Or maybe he wouldn’t and he’d end up on welfare thus increasing government spending. Or worse, he’d just steal from you.
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Or maybe he’d find some way to get out of the gene pool. 
I seriously believe that a lot of the 30+ years old living at home are just waiting for an inheritance. Of course, this means they’ll start complaining about all the money that old people are taking from the healthcare system, and that there should be limits to how long they can live … 'er limits to how much can be spent on them.
This was a big deal in Britain during the 80’s. Britain had nationalized health care, and young people thought old people were taking money from them. Very shortsighted, dull, and sad.
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Actually this country really should have some of that conversation. I’ve read that end-of-life care is one of the biggest expenses in healthcare. It is insanely high in the last few days of someone’s life. A person dying of old age should be allowed to go without unnecessary delays that could cost society tens or hundreds of thousands of dollars.
ETA: I’m not saying that this can’t be done today, only that the subject is taboo in this country, but it shouldn’t be. People young and old should be educated about the costs, chances of survival, etc, and be encouraged to exercise these rights in whatever situation they find acceptable. IMO the more people talk about it, the more they’ll find certain situations acceptable to them.
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I agree with letting nature take it’s course once one has lived a long, full life. Unless, of course, the person is paying the costs to keep them alive out of their own pocket. Then it’s their business. I don’t think that’s the case most of the time though.
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[ Not said with animus, but couldn’t find appropriate emoitcons ]
I agree with you and your doctor deciding your own treatment. I don’t agree with someone else deciding the definition of:
letting nature takes it course
Long and full life
Long or full life
I think it’s my business whether I’m paying out of my pocket or if I’ve paid for medical insurance. As much as I hate to admit it, I think it’s my business even if I’m not paying for it. I really do hate to say that.
I agree that it’s nobody else’s business and the decision should ultimately be made by the patient.
However, dropping the taboo status and talking about it will make it acceptable to the society as a whole and many members of said society individually. So there’s a chance that you might change your mind if it ever came to that. That chance is much slimmer if we never talk about it.
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If you want to standardize some definition of “extreme” end of life care vs hospice or similarly letting terminal people die sooner without lots of expensive and unpleasant procedures, then you could get a free market solution to the problem of end of life expenses. If you want, buy insurance that covers “everything a doctor is willing to do” and pay double for it; if you don’t want that stuff done to you, pay half price and don’t expect the insurance to cover that stuff. If you change your mind later and want to try some risky unlikely procedure when you’re very old and sick, that’s fine just expect to cover those costs yourself.
Right now, the patients (or doctors perhaps) who decide to pursue extreme and expensive life prolonging measures are spending everyone’s money in terms of higher average insurance premiums, so they aren’t bearing the full cost of their decisions and so the incentives are misaligned and you get wasteful outcomes.
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Read about how doctors choose to die. Maybe if everyone knew, they’d change what extraordinary things they’d request at end of life.
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I appreciate your honesty. 
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I find this a fascinating philosophical area that highlights the difference between a purely free market and a totalitarian government. By nature of the universe, there is always limited resources. If we have a totalitarian government distributing the limited resources, then the government has full control over how they are divided, which ultimately becomes a “death panel” discussion.
And yes, people will have to be chosen for death by the totalitarian government because that’s how limited resources work. Unless we decide that we should put 100% of resources into end-of-life care and every other medical care is uncovered and also not allowed. We can’t possibly provide all medical treatments for everyone, including end-of-life care, and also fund research for new cures. Just not enough economic resources for that. Even if we shifted 100% of our economy to healthcare spend, there’s still something we have to forgo with respect to new research since there will only be a finite number of scientists and someone has to decide how to allocate their focus on which diseases and medical problems.
On the other hand we have a purely free market where government isn’t involved at all. You want the most massive end of life care and can afford it, great! Can’t afford it - too bad, out of luck. Unless… a private charity steps in and takes care of it. People seem to forget that charities exist in free markets and if society really valued extended end of life care, then they’d donate money to these charities. If the government were compressed down to a fraction of what it currently is, taxes would be much lower and people would have more money to donate to charities. If, in this hypothetical example, people’s taxes drop down to 1% and they would rather buy a new car and TV than donate to end-of-life charity, then society has made their decision.
If you want to smoke cigarettes and eat junk food all day, go outside without sunscreen, and ride a motorcycle, have at it. But why force everyone else at gunpoint to pay for your inevitable healthcare due to your risky lifestyle? Anytime we pass a law for a government program, whether it be food stamps, public housing, or healthcare, we are essentially saying “I will make everyone pay for this, whether they like it or not, and if they don’t pay, I will send men with guns to make them pay, and if they still don’t pay, I’ll lock them in a cage, and if they refuse to go into the cage, I’ll have the men with guns murder them in front of their family.”
Unfortunately, when we write laws, we don’t include that verbiage. It might make people think twice about every new law they pass.
