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March 19, 2008
Is health care a right?
Russell Roberts
Is health care a right? I have no idea. What I do know is that treating it like a right can be hazardous to our health. Here's my debate on the issue with a doctor who thinks health care is a right and the government should provide it.
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Comments
What do you mean you "have no idea"? You have an idea, you have an intuition, you have a inclination, you have something.
I get your point that you want to move beyond that question to talk about the practical aspects of a national health care system, the real tradeoffs that would have to be made, but I think you do have an idea.
Posted by: scott clark | Mar 19, 2008 12:08:45 PM
Individuals have a right to acquire health care via voluntary exchange. They do not have a right to acquire health care by enslaving others to the task of paying for it.
Posted by: Sam Grove | Mar 19, 2008 12:28:04 PM
Even if we begin to consider health care as a basic right, why is the government responsible in supplying us with this right?
I think you are correct in respect to the fact that with the introduction of a government run system the incentive to innovate is removed.
Can't wait till everyone's favourite bolshevik comes in and tells us why this is not the case...
Posted by: Jonathan Nehmetallah | Mar 19, 2008 12:28:40 PM
Of course there are those who assert that, merely by living here, we have volunteered to let everybody else do whatever they want with the value we create.
Posted by: Sam Grove | Mar 19, 2008 12:32:35 PM
Of course healthcare is a right - if you're willing to pay for it. In the Soviet Union, healthcare was a constitutional right of all citizens. Of course, the practical cost of providing that right meant that there was only one (usually overflowing) toilet per 76 patients, anesthesia was rationed (woke up during surgery? too bad), you needed to have "connections" in high places to get hold of necessary medication, even urban hospitals often didn't have hot water and rural hospitals rarely had running water of any temperature. Doctors were paid so little that they refused to treat patients without adequate payment first - we called it a bribe, but it was really payment.
This is the "healthcare" we had a right to.
In Europe you can't get anything that approaches healthcare, as Americans know it, without paying out of pocket for private providers. The net result of this is that only the very wealthy and well connected are actually able to purchase the sort of healthcare available the "poor" in this pseudo-socialist healthcare system we have now.
Whether healthcare is a right or not is the wrong question. Even if we decide it's a right, the definition of "healthcare" changes.
Posted by: Methinks | Mar 19, 2008 12:39:22 PM
One way I like to think about this question is even if we agree that "health-care" (however you define it) is a right, how do you deal with a situation where an innovator discovers an incredibly expensive yet perfectly successful way to treat a major disease (e.g. a cure for diabetes). Suppose that the cure, initially, costs over $1,000,000 per treatment. Does everyone instantly have a right to that treatment?
That would be hard to argue in the affirmative, even if "health care is different."
Posted by: wintercow20 | Mar 19, 2008 12:43:04 PM
Wintercow, I'm not entirely sure that anyone would bother producing such a treatment if everyone had a right to it. Assuming that everyone else's right to the inventor's product supersedes the inventor's right to be paid a price he believes is appropriate, why would anyone bother taking the time, energy and investment to develop such a cure?
Note that before national healthcare, Europe was the leader in drug development and on the cutting edge of medical research. Note also that today, almost no products are developed in Europe.
I'm hoping this thread will attract CPUrick but I'm sure it'll only attract Muirgeo.
Posted by: Methinks | Mar 19, 2008 12:52:13 PM
Concerning health care as a 'right' I'll post what I've posted before.
The 'right to health care' must mean that if I decide of my own cognizance to hire a doctor to provide me with treatment that the police are not going to pound down my door and arrest me.
Yet, that is precisely what happens in socialists countries. Socialized medicine is not a 'right to health care' it is the surrender of that right. It is a surrender of that right to politicians and bureaucrats to ration health care for their own purposes.
Posted by: Marcus | Mar 19, 2008 1:08:44 PM
Sam Grove said:
"Individuals have a right to acquire health care via voluntary exchange. They do not have a right to acquire health care by enslaving others to the task of paying for it."
Just change a few words:
"Individuals have a right to acquire [a public education/a retirement stipend] via voluntary exchange. They do not have a right to acquire [a public education/a retirement stipend] by enslaving others to the task of paying for it."
