That's one way of looking at it. The other is to say that the citizenry discharge some of their personal responsibilities to each other through the tool of government, the most efficient way to take care of everybody.

Government: n. 1. A tool (of the people). 2. The most efficient way to take care of everybody

Thank you cactoblasta, I needed that laugh.

By dying earlier?! We could survive as a species with a life expectency of 30 years (due to no healthcare), just as we could survive if everyone over 50 years old was refused food and forced to starve to death. Doesn't make food any less of a need, in fact it shows that it is a need if you die much faster without it!

You already started to counter argue your own point there - profit making motive encourages increased efficiency, so it's not certain by any means that 'at cost' will be cheaper. Factor in overconsumption by making it 'free' and it could well end up more expensive

Why? With wants/luxuries sure, but we're talking about a basic necessity here - you're saying people should be denied such necessities simply because they're less productive than someone else? Now you can still allow very rich to obtain better healthcare (i.e. above that which covers the basic necesities) just the same as it is with food (pretty well all developed countries have at least enough of a welfare to allow people to purchase the really basic cheap food, while if you want to dine on caviar you need to be earning more), but take it too far and you could end up saying that for example you must have surgery undertaken without any anaesthetics by a poorly trained doctor using 30 year old surgical impliments for the 'crime' of not having/yet being as productive as someone else!

Until they (or someone they know) ends up in the situation of needing such care, I expect! Lets say you're 15 years old (hence still in full time education, hence no taxes likely paid, and unable to afford health insurance for yourself if you've even started thinking about such things). You're not as productive as your teacher, who probably earns a decent (but not massive) salary, pays taxes, might have insurance etc.; If you suffer a terrible and rare medical condition caused through no fault of your own, and need specialist attention costing say $50k in order to live beyond your 16th birthday, why should you be forced to have a substandard level of care (say $10k, the value of your parents combined assets+income that they have to spare) which causes your untimely death, while the teacher might have been able to see the specialist+survive if in the same situation? Should that child be punished simply because their parents may not be that productive (and hence unable to afford specialist treatment)? IMO it is immoral for such services to be denied based on income, and that everyone should be entitled initially to a basic level of healthcare that will mean if they need life saving treatment they will get it (although you could then introduce exceptions and would need cut off points - e.g. fat people who smoke might have to wait longer or be denied certain treatments, while highly expensive drugs that might give a 0.1% chance of saving someone simply wouldn't be viable either). This is of course in the context of the US or other developed countries, since such policies are affordable.

Age? Dependants? Contributory actions on the dying persons part? etc.

E.g. if you have two people needing emergancy lifesaving treatment, and only 1 can get it in time, and 1 is a 60 year old male lifetime smoker with no children who earns $2m a year, the other is a 23 year old woman with a 3 month old baby and a 1 1/2 year old child who earns $10k a year (and isn't likely to earn much more than that throughout her lifetime), most people wouldn't hesitate in saying that the young woman with dependants should be saved first - in fact even when you go back say 60-100 years to when you didn't have the same universal healthcare principals flying around that you do now, if a ship capsized, priority would b typicallye to save women+children first, and not simply the person with the most earning potential.

I'd have thought doctors would be the best judge of that, and in most cases it would probably be possible to determine; if you have 2 people, 1 of whom is expected to die within 24 hours if they don't get surgery, and one who will likely die in 24 days if they don't get surgery, you'd probably deem the first one to need surgery first. I.e. 2 people in an accident+emergancy ward, one has had his arm cut off and is going to bleed to death if not operated on, another has a gunshot to the leg that avoided any major arteries and will be in danger if not treated soon, but isn't critical yet, I'd have thought it wouldn't be too tough to determine who needs treatment more.

