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buiq

PUBLIC HEALTH

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Hello:

What is or are your opinion/s regarding public health in the perspective of Objectivism philosophy?

As you all know, public health has contributed to the improvement of health and lives over a century. Public health has extend life expentancy by 25 years while medical advancement only extended life by 5 years, during the last 100 years. Public health inhenrently concerns for the health of the population not an individual. The government (federal, state, and local) spent a large amount of money towar public health and it is tax payers money.

Is public health a role of government? Is it justified by taxing the citizens to provide public health, including those not citizen and not taxed? Also, public health role has changed from the traditional role such as providing clean water, immunization to include public health care clinics (for the indigents and non-citizens), bioterrorism. Is public health programs and policies in conflict with Objectivisms

QB

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You are misinterpreting the cause and effect. It is private health industries that have accomplished everything you mention. Enslaved doctors and a population of serfs achieving anything is beyond my ability to conceive.

That's in addition to the obvious, as Capitalism Forever mentions. The initiation of force violates the most basic political principles of Objectivism, individual rights. There is no going around or evading that fact, and it doesn't matter what good you claim to be accomplishing by it.

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The "public" can make no advancement without "private" impetus.

Every single advancement in "public" health can be traced directly to "private" technological or medical advancements.

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You are misinterpreting the cause and effect. It is private health industries that have accomplished everything you mention. Enslaved doctors and a population of serfs achieving anything is beyond my ability to conceive.
I respectfully disagree that I have missed the "cause and effect". Public health did improve and extend life expectancy of people during the past 100 years. Only 5 years were attributed to medical advancement. If youhave doubt this fact please visit the DCD website. Please also review Public Health: What It is and How It Works. by Bernard J. Turnock. If you even doubt these sources please visit the American Public Health Association for more information or even visit a local library.

Sanitation for instance, is under the purview of the public health department in the city where you live. Immunization programs are run by public health clinics and so on. These are only two of the examples where public health has a role in society. Agreed that Salk discovered polio vaccine but it is the wide spread programs that operated by public health agencies that reduce the incidents of polio. Small pox, malaria are other examples. Individual treatment will not prevent the speading of these diseases. I do not se how malaria, small pox, HIV, tuberculosis are controlled with individual treatment. It is public health programs that prevent the wide spead of diseases. These are facts not fiction nor misinterpreted.

With that being said, how do Objectivist view Public Health? Saying that the above facts are not true is diverting from conversation. Ascribing fact as misinterpretation of cause and effect is skirting the issue and minimize the contribution of public health. Even if you do not "believe" that public health has contributed to the health of the population greatly, you must agree that it does so at some degree. Even at this small degree of contribution to population health, how is this viewed by Objectivists?

That's in addition to the obvious, as Capitalism Forever mentions. The initiation of force violates the most basic political principles of Objectivism, individual rights. There is no going around or evading that fact, and it doesn't matter what good you claim to be accomplishing by it.

Capitalist is an economic theory (political as well) that practiced by may countries. I do not disagree here. However, would you not see Objectivists works together for the benefit of each individuals? There would be NO individual right if you are dead! Understanding that individual treatment cannot eradicate disease X. By working together to devise a program to eradicate this disease X would benefit each individual. Is it not self preservation and selfish to do so?

Every single advancement in "public" health can be traced directly to "private" technological or medical advancements.

I agree. Someone must invent a vaccine. Someone must comes up with the idea of the Germ Theory. There is no doubt in these facts and I am not doing so. But you must acknowlege that programs run by public health agencies that eradicate, prevent, and control diseases. Not individual doctor.

I wish to see and learn how an Objectivist reconcile the good that comes from Public Health programs. Is there any "good" in collectivism as in the case of Public Health?

Thanks

QB

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Well, Buig--let me take a crack at what I think you're saying.

Am I to understand that if I, of my own volition and own talent, invented a way to vaccinate people against a disease--say HIV or something--that you would think it was all right for the government to take the rights to that vaccination (which I created, as you recall), and put it into the service of public health? And you think this is a better solution than my getting to market the vaccine to clinics and patients?

By what right would you take away my property, which is the formulation of that vaccine? By what right is the "public's need" a claim on the products of my labor?

This sounds an awful lot like the claiming of Reardon Metal to me....

