Needs? Not really. Wants - most do. But needs? How did mankind survive without it for 100,000 years?
By dying earlier?! We could survive as a species with a life expectency of 30 years (due to no healthcare), just as we could survive if everyone over 50 years old was refused food and forced to starve to death. Doesn't make food any less of a need, in fact it shows that it is a need if you die much faster without it!
The market is, in theory, a marvelous thing to set the "proper" value of a thing, based on who is ready to offer how much, and who is ready to supply for how much. That way, there is the most economical efficient production available...in the US, hospitals have to turn a profit...While in Canada, it is always "at cost"...When you take out the "hunt for profit" of the equation, you might end up with much lower costs.
You already started to counter argue your own point there - profit making motive encourages increased efficiency, so it's not certain by any means that 'at cost' will be cheaper. Factor in overconsumption by making it 'free' and it could well end up more expensive
those who produce more (which is generally translated into having a higher income) should have access to better health care
Why? With wants/luxuries sure, but we're talking about a basic necessity here - you're saying people should be denied such necessities simply because they're less productive than someone else? Now you can still allow very rich to obtain better healthcare (i.e. above that which covers the basic necesities) just the same as it is with food (pretty well all developed countries have at least enough of a welfare to allow people to purchase the really basic cheap food, while if you want to dine on caviar you need to be earning more), but take it too far and you could end up saying that for example you must have surgery undertaken without any anaesthetics by a poorly trained doctor using 30 year old surgical impliments for the 'crime' of not having/yet being as productive as someone else!
most tax payers...certainly don't want to pay for the poor to have access to the same health care they do
Until they (or someone they know) ends up in the situation of needing such care, I expect! Lets say you're 15 years old (hence still in full time education, hence no taxes likely paid, and unable to afford health insurance for yourself if you've even started thinking about such things). You're not as productive as your teacher, who probably earns a decent (but not massive) salary, pays taxes, might have insurance etc.; If you suffer a terrible and rare medical condition caused through no fault of your own, and need specialist attention costing say $50k in order to live beyond your 16th birthday, why should you be forced to have a substandard level of care (say $10k, the value of your parents combined assets+income that they have to spare) which causes your untimely death, while the teacher might have been able to see the specialist+survive if in the same situation? Should that child be punished simply because their parents may not be that productive (and hence unable to afford specialist treatment)? IMO it is immoral for such services to be denied based on income, and that everyone should be entitled initially to a basic level of healthcare that will mean if they need life saving treatment they will get it (although you could then introduce exceptions and would need cut off points - e.g. fat people who smoke might have to wait longer or be denied certain treatments, while highly expensive drugs that might give a 0.1% chance of saving someone simply wouldn't be viable either). This is of course in the context of the US or other developed countries, since such policies are affordable.
you have 2 people dying - all things being equal, how would you decide?
Age? Dependants? Contributory actions on the dying persons part? etc.
E.g. if you have two people needing emergancy lifesaving treatment, and only 1 can get it in time, and 1 is a 60 year old male lifetime smoker with no children who earns $2m a year, the other is a 23 year old woman with a 3 month old baby and a 1 1/2 year old child who earns $10k a year (and isn't likely to earn much more than that throughout her lifetime), most people wouldn't hesitate in saying that the young woman with dependants should be saved first - in fact even when you go back say 60-100 years to when you didn't have the same universal healthcare principals flying around that you do now, if a ship capsized, priority would b typicallye to save women+children first, and not simply the person with the most earning potential.
And who should determine need? The government? Some random group of doctors? And what is the criteria?
I'd have thought doctors would be the best judge of that, and in most cases it would probably be possible to determine; if you have 2 people, 1 of whom is expected to die within 24 hours if they don't get surgery, and one who will likely die in 24 days if they don't get surgery, you'd probably deem the first one to need surgery first. I.e. 2 people in an accident+emergancy ward, one has had his arm cut off and is going to bleed to death if not operated on, another has a gunshot to the leg that avoided any major arteries and will be in danger if not treated soon, but isn't critical yet, I'd have thought it wouldn't be too tough to determine who needs treatment more.
As for need more generally (as in what treatment is needed), that would be a tougher gauge, and probably best for the population to decide via voting for the party/policies they feel best reflect it, but as a basic rule, I'd say if you're going to die or suffer terrible injury, and there is a reasonably cost-effective method for saving your life/preventing that injury, then you need that treatment. Doctors are going to again be the best ones to start with for assessing whether you need something. The 'cost-effective' part I inserted is mainly because if this expenditure is coming from government, and their aim is to reduce deaths, then you need to put a price on life - e.g. do you spend $100k on some traffic safety features that will likely save 1 life a year, do you spend $1m a year on providing special healthcare to a person which will save their life, etc.;
A bad analogy. You know why? Because like you said, funding comes from property taxes
Ok, how about the police then if you don't like the fire service analogy given? Two people are murdered, one of whom was on $40k, the other on $60k. Should they investigate murders equally based on the crime details, or should they devote 50% more resources to the person on $60k, or should they invest even more than 50% to the person on $60k (seeing as they'll likely have paid more than 50% more tax than the person on 40k, and hence base the increase in resources on the persons tax contributions)? In fact when you talk of basing such decisions on productivity+that it's unfair to pay for someone elses healthcare and not then get priority over them, are you thinking in terms of total taxes paid in lifetime, or taxes paid in that year, or income earned in lifetime, or in that year, or future earnings potential, or future taxation revenue potential, or some other measure?
The problem you have with such policies in the long term though is it causes massive resentment, and if rich people benefit from better public services than the poor I really don't see the party adopting such policies winning an election, while a dictatorship would not only result in higher taxation overall, but also then throw up issues such as revolution. Unless of course you had a democracy where you could only vote if you paid taxes - it'd have some merits, but also throw up other issues; would someone who had paid taxes all their life but was now retired be able to pay taxes? (although you could always then do it on the basis that people who had paid a certain tax for x years over their lifetime would be entitled to vote even when not paying any taxes, with voluntary contributions for people who wished to vote but had say been on maternity leave+looking after their family for some of those years; obviously you'd need to tie in other benefits like a pension to that so it's not quite about making people pay for the right to vote).
there are some very very liberal persons I know of who have been saying exactly that (forced euthanasia)
Hardly a left wing only issue - there are plenty of right wing people who support euthanasia (and therefore no doubt in extreme cases some who support forced euthanasia). Capital punishment is another case - it's not 'liberal' to support the death penalty, while a more right wing person would argue that you cut costs by killing the relevant people off, and that they've deserved it (never mind the small % of people who might get wrongful convictions). Hence on the issue of 'death to cut costs', I'd say the reasoning would likely be more 'conservative' than 'liberal'.
If 40% of Americans pay no taxes, there by paying 0 for health care (these people can replace the population of Canada with many to spare). I'll argue that if Canada had 40% of it's population as non contributors to the system that it would fail quickly
Well to pay for the healthcare taxes would raise, so you can bet that the figure would fall from 40%!
Government: n. 1. A tool (of the people). 2. The most efficient way to take care of everybody
Thank you cactoblasta, I needed that laugh
Perhaps you'd care to suggest alternative organisations that could take care of an entire nation more efficiently than the government in every conceivable situation? The government isn't perfect, but there are some cases where they are the most efficient method of achieving a particular goal.