Health Care, Why Call it a 'Right'?

After fifty years of growing government programs, health care costs continue to rise. The U.S. government now controls nearly half of all health care dollars, and the crisis is becoming acute. The plans we are seeing from Washington are not innovations, but rather extensions of the government interventions we have embraced for three generations.

But rather than assume that more government involvement is the answer, should we not at least consider that the source of the problem may be those very interventions? And, more deeply, should we not even consider that the reason for this decades-long pattern is not economic, but moral: the idea that people have a "right" to medical care?

Historically, the huge rise in health care costs began in the 1960s, when Medicare and other programs threw billions of dollars into the industry. Fiscally, Medicare is approaching monumental insolvency, with liabilities in the range of twenty-trillion dollars. To create another bureaucratic labyrinth now -- which advocates are proud to say will cost only a trillion dollars over ten years -- all but guarantees higher prices, and a greater crisis in the next decade.

But such economic arguments have not stopped the train to further government interventions, and we should ask why.

The reason is that advocates of government medicine are upholding health care as a moral right. The moral goal of a "right" to health care is blinding people to the cause and effect relationship between government actions and rising prices.

But the very idea that health care -- or any good provided by others -- is a "right" is a contradiction. The rights enshrined in the Declaration of Independence were to life, liberty, and the pursuit of happiness. Each of these is a right to act, not a right to things. "To secure these rights governments are instituted," which means to secure the rights of each person to exercise his or her liberty in pursuit of his or her own happiness.

By this understanding of rights, no one may force you to act in ways contrary to your own interests, as long as you do not demand that they act contrary to their own interests. There is no right to a good outcome -- no right to food, clothing, shelter, or economic security -- only a right to pursue that outcome, with the voluntary cooperation of others if they wish to offer it.

But consider what a right to a guaranteed outcome would mean. It would require an infringement upon the lives and liberty of those who are forced to provide it. If there is a right to food, there must be farmers to provide it -- or taxpayers forced to pay for it. Government medical plans with unique privileges, such as Medicare, institutionalize force against those who are to provide the claimed "right." And yet, neither the principle nor the consequences are changed if the force is spread out over millions of people in the form of a tax return.

These two concepts of rights -- rights as the right to liberty, versus rights as the rights to things -- cannot coexist in the same respect at the same time. If I claim that my right to life means my right to medicine, then I am demanding the right to force others to produce the values that I need. This ends up being a negation of personal sovereignty, and of individual rights.

To reform our health care industry we should challenge the premises that invited government intervention in the first place. The moral premise is that medical care is a right. It is not. There was no "right" to such care before doctors, hospitals, and pharmaceutical companies produced it. There is no "right" to anything that others must produce, because no one may claim a "right" to force others to provide it. Health care is a service, and we all depend upon thinking professionals for it. To place doctors under hamstringing bureaucratic control is to invite poor results.

The economic premise is that the government can create prosperity by redistributing the wealth of its citizens. This is the road to bankruptcy, not universal prosperity. The truth of this is playing out before our eyes, as medical prices balloon with every new intervention, and we face the largest deficits in human history.

If Congress wants to address health care issues, it can begin with three things: (1) tort reform, to free medical specialists from annual insurance costs of hundreds of thousands of dollars; (2) Medicare reform, to face squarely the program's insolvency; and (3) regulatory reform, to roll-back the onerous rules that force doctors, hospitals and pharmaceutical companies (who produce the care that others then demand as a "right") into satisfying bureaucratic dictates rather than bringing value to their patients.

Comments

[Amo Probos]

Excellent article. Kudos to the Huffington Post; All of this obligatory talk from the majority of media outlets is killing me.

[mdohle]

I just want to thank the Huffington Post for presenting an intelligent and well reasoned article opposing the right to health care. I am sure to frequent your news more often seeing as how you are able to pick out and present the essentials of the real debate.

Congratulations to John Lewis for an excellent argument and congratulations to Huffington Post for recognizing it and facing it head on.

Mark Dohle

[iblogleft]

With all due respect Mr. Lewis, you are what has gone wrong with this country.

Yes, you and people like you. I will tell you why.

When I send my child to school, and he comes home sick because another parent failed to take their child to get medical attention and keep them from school, their problem just became my problem.

When a disease spreads throughout a city, it is a fact that it spreads much faster and farther than it should, because there is not reasonable access to effective, affordable health care.

On another note; It is this system of forced poverty that creates the environment that my children must grow up in. The ideology that everything under the sun is created for private profiteers to feast, is social suicide.

When a man commits a crime, not from insanity, nor greed, but to eat or feed a drug addiction, it becomes my problem. It is this complete free market ideology tht you so proudly represent that infringes on my right to pursue happiness, because people like you make it so expensive to hold a roof over your head and feed our children, give them electricity, and provide health care, that leaves many people in our society with nothing.

