[H]ealth care is not a right. Certainly not a right in the way our country has always defined rights, for if there is an obligation for other people to pay for it, it becomes not a right but a duty, to the government, by other people — duties to the government being the antithesis of rights.
Having lived in Japan for twelve years and had several friends who (unlike me) work in health care, I had a lot of lively discussions about the relative merits of socialized medicine. What always drove me crazy was when people talked as if the money for health care weren’t going to have to come from somewhere. There’s plenty of great health care available in Japan, but stories have surfaced recently about patients’ being turned away or dumped by hospitals, and about desperate Japanese who travel to China for organ transplants. One doesn’t want to be like the NYT Style Section and inflate every clutch of three colorful anecdotes into a Major Trend, but the aging society does mean that there will be fewer workers supporting more geriatric patients in short order. Everyone is worried.
Of course, that’s a practical, not philosophical, problem. Whittle writes,
Constitutional rights protect us from things: intimidation, illegal search and seizure, self-incrimination, and so on. The revolutionary idea of our Founding Fathers was that people had a God-given right to live as they saw fit. Our constitutional rights protect us from the power of government.
But these new so-called “rights” are about the government — who the Founders saw as the enemy — giving us things: food, health care, education… And when we have a right to be given stuff that previously we had to work for, then there is no reason — none — to go and work for them. The goody bag has no bottom, except bankruptcy and ruin.
And, of course, when the government is in charge of giving out goodies, it gets to set priorities and trade-offs for individuals. Is your need for a procedure “urgent”? What’s an acceptable minimum for “quality of life”? Would you prefer to buy less health coverage and more of something else you value more highly? What happens when functionaries start telling fat people they don’t deserve bypass surgery because they’ve spent their lives tunneling through five Entenmann’s cakes a week?
Not, I hasten to add, that the current American system is anywhere near perfect…but then, neither is it a free-market system. Former AIG executive (!) Jon Basil Utley wrote the following in Reason a few months ago:
So why isn’t all this being debated in the presidential campaign? For one, some of the richest and most powerful lobbies in Washington are run by the medical and pharmaceutical establishments. They don’t want a competitive system. Democrats do propose forcing everyone to “buy” high-cost insurance, while continuing with the current system, and then have taxpayers subsidize premiums for the poor. But they also oppose tort reform which would hurt their trial lawyer political allies. Many Republican congressmen, meanwhile, also benefit from the lobbies and don’t want to rock the boat. After eight years in power, they don’t want to take criticism for having made little reform.
Medical cost reform is just one of many areas where Washington is corrupt and paralyzed, in particular because of the gerrymandered power structure, whereby sitting congressmen are almost invulnerable to defeat. They then legally collect millions in “campaign contributions” from the lobbies. Reform will only come about if Americans become better informed, yet most of the media is ignorant about health costs. Reform depends also upon major corporations attacking the current system, such as Wal-Mart has started to do with its in-store clinics. But most companies are silent and afraid to tackle the medical power structure. The Chamber of Commerce and National Federation of Independent Businesses seem reluctant to challenge both the monopolies and the current system. Lessons from the experiences of other nations are certainly available, but most Americans are ignorant of them and still believe claims that “our system is the best.” It may be “best” for Medicare, some Medicaid recipients, congressmen, state and federal government employees, and the military, but then they already have “socialized” medicine; they just don’t pay most of the costs.
I’m not sure exactly what can be done about the current mess. Public policy that enshrines health care as a right does not seem like a great plan, though. It would further separate the health-care payments citizens make from the goods and services meted out, muffling useful price signals. And it would further insulate government officials controlling the goodies from competition, feedback, and new ideas. That always works out well, huh?