Cure Rates Population Shifts And Health: Fill & Download for Free

Thank you (to the questioner) for putting forth an excellent question on an important topic. I shall try and answer the aspects to the extent possible, for I am no expert on healthcare.Short answer: 50–50 (or 2.5 stars out of 5)Long answer:Prior to explaining my rationale for the short answer (given above) for India’s National Health Policy, it is important to bring forth the context that India’s health sector is in. Four main features remain paramount to the challenges that India faces with regard to the health sector.a) The first major issue is the lack of public expenditure on healthcare, as this link shows. As the link shows, public expenditure on health in India is among the lowest at 1.3–1.4 % of its GDP. This is not just low than developed countries - Sweden (10 %), Denmark (9.2 %), New Zealand (9.1 %), France (9.0 %), Germany (8.7 %), Japan (8.6 %), Norway (8.3 %), United States (8.3 %), and United Kingdom (7.6 %) as shown in this link. It is much less than even the share of GDP spent on healthcare by governments in developing nations - Brazil (3.8 %), Russia (3.7 %), South Africa (4.2 %), Afghanistan (2.9 %), Maldives (10.8 %), Nepal (2.3 %), China (3.1 %) and further, what should be clear jokes, Bolivia (4.5%) and Ethiopia (~ 3%) - poorest nations in the South American and African continents respectively. Out of the 190 nations for which data is available in the year 2014, India ranks 176th in descending order (from highest to lowest spending). This is a clear joke when we realize that India has been among the fastest growing economies globally over the past 15 years, that India is among the top 5 nations in terms of dollar-billionaires, and should have been spending considerably on healthcare as it would have had money to begin with.But why is public expenditure on health care so important?b) In comes the second set of issues which add to our context. Even as our national incomes have risen significantly, especially after the economic reforms introduced since 1991, this has been accompanied by a lower quantum of increase in our per-capita incomes. Per-capita incomes are a measure of the purchasing power or capacity of our citizens, and lower per-capita incomes indicate lower capacity to spend. The situation becomes worse when we undertake a comparison of our performance with aforementioned nations, taking into consideration their per-capita incomes, as can be seen here. Here, the argument can work in two ways:1) Nations like Brazil, Russia and even Bolivia have higher per-capita incomes than India, so their citizens are in position to contribute more through taxes to running public health care systems. However, higher per-capita incomes mean their citizens are already wealthier than Indian citizens, and so they need not spend a higher share of their GDP on healthcare than India, as their citizens can afford to spend on health. Yet, they spend a considerable share, higher than what India does.2) Nations like Afghanistan and Ethiopia actually have lower per-capita incomes than India, yet they spend a higher share of their public income on health care than India does. Surely, that should be a matter of shame for us, given that even nations poorer than us are spending on healthcare for its citizens.Low capacity of Indians to pay (as indicated by low per-capita incomes) indicates that Indians can ill-afford to spend money on healthcare, for food, shelter, water and other basic amenities (such as education) are extremely critical for decent living and money needs to be available to spend on these. However, two more factors are critical to the whole context.c) Third is the fact that our poor per-capita incomes are further complemented by the high levels of economic inequality that pervade our country as described here. As can be seen, India ranks among the top nations in terms of income inequality, with its Gini coefficient reaching 51 in 2013, probably the third-highest among major global economies after China and the US. This is because even as economic reforms since 1991 have helped in improving incomes of all, it has also led to a significant increase in inequality of incomes and wealth across people cutting across different categories and identities: caste, class, states, regions, religions, and so on. This means that while our per-capita incomes are lower, specific communities and sections of people face the low incomes to a greater extent than others.This means that a large section of our population is thus so poor that it cannot afford to spend on their health from their own pockets. But the poor public expenditure by governments on health means that they are likely to actually spend on health. Is that the case?Yes.d) The fourth aspect which completes this matrix, is the high share of out-of-pocket private spending in India compared to the rest of the world. As per the Draft Health Policy of 2015 (here), about 60 % of the expenditure on health in India is private and out-of-pocket - i.e. people spending on their own on health. The unofficial figure though, according to one major international source, is ~ 90 % (here).This high share of private expenditure in total health expenses is a result of several factors. First, it reflects the pathetic situation of our public health infrastructure, as reflected in the poor state of government hospitals and primary health care centers - a combination of corruption, lack of sufficient public spending, and inefficiencies. Second, people falling ill to communicable and non-communicable diseases is not merely about lack of public spending on health, but is also related to poor spending and lack of proper infrastructure with regard to a number of sectors. These include lack of proper facilities for sanitation, solid and liquid waste management in our cities and villages; insufficient intake of nutritious food on account of lower purchasing power (lack of private expenditure) along with unavailability of nutritious, quality food through public distribution systems and mid-day meal schemes (due to leakages, corruption, inefficiencies and cuts in public spending); unavailability of safe, clean drinking water, and also a lack of personal hygiene (due to a combination of laziness and lack of information of safe, clean hygiene practices), especially with regard to non-communicable diseases such as diabetes and hypertension/depression.However, this means that health constitutes a significant share of out-of-pocket expenditure for our households, which in turn results in significant debt burden for our low-income households on account of health. In fact, health remains among the most prominent sources of debt for Indian households, something observed in the United States - not surprising therefore, that P Sainath always keeps saying that we are locked on to the US model. This in turn reduces the purchasing power parity for most Indians with regard to other consumer goods, thereby bringing down our economic demand that in turn can contribute to massive employment and income generation. It also means that India suffers from exceptionally poor health indicators, be it neo-natal mortality rate, infant mortality rate, still birth rate, or malnutrition indicators, despite some significant improvements as observed in the National Family Health Survey 4 (NFHS-4). All these figures contribute towards a weaker workforce (health-wise), which in turn reduces the possibilities of enhanced income and employability of our people, most of whom are poor or in lower-income class.Given this scenario, let us now ask the question: how good is the National Health Policy of 2017?The good features of India’s National Health Policy 2017 (NHP-2017) are as follows:a) First, the policy has moved away from the standard policy practice of tackling diseases to preventing their occurrence and growth in the first place. This is an important step, a major positive, and must be applauded.b) Second, NHP-2017 introduces a set of measurable goals against which the policy as well as the performance of the government can be assessed. These include:For most goals, the indicators have been clearly set – a major positive.c) Primary health centers in India have been mainly meant for programs related to immunization (such as Pulse Polio), check-ups of pregnant women (such as Janani Suraksha Yojana), and measuring malnutrition of children and addressing cases of severe malnutrition. However, NHP-2017 now mandates that PHCs will now focus on also screening non-communicable diseases (such as hypertension and diabetes), as well as other areas. This is a major positive, and if sufficient fiscal resources are provided, can give us a better indication of the spread of these diseases in the rural far-flung areas, as well as ways of countering them for the poor as well. NHP-2017 thus focuses on turning Primary Health Centers (PHCs) into Health and Wellness Centers (HWCs), which will focus not only