the Right countering “you support the policies that lead to that outcome, but don’t associate the outcome with the policies.”

    Nowhere did the authors even attempt to address the fact that the “generous social welfare state” that they advocate comes at the expense of BOTH of the types of freedom that they discuss. By restricting conversation to abstract definitions of “freedom”, they avoid the practical impossibilities in their definition.

    Orwellian language like “wage slavery” belies the fact that “there is no free lunch” is a characteristic of reality, not anyone’s ideology.

    “Freedom from reality” is not feasible, except in the solipsistic mind.

  13. E. Olson says

    The “Right” to “free” medicine means using coercion to force doctors, nurses, hospital administrators, drug companies, who provide medical services to work for lower than market rates. What does a Leftist think will happen when highly trained professionals and high IQ young people see their freedom to earn a decent return on their education, training, experience, and investment are taken away so that patients can get cured for free? Do they think doctors and nurses will continue to work the same number of hours, take the same extra training, continue to invest in the same amount of new technology? Do they think the same number of bright young people will want to train to be doctors or nurses or medical engineers/chemists when their salaries and status are drastically cut so patients can be cured for free? Do they think that pension funds, mutual funds, and venture capital funds will invest in the medical sector to the same degree when the potential returns are sliced to the bone so that patients will be cured for free? Do they think that the same number of new life saving medicines and medical techniques will be invented and adopted after funding is drastically reduced and far fewer bright people choose to work in medical technology fields?

    To give curious Leftists some answers to these questions, let me present the fact that the USA has less than 5% of the global population, but creates 50+% of new medicines and has won nearly 50% of Nobel prizes in medicine. And almost all this US medical innovation comes about to serve the 50% of the US medical system that is private – i.e. the VA, medicare, medicaid, etc. are NOT profitable segments and/or early adopters for most new medical innovation. And all this US medical innovation eventually gets adopted for “free” by the rest of world including the many single payer medical systems. Thus the US is the place to go for any advanced medical treatment, which is why foreign dignitaries, celebrities, and people with more money than time so frequently come to the US for their treatment even when they have “free” medical care at home. In contrast, virtually nobody with a serious medical condition travels to Sweden, Norway, or Venezuela or other “socialist” paradises to get medical treatment, although several European countries are favorite spots for people looking to get medical assistance to die (Netherlands is no. 1).

    There are already serious shortages of medical professionals in many areas of the US, and even more serious shortages in single payer socialized medicine countries, in part because the pay is often poor relative to the investment, and working in a bureaucratic medical system is not seen as rewarding work environment. The Leftist push to get women into STEM is also partly responsible, because women in medicine work far fewer hours and/or leave the profession early (often due to burnout) much more often than men. Thus the staff shortages and inability for “free” medicine to pay adequate wages and a provide a rewarding work environment mean that most Western countries increasingly rely on medical staff poached from developing countries. Technology might solve some of these staffing problems, but “free” medical systems don’t innovate, and if the US goes to a “free” system the primary source of most medical innovation and technology will disappear.

    But perhaps all these problems are worth it if “free” medicine provides high utility “freedom” for all the people who otherwise couldn’t afford to get treated. Unfortunately, the evidence suggests this is unlikely to be the case. The Oregon Medicaid lottery experiment found no better health outcomes for those enrolled in the Medicaid expansion versus those who were not, but did find greater medical spending on those enrolled (paid for by taxpayers). Research also finds the poor (and often under-insured) also have the poorest health habits (i.e. greater incidences of obesity, drug abuse, smoking, sexual promiscuity, and other reckless activity) that greatly increase their need for expensive medical care. When poor people with high needs suddenly get a “right” to health care, this means the freedom of medical professionals and taxpayers who provide the care is drastically curtailed. The tension this “freedom conflict” creates is further magnified when so many of the poor patients never provide any value to society in terms of good parenting, crime free living, productive and useful skills to employers, or successful innovation and entrepreneurship – i.e. it is highly unlikely that the taxpayer funded repair of a broken body of a crashed drunk driver on welfare will give us the next Bill Gates or Jonas Salk. Thus the only sustainable solution to this medical “freedom” dilemma is to generate medical innovation that makes medical care effective AND cheap, and only the private sector responding to the needs of patients paying for much of their medical care out of their own price sensitive pocket is likely to do this. Plastic surgery, Lasik surgery, and dental braces all used to be products only the rich could afford, but have become common for even the lower-middle class because they have become cheaper and better due to innovation aimed at reaching mass-markets. The entire medical system needs to be put on such a model if most people are to be “free”.

    • S. Cheung says

      E. Olson,
      I think you’re combining service and service-providers, with R&D pharmaceuticals and devices. And when you say “free”, is that from the POV of the end-user, or the system?

      Obviously, if you say that medical providers and medical networks must provide their services without charge, and that R&D private enterprises must provide their work-product (either the IP, or perhaps even the finished manufactured product) without charge, then certainly the system implodes in an instant. You of all people would never suggest that. So this was never about it being “free of charge” from a system standpoint.

      So it’s really about the end user having “free” access, while the system bears the cost. I would certainly agree with you that with rights should come responsibilities, and it always bothers me when people are quick to assert their rights yet shy to fulfill those responsibilities. So I agree that personal responsibility for one’s health (or “unhealth”) should be taken into account. I’m just not sure how to operationalize that, and to protect people who are truly the victims of terrible bad luck. User fees that various HMOs charge now is a start, so that people have some skin in the game. Perhaps there has to be incentives for good health behaviours (beyond being healthier), and disincentives for bad ones (beyond being less healthy).

