Some comments on Single Payer Health Care worth noting

These comments on Shagya Blog came on my radar last night and then today Werner has a post up with some interesting points that just give me more to think about, more to be confused by
Well let's see if I can sort it out


My position on this sort of thing thus far has basically been “I don't fucking know, the way things work right now is just a fucking mess, any sort of solution proposed based on current conditions is going to have serious problems, won't be radical because it's just based on existing conditions”
I dunno, well the 2 extremes are individuals should provide for their own health care OR society should provide health care.
I mean, right now that means The Government
but I hearken back to an idea remember from last summer, both in Nock's Our Enemy The State and Kropotkin's Mutual Aid... well Mutual Aid (what Nock called Social Power). And how that was replaced by State Power..
I don't know, I never finished Our Enemy The State and I don't remember every little detail from Mutual Aid but that idea stuck with me. I may have misinterpreted though. I should try reading both of those again.

Anyway, supposing I'm not horribly misinterpreting what the premise of both their arguments was... I'll run with this concept..

Social Power replaced with State Power
No, in fact, I recall Nock talking about it being converted into State Power..
Obviously as anarchists we ought to work to convert that State Power back into Social Power...
But what of existing State Power? Can it be used for good? Surely it can... but ought anarchists seek to use it for such purposes?

I see 3 options
1) Actively oppose a Single Payer system
2) Actively support a Single Payer system
3) Abstain from such a discussion

I've taken that third option because to me, principled anti-statism (regardless on the economic organisation of proposed society) means not saying “The Government should do this” or “The Government shouldn't do this”
I don't know that position just makes things less complicated
Werner's post today makes that position less attractive when you look at other factors.. I mean, I guess I haven't covered my changing views on Liberty (it's not just the absence of coercion) but health care is important.

Okay, I think that if you're going to take option 1, you really need to be talking just as much, if not more, about why the current Health Care Crisis exists and what should be done to fix it. You've put your foot in the arena and you can't just say “No, I don't think that more government control is a good thing”. Surely, in the current system, corporate control is no better.

Well, part of all this rests on the question of whether health care should be provided through a market or provided by society free of charge.

The other part of the question is “how can you be an anarchist and advocate the growth of government”
I suspect that any question about the size of government is largely, if not solely, a question for Libertarians, radical or not. The question of the size of government traditionally seems to be irrelevant to the anarchist concerned with the many heads of Authority and not just Government.

The point in this whole argument that I think is a valid one: how would you like your coercion?
And as Werner points out, the traditional anarchist critique of Government is more sophisticated that just a critique of coercion in the form of taxation.

Writes Werner:

The reason why social anarchists assert the need for positive freedoms is that in the real world we can't wait around until the perfect stateless – and therefore classless - society comes into being. In the real world people have needs and these must be met, if they cannot be not through mutual aid due through state-enforced economic inequality, then through government. To destroy social welfare – as well as protective legislation like the 8 hour day, or vacation time – and leave the rest of the state – and therefore class society with all its vast inequalities intact is to condemn the vast majority of the people to Third World misery. It needs to be pointed out as well, that [mutualist] Kevin Carson sees the need for a selective or top-down dismantling of the state with those aspects which benefit the capitalists and state bureaucracy going down first. The social welfare measures last, being converted into mutual aid systems or stakeholder coops. Thus, there is no real difference between communist or syndicalist anarchists and mutualists on this issue. The real bone of contention lies between capitalist libertarians and traditional anarchists. Social welfare – those aspects that actually help the people in some manner are a state-perverted form of the social aspect that lies at the root of our humanness. It is thus something good that has been twisted or has a contradictory aspect. Leaving people to die in the street because they have been denied by state-enforced inequality the resources to help themselves, is simply evil through and through. It also needs to be pointed out that even in an anarchist society a significant minority of the population will have to be subsidized or supported in some manner think of the aged, sick, those with mental health problems etc. In a free society – and therefore one without the present vast inequality of wealth, and the resulting culture of narcissism and sociopathology – this could be done by mutual aid. In the meantime, and I have been discussing this for years, we can work to democratize, mutualize (de-state) existing social welfare measures. For example, Unemployment insurance should be run not by the state but be set up as a cooperative along the lines of a credit union. All workers become members of this coop and elect a board of directors for their city or region. Hospitals should be taken back by the community and run by elected boards representing the user population and the work force etc.

I really should (re-)read both of those books..

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