on reducing disease burden and prevention, but also look at major non-communicable diseases, mental health, geriatric healthcare, palliative care, and rehabilitative care services.In particular, the government has set a major goal of reducing premature mortality due to cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 25% by 2025 (compared to 2014). Universal screening for these is also proposed, even though this was already under way in 100 districts before the finalization of the policy. Furthermore, it also seeks to achieve a “90-90-90” global target by 2020, whereby 90% of all people living with HIV will know of their HIV status; 90% of those diagnosed with HIV infection will receive anti-retroviral therapy on a sustained basis; and 90% of those receiving this therapy will also have viral suppression. The government also seeks to reduce the prevalence of blindness to 0.25 per 1,000 persons by 2025, while focusing on achieving the elimination of leprosy by 2018, kala-azar by 2017, and lymphatic filariasis in endemic pockets by 2017 (and continue to maintain it).Regarding disease burden – TB in particular, NHP-2017 aims at ensuring a cure rate of > 85 % in new sputum-positive patients, and reduce the incidence of new cases such that new TB cases are eliminated by 2025.d) Fourth, NHP-2017 proposes the provision of free drugs, diagnostics and emergency and essential healthcare services in all public hospitals. In particular, it seeks to focus on promoting the manufacture of drugs and medical devices in India as part of its “Make in India” initiative, mainly through reforms in existing regulatory mechanisms. This is crucial as ~ 70 % of medical devices used in India are imported, mainly due to tax incentives given on such imports. It also advocates the development of mid-level service providers, nurse practitioners, public health cadre and other human resource availability.e) Fifth, the government plans to set up the National Health Care Standards Organization that will lay-down patient-oriented protocols for treatment and managing disease burden. A tribunal will be setup which will have the power to enforce these protocols in public hospitals and health care centers.f) Sixth, a major policy shift and forward movement is the emphasis of NHP-2017 on the Indian system of medicine, where the policy looks at three-dimensional integration of AYUSH systems – cross-referrals, co-location and integrative practices – across different medicinal systems. This is hoped to help achieve effective disease prevention and therapy that is safe and cost-effective. In addition, Yoga will be introduced in schools and work places to promote good health practices.Then what are the major problems with aforementioned policy steps? They are as follows:a) While NHP-2017 agrees that health is an entitlement, it continues to remain a non-fundamental right, which is surprising as the Draft Policy had envisaged it to be so. The government can claim that health is a state subject under the Indian Constitution, yet there currently exists the Right to Education (and education is a state subject), and a similar objective should have been prioritized for health – a major public good.Moreover, efforts should have been made to bring health to the central list for better regulation, as this policy being a model policy, the states may not work hard to achieve anything on the front, and the Centre may escape its responsibility by just stating that it’s the responsibility of the states. The record on this front has been extremely patchy, as one can notice with the Clinical Establishments Act (only four big states have adopted it, while the others have ignored it or not framed rules for its stringent and effective implementation). The fact that health as a sector is not brought to the central or to the concurrent list also means that the implementation of the National Health Care Standards Organization will remain meaningless as it can only be imposed on hospitals under the direct supervision of the Central government. All this means that the NHP-2017 is just a model health policy, and if states do not implement it – a far likely possibility given that health is not a major election issue in almost all states – the Centre will be reduced to saying that “Health is a state subject” and the “Centre can do nothing much about it”.b) On two indicators – number of beds (to be installed in government hospitals) and increase in public expenditure on health (as % of GDP) – no deadline has been given. This remains a major loophole, especially given the poor state of public health infrastructure in our country. Also, NHP-2017 only “assures” health services instead of making it mandatory for governments to ensure that citizens get access to quality health services. Hence, despite the indicators mentioned in the policy, there does not remain any specific mandate (let alone a legal one) to ensure that sufficient fiscal resources are provided to achieve these indicators.This point must also be stressed on in light of the context in which the policy has been released. Despite the Central government accepting the recommendation of the 14th Finance Commission to devolve a greater share of tax resources to state governments, the expenditure on health has not increased much over the past two budgets. Moreover, unlike the draft health policy that talked about imposing a “health cess” to ensure that sufficient resources are mobilized for public health expenditure, the final NHP-2017 document has ignored this aspect (despite fewer resources being available with the Central government). Instead, the government has promised that it has enough resources to spend on health expenses, without laying a roadmap or giving a clear idea on where these resources will be coming from. The relevance of this point is also critical when we look at all the aforementioned positives. Lack of money will make it impossible to achieve many or all of the positive aspects mentioned before.c) While the initiative to get local production of medical devices is laudable, it must be remembered that tax incentives given on medical device imports should also be reduced systematically over a long duration so that companies get encouraged to produce and purchase devices produced locally. If such tax breaks given on medical device imports are not removed, attempts to promote their local production may not bear fruit. On this, NHP-2017 and any Finance Ministry directive or other document do not say anything, speaking of a lack of coordination on the subject.d) In many states, diagnostics, drugs and essential health care services are already free, so this is nothing more than a reiteration of something already done to get pats on the back, as opposed to something new – so that part is also not a new positive being talked about.References:http://www.thehindu.com/news/national/national-health-policy-to-increase-life-expectancy-to-70-years-nadda/article17474707.ecehttp://indianexpress.com/article/lifestyle/health/at-a-glance-key-highlights-of-the-national-health-policy-2017-4571701/http://pib.nic.in/newsite/PrintRelease.aspx?relid=159376http://www.hindustantimes.com/india-news/cabinet-approves-national-health-policy/story-TdyHX7f6VmHWTLwXX0Q7tK.htmlhttp://www.mohfw.nic.in/showfile.php?lid=3014http://www.moneycontrol.com/news/business/economy/10-highlights-of-the-new-national-health-policy-which-was-approved-today-2241335.htmlhttp://zeenews.india.com/health/national-health-policy-2017-all-you-need-to-know-1987142http://www.financialexpress.com/lifestyle/health/national-health-policy-all-that-you-will-be-assured-under-modi-governments-new-scheme/589971/http://www.livemint.com/Politics/dfYOpbKsFxkRNuS6pgQu7J/New-health-policy-aims-to-lift-public-spend-life-expectancy.htmlhttp://indianexpress.com/article/explained/why-there-is-not-a-lot-new-in-national-health-policy-key-issues-unaddressed-4572373/https://scroll.in/pulse/827659/interview-why-is-india-investing-in-insurance-schemes-instead-of-primary-healthcarehttps://scroll.in/article/764684/why-india-cannot-risk-putting-its-health-in-the-hands-of-the-private-sectorhttps://scroll.in/pulse/826146/will-india-see-a-much-needed-increase-in-health-funding-in-2017https://scroll.in/article/826883/maternity-benefits-theres-a-yawning-gap-between-women-who-work-in-the-formal-and-informal-sectorshttps://scroll.in/pulse/825316/better-laws-on-mental-health-and-maternity-in-2016-but-still-no-comprehensive-health-policyhttps://scroll.in/article/822044/think-tamil-nadu-has-good-public-healthcare-its-hard-to-find-it-on-the-groundhttp://indianexpress.com/article/india/india-spends-less-than-brics-saarc-nations-on-health-should-fix-it-in-budget/http://www.thehindubusinessline.com/economy/india-spends-least-on-healthcare-among-brics-nations/article3317902.ecehttps://www.devex.com/news/minimizing-out-of-pocket-health-expenditure-for-india-s-poor-87682http://databank.worldbank.org/data/reports.aspx?source=2&series=SH.XPD.PUBL.ZS&country=#http://databank.worldbank.org/data/reports.aspx?source=2&series=SH.XPD.PUBL.ZS&country=#http://databank.worldbank.org/data/reports.aspx?source=world-development-indicatorshttp://www.livemint.com/Politics/mTf8d5oOqzMwavzaGy4yMN/IMF-warns-of-growing-inequality-in-India-and-China.htmlhttp://data.worldbank.org/indicator/SH.XPD.OOPC.ZShttp://indianexpress.com/article/explained/why-there-is-not-a-lot-new-in-national-health-policy-key-issues-unaddressed-4572373/https://www.pri.org/stories/2012-10-17/india-medical-expenses-plunge-40-million-people-poverty-each-yearhttp://www.governancenow.com/news/regular-story/63-million-indians-are-in-debt-due-healthcare-expenditure-reporthttp://www.who.int/bulletin/volumes/88/7/10-020710/en/