      The system you allude to, where prices come down as technologies matures and is more widely used, already exists. Costs are prohibitive for early adopters, and become less so as greater uptake occurs.

      • E. Olson says

        SC – “free” health care is obviously from the patient’s point of view, and would include “almost free” as in a token $20 to $50 co-pay for a treatment with a true cost in the hundreds or thousands of dollars, with the difference between “free” and the actual cost being made up by tax-payers in a single payer system.

        The problem with single-payer systems is that they only benefit people who aren’t worth very much to society, otherwise people could pay their own way. For example, a recently graduating engineer or nurse with the prospects of a good paying career who gets a curable form of cancer will always be worth treating with the best medicine available because they are capable of repaying the system through their future tax payments. Private lenders would also likely be happy to loan them the money to get treatment because their future career earnings mean they would almost certainly be paid back. In fact anyone doing valuable work for society (i.e. earning a good salary, owning a profitable business, or even being an excellent parent) is likely to be a good payoff for private or public assistance in getting medical treatment. Even if such people smoke or eat too much junk food they are still making worthwhile contributions, and few would disagree that people who have contributed greatly during their working career are “owed” something for medical care during retirement. Thus if these type of responsible and hard working people are the vast majority of population, single payer can work pretty well, but likely wouldn’t be needed because the private system of insurance and personal savings would cover just about everyone.

        But what about the drug addict whose bad habits damage his organs and causes him to never hold a job for any appreciable amount of time? Or the obese welfare mom who has not been a very good parent, and now needs major heart surgery? Or the 95 year old woman living on public assistance who gets cancer? Do these people deserve the same quality and quantity of health care as that recently graduated engineer or a middle-aged school teacher or manager who pay taxes (or will) and/or also purchase their own insurance? What are we saving their lives for when we use heroic and expensive medical treatment to extend their lives at public expense? And it is the expense of paying for the high medical costs of deadbeats and losers that leads single payer systems and medical welfare to cut fees paid to doctors, nurses, hospitals, drug companies, and medical technology companies.

        Air conditioning in homes, offices, and vehicles used to be a very expensive luxury that only the very wealthy could afford. Thus a middle class citizen entering a new car showroom in 1955 would likely tell the salesman that although they really liked the optional air-conditioning, they would have to pass it up because they couldn’t afford to pay the extra 20% it added to the price of their new car. But over time innovation and a desire to expand the market has led to major decreases in air-conditioning costs so that now even the poorest Americans live in climate controlled homes and drive cars with A/C. But what would have happened if the government said in 1955 that every American had a “right” to an air-conditioned home and car, and if a particular citizen couldn’t afford the cost the US government would provide A/C to them for “free”. Under such a scenario, would the A/C manufacturers have any incentive to cut costs and innovate? Answer: No they wouldn’t because the A/C mandate and subsidies would mean the market was saturated and there would be no need to cut costs or innovate to grow the market. This is the situation with medicine today. If a new expensive drug or surgery is developed and that drug addict or obese welfare mom needs it, the US taxpayer pays for it rather than telling poor patient that they are not eligible for such expensive treatment and must accept a cheaper alternative, which is why medical costs don’t decrease except in the few areas where almost everyone pays for treatment out of their own price sensitive pocket.

        • S. Cheung says

          E.Olson,
          I agree with the issues you raise about those at the low end of the value per unit cost scale wrt healthcare access. I’m not prepared to say “too bad, so sad” to those people but I understand the ensuing hand-wringing. At least you’ve kept it to medically necessary scenarios.

          But I disagree about the drive for innovation. You are referencing a purely-single payer system. I don’t thing that’s what HCFA is about. My understanding is for a provision of some minimum level of care. There will still be a free market for boutique and premium services which would provide the financial incentives for innovation. And even for a public payer, the metric is not cost, but cost-effectiveness. So there will always be incentive for someone to build a better mousetrap.

          • E. Olson says

            SC – until politicians and medical practitioners are willing to tell deadbeat ill people “too bad, so sad” things will only get worse. With modern medicine it is basically possible to keep someone alive indefinitely as long as someone pays for the treatment, which leads to unbalanced systems when the people most likely to need expensive treatment are the people least likely to afford the treatment (or contribute substantially to insurance pools or tax based health systems). Most single-payer systems came about when medicine was much more primitive and cheap, as in the main form of cancer treatment were opiates to make you comfortable until you died, and whether you were a street bum or a Rockefeller you both got the same cheap and ineffective treatment because that was all there was. Now we expect our public health systems to give Rockefeller treatment to street bums, which we can’t afford so rationing takes place, and in the public system that means everyone gets crappy care (i.e. long waits, no expensive medicines or treatments, limited care to the elderly and handicapped). And until public systems are able and willing to tell the drug addict with self-inflicted medical problems and no insurance or prospects in life to shove off with nothing more than a bandage or prescription for cheap pain killers, we will never have enough money to invest in better care for the people that provide value to society.