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The point here - and it has been made already - is that no-one should be FORCED to pay for a public system through the form of taxes, because this violates individual rights. Objectivism is NOT however against working together with others towards a common goal. People are quite free to get together and form an organisation that would set up a public hospital for the poor or something along those lines, if it was done voluntarily.

EVEN if a public health system cured hundreds or diseases and increased life expectancy by ten years on average for each person, it would have been built upon the violation of rights, that in objectivism, that is always unacceptable.

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The original post is non-sensical. The public health is not even defined, and is referenced via contradictory statements. As such, any response is just a guess as to the meaning and intent of the poster.

I would suggest you ask for clarification of the statement and support for the WILD claims (unsupported assertions as they stand) if anyone is TRULY interested in pusuing the topic.

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buig: You have stated that all but 5 years of the life expectancy increase in the past 100 years was dependant solely on the public healthcare system (completely independent of medical advances). For clarification, I will rephrase your assertion: I there had been no medical advances in the past 100 years the life expectancy be only 5 years less than it is at present. Now, does anybody here honestly believe this... that without defribulators, and heart medicine, and all the vaccines, and--wait for it--antibiotics!. Surely it is clear that your claim is bogus. Now, buig, if you still want to argue in support of public healthcare, please show a little more respect for the fact that nothing may be stolen and handed out piecemeal until it is discovered/invented.

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Hi:

Thank you for responding. I have read Ayn Rand and do think that she is correct in her thesis. I wished I had read it when I was a teenager. However, I do need clarification on certain issue that was never mentioned (or I have missed it). Due to this reason, I am seeking your reasoning here.

Now, does anybody here honestly believe this... that without defribulators, and heart medicine, and all the vaccines, and--wait for it--antibiotics!. Surely it is clear that your claim is bogus. Now, buig, if you still want to argue in support of public healthcare, please show a little more respect for the fact that nothing may be stolen and handed out piecemeal until it is discovered/invented.
First, I do have full respect for individual right and property right. Let there be no doubt here. I do not support stealing anything from anyone. But that was not my point. Sanitation is in the public domain. No one owns it. It is public health programs such as immunization, HIV education, pasturization of milk, lead monitoring...and so on have contributed to the public health.

I have stated a fact that public health has extended life spand more than medical advancement. This claim is not bogus or a fabrication. I have cited text and resources for you to verify this. This claim is not pulled out of the air nor it is misinterpreted. You may also find additional information to verify this fact from the Institute of Medicine, The Deparment of Health and Human Services, or even local public health departments.

Let assume that public health has improved population health by 1%, how do you reconcile the fact that there is "some" good in collectivism? This is the issue.!!!!!!!

The original post is non-sensical. The public health is not even defined, and is referenced via contradictory statements. As such, any response is just a guess as to the meaning and intent of the poster.

I would suggest you ask for clarification of the statement and support for the WILD claims (unsupported assertions as they stand) if anyone is TRULY interested in pusuing the topic

AGAIN, my claim is not wild. Please verify my statement of fact. Please review this text book. Public Health: What It Is and How It Works. Second Edition. Jones and Barttlet Publisher. 2004 Bernard J. Turnock, M.D., M.P.H.

Which statement is contradictory? Please clarify. Which portion of my post is non-sensical? Please explain.

Please do not dismiss it as a "wild" claim without verifying it yourself. It appears that we are stuck on the matter whether my statement of fact is a fact and not the arguement itself. I donot want to diver from the point I want to ask you to answer. But for the sake of those do not know what public health is, I will attempt to define it.

Public Heath: "Activities that society undertakes to assure the conditions in which people can be health. These include organized community efforts to prevent, identify, and counter threats to the health of the public" Turnock 2004.

Institue of Medicine characterized public health as"fullfilling society's interest in assuring conditions in which people can be healthy".

The core functions of Public health are Assessment, policy development, and assurance.

The point here - and it has been made already - is that no-one should be FORCED to pay for a public system through the form of taxes, because this violates individual rights. Objectivism is NOT however against working together with others towards a common goal. People are quite free to get together and form an organisation that would set up a public hospital for the poor or something along those lines, if it was done voluntarily.
Yes, I do agree that Objectivists can cooperate with each other and open a public hospital, as you mentioned, as long as it is done voluntarily. However, the public health system in the US uses tax dollar money. Therefore, it is not not done voluntarily. Public Health does provide some good to individuals but mostly the population for it is inherently population-based. In this case how does an objectivist explain the good comes out of public health?

