What the world will be like in a hundred years (1922)

You are at this point reliant on the charity (read: voluntary) of others. Even if you were identified and your insurance accepted, the paramedics or doctors can just refuse to do their jobs, for whatever reason, and face only professional consequences. You are in no way guaranteed to be treated.

Also, the insured could demand coverage for this case from their providers, with liability to their estate if they are not treated. This would force insurers to negotiate with hospitals to treat these patients rather than incur the liability.

> don't deserve to die

What do you mean "don't deserve?". If you're laying shot in the street, then clearly you're going to die soon without lots of outside intervention. This is your lot. Insurance isn't there to provide a guarantee of some outcome, it's there to reimburse as best it can after the fact.

> don't like the instability that comes from a lack of welfare state

Doing what "people like" isn't the same as being ethical.

> the best thing for me to do is to steal from someone

That depends on the risk/reward balance between stealing and figuring out how to be productive. If the punishment for robbery is severe, then chances are you'll figure out how to be useful to someone before resorting to it.

> Is coercion voluntary

Yes? If your grandmother offers you a cup of tea, insists, and will be offended if you don't take it, does that make it involuntary? She's clearly coercing you.

> why isn't it violent to withholding food they need to live

Everyone needs inputs to live, and everyone is born without the means to provide them for themselves. Therefore everyone must, at some point, enter into a negotiation with those who possess what they need. Absent any law and order, these negotiations often turn violent. All we've any right to do is make some rules around the negotiations, not prescribe universal cooperation.

The ROI here functionally never makes sense for the insurer to do this, unless clients are paying enough to offset the cost of paying all unidentified people.

> You are in no way guaranteed to be treated.

Are you saying that this is the case today, or that this is how it would be. Because I agree with you. Despite laws that require doctors to treat you that exist today (to prevent this exact scenario), no one ever holds a gun to anyone's head. There's no need for violence. Professional (and in general civil) consequences are enough to enforce this.

> She's clearly coercing you.

Coercion requires force or threat. From me shooting you is the same as the harm from me starving you, so the threat is the same. A grandmother being upset isn't a threat, and certainly not the same level of threat, not is it force. So perhaps let's ask a different question: is choice freely given when your life is threatened?

> Doing what "people like" isn't the same as being ethical.

Utilitarians would disagree with you.

The root problem with how you approach the world is that you see any government force as worse than all force by everyone else. Like given how your approach contacts, if I coerced you to sign yourself into slavery, that's acceptable, since it meets your definition of "strictly voluntary, at-will, consensual".

If you believe government is the worse bad and nothing else can be as bad, sure that's a viewpoint. But it fails when you have other powerful organizations that hold the same power over an individual as a government does.

Imagine for a moment another extreme example where the government has a total use of force monopoly, and I have a monopoly on the water supply. You say that is unethical for the government to act against me, and also unethical for individuals to act against me, no matter what. This is true even if I use that Monopoly to enslave people or commit genocide, because I'm doing it without violence, only coercion. If that's your ethics, something's broken.

And pragmatically it's also stupid: people will lose faith in a government that fails to protect them. So a government that fails to protect its citizenship effectively will quickly cease to exist (the people with guns will desert to protect their families and tada: a new government). So once you accept that democracy is ethically good (and really even if you don't), the ethics are irrelevant. Governments must keep people happy or they will quickly cease to exist. And I subscribe to the idea that the purpose of a system is what it does. Governments try to make their citizens happy. If they don't, they'll be replaced by one which does, because that's what the people want. Your job is then to convince me, and everyone else's that sacrificing my safety is worth a government that is in your view more ethical.

That's an understatement. Americans do well on PISA compared to their ethnic relatives.(https://www.unz.com/isteve/the-new-2018-pisa-school-test-sco...>) Asian Americans do better than Asians; whites do better than Europeans; Latinos do better than Latin Americans; and blacks do better than Africans.

As you note, Hispanics and especially blacks' scores drag the US average down. Both white and Asian Americans score higher than Canada (and white+Asian is essentially Canada's racial makeup), and higher than New Zealand, Australia, the Netherlands, Belgium, Germany, France, Norway, and the UK; Estonia is below US Asians but above white Americans. Norway is by far the wealthiest Nordic state but its average is only two points higher than the US national average, despite not having a demographic that is 13% of the population and scores 85 points below the white American average.