            You seem to think public systems can be cost efficient, but they tend to achieve this only by cutting back on the quality of the service they provide to everyone. Only a private system (that isn’t mandated to provide free care to the uninsured and broke) can efficiently solve much of this cost problem, because only private systems have a real incentive to innovate so that profits can be made at lower cost to allow higher levels of care to be affordable to more drug addicts and obese welfare moms. Furthermore, knowing that a hospital or doctor can turn you away with minimal or no treatment if you can’t afford it offers strong incentive to find the funds to buy health insurance (maybe the “poor” can get by without the newest iPhone or cut back on their lottery ticket, smokes, and weed purchases).

          • S. Cheung says

            E. Olson,
            With a HCFA type system, there are no deadbeats, since care would be free. There would still be the “problem” with what you might characterize as “low value for unit cost” patients, as I’ve acknowledged.

            And maybe such a system would not have the premium service accoutrements, like fastest service, or cutting edge whatever. The stuff that won’t be early adopter things, which in the market cycle will have already come down in cost. So Buffett would not get the same as a “bum”, and vice versa.

            Again, this is the low end service. If you can afford it, nothing changes, and there needn’t be “rationing” or any of that. You seem to be arguing that if there is healthcare, it must be Cadillac service, or there is no discussion. I’m saying go with 2 tier, or however many tiers you want up to Bezos level (even post divorce).

            So there is still every incentive to strive to quit reliance on public system, to be able to pay for those premium services via cleaning up your life, getting a good job, and all the other stuff you repeatedly talk about. The medical industry still has every reason to innovate to satisfy the needs of the top flight.

            Nothing has to change except a willingness to care for those less fortunate. And don’t forget that actually includes a lot of non-bums, to point out your insistence on absurdity, but could be your average productive joe who loses his job and benefits, or has a catastrophic illness.

  14. David of Kirkland says

    “It may even save most individual taxpayers money.”
    You assume that Medicare for All provides the same coverage as most employer-paid plans. The price matters, but price only has meaning when comparing the same coverage.

  15. TheSnark says

    The leftist version of freedom requires providing good/services to those who don’t have them, so that the beneficiaries will be free from the wants and concerns. But to do that requires resources (somebody is still paying for that “free” health care”), and those resources have to come from somewhere.

    Those resources can only come from those who have them, via taxation. Your “free healthcare” is my tax burden. Your “right” to medical care is my forced obligation to pay for it. For that to work, the taxes must be politically acceptable to those who pay them, or else they are by definition coercive and anti-freedom. The US has done that to some extend with Medicare/Medicaid, Social Security, welfare, and food stamps; these are generally accepted. How much further are the tax payers willing to go?

    The problem with the rightist/libertarian view of freedom is that can leave many people behind economically. Its virtue is that it does not rely on coercion. The virtue of the leftist version of freedom is that in theory it leaves fewer behind. But unless you get buy-in from the haves, it is inherently coercive. And by any definition, one who is being coerced is not free.

    • David of Kirkland says

      Any why focus on expensive healthcare that’s a highly regulated industry and big business?
      Wouldn’t our first rights be to food, water, clothing and shelter? These are far more important to life than insurance to cover a portion of some healthcare service, services which are being invented globally every day and thus have no limit.
      You have a right to your life and your health, but not to force others to make your life and health better than you can manage for yourself. If there is such a right, then how is it that the right grows every time a new medical service is created, as that right to such a service couldn’t have existed before it was invented.

  16. Lightning Rose says

    One of the pivotal notions of our original “freedoms,” so obvious it went without saying, is that “rights” come with responsibilities. You want freedom from want, from coercion, from a circumscribed life? It’s pretty simple, really: Don’t let yourself become a druggie, a drunk, a slacker or choose single motherhood. We used to consider that the most BASIC “character” we expected all decent poeple to have. (This was before all nascent forms of self-destructive stupidity were excused as “diseases” of course!).

    It’s well-documented that if one finishes high school, stays sober and drug-free, gets a job (ANY job!) and does not have children before marriage, one has about a 98% chance of a middle-class standard of living. This is hardly a secret. This was the DEFAULT as recently as the 1970’s.

    You do NOT have “freedom” to be an irresponsible asshole and the rest of us will pay your tab.
    Yet that’s EXACTLY what leftists have been promoting since the days of Lyndon Johnson.

    • Ray Andrews says

      @Lightning Rose

      “It’s well-documented that if one finishes high school, stays sober and drug-free, gets a job (ANY job!) and does not have children before marriage, one has about a 98% chance of a middle-class standard of living. This is hardly a secret. This was the DEFAULT as recently as the 1970’s.”

      As you say, this was at one time true, but it gets less true every year. One hears the rightie propagandists say that working poverty is rare and temporary, but I heard a billionaire say, just a few days ago, that only 14% of working poor ever escape working poverty anymore.

      • Peter from Oz says

        A billionaire said it so it must be true, eh?
        Come on Ray, you can do better than that.
        If working people are struggling it!’s more likely to be a result of too much interference by government in the economy.

        • Ray Andrews says

          @Peter from Oz

          I didn’t say that. Nevertheless it’s sorta like when Warren Buffett says his taxes are too low, one might pay attention since he is arguing against his personal interest, which is a good indication of honesty. No, working people are struggling because their incomes are not keeping pace with the cost of living. I was going to pick one, but google ‘income distribution’ and pick a graph you like.