First off, we need to deal with the fundamental understanding that health care is not a right. You cannot have a right that requires taking something from someone else. It doesn’t matter if other countries say it is a right — it isn’t. If one day Sweden goes bankrupt and stops giving out all their benefits, was it ever really a right to begin with? No. A right is not synonymous with wish fulfillment. If you have to take from someone else, be it their taxes or time, to provide you a right, then to them your right is just an obligation or worse, involuntary servitude — slavery, if you will. Let’s look at the 2nd Amendment. That’s an actual codified right - to own and bear arms, but does a right to have them equate to the government’s obligation to give you a gun? You have a right to free speech, but is the government going to give you a stage, or a microphone? So let’s get away from this language of “everyone should have a right to Universal Healthcare”. No they don’t. Just no.Universal Healthcare is just a state welfare program — nothing more.That said, could it be a service that the government extends while it is able? Sure. Should it? Would that be the wisest use of our resources? We can have that discussion. That’s actually a healthy discussion to have. That’s essentially the question we ask when we think about the military, our roads, schools, and emergency first responders. We don’t have “rights” to these things either, but it very obviously benefits us as a nation and as communities to provide them.So let’s explore that question… is it simply a good idea to provide universal healthcare to everyone?We hear from the Left many arguments, some very good as to why Universal Healthcare would be a good thing, by good, I’m not even arguing about improving the quality of health of their citizens. By good, I mean that it represents a good investment, one which helps us compete against other groups who want to disrupt our way of life. We can never forget that our place at the top of the hill is never guaranteed, and many an empire has fallen exactly a few decades after generous welfare payouts. That said, some of these arguments aren’t just “nice”, they are legitimately good arguments of the positive economic outcomes that might result as an outcome of free universal healthcare. Those arguments are easy to find, so I am not going to list all of them here. I just want to acknowledge that there are a lot of good ones.Having said that, the Left has to get off their self-righteous posturing, proclaiming with the first available opportunity that anyone who disagrees with them want to kill poor people or, as is the fashion of the moment, “Why would you want to deny healthcare for 22 million people?” It makes you look like jackasses who can’t prop up an argument without vilifying your enemy so that the stupid people who fall for it will vote as you tell them to… because framing your enemy as a murderer makes you the good guy.The honest truth is that Conservatives aren’t opaque to the possibility of good outcomes coming from Universal Health Care, nor are they devoid of the part of the soul that develops compassion for those who are unfortunate. As I’ve said in a recent answer, the Conservative standpoint is that - normally we have an imperfect system, but it is fundamentally good. Too much radical change to correct one flaw creates great risk of damaging other systems that are considered vital to our way of life. The conservative asks first whether our system of interlocked institutions can handle the change that this will bring about, or will there be unintended consequences that will upset our way of life making it worse than the benefits resulting from this idea?That said, let’s run through a few of the arguments I’ve personally heard for why Universal Healthcare is actually a very bad idea for the United States, and by extension, even bad for the world.To begin, I had a discussion with a woman recently who asked the question,"What is irrational about seeing the success that several governments, including one of our closest neighbors, have had in offering universal health care and wanting the same for our country, too?"To begin, what we’re really doing here is comparing the way the United States does healthcare to the way others in the world do it. Progressives often bring up that the United States lacks so much, and that this is a sign of failure, and that we have a right to Health Care if others can provide it. As I’ve said already, just because others chose to give it, doesn’t make it a right — not for them or us. It might be an obligation because they took the taxes and are obligated to give them something, but fulfilling an obligation is not a right. And while the Progressives look to some ideal future we are progressing toward, the Conservative instead asks what we already have, if anything is good about it, and what we would lose if we adopted some new “progressive” model.First off, the American healthcare system is broken. No doubt about that. The costs are exploding at a pace that overwhelmingly outstrips the income of the Average American. I don’t even have to make this argument any more, you’ve all heard about that a thousand times. Can anything good be said for it?Yes.Americans fail to understand what it does for the world that no other healthcare system, not the Swedes, Canadians, or anyone else are doing, something the world would surely miss if it were to disappear.To ask a very honest question, where do the vast majority of medical technologies and improvements come from? The United States. Why? Because it costs too much, obviously, but those expenses still pay for new research because there is a major profit motive in the US to be a healthcare provider. So sure, we could transition to a universal healthcare model people are asking for, but then no new cures will be discovered, as is the case with medicine elsewhere. As with the graph below, even when there is an increase in foreign innovation, it is led by ground being broken in the United States.If people feel that we have discovered enough, and that everyone with an incurable disease from now on should just be happy that they have free health care to make them feel better, then the system called for works just fine.The harsh truth of the matter is that our system, as horrible as it is, the American system is the only one driving new cures and technologies. In fact, when the American system Conservatives are often attacked as wanting to kill everyone by taking away healthcare, I could just as easily accuse people who advocate for Universal Healthcare of condemning everyone who has hope that someday a cure will be discovered to live with a hopeless death sentence over their head.That isn’t at all to say our system is good. This is to make the Conservative argument, “In a system that sucks, what can we still not live without?” We have to acknowledge value in a system, and that throwing away that value is a choice that will kill many millions of people, not just in the United States, but the rest of the world who benefit from American medical research and technology. What the Conservative will tell you is that we have to acknowledge that benefit to the world before we break the system entirely.That said, our system is overburdened with costly regulation that causes those same developments to cost orders of magnitude more than they should. $1 billion to create a new drug that could save thousands of people's lives is killing people. People blame the drug company for being evil, but the vast amount of job growth in the industry isn't executives, doctors, or scientists, but admin and lawyers. This is to navigate the regulations that have stifled the industry in the only country that is producing new medical technologies. As an example, imagine the mind blowing speed of innovation in cell phone technology. Now imagine if it cost $1 billion to launch and develop a new app. If that was the case, we would not be having this conversation today.These two problems are specific to the United States, because by US efforts, and in spite of the obstacles, no one else needs to worry about development. Canada and all other "free Health care states" truly do get a free ride on the