The Marines, and the rest of Military, also demand that each individual does their job, pulls their own weight, and helps others.
When a service or benefit is "free", too many who are not pulling their own weight, or even making an effort, go along for the ride. If the provider attempts to eliminate those, they invariably eliminate the deserving as well.
Besides, we do have a system of essentially free care, at a minimal standard. Virtually every county or city of any size has a facility that anyone without the means can go to for 'acute' care. Yeh they probably have to wait longer than in the so called private hospitals, but even the latter must take anyone who shows up for "acute" care, switching them off to the "public" hospital, or in smaller places, sending a much reduced bill to the county or state. We do pay for that with our taxes, just not at the national level. Especially in a place a big as the US, the more decentralized system works better, and originally health care was beyond the powers granted to the national government(and legally still is). Once the national government, and in some cases the state governments when the system was run at the county level, stick their bureaucratic noses in, the system tends to move toward the "free for everyone" sort of deal, with the attendant abuses.
As an example, a county I lived in for 10 years, and still have a home and pay taxes, once had a privately run "Orphanage and Old folks home". It was a nice facility for it's time. the county paid for some of the cost for the orphans. The Old folks provided adult oversight of the kids, and paid some amount themselves. The kids helped with the "chores", such as washing, doing dishes, cleaning up, and so forth. The old folks also provided love, which the orphans needed more than anything, since some were really abandoned, rather than orphaned. The orphans also loved in return. then the state decided that that was "Child Labor", "Exploitation", etc. and separated the groups, causing the Old Folks home to become insolvent. The buildings still stand as a monument to the folly of over centralization. Probably not for long, developement is very near, and the property was sold some years ago. Meanwhile the old folks of today are in sterile "old folks only" facilities, at much higher expense for the state, and the kids are in foster homes, where the foster parent(s) is paid for taking them in and where they are far more often exploited and abused than was the case in the older facility which had lots of eyes watching over everyone. The kids often do not receive the love they would have gotten in the previous arrangement, and are shuffled from home to home with some regularity.
> When a service or benefit is “free”, too many who are not pulling their own weight, or even making an effort, go along for the ride. If the provider attempts to eliminate those, they invariably eliminate the deserving as well.
We certainly agree on that!
Our welfare systems in NZ are, in theory, supposed to prevent that from happening. If you are on the Unemployment Benefit, you are expected to check in with your case manager twice per week and log every job that you have applied for, and accept any suitable job you are capable of doing.
If you are on a Sickness Benefit, you require a medical certificate from your doctor, and it expires after 13 weeks. It can be renewed, but WINZ (our Work & Income dept) can liaise with your doctor.
Heaps of resources are made available to help people become productive: Occupational Therapists, Work Brokers, Career Counselors, Halfway programs for the disabled — they really do pull out the stops.
Abuse of the system is vigorously prosecuted.
Where the whole thing seems to fall into a screaming heap is the “Domestic Purposes Benefit”. Yup, you guessed it: for some dumb reason NZ pays single women to have children and stay at home to raise them. More kids = more money. No limit. Once you qualify, you are in until your youngest kid turns 18, or until you are in a stable domestic relationship...
...a well-intentioned idea that is just plain nuts when you think thru the implications.
Couple that scenario (perpetually unemployable and unproductive people, with every motivation to stay that way) utilizing expensive social services (such as free medical) and you can easily see how the system gets very expensive.
That’s not a flaw with Social Medicine, tho’ —but it is a flaw with other aligned social policies that coexist around it.