Death and Taxes

Yeah, well … what about this??

http://www.ispot.tv/ad/7BkA/cadillac-elr-work-hard

pansy french!

This is exactly right.

As mw suggests, socialism/capitalism does not explain differences between healthcare in the US and France. Much of the US system is driven by government meddling in the system; certainly healthcare has become more bureaucratic and more subject to insurance-related payment hassles over the past few decades, even as government regulation and the market share of medicaid and medicare have ballooned. (This is of course not to say “government drives all that is bad about US healthcare!”)

Oh, by the way, Happy Valentine’s Day.

Thank you!

I’m more than ten years into cancer treatments. My chemo has increased rather dramatically with a recent change in corporate structure. It was roughly $29,000 for four sessions prior to the change. Now it’s roughly $19,000 for one. I am very fortunate to have insurance, obviously.

Millions of Americans aren’t so lucky, of course. And most bankruptcies in America are due to medical costs, and most of those people have health insurance.

Actual socialism would end that nightmare for millions. As Corey notes, it wouldn’t solve the problem of mortality, obviously. But it would at least allow people to die in some semblance of peace with dignity.

mw,

One problem with our version of Medicare is it’s been partially privatized. There is really no reason why it should only cover 80/20 splits, for instance, other than lobbying by insurance companies for supplementals.

And, politicians made it impossible for Medicare to use its “economies of scale” to force drug prices down.

It’s okay for Walmart, but not for Medicare to use its size, etc. etc.

America is going to have to wake up, grow up and go all non-profit via insurance and health care delivery. An aging population will force this on us eventually. Our mish mash of for-profit dominance reduces the effectiveness of smart and humane programs like Medicare, and we’re just not going to be able to keep that up much longer.

You scarcely need “Socialism” to have socialized health care. Canada’s as far from socialism as can be imagined but we still have socialized health care. We still, should we so choose amidst the ten thousand distractions served up by the rest of the economy, we still get to contemplate the human condition.

Of course you don’t need socialism to have aspects and semblances of it. But given that it’s common sense to let the people control their own economic destinies, and to have true democracy including the economy, rather than rule by the few, why wouldn’t we want to change systems?

Socialism is obviously more logical, rational and humane as a system than our current one. Our current system depends upon economic apartheid to function, and the willing complicity of most citizens to ignore that fact.

I am a bad person to wonder how her father got access to French healthcare? When was the last time he paid taxes in France? How did he have a French insurance card?

All that said I 100% agree with the main thrust of Corey’s post.

“I wish the people advocating socialism could have experienced in real life the numerous opportunities for meditating on the human condition present in actual socialism.”

What is this actual socialism of which you speak? Where has it actually been tried?

Beautiful post, Corey. Where else but Crooked Timber?

Alex K,

Real socialism has never been tried. By definition. That would require true democracy, including the economy, with the people actually owning the means of production. Not political parties or dictators. The people.

You are confusing state capitalist experiments with the real thing. Lenin admitted that Russia needed to embark on a rabid program of capitalism in order to industrialize, and he actually implemented forms of primitive accumulation to force this upon the Russian people, especially in the countryside. The Soviet Union never transitioned away from state capitalism. Nor did China, Cuba, etc. etc.

Marx also said not to try actual socialism in a nation with scarcity issues, much less scarcity debacles. That, he said, would just socialize misery.

If, however, we switch to socialism in a healthy economy, or do this internationally (his other guideline), there are more than enough goods and services to fill all needs without those waits.

The richest 85 people in the world now hold more wealth than the bottom 3.5 billion. Obviously, if we spread that around, you don’t have long waits for bread.

Plus 85% of the production and resources go to the richest 20% of the world right now — leaving just 15% for the bottom 80%.

Do the math.

Obviously, if distribution and allocation of resources is done in a humane, fair manner, you don’t have waits for bread. Or medicine. Or shelter, etc. etc.

The problem of scarcity and long waits disappears with fair distribution and allocation of resources and productive energies.

In short, we don’t have an issue of too little for too many. We have an issue of a few people hoarding pretty much everything for themselves at the expense of everyone else.

Logically, reverse engineer this, and you’ve solved the issue of scarcity and “socialized misery.”

We have plenty. More than plenty. But that plenty is concentrated in all too few hands.

“You never get tired of this bullshit, do you?”

Well where has it been tried Alex?

Gerry @ 20: I found that ad fascinating. It’s clearly aimed at making rat-race occupants feel proud of their situation, but the argument is so flimsy it’s almost self-parodying. I mean, with real ads like that, who needs The Onion?