While I agree with it, I'm afraid that your particular argument has already been lost....down a slippery slope.
Posted by: I_am_a_lead_pencil | Mar 19, 2008 1:14:49 PM
What is scary to me is the percentage of people who want the government to nationalize health care or health insurance: http://www.pollingreport.com/health3.htm
I'd be curious to see what percentage of respondents are approaching or actually retired. Using the HHS statistics, the working-class pays, for themselves and their children, less than retirees out of their own pockets (it's about 70:30 for working-class, with the ratio being reversed for retirees). I don't understand how the working-class voters can want to pay for all of the health care costs for themselves, their children, and their parents rather than just for themselves and their children.
As for the innovation that comes out of the US, I can't agree more. I'll be eagerly awaiting the outcome of the election, doing with biotech and drug company companies what I did with military hardware companies immediately following 9/11 and during the run-up to the Iraq invasion.
Posted by: Justin Bowen | Mar 19, 2008 1:29:11 PM
I find it amazing that proponents of single-payer systems or universal care continue to talk about life expectancy and child mortality.
The other surprising thing is his recurrent insistence that America's health care failures are due to the lackluster profit-seeking system. Instead, I think it's because the tax code creates an employer provided care monopoly.
Do we replace that with the government's own monopoly, or consumer choice (e.g. individual coverage or HSAs).
Posted by: Will | Mar 19, 2008 1:45:54 PM
Let's dispense with it now then. No such right to healthcare exists. You have the right to be left alone, you have the right to your life and your property (things become your property though homesteading and then through voluntary exchange), you have the right to all the thoughts in your head and the right to express the thoughts to anyone who wants to listen.
You don't have the right to anyone else's care. You have no right to make people care about you by force. You can persuade them to care about you, you can exhibit all sorts of merit and good features and niceness and kindness to get people to care about you, but you would be wrong to force them. Healthcare is the same as any other kind of care. It means taking the time and attention of other people to come to your aid. Doctors are not slaves, they don't go to study biology to such a degree they when they gain a certain mastery of the subject they themselves then become submissive to the cries of sick, or submissive to the force of the government that tells them they must answer to the cries of the sick. They do it so they can trade their special value (healing knowledge) for some other value.
You don't have the right to food, but you can go and trade for food, or mix your productivity with unused, unclaimed land and the woodland creatures upon it to get food, oceans too, you don't have right to shelter, but no one can stop you from sheltering yourself with your own productivty and the resources you acquire openly and honestly.
Also, just so we're clear, you have rights by your nature as a human, a creature that can contemplate its own existence, can think about the future and make plans, can save its current production and invest in new methods of production, and harness and transform the environment around it to better suit its plans. Any thing that can do all those things has rights, any thing that can't do those things gets none. So AI robots get rights, fish, cows, other animals, no rights. The mentally ill or disabled who may not be able to exhibit all the above characteristics have the same rights as members of the species that can do those things, but they have no more rights then the rest of their species. Children have the same rights as well, but those rights are held in trust and can be excercised or suppressed by adults that take care of them, with the one irrevocable, unsuppressible child's right, the right to leave its current living arrangement at which point it will have its full adult human rights and responsibilities to care for itself or will be able to put them in trust to another who will take care of it.
I hope that clears it up. You make your own life the best way you know how, there are lots of people along the way who will help, but absent any explicit, voluntary contracts to the contrary, they owe you nothing.
Posted by: scott clark | Mar 19, 2008 1:49:29 PM
What's healthcare?
I'm not trying to be facetious. If Healthcare is a right, do I have a right to cosmetic surgery? What if it's to remedy a cosmetic problem caused by life-saving surgery? What about birth control? Do women have a right to birth control pills? How about condoms? If I get hooked on drugs, do I have a right to methadone treatment? What about the right to a sex change operation? Is Viagra a right? What about treatment for skin cancer from a tanning bed? Treatment for lung cancer from smoking? How about dental implants?
If these things are what the founders would have called "natural rights" -- i.e. rights which everybody has, just by being human -- then shouldn't there be some dividing line?
