Reply #133: That Is A Very Tired Wheeze, Sir, And Will Impress No One

[The Magistrate]

Essentially, it is simply a confession on your part you are begging the question, assuming as proved already what you are setting out to prove. Your simply stating a thing is true prior to another's comment on it does not entitle you to claim a burden of proof falls on subsequent commentators; seniority in order of comment does not entail any presumption of truth. Nor is it in any way an extraordinary claim to say that the arrangements of a city-state cannot readily be translated to the arrangements of a continental power; indeed, that has been well appreciated throughout political history, and particularly marked in discussions of democracy and taxation. Your 'example', above, falls of the weight of its ignoring much larger political units, within the same general cultural pool and historical stream, in which the measure mentioned obtains, and does so successfully.

In your promotion of Singapore, you over-look a number of factors. One is that its 'healthy life expectancy', the measure of the expected number of years to be lived without reduced functioning due to illness or disability, is lower than that of European countries. Another is that the proportion of elderly persons among its population is markedly lower than in European countries, as well as the United States and Japan; the increase in population of the place, rising with its prosperity, is recent, and so its population mix still approximates more that of the developing rather than the developed world. Taken together with other factors already mentioned, this suggests that the city-state's medical system has yet to be truly tested, and it remains to be seen how well it will cope with an aging population, such as is encountered in large Western countries. By far the largest portion of medical billings are generated in the last few months of life, and are concentrated on the elderly. In Singapore, individuals pay roughly two-thirds of medical expenditures, a higher proportion than even in the United States, and this is workable only in a polity with a reasonably even distribution of income, which certainly does not obtain in the United States. A further factor is the large population of 'guest workers' imported into Singapore, who work very cheaply at a number of tasks, including basic nursing aide care, and who do not appear in the city-state's health statistics, which relate only to its citizens, and do not seem to be covered by its health care structures. This introduces a considerable fudge-factor into both costs and claimed outcomes for the system. If one simply excluded the lower fifth of the population in the United States from its health care statistics, these would improve drastically in terms of life expectancy, disease outcomes, etc.