OP (or rather the second block quote within it): hey, “bonjour” is serious. It’s like “please” and “thank you” only more so.

I don’t know why we are not France. My first guess was that the lucky countries lost a lot of their right wingers in wars.

Where else but Crooked Timber?

Why did it take me four days to find out that Stuart Hall had died? What is this thing called the American Left?

(In other not completely unrelated news, Richard Seymour and China Mieville (+ others) have resigned from the ISN. A Very Public Sociologist has the juicy details.)

If we extended medicare to everyone in the United States, we would not have French healthcare. There is a lot more going on here. I don’t know what exactly is meant by socialism (different meanings from different speakers), but if we want to talk about not having to deal with economic problems on top of normal human misery, greater wealth and guaranteed minimums are both valuable. Rawls’ claims about only the latter mattering never made any sense. And I don’t agree that it’s obvious what combination of social/economic policies are best to achieve these goals and also think it’s unlikely that the same solutions are best in every time and place. But they are worthy goals.

“And I don’t agree that it’s obvious what combination of social/economic policies are best to achieve these goals and also think it’s unlikely that the same solutions are best in every time and place. But they are worthy goals.”

Oh I think we know what works; strong unions and strong social safety nets. We can do it but we (the big “we” not the we here) choose not to.

There does seem to be something specify about the French system which makes it particularly humane. There was a Slate article on this last week:

http://www.slate.com/articles/business/dispatches_from_the_welfare_state/2014/01/french_socialized_medicine_vs_u_s_health_care_having_a_baby_in_paris_is.html

Anecdotally, I know an older Australian man who fell ill with a type of blood cancer while travelling in France. His wife, a good friend of mine, is a nurse with many years experience working in many different countries and lots of experience in oncology nursing. She immediately decided that he would not move from France. Although not French (he can’t even speak French), the hospital staff simply didn’t ask any questions about his right to receive healthcare in France. He received magnificent treatment for free and his wife insists that he would probably not have survived in almost any other country (including his native Queensland).

I suspect that its something to do with the combination of a well funded centralised system with a very demanding customer base.

MPAVictoria @ 17, I wondered the same thing. But it sounds like they had an apartment in Paris and if they owned it they’d have been paying taxes. It isn’t clear though how long they’d had the apartment.

Their experience sounds better than what they would get here in Canada. Here you still have to go to the doctors and sometimes wait a long time and you don’t have much choice in doctors, either. And that doesn’t even count the wait for an appointment. But we don’t have to deal with the bureaucracy that Americans do, thank God.

” But we don’t have to deal with the bureaucracy that Americans do, thank God.”

Indeed! My interactions with the Canadian Health Care system have been pretty positive really plus I love my doctor!

While mpowell @ 33 is clearly right that different speakers here mean different things by the word “socialism”, can I just add how curious it is to hear dire warnings of queues for bread in the context of the French variety? I mean, you can certainly end up standing in line for 10 minutes or more on a Sunday morning in provincial France, especially if everyone in front of you wants cakes, but overall the process is both humane and efficient – and the bread is rather good too!

#1 omg that commercial! Throbbing pomo despair in a handy youtube take-along-pak. Hard to believe, which I’m sure is the point, or one of them. That wins the thread no matter what comes after.

mpowell,

Is socialism a philosophy of how to organize your economy to achieve a certain set of outcomes? Then you can’t claim that other perspectives on economic organization don’t have the same outcomes as goals in mind. Is is just the outcome you are looking for?

The goal of capitalist organization is to increase capital holdings (and wealth in general) for individual business owners. There is no “social” component involved. That must come from outside that system. It’s an add-on, not baked in.

OTOH, the goal of socialism is all “social component.” If it’s the real deal, it’s not concerned at all with personal wealth accumulation. It’s concerned with meeting social need and providing social good. That’s all it’s concerned with.

To me, it’s so obviously the best way to organize a society, because it has the good of society first and foremost as goal — at least in theory. Capitalism doesn’t. Not in theory or practice. It’s not interested in societal good. Outside forces, like democracy are. But not capitalism. It’s strictly a mechanism to increase personal wealth accumulation.

And because math is math is math, this must necessarily come at a cost to others. There is no addition without subtraction.

All too many Americans confuse democracy and capitalism, merge them, which adds another problem in these discussions. People often compare our form of democracy + capitalism to socialism, when an apples to apples comparison wouldn’t allow that.

