“. . . the argument [whether collectivized healthcare is good or bad] will never be settled until America universalizes healthcare and we find out what happens here and in the rest or the world.”
There are two reasons this is incorrect. First, no matter what happens, there will be no counterfactual against which to measure irrefutably “what happened.” There will be no agreement as to what was proved by the experiment. [i] But, second, there should also be little doubt that if America “universalizes” (I prefer the term, “collectivizes”) healthcare, the rate of innovation of medical treatments and drugs will slow. [ii] How much faster healthcare would have improved had America not collectivized healthcare would be the subject of interminable speculation; and multiple bias driven and confirming “empirical research.” (If sound theory and history tell us anything, however, the truth is that the rate of innovation will slow.) Similarly, if America does not collectivize there will be no way to measure how much more slowly healthcare would have improved had it been collectivized. Either way, we would see endless “studies” purporting to prove each side of the argument. This is why sound economic theory is the only way to make a reasonable judgment about how to proceed. The economic theories are good enough now to justify minimizing the degree to which the healthcare system is collectivized to the greatest extent politically possible. (This is not to say that there should be no collectivization. As I’ve conceded in prior posts, that bird has flown.)
“. . . that America subsidizes all the other ‘model’ countries universal health care programs, if true, is an unfair situation.”
Yes, it is unfair. Much of life is unfair. So what? The choice before America is whether to continue to reap the advantages of inventing new and better medical treatments and drugs at a fast pace or to slow the pace of improvements to medical treatments and drugs. Collectivizing healthcare would also mean forestalling the benefits of the advances that would be built on top of the deferred advances. I urge the country not to slow the pace of healthcare improvement any more than necessary despite the fact that it is unfair that other countries will not carry their fair share of the burden[iii]. (I don’t get the logic of pointing a loaded gun at my foot and declaring, “If you guys don’t do your fair share, I’m going to pull the trigger.”[iv])
Unfair assumptions of burdens are ubiquitous (check out the discussion at 52:25 of THIS OUTSTANDING TALK) and unavoidable if progress is to be made. Consider what life would have been like had Steve Jobs never lived. His influence on the advancement of smartphone technology was tremendous. To be sure, had he never lived, smartphones would eventually have acquired features very similar to those that we enjoy today–but probably many years from now. It is probably fair to say, that had Jobs never lived, smartphones today would be comparable to those we had five years ago. (Compare specs[v], and consider all the apps that were not invented five years ago—and how many of today’s apps would be unable to function on an iPhone 5 had those apps been nevertheless invented.
Steve Jobs became fabulously wealthy. But consider the raw deal he got in return for the joy and productivity he bestowed on humanity. All inventors of today stand on the shoulders of all previous inventors in their fields. (For example, high-efficiency fuel injectors could not have been invented to replace carburetors had the internal combustion engine not yet been invented.) Jobs and Apple Inc. received a fraction of the income made by creators of all of the iPhone apps that were made possible by the platform his company created. But he received little or nothing for all the apps on other platforms that were inspired by his creations. Apple received only a small fraction of the value of the customers’ enjoyment of their phones—and most iPhone customers would have paid more if they’d had to. How much would someone have to pay you to forevermore use a five-year-old phone? Multiply that number by the number of smartphones in the world and figure out the percentage of that amount Jobs got paid. Outright piracy of Jobs’s innovations was commonplace around the world.
The innovations made possible by Steve Jobs rendered obsolete generation after generation of smartphone. Millions of those no-longer-cutting-edge phones wound up in the hands of much poorer people around the world, to their great benefit. Jobs and his company received none of the value of the entertainment and productivity that those people have enjoyed.
It is unfair that Jobs did not receive a greater share of the wealth he bestowed on the world. It is also unfair that America should foot most of the bill to fund innovation of medical treatments and drugs[vi] while also being the most charitable provider of foreign aid the world has ever had.
This is the tradeoff, however. Either America continues to bestow those benefits from the faster pace of innovation on its own citizens and all citizens of the world, or no one will. It is unfair. But we should do it anyway because no one else can, and it needs to be done. The more collectivist America becomes, the less able it will be to fill that role.
[i] It would be much like the continued debate about the effects of minimum wages. The weight of evidence against collectivized medicine could be as overwhelming as the weight of evidence against minimum wage, but the debate would go on.
[ii] See PART I and PART II of my posts about repealing and replacing Obamacare. Also note that Germany was the leader in medical innovation before it collectivized its healthcare systems.
[iii] It is equally unfair that other countries do not bear their share of the burden of defending Western (liberal) ideals. That does not mean that America should not continue to defend those ideals.
[iv] It strikes me this as similar to the logic people use to defend imposing tariffs on less expensive goods from other countries. “If you (foreign country) do not quit subsidizing our purchases of your goods (making the things we want and need less expensive), we’re going to pull the trigger.”
|iPhone 5||iPhone 7|
|CPU 1.3 GHz dual-core 32-bit ARMv7-A “Swift”||CPU 2.34 GHz quad-core (two used) 64-bit|
|GPU PowerVR SGX543MP3||GPU Custom PowerVR Series 7XT GT7600 Plus|
|Memory 1 GB LPDDR2-1066 RAM||Memory 7 2 GB LPDDR4 RAM
Memory 7 Plus 3 GB LPDDR4 RAM
|Storage 16, 32 or 64 GB||Storage 32, 128 or 256 GB|
[vi] The same is true with respect to defense and disaster aid.