When somebody talks about health care as a "right," they ignore the fact that there is no guiding principle there -- somebody has to decide that treatment "X" is healthcare that somebody has a right to, and treatment "Y" isn't. And, there are no natural rights which only exist at the whim of a person. (That's why they're called natural rights.)
So, the position isn't "Everybody has a right to health care." Instead, the position is "The government should create a right to certain kinds of healthcare under certain circumstances." But, that's a lot harder to convince people of.
Posted by: Chris | Mar 19, 2008 1:53:05 PM
Seems like many folks don't know what a "right" is. Rights come from freedom, and freedom is constrained by the actions of others. Thus, rights are about being free of interference in your choices by others.
So, in the American context, you do not have rights to "things", but you have the right to be free of "things", those "things" being interference and constraint. We have chosn to employ collective action in the form of a government to guarantee those freedoms from interference.
In this framework, the statement "we have the right to health care" is simple nonsense.
However, instead of seeing government as a limited form of protection against the predations of others, too many people see government as the provider of things. And since government cannot generate any wealth through its industrial endeavors, it must steal from some to give away these "things" to which many people seem to think they have "a right".
Of course, when I speak like this to the average member of the public, they look at me funny and slowly move away. :-)
Posted by: bartman | Mar 19, 2008 1:58:27 PM
To people who don't believe in personal responsibility, everything becomes a "right". I don't see how its solved until you solve that larger problem.
Posted by: FreedomLover | Mar 19, 2008 2:04:28 PM
methinks - all those horror stories of medical care in the USSR aren't true because muirduck didn't see it!
Posted by: FreedomLover | Mar 19, 2008 2:05:40 PM
While I agree with it, I'm afraid that your particular argument has already been lost....down a slippery slope.
But the argument must be made.
Posted by: Sam Grove | Mar 19, 2008 2:16:15 PM
The clearest commentary on this imho is from Dr. Walter Williams.
http://www.capmag.com/article.asp?ID=2005
Posted by: Chris Meisenzahl | Mar 19, 2008 2:38:09 PM
Sam,
Yes, the argument must be made. First to keep from sliding futher down the slope, and also, when the programs already implemented begin to fail, it will be good to understand why they failed.
Posted by: Randy | Mar 19, 2008 2:39:02 PM
Randy - it's pretty useless to appeal to logic when so many view this is a fundamental moral.
Posted by: FreedomLover | Mar 19, 2008 2:45:37 PM
If health care is a right, lets make sure we aren't leaving out anything more important. I would consider food more important than healthcare. We can live a lot longer without health care than we can without food. We do have a right to eat? It's true we have relatively fewer people who go to bed hungry in the US than exists in other countries. Does that mean its less important? Lets make sure all of our people have eaten, realized their right to food, before we worry about health care.
I propose we nationalize the food industry, institute a single payer system. Instead of going to the grocery store with credit card in hand (we have to pay with a credit card due to the lack of funds in our bank accounts to write checks), we simply tell the cashier how many members of our family and they provide our allotment of rice, potatoes, beans, and milk. If we're lucky, we're in the front of the line and get a small chicken leg.
I've thought about this idea of whether its a right or not and where it came from. My guess is that thinking we have a "right" to health care falls under the previously expressed (back in '76) right to life. If we have a right to life, we, by extension, have a right to anything that helps us prolong life, enjoy life, etc. I disagree, but I wonder if that might be the thinking of those who believe it. I also think that calling it a right in the first place is simply an attempt to appeal to the inner Thomas Jefferson in us, a hope our emotions overcome our reason. But we shouldn't be surprised with this, because its the approach modern liberals have used for decades.
Posted by: hutch | Mar 19, 2008 2:49:19 PM
sorry. meant to say "Do we have a right to eat?"
Posted by: hutch | Mar 19, 2008 2:51:08 PM
I just wanted to add something. I haven't finished all of Russ's audio link, but I heard something interesting at the beginning. The moderator mentioned something about "mak[ing] health care a right." I've often thought of the debate being whether or not it was a right (as in from the beginning), not whether or not we should make it one. It doesn't change my opinion, but I thought it was interesting. We're talking about whether this is an "inalienable", natural right, or else the founders would have included it. We're talking about whether we want to make it one. Again, by using the word right, they're clouding the argument because most people think of a right as something that comes with being human, not something that other humans can bestow.
