The important issue is one of principle.
Do we, or don’t we, allow the government to take some of our income for our ‘own good’? Or allow it to force us to spend some of our income for our ‘own good’?
Some people have strong principled objections to supporting the military. They don’t want their taxes spent on killing people, as they see it. Should we force them to?
Others – as we have seen this year – don’t want to spend money on the police.
And so on. Do we make them do so?
There are arguments against forcing people to turn over some of their income, or the discretion of regarding how it is spent, to other people – the government. In an abstract sense, it’s a kind of legalized robbery: in both cases, men with guns take your money.
The argument was put pretty well by Robert Nozick, the main antagonist, from the Right, of the pre-eminent (liberal) political philosopher of the late 20th Century, John Rawls. Here it is:
Consider the following sequence of cases, which we shall call the Tale of the Slave, and imagine it is about you.
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There is a slave completely at the mercy of his brutal master’s whims. He is often cruelly beaten, called out in the middle of the night, and so on.
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The master is kindlier and beats the slave only for stated infractions of his rules (not fulfilling the work quota, and so on). He gives the slave some free time.
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The master has a group of slaves, and he decides how things are to be allocated among them on nice grounds, taking into account their needs, merit, and so on.
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The master allows his slaves four days on their own and requires them to work only three days a week on his land. The rest of the time is their own.
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The master allows his slaves to go off and work in the city (or anywhere they wish) for wages. He requires only that they send back to him three-sevenths of their wages. He also retains the power to recall them to the plantation if some emergency threatens his land; and to raise or lower the three-sevenths amount required to be turned over to him. He further retains the right to restrict the slaves from participating in certain dangerous activities that threaten his financial return, for example, mountain climbing, cigarette smoking.
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The master allows all of his 10,000 slaves, except you, to vote, and the joint decision is made by all of them. There is open discussion, and so forth, among them, and they have the power to determine to what uses to put whatever percentage of your (and their) earnings they decide to take; what activities legitimately may be forbidden to you, and so on.
Let us pause in this sequence of cases to take stock. If the master contracts this transfer of power so that he cannot withdraw it, you have a change of master. You now have 10,000 masters instead of just one; rather you have one 10,000-headed master. Perhaps the 10,000 will be kindlier than the benevolent master in case 2. Still, they are your master. However, still more can be done. A kindly single master (as in case 2) might allow his slave(s) to speak up and try to persuade him to make a certain decision. The 10,000-headed master can do this also.
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Though still not having the vote, you are at liberty (and are given the right) to enter into the discussions of the 10,000, to try to persuade them to adopt various policies and to treat you and themselves in a certain way. They then go off to vote to decide upon policies covering the vast range of their powers.
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In appreciation of your useful contributions to discussion, the 10,000 allow you to vote if they are deadlocked; they commit themselves to this procedure. After the discussion you mark your vote on a slip of paper, and they go off and vote. In the eventuality that they divide evenly on some issue, 5,000 for and 5,000 against, they look at your ballot and count it in. This has never yet happened; they have never yet had occasion to open your ballot. (A single master also might commit himself to letting his slave decide any issue concerning him about which he, the master, was absolutely indifferent.)
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They throw your vote in with theirs. If they are exactly tied your vote carries the issue. Otherwise it makes no difference to the electoral outcome.
The question is: which transition from case 1 to case 9 made it no longer the tale of a slave?
Clever, no? Case 9 is what we would today call a liberal democracy. But it can be seen as simply a point on a linear transition from total, cruel slavery.
I think there are fallacies here – we could apply the same argument to say there is no qualitative dffference between a new-born baby, completely ignorant and possessed only of inborn instincts, and an old man like me, replete with knowledge and full of wisdom. Where did the transition from child to adult occur?
Anyway, most conservatives accept, explicitly or implicitly, the ‘right’ of the state to regulate us. We are just always on our guard, or should be, about how this right is used.
A much-quoted observation, made originally by a dead white transphobic homophobic male chauvinist slave owner, is that if men were angels, no government would be necessary, and if we were governed by angels, no limitations on government would be necessary.
I happen not to think that’s quite true, but let that pass. It’s basically right.
Once you’ve conceded the necessity for government – a state, armed men, who can imprison you for not doing what they tell you to do – then we’re just haggling over the price, as the joke has it.
I think some form of government involvement in the provision of health care is necessary, just as it is in the provision of education. Once that is conceded, we can quibble over the details of how that is done. It’s an important quibble, because if you get these things wrong, in the nature of things, they are hard to undo: private companies which screw up will go out of business but government never does, as witness our dysfunctional government school system in the inner cities.
However, I don’t have the time or inclination to do the work involved which would allow me to put forth a comprehensive program for American health care. All I can do is say, Singapore seems to work pretty well, but I’d also look at other smart countries - all the Europeans, Australia, Taiwan, South Korea – and see how they do it, and – remembering that we have a different nation here, a different culture, different tribes – try to come up with something that combines the best of the others and avoids their mistakes.