As for need more generally (as in what treatment is needed), that would be a tougher gauge, and probably best for the population to decide via voting for the party/policies they feel best reflect it, but as a basic rule, I'd say if you're going to die or suffer terrible injury, and there is a reasonably cost-effective method for saving your life/preventing that injury, then you need that treatment. Doctors are going to again be the best ones to start with for assessing whether you need something. The 'cost-effective' part I inserted is mainly because if this expenditure is coming from government, and their aim is to reduce deaths, then you need to put a price on life - e.g. do you spend $100k on some traffic safety features that will likely save 1 life a year, do you spend $1m a year on providing special healthcare to a person which will save their life, etc.;

Ok, how about the police then if you don't like the fire service analogy given? Two people are murdered, one of whom was on $40k, the other on $60k. Should they investigate murders equally based on the crime details, or should they devote 50% more resources to the person on $60k, or should they invest even more than 50% to the person on $60k (seeing as they'll likely have paid more than 50% more tax than the person on 40k, and hence base the increase in resources on the persons tax contributions)? In fact when you talk of basing such decisions on productivity+that it's unfair to pay for someone elses healthcare and not then get priority over them, are you thinking in terms of total taxes paid in lifetime, or taxes paid in that year, or income earned in lifetime, or in that year, or future earnings potential, or future taxation revenue potential, or some other measure?

The problem you have with such policies in the long term though is it causes massive resentment, and if rich people benefit from better public services than the poor I really don't see the party adopting such policies winning an election, while a dictatorship would not only result in higher taxation overall, but also then throw up issues such as revolution. Unless of course you had a democracy where you could only vote if you paid taxes - it'd have some merits, but also throw up other issues; would someone who had paid taxes all their life but was now retired be able to pay taxes? (although you could always then do it on the basis that people who had paid a certain tax for x years over their lifetime would be entitled to vote even when not paying any taxes, with voluntary contributions for people who wished to vote but had say been on maternity leave+looking after their family for some of those years; obviously you'd need to tie in other benefits like a pension to that so it's not quite about making people pay for the right to vote).

Hardly a left wing only issue - there are plenty of right wing people who support euthanasia (and therefore no doubt in extreme cases some who support forced euthanasia). Capital punishment is another case - it's not 'liberal' to support the death penalty, while a more right wing person would argue that you cut costs by killing the relevant people off, and that they've deserved it (never mind the small % of people who might get wrongful convictions). Hence on the issue of 'death to cut costs', I'd say the reasoning would likely be more 'conservative' than 'liberal'.

Well to pay for the healthcare taxes would raise, so you can bet that the figure would fall from 40%!

Perhaps you'd care to suggest alternative organisations that could take care of an entire nation more efficiently than the government in every conceivable situation? The government isn't perfect, but there are some cases where they are the most efficient method of achieving a particular goal.

A government is an organization that controls a specific region via military strength.

Most are not of or for the people. A FEW are of or for the people, and those vary greatly in implementation. And like every very large organization, they are far from efficient. If you had corporations controlling the government in a competitive environment you would MAYBE get a somewhat efficient way to utilize wealth.. MAYBE... you would also get a very corrupt government whose purpose is to make money for its owners, not to protect or serve its citizens (so it would be efficient in making money for the owners, not in serving the citizens).

"Democracy is the worst form of government ever made... except for all those other ones"

Themselves.

The government doesn't exist to "take care" of things people should be able to take care of for themselves.

Again... police are paid for by property taxes. 

It's a bad analogy again.  Everyone pays for the police in one way or another.

Health insurance is not a basic necessity. We have emergency room treatment today for anyone.

But yea, if two people need an organ transplant and one of them is a single guy of 50 years old who smokes, drinks, but has health insurance he should still get the organ transplant before the guy who's 25, father of 4, healthy in every respect, doesn't smoke or drink but does not have health insurance. Why? Because the one made the choice to get insurance and the other did not.

The biggest fear I have about universal health insurance isn't the cost (which is a big concern though) but inserting individual human value judgment into the equation. I don't want another human being deciding my fate based on some arbitrary set of criteria.

Health care, like you said, is a matter of life or death. It's a limited resource.  I think it's a good thing(tm) that some people choose to opt out of buying health insurance. They can choose that for themselves but there are consequences for doing that.

Universal health care isn't about getting the poor medical care. They have that already, it's called Medicaid.  It's about evening out the *results* people get with regards to healthcare regardless of what life decisions they make.  I don't like paying for other people's mistakes.

The less the federal government is involved in our lives, the better off we are.  

If universal healthcare is such a wonderful thing, why don't the states offer it and see how it works out for them? California for instance, certainly has more resources than the typical European country, let them do it if they want it and see how well it works. 

