Matthew, while you want to treat the provision of health care services as uniquely different from other services, it is not. The vast majority of human labor is compensated based on time and not on a knowable outcome and always has been. If I run a fast food restaurant and hire a short order cook do I pay him per burger fried or per hour without knowing exactly how many burgers he will cook per hour? The fact that an entrepreneur is willing to take the “risk” that not enough people order burgers to compensate the cook is simply capitalism.

If you go to a lawyer to have a will prepared, you pay for the will… whether it is legal or not is not known until the will is executed and rarely does anyone get a refund if the will is not executable. What if the law changes between when the will was written and a person dies, then what was the value of the will, how can its true value be determined until some far distant time in the future. Is the will I paid for 1988 worth anything today (the answer is no)… should I get refund (the answer is they won’t give one). They got paid for the time they spent preparing it and as long as they put in a professional level of effort, I have no recourse. Ditto, health care…

That you want to socialize the “cost” of health care simply means you want to take money away from someone to fund the health care of someone else. It gets no more complicated than that. Don’t try to rationalize.

You argue that it is in the interest of society to keep people healthy so they can work. I don’t disagree with that. I believe those that do not earn enough working full time to pay for health care should get health care (the rest of us should subsidize it). But that is a personal value I hold, not an inherent right. I don’t believe, that someone who could work full time but chooses not to, should get the same benefit (again a personal value).

Interestingly, modern day socialists have forgotten the basic premise of socialism:” From each according to their ability, to each according to their needs”. Unlike capitalism which pays people according to their value, socialism puts in an additional “social” contract that promises people that work according to their ability (not what they choose to do), that their basic needs will be met. There is no implied “right” to health care or any other service to people that choose not to work, since they are not contributing according to their ability.

So whether a society is socialistic or capitalistic there is an inherent assumption that people must work to provide for their needs, the difference is how much will others make up the shortfall when you can’t provide for your needs working full time. In essence, socialism goes beyond the “living wage” idea and leans toward the universal basic income concept for someone working full time or if disabled doing what they can. The constant them in both socialism and capitalism is the inherent requirement of work.

Now progressives make the assumption that a society that is “rich” will always be rich and that its wealth is not a function of the “work” people put out to make it “rich”. So they begin to create “societal contracts” of “entitlements” that mandate a “sharing of the wealth” without regard to “work”.

This pushes the boundary from what was previously the shared idea that we all “pitch in” to help those in need (a shared sense of “kinship”) towards “people can expect society to care for them, regardless of whether they could support themselves if they chose to”. In essence it moves the goal line from help those that need help to providing those the financial independence to seek “self actualization” without consideration of whether they are contributing to society as a whole or whether such a structure will ultimately lead to the impoverishment of society as a whole. I do not think America is at this point.