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Based on this and one of your previous posts about charities I think you firmly believe that people would actually donate more money to charities if they had more money. I firmly believe that you are wrong – there may be a few people who will donate a little, but it won’t have nearly the same impact as what a government could do through mandatory taxes.
But it’s not that simple. As a society most of us could probably agree that we shouldn’t let people die or go hungry, but individually many, if not most of us would hardly do anything to help the needy if it wasn’t mandated.
I agree that we shouldn’t force everyone to pay for other people’s poor outcomes resulting from them knowingly making poor choices, but you can’t generalize and say that everyone with low income who needs food stamps or public housing is in that situation because of poor choices. This is why I support cigarette taxes (they’re supposed to go towards healthcare and research for related diseases), and I wouldn’t mind similar junk food taxes. A Poor Choices Tax
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First, I need to clarify the “I think it’s my business even if I’m not paying for it.” I did not mean to imply that I thought the public should pay for my healthcare, although I can easily see that’s how it sounded. I meant that I don’t think anyone, other than my doctor and I, should decide my medical treatment, whether that is end of life or almost anything else.
Second, I agree with almost all of your well written post. The lines I quoted, though, bother me because who is going to decide what is a risky lifestyle. I certainly lead a risky lifestyle compared to my wife, but I’m a great risk compared to a pot/meth/blow/heroin drug abuser.
As for the totalitarian scenario of nationalized / single payer healthcare, I am 100% against it. To me, the death panel thing is more of a political phrase to freak people out than a reality. It is true that the government will limit equipment and access to equipment as a way to control costs, and this does lead to adverse results, including death. However, this is denying access to all, as opposed to a single individual.
The worst thing that I attribute to single payer healthcare is a change in the attitudes of doctors. Someone in our style of healthcare might say that doctors are more concerned with billing than your outcome. From the few examples I’ve seen, doctors in single payer countries are more aligned with cost over outcome. Yes, this is anecdotal with only a ~12 point dataset, but my first encounter with it threw me for a loop.
For anyone thinking they want single payer, I recommend them try to get prompt (as prompt as the U.S.) treatment for a serious disease or have a serious accident in a country that only has nationalized health care. It is an eye-opening experience.
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I can’t speak for the entire country, but over 75% of my friends donate to charity. If I could deduct dollar for dollar, I would (could afford) to donate more.
This is just not true. I don’t know anyone who needs the government to mandate that they help the needy. Of course, I don’t know any millennials 
And where does it stop? Oh, and lottery taxes are supposed to go towards education. It’s the education system that is producing the mathletes who play the lottery.
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There are millions of people in need. How much do you and your friends donate? And why do you even know that 75% of your friends donate? It’s strange that you know this. Would you donate 20% of your income to the needy if there was no federal income tax? Do you think everyone else would too? I don’t.
I don’t know, it might not stop. If we know that something causes health issues, then make that choice more expensive to pay for those issues. Smoking, junk food, and smoked meats (which increase the chance for various cancers in the digestive system).
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Honest question, how much would the wealthy voluntarily donate if there wasn’t a tax incentive for them to do so? I’ve known many less wealthy individuals donate who don’t itemize but it wouldn’t come close to meeting the burden if there wasn’t a tax mandate or incentivised reason to do so.
There is a generous “feel good” and social aspect to donation contribution but I can’t honestly say the wealthy would subsidize voluntarily if there wasn’t a tax write-off or political agenda for doing so. Would corporations voluntarily raise wages just because they should, against their bottom line because it’s the right thing to do? No, they do it to stay competitive and retain employees because they need to. Corporations just like individuals in our society are by nature selfish. That is the human condition, especially in our US culture.
We game the system at every loophole and opportunity we can, whether it be taxes, credit cards, etc. I don’t think we could ever have a truly just socio-economic system that pays for itself because it is not in anyone’s agenda to do so. Lord of the Flies as it is, we all want to get ahead by whatever cost to others. That is the American way in our current society. If you don’t think so, volunteer at a homeless shelter or become a corporate executive and you will clearly see their agendas are not so different.
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Yeah, the VA here in the US and the NHS in the UK are examples of how pervasive and corrosive the lack of incentives for providing care can be - you end up with caregivers selected for their ability to navigate a bureaucratic system and play petty politics, rather than treat patients and it shows in their results. I was appalled at a survey that ranked the NHS as top among a dozen OECD counties for healthcare with the footnote that almost the only criteria they lagged on was “healthcare outcomes”. WTF kind of survey is that when the care sucks but people feel good about it or it’s affordable so that doesn’t matter? Dying at home is pretty affordable too, but it’s not what I want from my healthcare system.
But the NHS came 10th on healthcare outcomes [out of 11, 2nd worst], a category that measures how successful treatment has been – a significant weakness that was also identified in 2014. The experts concluded that the UK does very poorly in relative terms on five-year survival rates for breast and bowel cancer, and deaths among people admitted to hospital after a stroke, for example.