I agree fully, and this is also the crux of the matter... for some it is a bad thing. everyone but them is too stupid to make a right decision, everyone has equal right to life (except babies... heh... and I am FOR abortion... I just recognize the irony in what they say). and the state is a NANNY that has to say "we decide based on our own skewed moral beleifs who gets the transplant first... REGARDLESS of who is actually PAYING for it...

Liberal point of view: "the 50 year old smoking guy should pay to give a transplant to the 25 year old with kids because he needs it more..."

Will you tell the old man who probably worked all his life to pay for the hospital resources that you are going to offer those to somebody else instead of him, or shall I?

What about the next 23 year old woman who needs help and cannot get it because the hospital doesn't have any resources left after you decided to let the stupid rich guy who paid for all the stuff die?

Very good point... if the hospital saved that rich old man instead of the young woman with a baby, he would keep on paying his exorbent taxes paying for life saving treatments for dozens of other 23 year old women with babies who can't afford it. And again... even if he did NOT, you are still saying "she deserves to live more, thus I am gonna take YOUR MONEY and use it to pay for HER treatment and you will die... since you don't need it as much"...

Remember the part about "forced euthenasia?"... old people don't need the treatment as much is fairly close.

Strange reasoning in part - he was old, hence his working life was coming to an end. Meanwhile that woman not only has potentially a long working life (albiet not at much of an income in the example I gave), but also has children who have a long working life (who would probably suffer a decrease in their expected future productivity as a result of their mother dying). Thus it is quite possible that they could provide more via taxes. Furthermore, that old rich guy is a smoker who is more likely to have the same illness again in the future, and hence would prove more costly. Meanwhile their actions have contributed towards their own illness, so it would seem fairer, all else equal, to favour the person who hasn't brought it upon themself (and the law recognises this in many cases, reducing damages that can be claimed in negligence cases if the person claiming them contributed towards those damages themself). Then you have the more historic/cultural issue of women being saved before men - the view that men are the 'fighters' and hence should die for women (although that doesn't apply anywhere near as much now as it used to historically), while the man's 60 so is unlikely to be able to sire any more children, and certainly can't give birth to any, although the woman could.

Not really. If you can save 40 years of 1 persons life and 10 years of another persons life for the same cost, and you only have enough money for the one treatment, then all else equal you should look to save the most life - i.e. save the young person with an expected 40 more years to live than the old person who's likely to die of something else fairly soon even if you save them of this.
 So you could try and streatch it to forced euthanasia where resources are being spent maintaining the person such as life support machines, but not more generally to the issue of forced euthanasia where such resources aren't being spent. In the first case, why spend say $1mil maintaining someone in a coma per year, if you could use that same money, and save 10 young peoples lives (meaning many more 'years of life')? It may sound callous at first glance, until you realise that there are finite resources, and if you decide to use that life support machine, it will cost the lives of others - so in effect rather than looking at it as 'why kill this person to save money', you could look at it from the other perspective 'why kill 10 people just so you can 'live' for 1 more year'?

EXACTLY.  I don't want the decision as to whether I or my wife or my kids get life saving help to be made by someone else if I can avoid it.

I recognize that even today, that situation can/does come up all the time.  Adding 40+ million more people to the competition -- and paying for the priviledge of doing it -- doesn't sound like a a great idea to me.

This is precisely why we shouldn't have universal healthcare, determining who lives and dies when resources are scarce is too subjective.

Warren Buffet is 78 year old smoker. Pretty old.  Is society really better off without him but with the 23-year old welfeare mom?

I don't think I could illustrate better precisely why it's so scary imagining the government deciding who should get care than what you just wrote above.

For the most part, they can, they just choose to spend their money in other ways. THAT is why so many of us are against it.  We already have means testing for health insurance with the poor getting it for free.  The people who don't get coverage are overwhelmingly people who could afford it but choose not to. 

Look, this isn't rocket science: There are a finite number of doctors, nurses, transplants, etc.  The fewer people competing for those resources the better it is for those people.

Your premise is that it's a good thing to have everyone have access to those finite resources.  My response is that it's not.

If my son needs a bone marrow transplant, I don't want him competing with someone who's simply living off the system.

People CAN purchase health care insurance in the United States. If they're very poor, they get Medicaid.  Those who choose not to purchase health care insurance are making that choice for themselves.