Plume @ 47: “OTOH, the goal of socialism is all “social component.” If it’s the real deal, it’s not concerned at all with personal wealth accumulation. It’s concerned with meeting social need and providing social good. That’s all it’s concerned with. ”

It sounds like you want to define socialism based on economic outputs. But maybe not. If you think socialism implies certain forms of economic organization in a ‘math is math’ sense, then you have follow through with the work of demonsrating your economy will generate the results you claim, and that is certainly more difficult than addition and subtraction. In my observation people tend to want to define their preferred political approaches in terms of both their outputs and their methods. That’s invalid.

mpowell,

No. Socialism isn’t an economic system. It’s a political system, that contains the economic, but goes much further.

Capitalism “values” things insofar as they make more money for ownership. It doesn’t “value” things insofar as they benefit society — greater health, happiness, longevity, education, cultural access and horizons, clean environment, etc. etc.

Capitalism is just an economic engine. Nothing more. But because its cancerous by nature, it has grown to basically engulf every other life-sphere in our society, controls our politics, and threatens to destroy our environment outright. Its values are limited, narrow, opportunistic, self-centered. Personal accumulation of money, which leads to power, etc. Where math comes into play is there. A capitalist’s gain must come from loss elsewhere, or many elsewheres.

OTOH, an organizing principle that extends the meaning of “value” to encompass all life-spheres can act synergistically, not via subtraction only. It can create “gain” for society without loss, necessarily. If it’s only about economics, then you’re basically stuck with addition and subtraction.

Last year I wrote, somewhat tongue in cheek, that socialism is about converting hysterical misery into ordinary unhappiness.

This is precisely the sort of junk our comfortable Western middle-class like to spoof across the internet. In the same coin, obviously capitalism is about converting ordinary unhappiness into hysterical misery.

So where is there “misery” with full employment, high wages, fair trade, and properly funded public services wrapped in a stable economy?

Socialism is not necessarily “workers owning production” because when this happens they may still operate their enterprise along capitalist lines.

Socialism is specified by a simple motto: “From each according to their ability, to each according to their contribution”.

Of course this only establishes a stable economics based on hard headed economic rationalism. Left alone socialist economic rationalism generates its own styles of social injustice echoing Reagan and Thatcher. However, provided there is no distortion and as there is no structural need to expropriate workers through locking them into wages, a socialist welfare state will develop.

mpowell,

I’m actually trying to strip capitalism of its modifiers. Too many people confuse and conflate those modifiers and their results with capitalism. They then basically ignore what states, public sectors, intellectual inheritance, cultural legacies and even charities do to modify and mitigate the effects of capitalism.

These things generally reduce the cold slap in the face brought to us naturally by capitalism, if we’re not sitting pretty at the top. And those who cheerlead for capitalism typically just fold those things in with all the rest and credit capitalism for anything good that comes along.

That’s why you’ll often hear someone say “Capitalism has lifted more people out of poverty than any other economic system.” Which is, obviously, false. It actually forced more people into poverty and misery than any previous system, and only through those modifiers was it able to reduce those effects for some later. For the rest, it simply shifted the scene of misery to “out of sight, out of mind.”

(David Harvey is really excellent on the geographic cure.)

Of course, the dilemma in trying to establish any of the above is that capitalism can’t exist without the state. So I’m kind of experimenting with fish out of water stuff. Regardless, one of my goals would be an end to the credit taken so casually by capitalism’s fans, who all too often refuse to accept any blame when it goes bonkers again and again — as is its wont. That’s always “gubmint’s” fault, apparently.

Good state-funded healthcare doesn’t have anything to do with socialism, France isn’t a socialist country – can we stop calling it socialism, just confuses matters” at 12.

I mostly agree. This abstract discussion about socialism seems very american to me and not in a good way. The US right uses “scary” socialism and communism to elide the problems of the profit obsessed US health care industry and economy.

The French Health system is technically a mixed economy financed by state insurance and a tightly regulated private insurance top up. With most people and assets being in non state hands. It is a planned mixed economy if you like. You can debate the words to use as a description but it keeps coming out top in the comparative effectiveness or near the top in the world.

My only objection to 12 is that the president of France is a socialist who leads the French socialist party and was elected in a election by direct universal suffrage. This makes France socialist. France also has lots of right wing people and a history of Fascism but the French expect good public service what ever their ideology.

js

With the level of understanding you demonstrated – we may need more threads clarifying ‘socialism”. There is no need to be scared and bark in anxiety.