When people have nothing, they have nothing to lose. Then it becomes my problem.

[iblogleft]

Cont..

This righteous, self serving, profit at all cost society has bled dry the real patriotism in this country, the patriotism that calls for us to protect each other from the greed, hate, and ignorance that some would have us embrace, just to ensure we can place food on the table.

This line of thought you hold is a disease, and we must stop the spread. There is plenty of room in societies wants for the free-market, there is no need to make a killing on the needs.

[diver77]

The professor makes some great points in his last paragraph. Tort reform is very much needed. However, trial lawyers have one of the most powerful lobbies and politicians on both sides of the aisle are beholded to them. Medicare is nearly bankrupt; there is rampant fraud and waste.

Our federal government doesn't really run anything very well with the military being a notable exception/. You want to put the feds in charge of health care? Wake up! We have the best health care in the world. The system is broken, but some tweaking here and there would improve it.
We do not need a radical overhaul of the existing system. We need sensible reform.

[iblogleft]

I hear this argument all the time.

Running a business as non-profit (or a government system) is no different than any other business.
If they are run poorly, go after the management, not the system.

Our government systems are run poorly because we want it that way. We legislate it that way, simply to evolve a conversation into an area that will happily accept private profiteers to take over the system.

[pjburke]

Either the author is blowing so much convoluted smoke in order to sow confusion, or is thoroughly confused himself.

In any case, the piece makes a perfect case study of the fallacy of "post hoc, ergo propter hoc" ... that simply because B occurs after A, that therefore A caused B. T'ain't necessarily so.

[QuietLightTraveler]

This guy is lost in definitions. In the absence of a state we have "natural right" which basically is that we have a right to whatever our power allows us to take for ourselves. But we live in a civilized state, which has a government, so we give up our natural right. With a government, we then have a right to whatever rights are drafted into our government. And I don't believe we are prevented from allowing our government to give us the right to health care if we are taxed to pay for it.

[QuietLightTraveler]

This guy is chasing his tail with definitions of what is a "right" and not a "right". It matters for nothing in a real world. First, there are certain aspects of health care that involve ethics. You cant leave ethical issues to the corporate world because they basically have no ethics. Second, If health care is getting too expensive, it needs tight central control by a "non-profit" administrator. Granted, it's hard to get tight control by government but we have to try. The reason why all other countries have government run health care and we don't is because there is a level of corruption in our government that allows lawmakers to be bought by the capitalist market. Do you think we don't have government run health care because we are smarter than other governments ? No, that is simply not the case, although the opposite may be true.

[nz1m]

On the healthcare front, I find it interesting that "healthcare" and "insurance" are synonymous. How did that happen? You know how insurance works. We wager we'll have a car wreck. They wager we won't.

When did we ever have to wager we'd get sick and they take the bet? Everyone gets sick.

Everyone.

Seems like a lousy bet they took .... then they turned it into billions and billions for profit...

interesting...

Guess I should have had blue cross and keiser stock afterall... then I'd be be winning the bet every time I avoid going to a doctor...

[230AL]

mr lewis speaks of rights as composed by the founding fathers.those words they crafted have made this a much better world.however this is our world now .the immoral elitest have manipulated ,twisted it for personal profit.by his view we should undo all laws that infringe on those words,life,liberty and pursuit of happiness.you know Jefferson proposed we rewrite the constitution every 19 years. our consumer driven society is so different.we must participate in this world of consumerism jobs taxes.there is no off the grid believe me i've tried .the economy is "the company store"we must participate therefore there are in a contract in which the economy must hold its end of the bargain.employer provided health care is so similar to payroll taxes that employees wouldn't notice on their paychecks.it would just look like a different fica.

[hsr0601]

Good News !

A staff writer at The New Yorker and some experts have examined Medicare data from the successful hospitals of 10 regions, and they have found evidence that more effective, lower-cost care is possible.

Please be 'sure' to visit http://www.nytimes.com/2009/08/13/opinion/13gawande.html?hp for credible evidences !

Some have followed the Mayo model with salaried doctors employed, Other regions, too, have found ways to protect patients against the pursuit of revenues over patient.
And a cardiac surgeon of them said they had adopted electronic systems, examined the data and found that a shocking portion of tests were almost certainly unnecessary, possibly harmful.

According to analysis, their quality scores are well above average. Yet they spend more than $1,500 (16 percent) less per Medicare patient than the national average and have a slower real annual growth rate (3 percent versus 3.5 percent nationwide).