US's dime, as the technologies they have and the techniques they use, to paraphrase one recent President, “You didn’t build that.”I lose sleep at night wondering what the world healthcare would be like if a) it didn't cost so much to create new lifesaving technologies in the United States, and b) everyone else was innovating at the rate the Americans still are, in spite of the regulations. We could have literally already cured cancer. We could have saved tens of millions of lives, or even come up with enough new techniques that the detrimental costs of healthcare would have already been driven down so much that you could pay for a year's worth of medical care, no matter what it was, by doing a week's worth of Taskrabbit chores. I literally lose sleep thinking about this.Moving on, people on the Left seem to ignore the issue that Healthcare does not equate to Health Insurance. Conservatives are accused of “wanting to cut health insurance for 22 million people.” I’m just going to say, that’s a really nasty way to frame an argument, particularly when you’ve also subtly suggested that by doing so, we are committing them to a death sentence. I mean, we can work together on a solution, or you keep comparing everything we do to the holocaust. You’ve a choice. That tangent aside, let's talk about why Healthcare does not equate to Health Insurance.Healthcare means your medical expenses are provided — done. Health Insurance is one of the ways to pay for the healthcare that has been provided. Yes, other countries mentioned don’t provide health care through single-payer insurance plans. Let's look at why.Consider milk. Let's say that we subsidize the purchase of milk with something like food stamps, or better yet, milk vouchers. The vouchers say that you can get one gallon of milk and the store will accept the voucher as a $4 bill for milk, payable only from the person who was given the voucher. That's it. It is a simple $4 bill that is only good for milk. That drives a person to find milk that is under $4 and also limits stores from charging excessive fees (for everyone) because it creates an economic price ceiling for that product. This system actually keeps costs down for all consumers of milk. It’s not wonderful for milk producers, but it provides them with the means to continue.Now, let's say instead that we used government backed insurance to pay for milk. At this rate, the consumer has no incentive to shop around for milk. They just get the one that looks the best. So instead of paying $4, what is to stop them paying for the $40 premium milk? Nevermind that I’ve never had milk that was literally 10 times better than the regular. Now, they've artificially inflated the cost of milk by 1000% because there is no incentive to be a good consumer.It doesn't stop there, though. The Grocer knows that the consumer doesn't care about the price, because they aren't paying for it... and neither is he. A third party is, one who he never sees and doesn’t have to bargain with. So what is to stop him from charging $400? Now, goods that should cost $4 now have 100,000% mark up. And nobody even saw it happen. It was just a number that was compiled with other numbers that eventually fell into the gross national budget that no one looks at it enough to say, "How in the world are we spending $300,000,000 on milk?" Some Conservative will say that we have to cut this expense and that the system isn't working, whereas some Leftist will accuse Conservatives of wanting to rob families of the milk they need and that the Republican party candidate wants to kill little babies who just need milk.Sound outlandish?Two years ago my mom had to have knee replacement surgery. It ended up costing her around $10,000. If she had gone to India, she might have only had to pay $3,000 for the surgery. That sounds pretty ridiculous, until you realize that even though she paid $10,000, the hospital billed her insurance for $150,000. A 5,000% mark up from what can be delivered in India. Granted, part of this is the first two problems I mentioned, but the big thing is that insurance took care of it.So why do we go with Insurance where other countries don't? You've said it. I've said it. You know the answer. Big banks have an inordinate amount of power in US legislation. Democrat and Republican, these insurance companies are able to get their legislature across where smarter methods never seem to come up in conversation. There are other ways to solve this problem, but instead of much, much better methods, all other options have simply drifted away... as if by magic.Having said that, you’ll notice in the above graph on medical technology, we saw that medical advancement in the form of new technologies increased following the implementation of the Affordable Care Act. Unfortunately, this did not lead to any sort of reduction in costs, quite the opposite. As described in an MIT study, where other industries reduce costs with increased technology, Medicine’s costs increase. This is because, according to the study, the implementation of new equipment incurs massive costs that are directed down to the patient. Other industries are geared toward efficiency, where consumers make decisions toward the cost of goods. Healthcare’s value proposition is service, whereby they aren’t required to structure themselves around reducing costs, but offering more options for care.Insurance enables this behavior, where hospitals aren’t required to drive for efficiency. They can simply shift the costs on to the consumer, who pays it out of their pocket (which is still growing precipitously) and shifts the rest of the expenses to be billed to insurance (which are also growing precipitously). While the United States still boasts of the best care by several measurements (number of years of life after a cancer diagnosis comes to mind), the overall costs of the total system skyrockets. This is why, even under the Affordable Care Act, and even with the improvements in medical technology ushered in, health care premiums have continued to rise, out of pocket expenses have continued to rise, and so have overall costs. The health insurance enabled system drives up prices, and has since health insurance began, being an obligatory job perk. It’s a systemic feedback loop, that when given enough time, will continue to drive prices out of control, even when compared to today.The method called for to avoid the insurance trap altogether while still providing universal healthcare is direct socialized government care. In this case, the government takes full control of the medical industry to manage healthcare for the population. In so doing, they set prices over the industry, as well as dictate service. To understand what that looks like, we also have an example. We’ve actually had this all along because the government has delivered true socialized healthcare for over 70 years, as in the government literally pays for everything associated with healthcare. You know where?The Veterans Administration.Let’s look at the VA’s record and see if it is something we would want for ourselves.First, the VA is the second largest department of the government, after the military itself. At $186.5 billion in the 2018 Presidential budget proposal, it also is the second most funded department. What’s its job? Basically it’s a government run healthcare service for less than 8% of the population. Yes, that’s the second point. Even with the high costs, it still only covers about 7.6% of the US population and third, it only covers them for injuries they incurred during their time in service. For most of us, that is four years in our twenties. Cancer in your 50's? Good luck. Not covered. So that’s it, only 8% of the US population is covered for injuries related to only the time they served. Nothing more; often less.In spite of this, over the last eight years, the VA has been racked with scandal as veterans have had to wait 6 months to a year just to see a doctor, they received inadequate treatment and once they do, they are abused by VA staff, and that a disturbing number of veterans died while waiting for their free healthcare. The healthcare received was substandard, usually in the form of just throwing psychotropic drugs at patients, leaving many in the veteran community to fear being medicated with depressents until they kill themselves. This, also at a time, where some 22 veterans committed suicide each and every day. Some places do well, but for a federal system, care is remarkably inconsistant across the nation. Frankly, in spite of the fact that it was free, there is a reason that most veterans voluntarily walked away from VA help.To drive home a point, this all happened during the time when the man responsible for declaring to millions such healthcare was a right, was the man in charge of the VA. That man was Bernie Sanders. Sanders headed the Senate Veteran Affairs Committee and regularly fought incentives that would allow more veterans to have choice over