Capitalism has little to do with markets because firstly market socialism operates on the same basis, Marx was a market socialist – but not a market communist.

Secondly capitalism destroys the free market and maximises profits through cartels and degrees of monopoly.

If you follow free market theory to its logical conclusion, once all entry and exit has occurred, all profits are competed away, leaving only socialism or fuedalism.

The differentia specifica capitalism is not markets, it is the existance of capital accumulation based on wage-labour.

If you leave capitalism to markets you end up with over 100 trillion in debt. In dollar notes this would stretch all the way between the earth and the sun, and back 50 times.

This is the graveyard of capitalism, so any effort at finding an alternative should ne welcomed.

One problem with equating socialism (ownership and control of the means of production by the workers) with social democracy (the Bismarckian Welfare state) is that they are unequal — radically different. In fact, the purpose of the second was to prevent the first.

Yes, I’m aware of the origins of the welfare state, and you’re quite right. And I pretty explicitly was not suggesting that the public provision of goods in a welfare state should be equated with the communal ownership of the means of production. I was noting that (a) the broader, perhaps technically incorrect use of “socialism” is both widespread and understandable (cf. “social democracy”) and even more that (b) an endless back am forth on what “socialism really means” generally ends up being pretty unedifying. You may of course disagree, and frankly I find this topic fairly tiresome, which more than anything else is what my comment was expressing. (My views are probably about as far left as yours, by the way.)

I can’t make heads or tails of what Chris Warren is on about, but I’d humbly suggest that I don’t any lessons on Marx, nor am I inclined to give any.)

“If you leave capitalism to markets you end up with over 100 trillion in debt. In dollar notes this would stretch all the way between the earth and the sun, and back 50 times.”

So what? Really so what?

…and then once a technically incorrect term that is advantageous to one side comes into common usage, people insisting on clarity and correct terminology are treated like obfuscators, pedants, or political hacks.

MPAVictoria 02.15.14 at 2:57 am

What so what?

If debt accumulates, it does so in the expectation of economic benefit. Consequently the factor share to labour is incrementally destroyed, and the value of pensions and wages declines. This disrupts the circular flow. Smaller capitals, less able to increase debt, go bankraupt.

Also the GINI coefficient deteriorates and, finally, in a generation or two, social violence erupts.

Only the Tea Party celebrates.

Maybe piling on here a bit…but in speaking with my 23 year old son and 18 year old stepdaughter and her friends, I think we have finally reached the point where we can discuss public ownership of ,health care, infrastructure and production, without some sort of ritual denunciation of Stalin and all his evil works.

By comparison, capitalism, to these folks, is equated with the Wall Street plutocrats who created this misery that all the college grads are being thrust into.

Further, in reading Catholic social teaching, it is remarkable how nonchalant the papal encyclicals were regarding the socialisation of portions of the economy.

The constant jibes about the horrors of Communism now sound a bit tinny and musty, like an argument from generations past that doesnt have currency.

I don’t know, maybe it would help just a little bit . There are a relatively small number of polical positions, and a near-infinity of words; organising the allocation of positions to words is a problem with the charectistics of organising the allocation of beer bottles to guests in a brewery party,

If you can’t solve that simple problem of distribution, it hardly bodes well for anything more difficult.

In particular, if what you are suggesting is the continuation of a movement who’s results you are going to commit to at least partially defend, use one word. If what you are opposing is something commonplace in many countries, making them, you would argue, better in that aspect than yours, use another.

And if you have something new in the course of human history, that owes nothing to either, then perhaps you should take the effort required to come up with a new word.

I don’t know, but I think the variety of coffee shops might be slightly larger if there was a law against corporations growing as big as Starbucks.

Guy Standing in The Precariat among many others, explains that the project of neoliberalism is to privatize and offload as many of the costs of production and social reproduction from business and the state onto the individual worker as possible, either as an attempt to increase profits or a desperate attempt to maintain them. Example:the recent SCOTUS decision about workers having to change into safety clothes on their own time.

The paperwork involved in American healthcare and the new additions from the ACA are mostly I think moving costs from industry and government to labor, and also an attempt to create new sites of exploitation and profits, like temp agencies and job search firms.

And yes, it has side effects beneficial to Capital, like diminishing the time and social space available for labor organization, increasing stress and insecurity etc.

But a good analysis of neoliberalism is sufficient without going metaphysical.

That’s a key insight there, that libertarianism is about not confronting death and taxes, but wanting to avoid or get rid of them instead. What other thoughts do you have on this idea?