Am I to understand that if I, of my own volition and own talent, invented a way to vaccinate people against a disease--say HIV or something--that you would think it was all right for the government to take the rights to that vaccination (which I created, as you recall), and put it into the service of public health? And you think this is a better solution than my getting to market the vaccine to clinics and patients?

By what right would you take away my property, which is the formulation of that vaccine? By what right is the "public's need" a claim on the products of my labor?

This sounds an awful lot like the claiming of Reardon Metal to me....

Never said or support taking away anyone's invention/s. That was not even the issue that I am discussing.

You are right. I donot have any right and no one should have the right to take your property and market your invention. I never said the public needs have a claim on your property nor I support such position. You are missing the point.

Q

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Buig--

I'm afraid you are the one that is missing the point. There are at least two problems with public health activities--they've been stated:

1.) Where are you going to get the money to support it? From tax dollars of citizens who haven't volunteered for it.

2.) From where are you expropriating the technology and science behind it?--from private individuals who have a right to their intellectual property.

You seem to be operating under the assumption that "good" means "the greatest good for the greatest number of people." An objectivist doesn't hold that as the good. An objectivist holds the rights of an individual as the good.

First, I do have full respect for individual right and property right. Let there be no doubt here. I do not support stealing anything from anyone.

If you have such respect for individual and property rights, how and where do you propose you'll be getting the money to fund your little pet project of public health? You are stealing when you take tax dollars away from from people who are working productively to make money. It's legalized theft. It's simply that instead of holding a literal gun to someone's head, you're holding the threat of a jail sentence over it.

I'm not sure how I can put this more blatantly....

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Appealing to public health organizations about the wonders of public health isn't my idea of an objective source of information. I mean its not like the gov't advertises the fact that it sucks on loudspeakers or anything while most rational individuals know they waste most of the money that is taken from the taxpayers.

I also disagree with the assertion that the only way to achieve sanitation, immunizations, etc. is through publicly funded means.

If only the founding fathers had been more specific ( "provide for the general welfare" ). ;)

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I can explain the "good" that comes out of public health quite simply. It is just like the "good" that comes out of public education. You point to the millions of people that have graduated from our public education system and declare, "See, without public education all these people would be illiterate!"

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Let assume that public health has improved population health by 1%, how do you reconcile the fact that there is "some" good in collectivism? This is the issue.!!!!!!!
Now that we have some respect for medical advances, I will move on and answer this. The fact is... It hasn't. You make three assumptions:

1. Immunization, HIV education, pasteurization are valuable (true).

2. People would be unwilling pay for those things (not true, you already said they are valuable, why would people not pay for them?).

3. It is good to force people to pay for things which they don't want to (not true).

Sanitation is in the public domain. No one owns it.

I pay for sanitation... what if I could do it cheaper--many could--and do not want to pay for it anymore? They will make me. If I don't pay, I go to jail. I am being thieved from... so that the neighbor doesn’t have to take his garbage to the dump himself, or pay someone else to do it. There is no justification for this, and there is no justification for it in medicine either. NO GOOD comes from public health. 0%.

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1.) Where are you going to get the money to support it? From tax dollars of citizens who haven't volunteered for it.
Yes, I have stated that tax dollars would be used for public health programs that would benefit the population. I do not dispute that it is a redistribution of wealth. I do not support it. The debate is not whether redistributing wealth is moral or ethical. The point I was making is public health programs, using tax dollars (that I do not and you do not support), have improved the health of the population. So far, your only objection to public health program is that it uses tax dollar money and that money was not obtained voluntarily. You do not reject the fact that public health has improved the health of the population. Am I correct?

2.) From where are you expropriating the technology and science behind it?--from private individuals who have a right to their intellectual property.

Again, I am not disputing that people DO have property right and individual right. As mentioned, public health sanitation idea or method does not violate any property right of any individual. Would an objectivist agree that public health has positive effect on individuals and population, aside from the objection that it is immoral to use tax dollar money for such projects.

If you have such respect for individual and property rights, how and where do you propose you'll be getting the money to fund your little pet project of public health? You are stealing when you take tax dollars away from from people who are working productively to make money. It's legalized theft. It's simply that instead of holding a literal gun to someone's head, you're holding the threat of a jail sentence over it.

I'm not sure how I can put this more blatantly....