who provided them care. Instead, forcing them into a system, not unlike the Socialized healthcare systems of many countries, that affords the patient no choice in the quality of their care, and nowhere to redress problems when the system fails.That face you make when you’ve killed more veterans than the Iraqi Army.Now, given that the second most expensive department in the US government is a dystopian clusterf***, so much so that veterans themselves won't use it... you really think that the compassionate thing to do is make that the standard for everyone? If we can't manage a few million people for health problems over a minor portion of their life, how can we possibly manage all health problems for all 320 million in a manner that even slightly resembles humane? You want to know why I think that socialized universal healthcare is horrible? Because I’m a veteran, and the guy who is selling it to millions of people who don’t know better is the same guy who drove that department into the ground. Think about that the next time you start talking about how universal healthcare will solve all people’s problems.Beyond that, let’s make another Conservative argument for why this form of care isn’t just bad but represents an actual threat to our freedom and liberty.If the government does take control of the entire medical industry, as in, they pay for everything and insurance isn’t involved at all, that will do several things. First, costs will go down, at least, the costs of the goods themselves will. Overall, we might see the overall expenses grow as we did with the VA, where costs are reduced by implementing a massive bureaucracy to fight it… a bureaucracy which itself, costs a lot of money. However, the actual costs of the healthcare will go down. Unlike an insurance based system, a government mandated system is incentivized to keep costs down.If we look to other countries, they can do this in different ways. The first is that they could go the route of other countries who have looked at the logistics of providing care. Seeing that the majority of a person’s medical expenses happen in the last years of life, some countries have begun the practice of creating boards which determine if a person does or does not rate healthcare, deciding that a new hip on an 80 year old woman is simply not a cost that the state is willing to front. This is true across the board where healthcare we assume to actually be universal, is really board mandated and suffering a stark decline in quality of service.Say that they don’t have the “death panels” as they’ve been called by others. Say instead that they opt to “take care of you” before you incur costs to the government, from the start.Most deaths in the United States aren’t caused by cancer, or by guns, or by car crashes. Most of the deaths in the country are related to heart disease. I’m just going to be clear… we’re fat and it’s killing us. We know it. Moving on. With that fact well known, the government has an obvious solution to the problem of paying for healthcare for all the fatties… force people to be thinner. Knowing that the cost savings could be in the trillions, would anyone be surprised to see the FDA suddenly start issuing out thousands of new governmental food control mandates, limiting what foods we can and cannot eat.“That’s so great! Now everyone can eat like they are at Whole Foods!”Yeah, there’re problems with this. Not only have we suffered a reduction in the quality of our healthcare, but now to provide service, the government is taking authoritarian steps in other directions to fulfill the obligations it made when it agreed to tax us out the wazoo for healthcare services. Now the government is in your fridge and in your pantry, severely limiting the choices you are allowed to make in the food you eat.“All is well that ends well, though.”Maybe, until you think about why people don’t shop at Whole Foods now. You ever heard that joke about them?A woman walks up to the counter at Whole Foods. The she realizes that she will be $20 short with the money she brought. She asks the clerk to take back two apples and a grape. The end.Nutritious food comes at a premium. The reason we’re fat is one of those unintended consequences of a something no one would have thought to blame — World War II. To fight the war, the United States embraced the philosophy of “An Army marches on it’s stomachs”. We learned how to send off our fighting men with an unprecedented amount of food and supplies. To do that, we pioneered technologies like refrigeration on ships, and processed foods to get more calories to the boys at the front, even when it was packaged in a factory on the other side of the planet. Spin that same technology forward 70 years and you have a country where the greatest calories per dollar spent is in the cellophane wrapped candy aisle next to the potato chips. Sure, you can eat healthy in America, but you either have to spend a great amount of money or a great amount of time to do it. For most people struggling to get by, fatty and unhealthy foods are simply the cheapest and easiest thing that they can afford. Simply, we are a nation where technology has made calories so abundant that being thin isn’t a sign of starvation, but of wealth. Damn Nazis.So one of those unintended consequences of a government suddenly deciding to cut its costs on healthcare is by limiting the ability of millions of people to buy the only food they afford in the quantities necessary to feed their family. That’s right, there are a lot of people out there who can’t afford Whole Foods, so taking away from them foods that aren’t good would be no different than placing a poverty tax on their lifestyle, pushing them deeper into a state of not being able to afford getting out of poverty. Given that they may also be paying upwards of 50% in taxes already by that point, Conservative economists would likely argue that these people have an insurmountable obstacle to joining the middle class… hunger. In the worst case, we may see millions of tons of food rotting in the dumps as millions of others die of an artificial famine in the wealthiest nation in history.Why the hyperbolic doomsday scenario? It is to make it clear that when you give the government authority to govern one aspect of your life, they will eventually make the rational choices that are direct consequences of the new responsibilities they’ve been given. The government will always do what is best for the government and people need to remember that when they turn over their rights of choice for something “free”."But those other countries!" You say. “There are so many countries that have universal healthcare and are happy! Why then can’t we do it that way?”There are only a few places that can make this work, and you're going to have to honestly look at why. Of course, we could have talked about Venezuela, but we’ll stick to the examples of countries that seem fine for now. Let's begin by talking about places like Sweden and Canada. They both have a few traits in common.First, an aging population that is still working.Above is a population pyramid for Canada, oft cited for its ability to deliver free health care. It shows that presently, most Canadians are at the height of their income earning potential and able to be taxed for maximum returns. Very soon, that will no longer be the case. The baby boomers will be entering retirement at phenomenal rates and living off fixed incomes. When they do, they will be taking with them massive amounts of money saved in retirement savings. Such funds are used by banks to invest back into companies and as a necessary prop for the economy. This means that economies like Canada and the aging Europe are going to suffer once they are no longer depositing into their retirement funds, but withdrawing. At that point their medical care will also skyrocket, even at the reduced rates we've talked about earlier... because they'll be old. This will be compounded by the fact that fewer young people are going to be available and working to share the overwhelming burden of their parents and grandparents' "free" healthcare. These young people literally have to be able to pay for not just their needs through taxes, but also about 1.5 retirees apiece. That would be like saying that you have the first $9,000 of your taxes every year, go to nothing else but two other people’s healthcare, as well as your own. This is before any of the Canadians’ other needs, such as infrastructure, military, or education. This is what happens when successive generations only have one kid and call it a day.Clearly, not everyone will be able to contribute their “fair share” of the bill. It’s going to require that a few of this new generation of kids become very wealthy so that their taxes can cover everyone else’s needs. As for that kid looking at a future where he is working to pay off his grandparent's generation? Are you aware of the phenomenon of capital flight?Taxing the rich for the