Posted by: hutch | Mar 19, 2008 3:06:04 PM
Randy,
Take another look at the argument:
"They do not have a right to acquire health care by enslaving others to the task of paying for it."
Social security and mandatory public schooling have rendered this argument impotent. These accepted programs have paved the erroneous ethical path down which ‘universal healthcare’ is now marching. We should not be surprised that this is the case. Arguing against walking down this path - which we have strode along for decades - is not going to win many folks over….even if a few of us can agree it is not the proper path that we should have walked on.
Looking at “why they failed” (or will fail) is a separate argument - but it has nothing to do with the ethical one.
Posted by: i_am_a_lead_pencil | Mar 19, 2008 3:29:55 PM
Where is my right to free markets?
Posted by: Unit | Mar 19, 2008 3:50:36 PM
I loved your responses on the question "Would making health care a right benefit the country?".
I also loved how the first thing the doctor said was how he didn't think the right to health care meant you had a right to provide health care. Nothing like protecting your monopoly, doctor.
And finally, I loved how the good doctor could easily run a health care system for the whole country, all we have to do is make him the dictator of health care. What a fascist.
Posted by: Keith | Mar 19, 2008 4:31:18 PM
the first thing the doctor said was how he didn't think the right to health care meant you had a right to provide health care.
Sorry, I can't get the interview to play on this computer - did you mean "...didn't have the obligation to provide health care"?
If this is what he said, then we're graduating some very logic-impaired doctors.
Posted by: Methinks | Mar 19, 2008 5:00:34 PM
lead pencil,
"Looking at “why they failed” (or will fail) is a separate argument - but it has nothing to do with the ethical one."
Well, it seems to me that an ethical argument must also be practical. For example, can we argue that soviet style communism is ethical when we know from experience that it is impractical?
Posted by: Randy | Mar 19, 2008 5:10:16 PM
Do we have a right to not be murdered?
Do we have a right to golf on the country club course anytime we want?
Do we have a right to drive on the left side of the road?
Rights IMO are given based on the established rules of society or of a club to which we are born or choose to join.
Myself and Von Hayek both agree a good case can be made for a universal public health care system. Likewise the doctor in the interview made all the appropriate points to back up his position.
Posted by: muirgeo | Mar 19, 2008 5:27:05 PM
And we're off!
here you have it, folks!! Muirduck and Hayek are in complete agreement if society decides to change its rules regarding murder, we will be able to murder with impunity. As long as society establishes it as a rule. Awesome.
Posted by: Methinks | Mar 19, 2008 5:44:31 PM
If armed men will shoot me for doing something (or not doing something) to you, you have a right. That's the only sense I've ever made of the word "right". Nuff said.
Universal health care is an obligation to carry health insurance and a more limited obligation to contribute to the health insurance premiums of people who can't afford them. I think this obligation is O.K. myself, with some caveats. The other side of this obligation is a right to certain health care.
I feel the same way about automobile liability insurance for similar reasons. We aren't going to leave critically sick people in the streets in the U.S. Someone must pay for health care. Ideally, I pay for mine, and you pay for yours, and we share risks through insurance.
Does this doctor therefore have a right to a job? No. Do auto mechanics have a right to a job? No.
Posted by: Martin Brock | Mar 19, 2008 5:52:41 PM
Then perhaps you haven't heard of an unalienable right to life, liberty, and the pursuit of happiness.
We do not have to constrain our context to the legal sense, even if you choose to do so.
Posted by: Sam Grove | Mar 19, 2008 5:59:29 PM
I've heard a lot about it. Flapping lips and a few bucks will get you a cup of coffee at Starbucks, these days.
The trouble with your unconstrained sense is that the word "right" means whatever you want it to mean in this sense, and different people want it to mean a dizzying variety of contradictory things. I already have the word "preference" for this purpose.
Posted by: Martin Brock | Mar 19, 2008 6:06:59 PM
Martin - once this country used to be about rugged individualism.
Posted by: FedFan_2007 | Mar 19, 2008 6:34:09 PM
The trouble with your highly constrained sense is that we are then left at the mercy of politicians to do the defining.
