I didn’t say that people weren’t qualified to make informed decisions about anything at all. Various services that we enjoy exist on a spectrum of rational understandability. Health care is way over on one extreme – people are absolutely terrible at gauging the quality and value of the medical care that they’re receiving. Ice cream is at the other extreme – people are very well-equipped to figure out for themselves what amounts of which flavors of ice cream are optimal for them. There’s a certain amount of inefficiency introduced by top-down decision-making, and the government should only interfere in markets when their natural state is so ridiculously inefficient (health care, education, policing, highways, etc) that it’s justified. But it is worth noting that aspects of almost every market are in fact this inefficient – there’s a reason that anti-fraud law pervades just about every industry out there. We do believe that the government has a role in the ice cream business, at least insofar as it ought to make sure that the people making ice cream are using safe ingredients and clean equipment.

Also, some differences between industries are cultural. Most people don’t want to manage their own IRAs, and so it isn’t an issue. Regardless, that’s kind of what Social Security is for – it’s a government-managed retirement fund. And we do mandate that people get car insurance. And we do mandate quite a bit about how much and what kind of education people get.

Like our esteemed columnist, I too have a “continuing condition” which has given me a fair amount of experience with the health care systems of both countries, and I have never once experienced any sort of “rationing” or anything like that. Certainly, departments have budgets that they need to stick to, and the system is not perfect by any means – there are inefficiencies, and there are queues and waiting lists. But fundamentally, a universal health care system means that when you get in a situation where you require medical care, you can go to the hospital or to a specialist and get the treatment you need without the question of money ever being raised at all. When faced with the sort of stressful situation that a medical problem usually is, that sort of security is simply, in every sense of that word, invaluable.

It’s that health care costs are too high in general.

Giving people more money doesn’t address that the costs are too high.

There’s already plenty of money in the healthcare system. We’re at a point with high cost, no benefit.

Reform will change it, not more money.

More to the point: I have never lived in the USA, but I am quite happy with the two health care systems I have experience with (German and Swiss). While we Germans are always complaining about the high costs and bureaucratism of our heavily regulated system, it actually seems to be more cost-efficient than the American one from the figures I have read, and it covers virtually everything. The Swiss system has a lot of private insurers but they are all forbidden by law to reject basic coverage to anybody, and everybody is required by law to be insured. You pay extra for and are not required to have anything above basic coverage, including, much to my annoyance, dental, but apart from that it seems like a decent compromise between “freedom of the market”-mania and the fundamentally civilized idea that everybody should have access to medical services in case of accident or illness regardless of their income.

All we’re talking about it bringing coverage to everyone by making people, not the government, responsible for purchasing their healthcare.