The debate is not personal but I sense a tone of aggression. :(

I am trying to understand how Objectivist rationalize positive (forget the word good here :) ) outcomes from public health programs. Again, the debate I am seeking is how Objectivist reconcile the positive outcomes from public health programs when tax dollars is used. It is not a debate regarding redistribution of wealth.

Q

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I am trying to understand how Objectivist rationalize positive (forget the word good here  ) outcomes from public health programs. Again, the debate I am seeking is how Objectivist reconcile the positive outcomes from public health programs when tax dollars is used.

They don't rationalize positive outcomes from public health programs. We're not pragmatists.

edited to say: I'm not trying to be aggressive as you probably mean that term--only to be as clear as humanly possible :)

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I reject your concept of the good. Curing the sickness of one man at the forced expense of another is not good, it is evil. Doing it on a national scale changes nothing.

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Buiq, by you asking us to 'admit' that some 'good' has come out of the public health system, you are asking us to ignore the fact that the money to fund it was stolen. You are asking us to ignore cause and effect. You are asking us to ignore what the ROOT of something is. We can't do this because good can't be built through an evil act, no matter what the final outcome is.

And a hypothetical for you:

There are two countries. One socialist, and the other is capitalist. Both countries have equal populations, and both populations have people that need to eat. The socialist government decides that it will steal money from its citizens to fund a public farm, even citizens who grow their own food, meaning that they will never use the food grown at the public farm. It steals the innovation of farmers who come up with new ideas and new methods for 'the public good'. As a result of this, an x number of people in the country get to eat.

In the capitalist country, private individuals set up farms. No-one is forced to pay for anything that they don't need/want. The private farmers know that there is a certain amount of demand for their product, so they set a price accordingly, and profit from their efforts. The citizens who choose to buy the food are satisfied. The innovations of farmers are not stolen by the government, and because of this, the farmers continue to come up with new, more efficient processes and products, and this leads to the consumers getting better and better products (innovation) at better prices (competition). As a result, every person that wants to eat, has better quality food than in the socialist country at better prices.

What is the point? Well, simply that any 'good' that has come out of the public health system have been due to capitalistic principles. This good can be maximised in a country that has no public healthcare because it will ultimately lead to greater innovation / products and better prices for its citizens. And all this will be built upon an ethical foundation.

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Hello Richard:

Now that we have some respect for medical advances, I will move on and answer this. The fact is... It hasn't.
I do not want to debate whether the statement that public health contributed more than medicine in improving human health because no one is willing to check the fact. But if interested, please verify this in the text book i suggested. Or better yet, go onto PubMed and look for public health articles. (BTW, I am in the healthcare profession and do have respect for medical advancement and that of public health).

You make three assumptions:

1. Immunization, HIV education, pasteurization are valuable (true).

2. People would be unwilling pay for those things (not true, you already said they are valuable, why would people not pay for them?).

3. It is good to force people to pay for things which they don't want to (not true).

We agree on 1)

Regarding 2) I did not make the assumption that no one pay for it. Some of us pay for flu vaccine every year. However, some do not get vaccinated and infects others. Influenza over the past centurykilled millions of people (you can check this fact as well). For example, according the the CDC, Houston, Texas "immunization rate in 1991 was estimated by CDC to be 11 percent. By 1995, Houston had achieved a 74 percent immunization rate according to the NIS. An infusion of federal dollars in 1993, along with unprecedented public and private partnerships increased coverage levels dramatically throughout the country. There have been no subsequent epidemics in Houston and external funding and partnerships have decreased.) Houston's rate last year, 1997, was 64 percent. The most recent survey, 1998, indicated a 4:3:1 immunization rate for 19 to 35 month old children at 66 percent, a two percent improvement over 1997" http://www.ci.houston.tx.us/departme/health/newnote1.htm#immunaization

Not all will pay for vaccine because they cannot afford to do so or voluntarily decided not to get vaccinated. When a communicable disease is spreading, those not vaccinated will spread the disease. Death may be the end result for many. It is public funded andnon-profit programs ensure the majority of the public to be vaccinated. Laws have been enacted to make children vaccinated before entering schools. This has reduced rate and incident of infection in school settings. Is this not a positive or "good" thing?

