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lessdazed comments on Rationality Quotes September 2011 - Less Wrong
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This claim is disputed, but I have negligible information either way.
Personally, I say that universal health care would be worth the higher taxes. For any given person the answer depends on their utility function: the relative values assigned to freedom, avoidance of harm, happiness, life, fairness,etc.
This sets off my Really Bad Idea alarm. I don't trust the aggregate decisions of individual citizens to add up to any kind of sane budget relative to their CEV. (Note: the following sentences are American-centric.) Probably research would get massively under-funded. Defense would probably be funded less than it is now, but that might well put it closer to the optimal value if it forced some cost-effectiveness increases.
Basically, each person would assign all their taxes to whatever they thought was most important, thus prioritizing programs according to how many people pick them as first choice, regardless of how many dollars it takes to make a given one work. The same kind of math used to discuss different voting/electoral college variants would inform this, I think, but I'm too lazy to look it up. And of course, if too much freedom was allowed in deciding, all companies and most people would decide to allocate their money to themselves.
What does this mean? In particular, what does "universal" mean?
It means that each person in the country would, if ey got sick, be able to receive affordable treatment. This is true in, for example, Great Britain, where the NHS pays for people's medical care regardless of their wealth. It is not true in the United States, where people who cannot afford health insurance and do not have it provided by their employer go without needed treatments because they can't afford them.
ETA: does someone think this definition is wrong? What's another definition I'm missing?
How different are the ways a society would treat citizens and various other people not covered by a system, such as Americans? What about tourists?
Isn't it true that Great Britain could provide better medical care if it diverted resources currently spent elsewhere? How are any other government expenditures and fungible things (like autonomy) ever justified if health could be improved with more of a focus on it?
Do you primarily value a right to medical care, or instead optimal health outcomes?
An intuition pump: What if a genie offered to, for free, provide medical care to all people in a society equivalent to that the American President gets, and a second genie, much better at medical care, offered even better average health outcomes for all people, with the caveat that he would randomly deny patients care (every patient would still have a better chance under the second genie, until the patient was rejected, of course). Both conditional on no other health care in the society, especially not for those denied care by the second genie. Which genie would you choose for the society? Under the first, health outcomes would be good and everyone would have a right to health care, under the second, health outcomes would be even better for every type of patient, but there would be no right to care and some people with curable diseases would be left to die.
If you would choose the first genie, your choice increases net suffering every person can expect.
If you would choose the second genie, then you're making a prosaic claim about the efficiency of systems rather than a novel moral point about rights for disadvantaged people - a claim that must be vulnerable to evidence and can't rightly be part of your utility function.
What if there were a third genie much like the one you chose, except the third genie could provide even better care to rich people. Would you prefer the third genie and the resulting inequality?
I prefer the genie which provides the maximum average utility* to the citizens, with the important note that utility is probably non-linear in health. The way I read your comment, that would appear to be the third. Also note that the cost of providing health care is an important factor in real life, because that money could also go to education. Basically, I do my best to vote like a rational consequentialist interested in everyone's welfare.
*I am aware that both average and total utilitarianism have mathematical issues (repugnant conclusion etc), but they aren't relevant here.
OK, so when you say "Personally, I say that universal health care would be worth the higher taxes," you are referring to internal resource distribution along state, national, voluntary, or other lines to achieve efficient aggregate outcomes by taking advantage of the principle of diminishing returns and taking from the rich and giving to the poor. You don't believe in a right to care, or equal treatment for outgroup non-citizens elsewhere, or that it's very important for treatment to be equal between elites and the poor. Not an unusual position, it's potentially coherent, consistent, altruistic, and other good things.
I asked for clarification from your original "Personally, I say that universal health care would be worth the higher taxes," because I think that phrasing is compatible with several other positions.