Why Not "Save Lives" With Single-Payer Healthcare?

To a Green who asks "why is it patently wrong for it to “initiate force,” a.k.a raise taxes a little bit, in order to save (for the sake of argument) 18,000 lives?"

You have to distinguish between 1) personal ethics in a lifeboat or Trolley Problem scenario and 2) institutional design of government.

If, by some quirk of science fiction or historical accident, I were personally faced with a lifeboat-style choice, I would make what I consider to be the utility-maximizing choice. And if that involved violating anyone’s individual rights, then I would subject myself to the judgment of a jury of my peers.

But I don’t face such a choice, and neither do you, and neither does President Obama. What we as a polity instead face is a choice about the institutional design of government.  I maintain that the design I favor actually saves more lives than yours does in the long run.  One of the ways it does that: for any level of income redistribution that you might fantasize about, my design will actually deliver that increase in living standards within two or three decades.  And then it will deliver another such increase in the subsequent decades, while your nanny state has imposed Eurosclerotic pressure against such growth in our living standards.

Another way it does that is by restoring nature’s safety net, by ensuring that everyone enjoys their inalienable right of equal access to the natural commons of the Earth. The details require understanding a technical economic concept called ground rent, but the result is what we geolibertarians call a citizen’s dividend.  It’s a handy thing, because it erases your claim that my design will leave the indigent to die on the street.  Sorry, but you’ll have to find a less melodramatic and emotional argument to support your proposed design.

Of course, you still won’t agree that my design works better, because you probably think that the outcomes we both want will only happen if centrally planned and imposed by force.  So let’s assume, for the sake of argument, that you’re right, and that we can in the long run prevent more deaths by means of forcible government appropriation of people’s labor, peaceful production, and voluntary exchanges.

If so, then I have some questions for how you plan to legislate your moral calculus. How much of other people’s money are you willing to spend to save one more life?  How do you decide that level?  And how do you decide how far your concern reaches?  Will you be rescuing all the cheap-to-save people in Africa before you start rescuing the expensive-to-save people here in America?  If not, then how are you not a horrible xenophobic monster?

(Note to any observant anarchist critics following along: I consider it crucial that such a calculus should not be legislated, but also unavoidablethat cops and soldiers must apply some such calculus — because they are in the lifeboat business. Their decisions are to be reviewed by jurors and voters, not pre-programmed by legislators.)

Whence individual rights?  Great question.  Not from any gods — they don’t exist. For the purposes of political discourse, I stand with Jefferson.  In this context, I hold these truths to be literally self-evident:

• All persons are created equal, and are endowed at their creation with the inalienable right of equal access to the natural commons of the Earth — everything that is neither a person nor in any way a product of persons.
• Each person has full rights to his body, labor, peaceful production, and voluntary exchanges, but he must compensate those whose access he impairs when he monopolizes, depletes, pollutes, or congests a natural commons.

If, for whatever reason, you think that some people don’t deserve these rights, or that nobody fully deserves all these rights, then there are inherent limits to how far we’ll be able to get along peacefully. If your vision of government becomes too destructive of these individual rights, then I agree with Jefferson that it is the right of me and my neighbors to alter or to abolish your government, and to agree to such new governance as to us shall seem most likely to protect our liberty.

But I doubt it will come to that, and to help prevent it I’m willing to share my own underlying political ethics with you. (This has nothing to do with metaphysics, which is the study of being.)  It’s too long to paste here, but my ethics are described in the Axiology section of my book.  Enjoy.

I have to say, I find your last sentence very disturbing: "Our country is wealthy enough to afford medicare-for-all, so health care should become a human right".  Are you seriously advocating as a principle of ethics that your mere proximity to wealth entitles you to a share of it?  I.e. that what rights you have changes according to how much stuff is owned by the people around you?  Can you please explain how this ethical principle is distinguishable from that of a common thief?  Has some god vouched that your utility function is more noble than the thief’s?  Would you bet that there are no thieves in the world who give a bigger fraction of their income to charity than you do?