I am aware of how you look at things, but as I am not philosophically a utilitarian, I do not find myself constrained to your way of looking at things, nor have I seen any benefit in doing constraining my self in such a manner.
I am quite aware of the nature of the state, the men with guns, etc. I do think I comprehend the symbiotic relationship between the manifestation of political power and the common sensibility of the people that support that manifestation either by belief, actions, or absence of same (defaulting).
Acknowledging the very real nature and state of our existence and the manifestation of state power does not relieve us of the necessity of examining those beliefs and figuring what about that symbiotic relationship is amenable to modification and what modifications should be made.
Nor does that acknowledgment require us to constrain our imaginations and our discussions to how we deal with the 'what is'.
Yes many different people make various claims about rights. The task is to separate the wheat from the chaff.
Even if we go by your sense, the task remains as to what should be legally defined as a right and what should not. Adopting the utilitarian philosophy does not resolve the problem, it merely changes the way we talk about it.
I think the right to your life is not at all unconstrained. It seems to me to be quite specific. And liberty means essentially a right to be left alone as long as I am not interfering with the equivalent rights of others to their lives and fruits of their labors. Is anyone really confused by that, anyone that does not understand the meaning?
Preference: I prefer to wear a hat outdoors.
"I prefer life over death" isn't quite strong enough to indicate the situation. I am actually imbued by nature with a compulsion to avoid death.
Posted by: Sam Grove | Mar 19, 2008 6:42:56 PM
Martin,
I have no problem with insurance. Insurance is voluntary and you know that you're signing up for spreading both the risk and cost over the pool of insured at the time that you acquire insurance. My biggest problem with insurance is that insurance regulation has prevented competition and choice. Lack of competition and choice means that more people in states with lots of mandates can't afford insurance.
Posted by: Methinks | Mar 19, 2008 6:53:36 PM
methinks - my biggest problem is FORCED insurance. I don't like that I'm forced to buy anything by the government. What I buy should be dictated by my own needs, and nothing else. But I guess that makes me an evil, selfish bastard Republican.
Posted by: FreedomLover | Mar 19, 2008 7:53:52 PM
Those who claim to believe that people have a right to health care are lying to themselves and to others. What they actually mean is that people are entitled to health care. And, in an entitlement society (as other commenters noted), that means government taking wealth from some and giving it to others. This tiresome trend towards socialism makes me ill.
The physician arguing about the right to health care actually was arguing to ensure that all his patients have the ability to pay for the care he provides. This type of self-serving behavior among my fellow physicians is partly responsible for the declining trust people have for the profession.
Posted by: Dr. T | Mar 19, 2008 8:09:55 PM
“I have no problem with insurance.”
- Methinks
“Ned considers insurance a form of gambling.”
-Maude Flanders (The Simpsons)
Posted by: Mesa Econoguy | Mar 19, 2008 8:20:08 PM
Health care IS a right, but there are far more competent people than government to administer it---like doctors, for instance.
http://www/gopcatholics.blogspot.com
Posted by: Peter | Mar 19, 2008 11:02:19 PM
The most competent people to manage health care are those who pay for it: consumers. And doctors can do what they're damn well told.
Posted by: Marcus | Mar 19, 2008 11:08:05 PM
I don't like that I'm forced to buy anything by the government. What I buy should be dictated by my own needs, and nothing else. But I guess that makes me an evil, selfish bastard Republican.
Selfish, evil Republican bastard,
I agree. It's even worse when we are forced to buy insurance designed by the government itself.
Posted by: Methinks | Mar 19, 2008 11:45:55 PM
"Rights IMO are given based on the established rules of society or of a club to which we are born or choose to join." - Murthaduck ("the children they've killed in cold blood").
Sam, Methinks,
Have pity on our poor little troll - he's trying. It only took him twenty years to read "We the people". Those are big words! Perhaps in another forty years he'll get to the document that explains that rights aren't 'given'.
BTW, Murthaduck. I'm still waiting for you to pony up for that printing press and Thompson that you agreed is owed to me as you interpret the Constitution.
Posted by: brotio | Mar 19, 2008 11:55:17 PM
Anyone have any thoughts on the doctor's claim that NIH has been an effective distributor of research dollars? How do we know whether NIH is effective? As compared to... what?