          You know, it might very well be the case that the government interferes too much in some things, but when I ran my business the fact is that the government interfered with me not at all. Zero. Mind, there were building inspectors, I couldn’t build just anything and have folks live in it. But as to how I ran the business, the government had not one single thing to say presuming I paid my taxes, which I did. And that’s up here in the People’s Republic of Canuckistan. Dunno, maybe it’s worse in Oz. But I suspect that libertarian types exaggerate.

    • S. Cheung says

      Lightning,
      “This was the DEFAULT as recently as the 1970’s.”
      That’s baby boomer boilerplate. We are on the 4th generation beyond that today. Forget default; I suspect it will be detached from reality when the current generation alpha comes of age in a decade of so. It will probably only be of historical interest even for Gen Z types who are entering the workforce now.

      But I’m with you on “rights AND responsibilities”. That’s what I wish they had put on “The BIll of”.

      • Ray Andrews says

        @S. Cheung

        It’s you and me against the libertarians, Comrade ; – )

        There’s one lousy thing about being a dolphin and that’s that my Che beret keeps sliding off.

        • S. Cheung says

          Ray,
          To a certain subset( and most around here), the answer to the question “what ails every conceivable person in any conceivable situation in every conceivable way” is “government”. In that way, it’s like anti vaxxers. Who needs vaccines? There’s no measles….wait what? Where do i get the shots AFTER the outbreak?

          • Ray Andrews says

            @S. Cheung

            All fundamentalists have the same kind of mind. To some of the folks here, as you say, government is the source of every problem. To the SJW whitey is the source of every problem. We can all fall into this sort of thinking tho. The task of the reasonable person is to fight to maintain reasonableness.

          • Peter from Oz says

            S.C.
            You are wrong. What we right wingers are saying is that too much government or bad government is something that does no one any good except civil servants, lobby groups, rent seekers and politicians.
            The thing is that government has some very vital functions: keeping the peace, protecting us from foreign enemies, providing infrastructure and public health. But when government expands into lots of other areas it ceases to do its core job well. When it seeks to change society, by using tax laws to shepherd people into some form of behaviour or other “nudging techniques” we get close to the stage where we are the servants of the government rather than the other way around.
            Regularly on the news here in Oz we hear that some kind of behaviour is “costing the taxpayer so many billions through health expenditure.” The immediate response from the commentariat and the politicians is to find some way of reducing that behaviour, so that “we can can continue to pay for healthcare”. So the government is the master and the people are there to obey.
            In Spain and Belgium in recent years there were prolonged periods when there was no elected government, as parties wrangled over forming coalitions. The civil servants and the other bureaucrats ran the country, whilst government was in caretaker mode. Guess what, after an initial period of market jitters caused by the media, which can never say anything bad about the whole political circus and is aghast at the idea that it is all mostly unnecessary, things settled down. The economy in both countries improved mightily.
            Why is Hong Kong such an economic miracle? Because in the 1960s the British administration banned the collection of financial statistics by the government. Instead the government got on with its core duties, which don’t include managing the economy, and left private industry to thrive.
            The classic example of government making things worse in Oz is the ridiculous reaction to climate change alarmists which has led to rent seeking on a large scale as subsidies are given out for renewables that don’t work efficiently. Meanwhile, in a country which has the biggest coal export port in the world, Australian governments of all persuasions have decided to cave into the idiocy of the green loonies and close down coal fired power plants. A whole state was without power the other day as a result. And of course power has become incredibly expensive which has had a huge knock on effect throughout the economy.
            The problem is that government is very good at certain things, but politicians can not afford to let the administration just tick on. They have to make themselves relevant by continuing to fiddle about and solve “problems” which are really of their own making.
            In Australia the politicians decided to have compulsory superannuation payments deducted from employees’ wages at the rate of 9.5%. The system has been altered over 20 times since then and become such a complicated mess that no one really understands it. The whole idea of the system was to allow people to have enough money to retire without needing a government pension. But governments soon realised that there was a huge new pool of money that they could tap into when funds ran short. So they have done all sorts of things that really undermine the whole essence of the original plan. In addition, the system was set up to give union bosses power by allowing them to control certain superannuation funds. Even though union membership is less than 10%, unions have been given a power base that provides them with far more influence than their membership merits. This of course allows them to fund the Labor Party, amongst whose policies are incredibly complex tax rules to stop people investing in property and becoming capitalists. Can’t have ordinary people being investors and not being whining wage slaves, beholden to the union dross, now can we?
            Add to all that governments getting involved in “diversity” and other such wankery, and you can understand why a lot of us think that government is a problem. But it is not government in general that we conservatives deplore, just overactive and nannying government that fails in its core functions whilst getting involved in areas far better left alone.

          • Ray Andrews says

            @Peter from Oz

            ” What we right wingers are saying is that too much government or bad government is something that does no one any good except civil servants, lobby groups, rent seekers and politicians.”

            We centrists couldn’t agree more. The question is what is the natural business of the government? There’s lots of room for honest debate. But when the righties tell me that the government should not maintain the safety net — not to worry, private charity will cover everything — I say they are not telling the truth. Note, I do not say I disagree, I say they are not telling the truth because they know perfectly well that the old days of tight social support are gone forever. We still see private charity, and they often do a very good job, but they can’t begin to cover all the problems. The government can and should consider it part of their mandate, and the voters should make sure they get value for their tax dollars.