simple reason that they are rich comes off as an attack, which it is. For that reason, the rich will defend themselves by whatever means they have available, most notably, through means such as Capital flight. Capital flight is when the rich simply leave a stigmatizing wealth environment that overtaxes them, depriving that environment of the top tax base. It doesn’t matter what your opinion is on if they are being overtaxed, but what their perception is on the matter as they are the ones with the wealth and the mobility, and their perception determines the reality of the system. This shifts a much larger burden down on the next tier of the tax base, who also move, perpetuating the cycle downward until we reach a point where the richest people are still being taxed, now overwhelming so, but these are the people who, in fact, are just the richest of those too poor to leave. In this situation, the wealth producing class has fled, and there is no one rich enough to provide the social welfare support for the lower class. Thus the system collapses.Expect many of those young people to flee these countries for places that allow them to keep their wealth. If enough do, the entire system will collapse.But it does work fine for now.The next thing that makes other countries different from the US is the extremely high wealth per capita. Are you aware of how much oil there is just off the coasts of the Scandinavian countries? There is so much money around that the people of those nations are living in a world that is completely unrecognizable to the rest of us. Compare this also with the fact that the population of Sweden isn't measured in the hundreds of millions, but is comparable to the population of Ohio. Canada actually has fewer people than California. So their problems are marginalized by how much wealth the country has to spread around such a small population.This is compounded with the disturbing reality that, if we really want to look at the success of these countries, we can see a disturbingly good argument that supports arguments for multiculturalism’s failings.“Gasp! Multiculturalism could be a bad thing?! That’s Racis…”Yes, look at the realities of it.The United States has around the same level of income per capita as many of these nations. Forget Switzerland. But our riches are spread among a vast array of income and wealth levels. We have millions upon millions who aren’t able to contribute the vast amount of taxes necessary. That’s because we are different, in every imaginable way, the US is different from other countries, mostly because the US is diverse beyond imagination. This matters because other countries are successful, in part, because they have almost no diversity at all.. We are comparing countries that serve as an example of how well people get along in the egalitarian dream, but they are countries with virtually no population diversity. Looking at various cultures across Europe shows you one thing they have in common… everything.The vast majority of people in most of these countries have the same ethnicity, the same religion, the same cultural background, and the same history, most are of the socioeconomic class, have the same education levels. Considering that countries are also incredibly small, Sweden for example having a population more comparable with the US state of Georgia than to the United States itself… half the people are probably related. For this reason, most have the same values, as they face the world from mostly the same viewpoint. They don't have the massive cultural burden of the US, where we are constantly told we have a diversity problem. They don’t have a problem with Mexican integration, a population that is more than 5 and a half times larger than the entire population of Sweden. They don't have the history of slavery we do, blacks in the United States numbering nearly four times the total number of Swedes in Sweden. They also don't have the Indian Wars, namely because all the other ancient people of Scandinavia were wiped out, long ago. Likewise, they don't have the massive history of immigration from across the world that the US has always had. Simply, they are truly one people with no diversity whatsoever to deal with, at least not on the scale of the US. That's not totally true. Sweden has recently brought in a sudden influx of new people to ease the burden of their aging population... I mean, because they are such nice people. Without going too deep into that discussion, it isn't really working out so well for them.Compare this to the United States where since 2000, legal immigrants to the United States number approximately 1,000,000 per year, of whom about 600,000 are Change of Status who already are in the U.S. Legal immigrants. Meaning that at least 400,000 enter the country on average, every single year legally.Here’s the thing, none of this is a criticism of Sweden, or really any other nation that I could have chosen. Canada, Norway, the UK, Finland, Switzerland, Germany… the United States’ “diversity problem” pales in comparison to the nations that have almost no diversity to speak of, no pun intended. They are just different from us, but their lack of diversity and small populations makes certain things far easier for them to do than us — share.All that said, this monolithic challenge that the United States has uniquely matters. It is a massive factor of why we can’t give to everyone because we have monumental differences in our culture. These differences translate into differences in cultural education levels, income earnings, societal integrations, work ethic, wealth accumulation behaviors, crime levels, and even language barriers. Again, this is not a criticism of European countries. It’s just an acknowledgement that we are different, and that they have it easier, so drawing the comparison of one nation to another isn’t appropriate unless we try to force the sort of cultural uniformity within our nation that they came by naturally.So no, it isn't like we are making an argument for white supremacy, here, but we Americans who argue for Universal Healthcare because other nations provide it need to really start looking at the realistic costs of all our diversity compared to those who don't have it and acknowledge that we have challenges other countries don’t.Finally, and this the big one, it's really easy to provide for some things when you don't have to provide for others.People complain about the high costs of the American military. They assume that if we gut the military, particularly the Navy, then we could afford all of the nice things everyone else gets to have. The problem is that our military, in particular the Navy, is why they all have nice things. Even more so, it ensures everyone has nice things. The US military ensures the security of the global trade networks that make your iPhone, the gas in your car, and even your car itself and the thousands of products that go into producing it possible. By removing bad actors who would disrupt global markets, including dictatorial regimes and piracy, we make it possible for the world we live in to work.History has shown that the world prospers when there is one predominant military power to force cooperation between various groups that would otherwise be unproductively competing. We can see this in the first empire that brought under the control of a single city state a territory that created large amounts of tin, and another that created large amounts of copper — thus starting the Bronze Age. From there, we saw the Delian League, where Athens used their powerful navy to facilitate peace, trade, and cultural exchange throughout the Aegean. Following these, the Pax Romana, the Pax Sinica, Pax Mongolia, Pax Islamica, and even the Pax Britannica, which the United States was part of.Now, imagine the world without the US Navy.We’ve had no major wars involving the Navy in over 70 years. A main reason for that is that the US Navy exists in such an overwhelmingly powerful and global way that they serve as a deterrent to other nations attempting to field a similar force for the purposes of challenging us. Peace through superior firepower. But say we didn’t have it, and the seas were open to whoever would want it. A few things would happen.The first thing China would do would be to secure the South China Sea. This would mean that it would control all trade from the Indian Ocean to the Pacific, effectively closing off the Middle East and East Africa to trade in that direction unless at the will of the Chinese Communist Party. Australia would be isolated from world markets, forced to deal exclusively with China. Japan would become far more aggressive. They serve as a natural defense to Chinese access to the Pacific, but likewise, China serves as a barrier to trade with the rest of Asia. The two would force a dangerous balance where the entire region, and billions of people, would be under constant threat of economic collapse. Everything from Korea would be no longer