At best, one could say that capitalism is pretty good at allocating goods and resources to those who can afford them. IOW, the bar is set really, really low for “success” when one speaks honestly of capitalism.

And since capitalism necessarily thrives due to radically underpaying labor, it eats its own. Without governments subsidizing this process of forcing labor costs down, the numbers of people who could afford its products would be even smaller. And that number is already tiny as a percentage. If it couldn’t off-load (externalize) most of its costs onto the public, it would have an even smaller consumer base — and fewer capitalists as well.

The obvious contradictions inherent in its model would have crushed it long ago if not for states keeping it afloat. And they keep it afloat primarily because capitalists elect the people who run those states, etc. etc. An incestuous arrangement of mutual support and dependency never before seen, at least to this degree, prior to capitalism.

LFC 74,

“You’re ignoring the basic argument of the OP, which is quite straightforward and is that the bureaucratic/insurance hassles characteristic of the U.S. health-care system tend to occupy the time of patients and families that might have otherwise been spent ‘dealing with and confronting’ (the OP’s phrase), or coming to terms with (if you prefer that phrase) the terminal (in this case) illness.”

LFC, I don’t think Schiffrin’s story really demonstrates a “coming to terms” with terminal illness. Pancreatic cancer is almost always fatal, and the best one can realistically hope to do with chemotherapy is eke out a few more painful and debilitated months, at great expense even under the French system. So for all its dignified ceremonial Schiffrin’s chemotherapy was still a reckless, costly gamble on a forlorn hope—just a last-ditch effort to fend off the Grim Reaper for a few more heartbeats. It’s a far cry from a philosophical acceptance of mortality, which in medical terms would call for palliative care to afford a gentle exit. In France as in America, health care boils down to a doomed struggle to keep death at bay.

That’s why Corey’s Freudian theory of the greater realism of socialized versus capitalist health care doesn’t ring true. Corey argues that the bureaucratic maze of American health care, the endless haggling and paperwork, stems in part from a neurotic desire to avoid confronting the reality of death by distracting ourselves with busywork. I’m not sure about that. At bottom the haggling does indeed confront the hard reality that there are competing claims on resources. And I’m not sure that American-style insurance wouldn’t lend itself quite avidly to a forthright acceptance of death: “You say you just want morphine instead of chemo? Great, we’ll pay for that—thanks for being so philosophical about your mortality!” But in any case, Corey’s distinction between capitalist health care’s neurotic denial of mortality and socialized health care’s accommodation of the Freudian/Marxian reality principle can’t be right, because socialized health care is all about frenzied, ultimately futile attempts to evade mortality, as in Schiffrin’s case.

I’m not defending capitalist health care. The French system is fairer, more humane, more efficient and more effective—better all around. But to critique capitalist health care as an anomalous psychopathology of denial is really a stretch. If death is an inescapable reality, so is the fact that humans do anything to escape it. Socialized health care’s virtues are pragmatic, not spiritual—it simply does a better job keeping us alive so we can whistle past the graveyard another day.

The real problem with capitalist health care is that profits and massive executive salaries divert resources from patient care. The overhead for a for-profit health care insurance company is roughly 30% . . . . versus less than 3% for Medicare.

(Medicare could do even better, if it reversed its partial privatization and was able to bargain with Big Pharma, etc.)

It’s not rocket science. A truly public, all non-profit system can devote a much, much higher percentage to actual health care. Any business in business to make profits and pay large compensation to executives simply allocates far less to patient care.

It’s math, more than a different confrontation with mortality.

Though that math, that “bottom line” expectation and reality then brings in matters of morality and ethics, which alters that confrontation. There, too, socialist or any kind of truly public, all non-profit model is superior — if for no other reason than that it does focus primarily on patient care, instead of executive pay and bonuses.

Keith is right. France is a “mixed economy”. I hardly ever hear that term these days and it’s time it was revived so that the unproductive arguments around “b-b-b-but SOCIALISM!” can be put to bed.

Oh, and (sorry, clicked Submit too soon) we don’t have bread queues, except on the Surf Coast at the peak holiday period.

we don’t have bread queues, except on the Surf Coast at the peak holiday period.

Even assuming this isn’t a tissue of lies, I notice you still aren’t being square with us, as you conveniently omit the toilet paper shortages, which are much less charmin’. And as long as you Australians continue in your socialist health care ways, you will never be able to put such things behind you. We Northern capitalist types need only bidet our time until you all finally come clean about how your system doesn’t pass the smell test.