          • S. Cheung says

            Peter,
            Too much government, like too much of anything, should be avoided. So no argument from me there.
            But what I was speaking about was some provision of universal health care, in a manner to provide some minimum level of coverage for everyone, for what is deemed to be medically necessary care.
            So the first question is whether even that alone is an acceptable concept. Based on some of the comments and characters here, even that is already a bridge too far. So if even that kind of social safety net is off the table, I don’t know what else there is to say. And certainly not all right wingers go that far, but those who do are hardly rare birds either.
            If that underlying premise is at least palatable, then we can at least parse how to go about doing that, and how to keep the bureaucracy in check. But keep in mind that in the US, with myriad payers and difference coverage and payments for different things, that alone is a whole bureaucracy in and of itself (only difference is it is a private enterprise bureaucracy, but the net effect is still that people are paying for paper pushers rather than actual healthcare, and I don’t see how a private paper pusher is any better than a “government” one).

  17. Jim Gorman says

    D.K. –> You have a right to your life and your health, but not to force others to make your life and health better than you can manage for yourself.

    You have hit the nail on the head. Natural human rights are all individual rights, as in the Bill of Rights to the U.S. constitution. The “right” to healthcare is no different. It is as you say YOUR life and YOUR health.

    One cannot say it is up to someone else to protect my right of free speech or to insure due process is followed. That is up to me and me alone. I can not turn to my neighbor and say “Hey, hire and pay for a lawyer to fight this!” Worse, I can’t say to the government “Force my neighbor to hire and pay for a lawyer.” Now I’ll make a bet there are many liberals (but probably not many lawyers) that would say “How about a single payer system for lawyers”.

    How about it liberals, will I pay less in taxes that I do in medical insurance today and if that can’t be met the system will be scrapped? Will you promise this will be put into law?

    Remember, if taxes are higher than now, there will be some who can’t pay to fix a broken automobile, send their kid to college, contribute to charity, heck, even have another child.

    • Lightning Rose says

      “Health care is a human right.”

      Depends on what you mean by “health care.” Everyone talks as though “health” is something we purchase from the medical-industrial complex. In truth, 5% of the population uses as much as 50% of all the “health care.” Gee, the other 95% must be, what, HEALTHY? As in, “not under medical orders and taking prescriptions all the time.” Truth is, most of “health” is pretty simple–in the livestock industry it’s called “good management.” The dirty secret is this is a no-brainer for the advantaged, and well-nigh impossible for the poor. We blow billions every year profitably micro-adjusting surrogate outcome numbers for the rich “worried well” while ignoring the ugly mastodon in the room–self-inflicted ill health among the poor.

      If you fall down in the street, insured or not, the ambulance will lug you to the ER, where you’ll get the same triage, x-rays, CT scan and MRI as the scions of Greenwich. And most of the privately insured and taxpaying public has no problem with this. We might, however, have just a BIT of a problem with paying for your 4th drug rehab, your in-vitro fertilization treatments, your gender reassignment surgery, your 3rd abortion and your psych sessions. Just sayin’! Not everyone considers everything that CAN be done in the category of “human rights.”

      • S. Cheung says

        Lightning,
        ” And most of the privately insured and taxpaying public has no problem with this. We might, however, have just a BIT of a problem with paying for your 4th drug rehab,…”
        That again is not a matter of principle, but one of extent. THe principle is that the inability to pay should not preclude access to some level of health care. THe question is what that level should be. But as it stands, some people use health care without paying for it…but somebody is paying for it…ie. the ones with insurance now. Insured patients already are subsidizing the uninsured…unless you expect the providers to eat those costs. Something like HCFA simply re-frames it so that everyone is insured, but some are subsidizing others (via taxes, rather than in mark-ups).

      • neoteny says

        Depends on what you mean by “health care.”

        Nope, it doesn’t depend on that. As the article says:

        a positive right to health care is little more than a politically contingent claim to some health care, revocable and modifiable by morally irrelevant factors

  18. Jack Danzey says

    This is an interesting article all the way through. I hope to provide some constructive criticism.

    I will start by saying that both forms of freedom have value. If you define them, they both sound like things that we should strive for. However, I must somewhat disagree with the argument that these are merely different forms of freedom and neither side is wrong. Negative freedom does not solve all problems. As I said, positive freedom is something that we should want to have more of. A key difference between the two is that negative freedom does not require anything from someone else. Negative freedom is simply more freedom, full stop. Positive freedom is also more freedom, but is necessarily at the cost, coercion, and even denial of freedom of others to provide that freedom.

    Yes, negative freedom is not perfect in that it provides freedom to do things that one may not have the resources to do, effectively nullifying that freedom in some ways for some people. This is not a good situation, but unlike positive freedom, nothing has been taken from anyone. Poverty is the default setting. Your lack of freedom to afford, say, healthcare, is unfortunate, and something that we should strive to alter. But nobody has robbed you of that ability to afford healthcare, it simply does not exist as a default.

    Both forms of freedom are worth striving for, but we need to find the best ways to provide positive freedom without restricting the freedom of others.

  19. Fabio says

    “contention of many progressive thinkers—from Karl Marx to Amartya Sen—that the provision of these social goods enhances not just the welfare and equality of many individuals but their real freedom.”

    Please provide source for where Karl Marx says that. I am sick of today’s press attempts to transform Marx into a palatable modern social-democrat. It’s like they havent’t read anything he wrote, but can safely assume what is there.

    • Fabio

      Good point – Marx had little patience for redistributive ideas of socialism which were prevalent in his day as they are today. Interesting that this misconception of Marx is repeated by both supporters and detractors.