available. Most of the Scandinavian countries as well as Germany would be under the influence of Russia, while France and England attempt to maintain trade relationships with each other and their partners. Meanwhile smaller trade regions would form across the world. These bubbles will be regions where goods will be difficult to flow in and out of, bringing the global market boom of international goods flowing from one continent to another, constantly improving as raw materials become parts, that become parts of bigger parts, that are then manufactured into finished goods, which are sold in wealthy nations — to a grinding halt. Let’s say that no one ever fires a single shot, but our entire ability to have a global ecosystem will collapse once enough regional powers stop playing by an international system of cooperation.Want to know more? Hegemonic stability theory.HST suggests that that the international system is more likely to remain stable when a single state is the dominant world power. This doesn’t mean an empire that controls others through military force and authoritarian edicts, but one who is influential enough that it’s choices limit the choices of other nations, such as to trade or go to war. In this way, the United States is able to influence other nations to act cooperatively. The big negotiating chip here is the military, which doesn’t even have to be a bully. The fact that all these nations know the US will prevent bad actors means they are more willing to build international trade relationships, knowing those investments will last. In doing so, nations which would have never come to the table before, are trading indirectly with one another in a process that lowers the cost of goods sold on all goods purchased, as it increases the wealth and standard of living for everyone who takes part. That benefits literally the entire planet.But the US is the only one paying for it. Everyone benefits, only one nation pays. This is particularly egregious when the alliances we have built don't contribute their fair share to creating and maintaining that global security. The following is a graph showing the contribution of major nations within NATO to their military, a necessary expenditure if the term “alliance” is to mean anything.Greece and Estonia are doing a great job, as the NATO obligation is 2% of GDP, but in real terms they don’t amount to much. Factoring in for real terms, the only nation in Europe doing anything to provide for European security is the UK. France regularly fails to meet their requirements, and the rest of NATO is barely trying. They have allowed their own militaries to fall behind to the point that most of their nations are indefensible if left alone. They seem to be acting as if allowing American bases in their nations fulfills the obligation they signed as part of the treaty to prevent Soviet incursion, a torch the Soviets have clearly passed on to new threats.Ignoring the costs of security, there is also the cost of diplomacy, i.e. the UN — the chief facilitator of global diplomacy and stability. With that, the United States pays 22% of the UN’s final budget and more than 28% of the peacekeeping budget (approximately $2.402 billion). It’s important to know that 22% is actually the cap of how much one nation can give to the UN. Meanwhile, the United States is shamed for not giving enough or being more supportive of the UN, but when we consider that an organization which regularly votes against our interests is almost completely reliant on us for its existence, I’m really not concerned about the world’s opinion of us.So the utopias often mentioned regularly underfund both militarily and diplomatically the global system, but reap mightily the benefits of a globally integrated economy that is more than willing to buy their goods and services. They receive so much, yet contribute so little to the common good of the international marketplace that allows them to be so generous with their own people. We could have a more democratic and diplomatic system, perhaps a lot less terrorism, fewer and shorter wars, and prevent the strong arming of despotic rulers, such as Russia, but the US is literally the only one who regularly pays its fair share toward all the institutions that make those things possible.Why do they do this? Because they know that whatever mess they find themselves in, the United States will always be there to take care of reestablishing order if the global system is truly at risk. If Canada, Sweden, Germany, or any number of other nations were to face some great military threat, we would be there. We are always there. And they know it. So they take advantage of that fact that the US will be their safety net. So they don't provide their own safety net, instead giving to their people. From a cost benefit analysis, the choice is clear, we can contribute nothing to our security, and be free to provide all the healthcare we need.Why does the United States do it? Because the US knows that they grow wealthy from the global economy too, and that that wealth greatly offsets the costs of our military. So it’s an investment, but given that everyone is catching up, and it is creating a natural egalitarianism through global capitalism, eventually the United States isn’t going to be able to compete militarily, and will be forced to withdraw.All that to say, the utopias are able to provide all of these services to their people only while the economy makes it possible, and only so long as they aren’t forced to fund their own military to keep it that way. Remove any of these two factors, and much more austere measures are going to replace what many have grown to accept as “rights”.This returns to the point that the United States has a far different set of problems than the rest of the world that is capable of offering these benefits to others. It can't work for the United States because if the United States were to pull out of our military obligations, then everyone else along with the US would collapse. The US can manage independently in a reduced capacity, but the rest of the world would absolutely suffer. First to go? All the services they now offer as “rights”. You start to realize a right isn’t a right anymore when things change. As for the US today and now, we cannot afford to provide for both the quality of life allowance for our people that other nations do for theirs, while also ensuring they remain wealthy and prosperous through obligations they regularly fail to fulfill.So you ask why, if other places can give free healthcare, why can't the US?Other places don't have to fund the development of their healthcare. They just use ours.Other places don't use insurance to pay for their costs. We forgot you can even do that.Other places lack the population dynamics we do, so it is far easier to share with other rich people who are exactly like they are.Other places can give to their people generously, because they don't meet their obligations in other ways. They are free riders in the global economy, and can afford to give where the one nation paying for the system, can't.The simple answer is that we can't do what they do because we aren't them. We are the people who make their lives of wealth and prosperity possible, even when we lack it ourselves.And to answer the broader question why we the Conservatives are against Universal Healthcare? In theory, we aren’t. We like our people to have nice things. We think that the current system is completely screwed up, but there are realities that prevent us from being able to do much about that. Next, almost all the plans that are out there suck — whether we are talking about single payer insurance or true socialized healthcare, they all suck. The only time they don’t suck is when the heavy lifting of developing medicines and technologies, as well as paying for other services vital to the nation’s interests, are paid for by someone else. America doesn’t have someone else. We are the someone else. People compare the United States to places that aren’t the United States, that don’t have the United States’ problems, or worse, profit off the United States while not contributing to why they can give so much.And American Progressives simply advocating for change for the sake of change, Conservatives feel, is even more stupid than the system we have. Conservatives want Americans to all have good lives, but there are no plans that have been brought forward yet, even including the Republicans’ plan, that doesn’t suck when all the factors come into play that matter. Frankly, those of you who say we just want the poor to die need to remember that the majority of us don’t live charmed lives, myself included. Painting us as evil doesn’t help anything. It’s just a nasty way of lying to people who don’t know better to get them to vote for you, and it needs to stop. Simply, nothing makes sense right now, given the options that have been brought forward.And that really sucks.***Thank you for reading. If you liked this answer, please upvote and follow The War Elephant. If you want to help me make more content like this, please visit my Patreon Support Page to learn how. All donations greatly appreciated!