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It’s really easy to agree to something when you do not have to contribute. What if Fragile Deal as a whole agreed that you should wash my car. We all agree that my car should be clean, but I don’t live in a house and my apartment forbids cleaning it here, and I can’t afford to pay a car wash. Since we all agree it should be cleaned and you’re the only one with the means to clean it, it should fall on you, right?
How can society “agree” to something that they don’t want to contribute to? They agree to make other people do the thing they want done, but don’t want to do themselves. They want free healthcare but want someone else to pay for it. Want free food for the poor, but want someone else to pay for it. Wouldn’t we be better off if everyone that wanted something actually went out and did it themselves instead of tried to force others to do it?
If someone wants to feed the poor, how about getting a part-time job to earn extra money so you can donate to that charity? If someone wants free healthcare, how about going to nursing school and volunteering at a hospital on nights and weekends? Instead, if people want things done that they themselves don’t want to do, we have an involuntary taxation system where the people with money will do everything they can to avoid it. Warren Buffet pays a lower tax rate than his secretary. Why? Because he doesn’t want to do all of the things that “society as a whole” decided they want done but wanted him to pay for.
So now we have the largest value generators in the country going through great means to avoid taxation instead of putting that effort into creating more economic value. How many accountants and financial planners are a complete waste of economic value because they spend all their time trying to help people avoid doing things that “society agreed to” but didn’t want to pay for themselves?
If we stopped that system, could those accountants and financial planners now do something productive that grows the economy as a whole and makes everyone better off?
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I can’t tell if this is rhetorical, because you’ve answered your own question in the first four sentences preceding the question. Yes, we would be better off if everyone that wanted something actually went out and did it themselves instead of trying to force others to do it, but that’s not what happens – we all want something, but we don’t want to go out and do it ourselves. We all want something for nothing, it’s human nature. You can’t change human nature, not easily, not quickly.
How do we define the arbitrary limits where government needs to step in? Should it be limited to necessities of life such as food, shelter, and healthcare? And if so, how do we define how far to go into those limits? Is it sufficient for government to provide (via means of wealth distribution by threat of force) free housing to those in need in a dormitory style where 10 bunk beds are in a large room with a shared bathroom, or provide a 2,000 sq foot house for free? And if it’s somewhere in the middle, how do we define it?
Unfortunately, this becomes the problem of special interest groups. 10% of the population might be receiving free government housing at the cost to the other 90%. But the cost to the other 90% is so low (perhaps $5 a month per taxpayer) that if a proposal goes into effect to increase free public housing, it’s not worth the 90% of people’s time to take off work and protest over $5. But it’s greatly in the interest of the special interest group 10% that is getting the benefit to go into the streets with signs and take off work, because it’s worth $1000 a month to them. This applies to corn subsidies and anything else the government provides via means of wealth distribution.
The next question becomes where do we draw the line on what to provide. I want to be thin and healthy. But everytime I drive past McDonalds, I can’t help but eat it. Should the government prevent me from eating there, because it’s agreed upon that I want to be thin and healthy but I don’t have the means to do it (because I lack self control)? If the government adds a fast food tax, I have the money to pay more, so that won’t stop me. I’ll still eat it and get fat. But I want to be healthy and it’s a benefit to society as a whole for me to be healthy. Eating well is more important than free healthcare - we’d likely not need so much healthcare if we all ate properly.
Should the government stop McDonalds from selling to people? Or just stop selling to people who are fat or who have poor blood work tests? Or should the government make it illegal for me to buy from McDonalds, in effect, helping me with my self-control, by locking me in a cage if it finds me eating there?
And once we start having the government do these things, how will it ever end? There’s always going to one more special interest group that wants something without paying for it, either paying in money or willpower. Does it ever end? Or does it scope creep until the point of complete 100% totalitarianism?
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Possibly, but please define need. I don’t think that someone with cable tv is in need. I don’t think that someone driving a new car is in need. I don’t think someone with an Iphone is in need. Heck, I’m in need of a new truck, but I don’t think that someone ought to be forced to buy it for me.
I don’t know how much my friends donate, but I donate enough to feel comfortable. If I had more money, I would donate more.
I said that at least 75% of my friends donate. What do you think is strange about knowing that? I think that I’m a lot older than you, or we define friends differently. I’ve known the vast majority of my friends for over 20 years, and you learn something about who you call friend over that period of time. I’m not talking about facebook friends or selfie friends, or people that I see three times a year year (unless recent locale changes have occurred).
Yes, would you? But keep in mind that our definition of “needy” is possibly different.
Everyone else would not. You’ve made that clear. 
At various points in my life we knew that coffee was bad for you, drinking was bad for you, butter was bad for you, eggs were bad for you, etc. We’ve since learned that none of these are bad for you.
OTOH, let’s assume that we really do know that something is harmful. Isn’t it selfish to try to make money off of it? Should we not show how much we care and ban it completely?
If it sounds as if I’ve gone off the rails, someone please pull me back on. 
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