      Marx was all about emancipation which could only come about by a radical change in economic relationships, not by government “spreading the wealth around”.

  20. Jairo Melchor says

    “Freedom is also about how capable one is of making choices to pursue various life goals”

    Isn’t that capabilities instead of freedom? And this implies that someone or something is suppresing that choice making when in reality, there is no such thing if we were to go with that route.

    I can have all the liberties i want in a society but that does not mean that i can do all i want in a society, simply because i am me. I may get sick, i may have an accident, and i may just be lazy.

    Is not logical that this outcome should be the burden of someone else when they had nothing to do with it.

    What happened with “With every right, you have a responsability.”?

  21. Village Idjit says

    With the definitions of freedom presented here, the leftist one seems indistinguishable to me from power. The right says you should be FREE to exercise the power you possess as you choose, without another infringing on that at some, frankly arbitrary, line depending on the flavor of right winger. The left however claims that should you not have the POWER to do something, you are not free to do it on your own. Therefore that power should be transferred to you after some, again arbitrary, line is crossed, which is located according to the particular philosophy. This, ironically enough, inevitably involves having power over someone else and decreasing their freedom whether through taxation of their money (proxy for power and therefore availability of choice, i.e. freedom) or just by straight up forcing them to do something they don’t want to do. At least if the government is involved, anyway. That’s perhaps my problem with it, that it isn’t, to me, as much about everyone’s freedom as it is about picking and choosing whose freedom matters.

    My gut reaction is then to say that “negative freedom” should therfore be called freedom and “positive freedom” should be power, but I suppose you could also reframe negative freedom as being the determination of when one person’s power is allowed to infringe on another’s. It decides where power you already have should be restricted, whereas the leftist idea transfers power where it decides you are deficient. When to restrict power vs. when to give power. This leads to the extreme libertarian position of “no power should be restricted,” but I’m less clear on how this frame would render the extreme leftist position.

    All power should be given, perhaps? Not the most savory sounding goal, but it seems to me like that’s where the logic hits its extreme. They’re constantly looking for those in society without power to do what they want, within the window of morally acceptable behavior, and trying to give them the power they want/need. But then they simultaneously force that window of acceptable behavior wider and wider, making the actual limit to what power should be held by each person an open question. But ideally, eventually, the goal would be that everyone have the power to do everything they want.

    I suppose I should ad a disclaimer that I think both extremes are obviously absurd. Regardless, point is I still think framing the leftist idea as “positive freedom” is a bit of a euphemism for power transfers. Maybe that’s just my bias.

  22. Fickle Pickle says

    Eternal and total freedom, Wisdom and unbounded Happiness are the primary needs and ideas of human beings.

    Every separate or self-possessed human being is involved in a passionate and mortal struggle with everyone and everything that is presumed to be objective to it.

    Every self-possessed human being is always active as the opponent of all other self-possessed human being. Paradoxically every opposition is an irrational and fruitless search for equanimity, peace, and love.

    Every separate or self-possessed human being is inherently, always, and irrationally (or meaninglessly) opposed. The presumed other is always an opponent. in effect, if not by intention. It always confronted only by finding forces, and it is itself a force that is tending to bind ever presumed other. The other and the I are mad relations, always together in the growling pit, bound by Nature to do Nature’s deeds to one another. And Nature is itself an Immense Pattern that always seeks and inevitably attains superiority, dominance, and destruction of every part and self.

    By contrast Truth is Prior or Eternal Freedom and Humor, whether or not the Other or the Opponent seems to be present. Therefore the Awakening to Truth is the only Refuge. Then there is the simultaneous Awakening from the nightmare of condemned life and its always fruitless search for pleasure, victory, and escape.

    Meanwhile in an earlier essay Matt referred to the work of among others Erich Fromm who wrote a seminal book titled Escape From Freedom, sometimes titled Fear of Freedom. The arguments in that book are just as relevant now as they were when he wrote the book – even more so!

    Not much real Humor to be found on this site,or anywhere else for that matter.

  23. the gardner says

    “Freedom is also about how capable one is of making choices to pursue various life goals. Acute precarity or lack of resources, for instance, can severely limit freedom by curtailing the number of choices available to an individual”

    If person A’s “lack of resources” means that person B must be taxed to provide person A with “freedom”, is person B free?

  24. Bob G says

    Thank you for writing this. I have been thinking about this dichotomy in the interpretation of Freedom for some time and this was useful to further consider it. I noticed back in the 80’s that citizens of the soviet Union, and even Russians today, believe they were/are more free for just the reasons described here.

    But it really is about values isn’t it? The “left” version of freedom here launches into a technocratic application of a particular set of normative values as “good for the whole”. This unseats the position from legitimately calling it “freedom”. It really is the crime of a linguistic seizure of the word. Because freedom has to be about an individuals relationship with the material reality. That is to say the freedom to succeed or fail how they would choose with the choices they have. And by the way there is no promise of equity. Every drop of power animated to soften reality extracts from freedom.

    “Most people cannot afford to create a business”. In most cases they cannot effort to because of the choices they have made or are unwilling to make. Or maybe they just lack the ability.

    The left is always selling some utopian spin and in the process claims the ownership off the “good words”. I am not saying the left does not have good policy arguments, but they need to keep their greasy paws off the word, “freedom”. If we let them own it, what word should we use for actual freedom then?