About 3) No, it is not good to force anyone to do anything they do not want to. In the case of public health agencies, their program such as immunization has contributed to the improvement of public health despite using tax payer money to provide vaccine to those cannot afford it. Reducing incident or prevalance of a certain communicable disease in a population is not a good thing?

I pay for sanitation... what if I could do it cheaper--many could--and do not want to pay for it anymore? They will make me. If I don't pay, I go to jail. I am being thieved from... so that the neighbor doesn’t have to take his garbage to the dump himself, or pay someone else to do it. There is no justification for this, and there is no justification for it in medicine either. NO GOOD comes from public health. 0%.
I agree with your examples. I do not want to pay more than I have too. If a private company would collect my trash cheaper and efficiently, I would use that company's services. No debate here.

Sanitation under the domain of public health has improved human health. In 1854, John Snow, an English man, was the first to use epidemiological technique to prevent cholera from speading. Quarantine of the use of a water well prevented further speading of cholera. His idea of sanitation is now in the public domain. The issue is not whether it would be better if a privately owned company runs the show or not. We agree that it would be better if the government stay out of it. With that being said, do you not agree public health and its policies in its present state, using public money (even though it is unjustified), has improve the health of individuals and population?

======

Hi Erik

Appealing to public health organizations about the wonders of public health isn't my idea of an objective source of information. I mean its not like the gov't advertises the fact that it sucks on loudspeakers or anything while most rational individuals know they waste most of the money that is taken from the taxpayers.

The sources I have mentioned are credible. What do you suggest? Which source would be acceptable to you? By your rationale, most research articles are not credible for they are funded by NIH (part of the government). At the same time, we should not consider any research result published by companies for they would be promoting their products.

I also disagree with the assertion that the only way to achieve sanitation, immunizations, etc. is through publicly funded means.

I agree with your assertion.

I guess this debate has digressed. :)

Q

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Hello Concerto of Atlantis:

Buiq, by you asking us to 'admit' that some 'good' has come out of the public health system, you are asking us to ignore the fact that the money to fund it was stolen. You are asking us to ignore cause and effect. You are asking us to ignore what the ROOT of something is. We can't do this because good can't be built through an evil act, no matter what the final outcome is.
Yes, that is I am trying to do. I want to know if anyone would admit some good stems from Public Health. I do not ignore or hide the fact that the money used in public health is tax payer money. Some paid unwillingly and I have stated so.

Based on your statement, Public Health Institutions such as NIH, CDC, HEalth Departments...etc are "evil" regardless of the good it provided.

What is the point? Well, simply that any 'good' that has come out of the public health system have been due to capitalistic principles. This good can be maximised in a country that has no public healthcare because it will ultimately lead to greater innovation / products and better prices for its citizens. And all this will be built upon an ethical foundation.

Oh boy. I have provided the definition of Public Health. I do not mean public health as socialize medicine.

Q

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Buig--

I do not mean public health as socialize medicine.

Please explain how you intend to fund public health as something other than the socialization of medicine.

The debate has not digressed--you've simply never given us anything that is subject to debate. By asking a bunch of objectivists to rationalize the idea that good can come out of stolen tax dollars, you've simply asked a bunch of objectivists to suspend their morality to become pragmatists.

What is your angle in doing that? Why are you trying to get us to justify the means through the ends? Are you looking for some sort of moral sanction? I'd be very surprised if you got that here

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Based on your statement, Public Health Institutions such as NIH, CDC, HEalth Departments...etc are "evil" regardless of the good it provided.

That is correct. Any 'good' must have roots in ethics. It is never ethical to steal. A good outcome therefore cannot prevail from an evil act. The end.

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"Let assume that public health has improved population health by 1%, how do you reconcile the fact that there is "some" good in collectivism? This is the issue.!!!!!!!"

There is nothing to "reconcile". Your question and premise is the same as saying "Lets assume that thieves giving their stolen wealth to others, improves those others lives. How then do you reconcile the fact there is "some" good in theft?"

Stolen wealth is not destroyed. It does not cease to exist. Using that wealth in a particular field or industry may indeed increase the output of that industry, etc.

The point is whether or not one has the right to take and use it in the first place. By ignoring WHO produces it, and thus WHO has the right to dispose of the wealth, you declare that the wealth and the person who produces it are YOURS to dispose of - they are YOUR property.

There is a term for such people: slaves.

No matter how 'healthy' you keep your slaves, it does not justify their enslavement.

Figure it out.

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