The people of Eastern Europe (and much of Western European working class) oppose mass immigration because they do not want their culture altered by those from premodern societies, nor do they want to create societal division that never existed in their societies (beyond arguably Jews, and that didn’t work out too well), and nor do they want competition for scarce jobs in these relatively impoverished countries.Besides that, having a smaller population isn’t necessarily a bad thing; the world is overpopulating anyway and medical technology is rapidly advancing to take care of the older generations.But what about kebabs? What about learning about other cultures? It’s just a cultural change.Cultures constantly change when exposed to new ideas. Eastern European countries can go visit Pakistan or Turkey, or even look online for recipes, if they want kebabs. The same way tea (brought from China and India) and fish and chips (brought by Sephardic Jews) reached England, foreign foods can reach other countries. This is just called international exchange of ideas. There is nothing wrong with it. However, multiculturalism, which is when a society not only appropriates elements of other cultures but when other cultures coexist in the same cities and towns, just creates division. Look beyond the new foods and whatnot and you see gangs, ghettos and resentment.[1][2](I could cite more, I really don’t think I need to make citations for the existence of predominantly-foreign communities in Western Europe). There’s a reason why European middle class are the ones pushing immigration, and the working class are turning to populism (which literally means people’s movements; I see no reason why populism is inherently a bad thing). The upper middle class doesn’t receive any of the negative effects of immigration. The poor does. And it isn’t inevitable.But don’t the old people need to be taken care of? Doesn’t Europe face a population crisis?Considering as how a) young people in these countries are going to college more, b) there are ways to encourage natalism (France has brought up their birth rates through economic incentives, for example) and c) much of the low-skilled jobs in the health and service sectors are being automated, immigration is not necessary. I agree that these countries have issues with birth rates. There are better ways of solving that by shipping in millions of people to permanently change their culture without nearly enough time to integrate them (and no, you could not solve this by slowly allowing in immigrants; there wouldn’t be enough to make up for birth rates that are less that 1.5 per family without a massive demographic shift within a generation). This has lead to the ghettoization that you see in Sweden, France, Germany and Britain.But most terrorists and gangs are second generation.There isn’t going to be a second generation that needs to integrate if there is no first generation. Yes, many countries have had immigration for decades and are only now realizing the problems, and they obviously cannot deport their own citizens; they must integrate them. But for countries like Slovakia that literally have zero mosques, integrating the second generation of disaffected criminals is a solution to a problem that doesn’t need to exist.But they improve the economy…Define “improve the economy.” There are obviously immigrant entrepreneurs and investors, but the practical effect of increasing the labor market is a decrease in wages and less jobs per person. Now, this might not be the case in countries like Canada that are having a plurality of their immigration from people who get degrees. [3][4][5]However, immigrants from Africa and the Middle East in Europe simply are not as high-income, and are far more likely to be job competition, not job creators. Even if these countries have low birth rates (and thus plenty of jobs to go around), there is literally zero reason why having employment be a given is a bad thing.But they’re just taking jobs that nobody else wants to do.But they aren’t. In 2011, in Britain, just as an example, the most common fields for Pakistani and Bangladeshi immigrants was food service and motor vehicle repairs.[6] In Sweden, while I could not find as precise statistics, if we were to (incorrectly) assume that everyone working in construction, along with 90% in the “other” (real estate and business services; public administration, defense and mandatory national insurance; electricity, gas, and water supply; agriculture, hunting, forestry, fishing, and mining; other community, social and personal service; transport, storage, and communication; wholesale, retail trade, and repair; household activities; financial activities; and territorial organizations and foreign embassies) section, the majority of the immigrants are either employed in health, manufacturing or hotels and restaurants.[7]Thinking that most immigrants (especially not the immigrants that come from EU countries; Eastern Europe already has an open border with them) are working in jobs that the natives don’t want is fallaciously applying an arguably true statement about America’s immigration crisis and tacking it on Europe.But *insert posh London accent* nobody is entitled to a job.Yes, they are. That is literally the purpose of an economy, to materially improve the quality of life for its inhabitants. The only way to do that in the current system to not be poor is to have a job. Adding job competition is not good for the natives, which is why they, as citizens, do not approve of the way the EU is handling immigration.[8]But isn’t this just dividing and distracting the working class?No, what is dividing the working class is immigration, not the fact that they don’t like immigration. And as for the notion that the right is just using the issue to make their economic agenda palatable, let me ask: why not support left-wing economics and closed borders? That way, the left could be palatable too.Stop being xenophobic and racist…I don’t fear foreigners, a small amount of immigration is okay (so long as the immigrants fully assimilate) and I don’t believe in any sort of genetic supremacy of Eastern Europeans. In addition, I would not expect Africa and the Middle East to accept millions of Europeans who don’t want to assimilate; they have the right to their borders too.You’re an American, why do you feel entitled to speak about Europe?Ad-hominem argument. I explore international issues, and I speak my mind. You can do the same about my country. Criticize America as much as you like, I’m not offended.But don’t the immigrants deserve a better life? Why don’t you care about brown people? Why can’t they come?If the question was, “Should Eastern European countries go to the third world and give African farmers tractors and infrastructure and petition the EU not to go into pointless wars”, I would wholeheartedly say yes (at least for the less-impoverished Eastern European nations). But that’s not what the question is. Immigration isn’t exactly curing third-world poverty; the vast, vast majority of impoverished third-worlders are still stuck in their home countries. If you actually cared about brown people, you would want to actually give their nations some capital, not export a small fraction to Europe at the expense of the working class.And furthermore, immigration is not a right. These countries are democracies, and have what the thinkers of the Enlightenment termed the social contract. This means that their governments exist as contracts between the citizens and the state, where the state rules over a parcel of land, and is supposed to act with the consent of the governed to defend the rights of the governed. If the governed do not want immigration, and the state forces it on them, the state is acting, in the terms of John Locke, tyrannical.The people of Eastern Europe (as shown by statistics earlier, I’m not talking out of my ass) do not support having their societies divided, their jobs taken and their cities suffering monthly terrorist attacks. They see what’s happened to Western Europe, they don’t want it there. And considering as how in the span of less than three years, Germany, France and much of Scandinavia have gone from shipping in millions to closing their borders, I don’t think it’s any sort of surprise that Eastern Europeans don’t want a similar crisis.Footnotes[1] What is going wrong in France's prisons?[2] Violent crime rises in Germany and is attributed to refugees[3] Immigration to Canada - Wikipedia[4] Filipino community in Toronto - Wikipedia[5] South Asian Canadians in the Greater Toronto Area - Wikipedia[6] Office for National Statistics[7] Catching Up: The Labor Market Outcomes of New Immigrants in Sweden[8] European opinions of the refugee crisis in 5 charts