  25. Fickle Pickle says

    For a completely different Understanding of True Freedom and the human condition altogether than that proposed and defended by all of the the usual right-wing, and adolescent “libertarianism” suspects, check out two books by Jiddu Krishnamurti: namely Freedom From the Known, and The First and Last Freedom.

    The foreword to the First and Last Freedom by Aldous Huxley is itself a rare gem.

    Krishnamurti’s entire corpus was very much about True Freedom, or a way of living beyond and prior to our dreadful mind-forged-manacles.

    http://selfdefinition.org/krishnamurti/Jiddu_Krishnamurti_The_First_And_Last_Freedom.pdf

  26. Peter from Oz says

    If the US brings in socialised medicine, where will the rich Canadian lefties go to get vital medical care they can’t get quickly in Canada?

  27. S. Cheung says

    I suspect most people here who are balls to the wall against the concept of universal health care are relatively young, and relatively healthy. Time has a funny way of making a mockery of both those things. So I wonder how these very same people will feel about the concept in say 20 years time.

    • K. Dershem says

      For all the horror stories about “socialized medicine,” the facts are abundantly clear: every other industrialized country spends less (on a per capita basis) on health care than the U.S. while providing universal access to basic services. No system is perfect, but I would gladly trade the problems with the NHS or Canadian systems (long waiting times for elective procedures, less access to cutting-edge medical technologies) for the tens of millions of Americans who are uninsured or underinsured, and the millions more who face bankruptcy due to medical expenses.

      • Peter from Oz says

        The old myth about spending on healthcare refuses to die. It is a silly argument. Overseas countries all get the benefit of US R&D and pharmaceutical development. So their spending is less.
        The number of underinsured Americans is actually quite small. The real problem is not that the US system is a free enterprise one and the rest of the world have socialised systems. For a start most countries have mixed private and public healthcare provision and the US has a large Medicare system funded by government. Plus the US insurance system costs a lot because of poor regulation. Make the American system real free enterprise and it would improve mightily.
        I also get the impression that many people conflate healthcare with the funding of that care.
        Here in Oz we have Medicare for all. One of the biggest problems that causes is over servicing by doctors and people visiting doctors in relation to trivial measures. People are actually convinced that they are less healthy than they are because of this system. I see so many adults become almost childlike in their devotion to medical treatments that have a marginal effect, but which make the patients totally dependent on the state.

      • hail to none says

        @K. Dershem– I think we live with a health care system that is very dysfunctional. It is only partially based on market principles (I rarely know the costs of the care I am receiving). So while I might agree that a single-payer system would have a number of advantages over our current system, I think it is far from ideal and worse than other systems that incorporate more free market competition among insurers. I am convinced that competition makes organizations more responsive to people’s needs.

  28. Softclocks says

    Servicable article and a stellar debatr in the comment section.

    Just as I have come to expect of Quillette.

  29. TheSnark says

    A big point of confusion regarding “freedom” is the concept of “rights”. Most people think of “freedom” as being able to pursue their “rights”. In the US, those rights were encoded in the Bill of Rights. But when you actually look at it, the Bill of Rights is not about what citizens are allowed to do, is a list of things the government is not allowed to do. It does not say citizen are allowed free speech it say the government will do nothing to restrict it.

    The “freedoms” the “progressives” are talking about are really a list of things the government would be required to do. These “freedoms” are based on newly created “rights”, such as the right to free healthcare, which have nothing to do with anything the founders would recognize.

    By the way, I think we in the US should put in some sort of universal health care, which would be heavily subsidized by the government (ie, taxpayers like you and me). But I do not hold that view because I think healthcare is anyone’s “right”. I hold that view because I think it would be good public policy,

    (And unlike most supporters of that view, I recognize that is will raise taxes a lot, involve massive layoffs in the insurance industry (we won’t need 300,000 claim adjusters), and require many doctors to take large salary cuts. It will also severely restrict pricing by all health care, pharmaceutical, medical device, etc companies, which sounds great until you realize it will tank their stock prices, which are a big part of your retirement account.)

  30. Cedric says

    I don’t have much to contribute other than to say “freedom” results in consequences. Freedom FROM consequences is not freedom at all because it imposes on someone else’s freedom (e.g., a low-income smoker who doesn’t pay taxes gets lung cancer and uses UHC for treatment even though a richer non-smoker pays for the UHC).

    Your boss is free to say “date me or your fired” (even though he is probably violating company policy and federal law – setting that stuff aside for the example, though). You are free to refuse. Your boss is free to fire you. You are then free to sue him and the company for wrongful termination. The entire situation sucks, but it all involves the consequences of exercising freedom.

    I’m kind of shooting from the hip on analysis (this is a comments section, after all), but am I totally off base here? It seems like we’re blurring the lines between “freedom” and our individual concepts of fairness.

  31. Lightning Rose says

    The biggest thing the Left keeps tripping over is their concept of “fairness,” which only applies to sharing crayons in kindergarten. They keep pitching majickal “socialist” nonsense that the country can’t begin to pay for, they’re going down in flames in 2020. Fairness! and silly weather hysteria plus calling everyone in sight a racist is all they’ve got right now–Trump will win a second term in a walk, and probably take back the House as the cherry on top. The Left STILL don’t get it that we’re not idiots, and most of us vote our own financial self-interest.