Surprisingly, 16 % of about $550 billion (the total of medicare cost per year) is around $88 billion per year, except for Medicaid (total cost of around $500 billion per year), medicare 'alone' can save $880 billion over the next decade.

In addition, under the reform package, along with the already allocated $583 billion, the wastes involving so called "doughnut hole" , the unnecessary subsidies for insurers, abuse, exorbitant costs by the tragic ER visits etc are weeded out, the concern over revenue might be a thing of the past.

[agentpolsky]

I like the almost religious fervor...

"Good News, true believers!"

[n4m]

cont'd
Our government already has this power under the Constitution.
In fact, the preamble makes it the duty of .our government to "promote the general welfare" of the citizens of this country.
The Constitution also delegates the power to Congress "to do whatever is 'necessary and proper' to carry out its enumerated powers and, crucially, all others vested in it.
In the first case to limit the federal government's powers to those specifically enumerated by the Constitution, specifically, the establishment of a national bank..." Marshall wrote that a Constitution listing all of Congress' powers "would partake of a prolixity of a legal code and could scarcely be embraced by the human mind." Since the Constitution could not possibly enumerate the "minor ingredients" of the powers of Congress, Marshall "deduced" that Congress had the authority to establish a bank from the "great outlines" of the general welfare, commerce and other clauses. Under this doctrine of the necessary and proper clause, Congress has sweepingly broad powers (known as implied powers) not explicitly enumerated in the Constitution."
We can end the discussion over whether or not Americans have the right to health care, be it public, private, or single payer, right now.
We have the right, and the power, to establish any system we want.
So, let's do it.

[agentpolsky]

Unfortunately, your interpretation of the Constitution is not supported, to my knowledge, by any court case. In other words, interpreting the words "promote the general welfare" as guaranteeing all citizens healthcare, or food, or clothing, or shelter, or anything else really, is a RADICAL interpretation of the Constitution. Obviously, you are free to have whatever interpretation you want. I don't think you'll find a judge (or many lawyers) who would back you up however.

[skippypicasso]

Then your 'knowledge' is sorely lacking or else Medicare would have been found unconstitutional. Unless you're reading a Consitution I haven't seen yet, there is nothing in the Constitution to prevent the creation of a Medicare that covers everyone.

[n4m]

The Constitution is at its essence, a guarantee.
guarantee-To undertake to do, accomplish, or ensure (something) for another: guarantees freedom of speech.

http://dictionary.reference.com/browse/guarantee

[montestruc]

The general welfare of all the people, not the specific welfare of some people. If you assure that Joe Blow gets health care, at the expense of his fellow citizens, the cost to his fellow citizens counts too, as does the cost to his fellow citizens of the loss of freedom of choice that the resources spent to give Joe Blow health care.

FYI - since the UK and Canada went on such programs the death rate in many illnesses that are treatable with high success rate has gone up a lot because government committees decide to save money.

Specific examples:

http://spectator.org/blog/2009/08/13/why-we-dont-want-government-ru

* Breast cancer kills 25 percent of its American victims. In Great Britain, the Vatican of single-payer medicine, breast cancer extinguishes 46 percent of its targets.

* Prostate cancer is fatal to 19 percent of its American patients. The National Center for Policy Analysis reports that it kills 57 percent of Britons it strikes.

* Organization for Economic Cooperation and Development data show that the U.K.'s 2005 heart-attack fatality rate was 19.5 percent higher than America's. This may correspond to angioplasties, which were only 21.3 percent as common there as here.

[skippypicasso]

First of all, here are the details on the "National Center for Policy Analysis" whose numbers you rely on and take as gospel: "The National Center for Policy Analysis (NCPA) is an American non-profit conservative think tank partially financed by the insurance industry. NCPA states that its goal is to develop and promote private alternatives to government regulation and control, solving problems by relying on the strength of the competitive, entrepreneurial private sector." Yeah, that's where I'd go first for statistics on health care outcomes.

How can the general welfare be promoted without promoting the welfare of individual members of the general population? If Joe Blow receives better health care than his fellow citizens and doesn't pay his taxes, then you have a right to complain that you are somehow losing something. Providing someone with resources does not automatically mean the resources are not available to you, just that Joe Blow's appointment was at 10:30 and you are scheduled for 10:00.

[n4m]

WilliamBradford
"The gun plan would actually be a much better argument, since the right to bear arms is actually in the Constitution, whereas you are reaching like mad to find a right to get medical care."
Before December 15, 1791 there was no 2nd amendment, no right to bear arms.
After December 15, 1791 the Constitution which said nothing about your right to bear arms, did.
Did they have to reach like mad to create this right?
No, they did not, and neither do we.
All that was required to make the possession of firearms a right, where once no such right existed, was the political will to do so.
It wouldn't even require an amendment for the federal government to create any one of the health care proposals, including single payer, right now.

