Todd G. Simpson

Those of us raised in Democratic societies take it for granted that those societies provide better well-being (for common individuals) than other forms of governance. At the heart of democracy is personal freedom and autonomy, backed by the rule of law. We also take for granted the interplay of decentralized versus centralized authority. Decentralization can mean many things, but here we refer to it in terms of power, authority, and decision making. The more authority individuals have, the more decentralized the power system in which they are operating.  Almost by definition the more democratic a system, the more decentralized it is, with the caveat that some agreed upon axioms exist, such as the rule of law and its enforcement. Of course, authority can be too decentralized leading to "every man for themselves", so we put limits on decentralization through that same rule of law. With the advent of decentralizing technologies , which make possible more decentraliz

Being a Canadian living in the US, I have first hand experience with both a single payer system, and the completely dysfunctional US approach, which is caught in the nether-land between Government support and market driven forces - as a result it has none of the advantages of either.  Proponents of a single payer system want, appropriately, to make basic health care a human right - we have a moral duty to help those less fortunate than us.  Other single payer systems have better outcomes at lower cost.  Proponents of a pure market driven system believe we would enable bad behavior by giving healthcare to all, and that if the system was truly driven by market forces we would end up with solutions for both the low and high end.  They also, with at least some support, claim that innovation is higher in a market driven system than in a government run one.  If you put a system completely under government control, innovation grinds to a halt.   Of course, both are right and wrong.