  32. Bernie is right about freedom and healthcare. It is freedom from worry. In Switzerland, Denmark and New Zealand, if you are sick or injured, you just go to the community of health professionals and they try to help you. There are no other concerns or worries. Very simple. Nobody really thinks about healthcare much.

    In the US, where healthcare is delivered by private for-profit insurance companies whose primary mandate is to enhance shareholder value – aka denying claims and disallowing coverage – a huge swath of the population worries about healthcare all the time.

    Freedom from worry and stress is very real.

    • Cedric says

      @seekinghealthandwisdom

      I just can’t get behind the idea that freedom from stress and worry is very real (at least from an objective point of view).

      What is stressful and worrisome to you might not be stressful and worrisome to me. You’re using a word that is easily analyzed objectively (“freedom”) and tying it to something subjective (stress and worry). That’s why I said in my original comment that the concept of freedom is being blurred with fairness.

    • neoteny says

      In Switzerland, Denmark and New Zealand, if you are sick or injured, you just go to the community of health professionals and they try to help you. There are no other concerns or worries. Very simple. Nobody really thinks about healthcare much.

      I’m fairly sure that the people working in the healthcare industry indeed think about healthcare much: after all, that’s their work, they get paid in exchange for thinking about people’s healthcare all their working time.

      And I’m fairly sure that most patients in those countries are concerned (and sometimes worried) about the waiting times, the professional & personal qualities of the personnel treating them, the rightness of the treatment they receive, and other things.

    • In Canada (which is what Bernie wants to emulate) there are massive long waits for procedures. Further, there is a shortage of primary care doctors. So yes, they have to worry. Remember, Obamacare here in the U.S. was supposed to be “universal health care,” but it didn’t work out.

  33. If state provision is seen as enhancing freedom, then it is harder to argue against it. At what point does provision become dependence? At what point do the sheer scale of the state undermine its accountability? The “left” concept of freedom presented here seems to be the start of the argument rather than the conclusion of it.

  34. ga gamba says

    Consider the following thought experiment. An oddly conscientious thief steals my car and leaves more money stacked in my driveway than I would have likely received had I put the car on sale. This, however, doesn’t detract from the objectionable involuntariness of the theft.

    That’s putting it mildly.

    This confiscation of my car could have dire consequences for me or others. Perhaps I’m fired for being late to work. Maybe I’m unable to attend a meeting that was important to my life. Heck, possibly I just liked that car and no sum would have me part with it. The thief didn’t ask; he just assumed unilaterally and without my consent that we’d be square based on his exclusive understanding of the situation.

    If there are other cars for sale, which I presume there are because the thief left me money to burden me with the chore of finding a replacement, why didn’t he take on the burden of finding those sellers himself? “I’m doing it for the benefit of those who want to ride in your former car” doesn’t wash with me.

    Anyway, I enjoyed the thought experiment because it goes far to prove the cockamamie ideas of progressives and the lack of respect they have for others. All gussied up in the claim of “doing it for the people”.

  35. Interestingly, I’ve known traditionalist conservatives who play this same game, and say that “freedom” is actually self-control. How do they describe a lack of external coercion? “License.”

    This basically is a dishonest game with words. If one believes that equality, or security or whatever justifies government taking away liberty, just say so. Don’t play word games.

    • TJ Andre says

      Dishonest, or perhaps self-deceptive? As I read the article it kept striking me that there was a word that was being avoided, for all the uses of words like “domination” and “coercion”, the elephant in the room never quite raised its trunk. “Power” – who has it, how they use it. That’s what this is about – the uses of POLITICAL power. If one is promoting the use of political power in pursuit of one’s ends, it is a bit of sleight of hand to then say that one’s perspective of freedom should not be focused (primarily) on “political” freedom. I don’t believe the oversight is deliberate, but it is nonetheless invidious.

  36. Jeff says

    That’s a very reductionist account of how the Right understands negative freedom. One can understand negative freedom as the ability to make formal choices, without any reference to property whatsoever. In fact, I assume that this corresponds to a lay understanding of the concept of freedom.

    Conversely, the Left’s understanding of positive freedom goes beyond having different options, as shown by the concept of “alienation”. The Left considers some choices to be authentic, autonomous, and some choices to be “alienation”. This distinction has nothing to do with positive freedom. For the Right, at least the Libertarian Right, this dinstinction is meaningless.

    This is salient in the many instances where at least some elements of the Far-left converges or has historically converged with social conservatives on some societal issues, mostly in the area of bioethics, psychiatry, and technology in general. For instance : prostitution, porn, transgenderism (until recently), genetic engineering, involutary commitment, video games (to an extent), opposition to popular culture, etc… These associations have symetrically caused lefty-ish people to associate with Right-Libertarians to defend negative freedoms even though they don’t give two shits about property rights.

    Freedom as defined by democratic socialists like Bernie Sanders remains individualist in Nature, the disagreement is on the how rather than the what, so perhaps he’s not the best example.

  37. Sean Michael Bearly says

    “Why Everyone Values Freedom”
    Because we are going to define two opposing ideas and call them both “freedom”. Just to be nice to each other. See? People don’t have to disagree and be upset at each other! How about truth? It’s narrow definition has caused too much friction in the world. Let’s define truth as “whatever you believe”. There, now everyone is truthful all the time. Is it too early to redefine “good” as “whatever you do?” I so want to live in a world where everyone is good.

Comments are closed.