[agentpolsky]

Well, actually you would have to 'reach like mad' to create this right -- to make it part of the Constitution, which is a pretty difficult process. Consider the Equal Rights Amendment. You'd have thought they could have passed that in the 70s with the U.S. at the height of its liberal fervor. Obviously to create a law that gives everyone healthcare, you'd only have to pass the law, not 'reach like mad,' but passing a law does NOT make something a fundamental right, or even simply a 'right.' The Courts have been wary of considering any entitlements fundamental "rights" in the sense we are using the word here. The most they have been willing to allow is that entitlements are 'property' for purposes of due process -- if they want to take away your welfare, you are at least guaranteed a hearing by the Constitution -- i.e. "due process." But the Court (the Supreme Court) has never really allowed such entitlements to be considered fundamental rights in the same way that say, something like political speech is considered a fundamental right. So really the argument is entirely in the theoretical realm anyway. Even IF they pass a healthcare reform, the issue of whether or not healthcare is a "right" will still be undecided.

[n4m]

I took WilliamBradford's use of :"reaching like mad" to mean that the establishment of health care as a right would be to add a right where once there wasn't one.
I disagree that the you have to reach like mad to amend the Constitution because the specific means to amend the document are in the document.
I agree it requires a lot of effort to do so.
However, there are rights not expressly contained in the Constitution, and yet they are completely constitutional. They are called unenumerated rights. No reach required.

[skippypicasso]

Part 7. (con't)

If Congress wants to address health care issues, it can begin with three things:
(1) incentives to encourage more doctors to enter primary care as opposed to currently more
lucrative specialties as well as a concentration of reliance on advanced practice nurses to provide the first level of patient care (2) to either force insurers to bid to cover all citizens or to re-establish equitable tax rates that will ensure the sustainability of Medicare programs, along with increased penalties for fraud and abuse in all systems; and (3) regulatory reform, to create rules that will force
health insurers (who produce absolutely nothing except bureaucratism and waste) to stop satisfying their own ceaseless internal dictates for profitable outcomes and start providing real value to their clients and care to those who most need it--or get out of the way while we the people do it ourselves.

[skippypicasso]

Part 6 (con't)

Health care is not a product, but the act of trying to make you well and restore your vital functioning.
Health care is a service, and we all depend upon thinking professionals for it. To continue to place doctors under the hamstringing bureaucratic control of the myriad of health plans and companies
with which they must deal has created the poor results that plague our current health care system and continue to drop its world ranking.

The economic premise is that the government has create prosperity
by redistributing the wealth of its citizens. This has proven to be the road from Maine to California and all points in between. The truth of this is playing out before our eyes, as medical prices balloon with every year the government fails to intervene, and we face the largest
deficits in human history due to our continuing disparate income and taxation system wherein the wealthiest continue to earn at an exponentionally greater rate than those at the bottom of the scale. (con't)

[skippypicasso]

Part 5 (con't)

The notion of rights includes the notion of the right to things (private property),
and the right to liberty and have coexisted for a couple hundred years. If
I assert that my rights are not limited to the three listed in the Declaration of Independence
as being 'among' my rights, then it is not unreasonable for us as a nation, through our representatives
to decide that we would be well within our right to demand access to health care (although not specific outcomes)
for all. This would be just as much a negation of personal sovereignty, and
of individual rights as the national armed forces or the funds that will be used to pay for your attorney
when you decide not to pay your taxes because you don't agree with how the money is spent.

To reform our health care industry we should challenge the premises
that invited expanded corporatism in the first place. The amoral premise
is that sickness without wellness is a right. It is not. There was a "right" to such care
from doctors before corporatism evolved to demolish our rights because a
doctor's oath compels him or her not to allow harm to come to you through
either action or inaction. (con't)

[skippypicasso]

Part 4. (con't)

at every level--to lend support to government mechanisms which support their rights and obligations to each other. In many localities, voters are asked yearly to raise their own taxes to provide services and
in an overwhelming majority of cases they do so.

Consider what a right--not to a guaranteed outcome--but to the means
for all to access our world-class health care system equally would mean.
It would not require an infringement upon anyone's lives and liberty. If there is a right
to food, there must be farmers to provide it -- or taxpayers forced to pay
for it as we do in the states with Food Stamps and WIC
programs. Corporate medical plans with basic equal treatment for all,
such as Medicare, do not exist. Since health insurance corporation can
choose to provide or deny care while setting any prices they choose,
there is no mechanism for the average worker to make his or her own
choices over competing plans. Without true competition, we have
socialized corporatism and forced the majority of health care dollars
to be spent in the pursuit of corporate profits. (con't)