I will accept your first criticism as possibly valid, although none of the changes you mention do a thing to address the root of the problem, which is providing medical care to those who are incapable or unwilling to provide themselves with it. All they do is provide alternative ways to pay for those who are capable of doing so.
Your second point is not valid. Either you are willing to provide care in emergency rooms to whoever needs it, whether they can pay or not, or you are willing to let people die in front of the hospital.
In the first case, which is what we have now, the shortfall in revenue to the hospital must be made up some way, either by charging paying customers more or by government (taxpayer) subsidy. Or the hospital will go out of business or will stop providing ER services.
If people are turned away from ER rooms because they can’t pay, then you will indeed have people dying on the street out front.
My main point is not whether allowing this is justifiable or not philosophically, it is that it would be utterly disastrous politically. Unless you are deluded enough to think such Randian beliefs are majority opinions. Personally, I would be quite surprised if 10% of the population would be willing to go along with repealing the requirement that all ERs provide emergency care regardless of whether the recipient can pay or not.
I’m not quite sure why you insist on injecting Ayn Rand into this as I’ve never mentioned her. If you wish to insert a straw man, I’d prefer Murray Rothbard. At any rate.....
You’re wrong when you say these changes would only provide alternative ways of paying for those who already can. Every dollar they bring costs down makes health insurance more attractive than other alternatives on individual value scales. Some will conclude that they can “afford” it who previously concluded otherwise.
Your refusal to confront the logical implications of your belief system is telling. You phrase everything in the language of the statist.
Not compelling a person to provide a service to another gratis is “letting him die.”. There is no way around the fact that this formulation makes the provider’s labor the property of an unlimited number of potential recipients by virtue of their mere existence. You can dress it up as “compassion,” “fairness” or whatever you like, but it doesn’t change that fact. Nor does mass acceptance of this horrific statist dogma.
Hank