David Livingston wrote:The point remains folks are made bankrupt because they cannot pay their medical bills in the USA but not in europe.
Rebutting this statement was covered in the first part of the post. I am not making a statement that Europe and America have the same problem, just in different forms. I am making a statement that coarse comparisons of European and American systems often miss the mark because they are not comparing the same things. People of modest means in the UK and the US will both become insolvent if they try to access an expensive cancer treatments. This manifests differently in each country, but accessing the fundamental resource is still constrained by the ability to pay. The only difference is who pays, when do they pay, and how much do they pay.
In the US:
You get the treatment at the hospital.You get a bill for the portion the (already expensive)insurance won't cover.You struggle to pay until your finances are completely shot.You file for the court insolvency process known as Chapter 11 bankruptcy.
In the UK:
You go to the NHS GP to get the doctor to recommend the treatment.You find out the treatment you want is not available on the NHS.You appeal to the NICE committee, which decides which treatments are "worth" offering on the NHS. Your treatment request is eventually denied.You must purchase the treatment yourself overseas. Overseas because if the NHS won't pay for it, often the treatment isn't even offered privately in the UK.Your financial situation deteriorates until you file for an IVA. IVAs are a private insolvency process that is not classified as a bankruptcy.
Socialized health systems are subject to exactly the same resource constraints as private ones. They manifest in private systems as uneven, missing, or expensive coverage. In socialized systems they manifest as treatment approval committees(like NICE in the UK), long waiting times, rationing, and periodic bouts of benefit/welfare reform to keep the health systems solvent.
David Livingston wrote:As for the fear that some ones care may be open ended in practical terms this never happens people die I think to suggest otherwise implies some people are immortal .
In 1860, the only treatments for cancer on offer were ether, scalpel, and a bonesaw. You could offer these services to everyone quite cheaply. Today there are hundreds of different cancer treatments that can be tried, each costing a few thousand to a few million. So long as SOMEONE is willing to pay, a person now has the capacity to consume millions in cancer treatments. The only limits are the number of treatments on offer, and the willingness of someone to keep pumping resources into providing them. That is what I mean by unlimited.
A community or family voluntarily giving their surplus to support a sick member of the community is NOT ethically equivalent to demanding(or forcing) that a community give their surplus to support a sick person who is not a member of that community. My willingness to give to members of my community is the measure of how much I value I place on the interactions with them. The community or individual has no right to claim more. I don't have to justify giving or denying someone my surplus. "Because I NEED your resources..." is not a good enough argument. That seems to be the core of the Third Ethic argument that Paul was making.