“OTOH, the hospitals are government owned, so no matter what the cost, there is at least a 30% lower cost than the commercial hospital system in the US, plus there are no advertising costs for Cancer Centers of France, and then since there is single payer there is not an additional 20-40% profit and administrative cost for health insurance payments to the physicians and hospitals and nurses. Then, of course, since the hospitals are government owned, why hey, there is no issue about how many MRI, etc. instruments are needed and then we can get into the issue of pharma costs.”

Hmm, govt owned hospitals provide 65% of the French beds, the remainder comes from private for- and not for-profits. It is also not a single payer system. There is indeed tax run insurance but that normally only covers 70% of costs (depends a bit on the actual treatment) the remainder being out of pocket or covered by a private insurance contract.

And putting “Cancer Centers of France” into Google brings me to Unicancer, a “UNICANCER groups together 20 French Comprehensive Cancer Centers (FCCC), which are private, non-profit establishments with a threefold mission of patient care, research and oncology teaching. ” They might well advertise you know.

Oh yes, they do:

http://www.adforum.com/agency/14302/creative-work/34470250

The French system is indeed a very good health care system, better (certainly on equity grounds) than the US and better (in outcomes) than the NHS.

Perhaps it’s because it’s one of these mixed economy things?

French health care couldn’t stop André Shiffrin from dying; nothing in this world could. Instead it created a space for him and his family to deal with his dying, without the distracting mayhem of our system.

But American health care does exactly the same thing, all the time. It’s not as if everyone’s experience is similar to Shiffrin’s UES experience; many Americans get treatment that is much closer to his French experience. This isn’t to say that the French system isn’t vastly superior, on the whole, but isn’t their biggest advantage cost? For example, the American system will send nurses, physical and occupational therapists, hospice people, paramedics, etc., to a patient’s home, but not, so far as I know, doctors, but I would guess that this is because our doctors are so expensive – if we had French doctor prices, maybe we’d send them too.

Anyway many elderly Americans experience (or their loved ones) very little distracting mayhem from cost considerations in their final months and days. They do have to make some decisions and deal with bureaucracies at times, but I can’t beleive this doesn’t happen in France also.

Again, obviously there are at times bureaucratic nightmares that result from our peculiar health care system. But this doesn’t seem to result from a fundamental philosophical difference in provision (see 57 and 82). Why the French mix of public and market provision works better than ours is a good question, but what does it have to with “socialism?” I think I would rate this the single strangest post I’ve ever seen on CT – that’s amazing, considering how strange some of Belle Waring’s have been, at least to me. (Not that strange means bad, btw).

Socialism won’t eliminate the sorrows of the human condition. Loss, death, betrayal, disappointment, hurt: none of these would disappear or even be mitigated in a socialist society. (….)

But what socialism can do is to arrange things so that you can deal with and confront these unhappinesses of the human condition. Not flee from or avoid them because you’re so consumed by the material constraints and hassles of everyday life.

I’d like to add that it seems like there was a bait-and-switch here: instead of “loss, death, betrayal, disappointment, hurt” we get an anecdote about ill health. Sick people consume goods and services that embody a lot of human labor and are therefore expensive: therefore we have a question about whether to provide these goods and services with market or government provision. (And there is strong logic that favors government provision, not that a purely private system might not work, if only in theory).

But “loss, death, betrayal, disappointment, hurt” don’t strike me as fundamentally expensive, except for death, where the system of private/public life insurance seems to function without too many complaints, and therefore these things are not much about Socialism vs. Capitalism. I guess someone suffering from betrayal or disappointment might decide they’d like to take some time off work, and I can see that this circumstance would be difficult to privately insure for, but on the other hand is there a country in the world that provides for things like this publicly? In France, can you go to (say) a psychologist and somehow get a state-sponsored vacation, because you’re unhappy? You’d think not, because it would be subject to gaming….

Will Boisvert @81
Well, I understand what you’re saying. Much depends on the individual circumstances, I would think.

Sure, it’s possible to reject chemotherapy and opt for palliative care anywhere. But opting to stay alive a little longer doesn’t necessarily mean that one is deluding oneself. I haven’t read Schiffrin’s daughter’s piece and I don’t know the circumstances, so I think it would be presumptuous of me to speculate about the ‘coming to terms’ aspect in this particular case. Perhaps Schiffrin just wanted to spend a bit more time w/ his family; I don’t know. I’m not saying I completely accept the OP’s argument as a general matter, but in some cases I can see it being applicable.