Posted by: Student | Mar 20, 2008 12:33:22 AM
"As for the innovation that comes out of the US, I can't agree more. I'll be eagerly awaiting the outcome of the election, doing with biotech and drug company companies what I did with military hardware companies immediately following 9/11 and during the run-up to the Iraq invasion."
-Justin Bowen
I can only assume you had success in developing military hardware after 9/11, your post made me realize. While there is fear of big government killing innovation and stifling freedom on the one side, there is the same level of fear on the other side that the reason you had success in military hardware and hope to in drug companies will be prompted by malfeasance, maliciously created wars and medical disasters for the explicit purpose of manufacturing an incentive for individuals to innovate and create solutions, the window breaking thing.
I am not stating my belief but found it fascinating how equal the fears are on both sides.
What I really wanted to contribute was how I enjoy the public school analogies. It reminded me of a famous Thomas Paine quote "A long habit of not thinking a thing wrong, gives it a superficial appearance of being right." I am reminded of this quote because many people in my area think the public schools are wonderful, but when I hear how far back the US is in education internationally, I realize all the public schools seem wonderful because they are in comparison to themselves making them seem proficient.
I would gather that if the healthcare system stagnates upon being substituted by a government monopoly it could keep its appearance but after time as it doesn't progress it will still seem fine, even if other countries are surpassing the US.
Posted by: Brian-NJ | Mar 20, 2008 12:48:53 AM
"If armed men will shoot me for doing something (or not doing something) to you, you have a right. That's the only sense I've ever made of the word "right". Nuff said."
Thank you, M. Brock. To me a 'right' implies a positive duty on other. To say a 'right' can be stand alone (say, self-defense) is not really so much a 'right' as much as an 'ability' hence Liberals deny there's any thing such as 'natural rights'. E.g. a woman who demands not to be raped in an overt patriarchal society where women don't any rights might as well spit into the wind and it may be discomforting if the only way that woman could make the 'right' real is to marry a man and get her protection from rape because she is that man's 'property'.
Similarly to say people shouldn't use 'force&fraud' implies a duty on people NOT to use force&fraud which contradicts the notion of 'negative rights'. Therefore for the notion of 'no force&fraud' not be in contradiction it is a personal moral directive of Libertarians to self-identify when force&fraud is being used against them and defend by themselves or voluntarily group up with others.
See:
http://www.huppi.com/kangaroo/L-rights.htm
Posted by: Gil | Mar 20, 2008 1:12:53 AM
I loved the little note at the end, about how some state is mandating that pediatricians provide mental health screening for Medicare kids. The doctor they interview asks where they will find the time with their workload of flu shots, colds, etc.
And the other part I loved was Russ's debate opponent decrying the series of events that cemented employer subsidized health insurance into our system, not long after channeling muirgeo to say that the government does everything right by definition. Hilarious. But not quite so hilarious as when the good doctor talked about how this messed up our competitiveness. I noticed that Russ didn't try to tell him how to conduct brain surgery.
Posted by: BoscoH | Mar 20, 2008 1:33:59 AM
BTW, any of our debates are tempest in the tiniest teapot. 99% of Americans are socialist boobs who will never follow 1% of Hayek's advice.
Posted by: FreedomLover | Mar 20, 2008 2:47:34 AM
If health care is a right -- an entitlement right -- then what is stopping us from advocating for housing and food as an entitlement right? Housing and food are every bit as important as health care.
I'll take the steak and lobster and the mansion in the Hamptons. But who's going to get my crappy-ass temporary apartment in Roswell? muirgeo, you're an altruist, will you switch places with me. You take my apartment and I'll stay at your Villas at LF. It's a short hop from there to my childhood hometown of Martinez...not all that far from the John Muir house off Alhambra Road.
Posted by: LowcountryJoe | Mar 20, 2008 7:14:30 AM
Quote from Methinks: "Sorry, I can't get the interview to play on this computer - did you mean "...didn't have the obligation to provide health care"?"
No, I think the doctor was saying that people don't have a right to provide health care, as in you don't have a right to practice medicine.
Posted by: Keith | Mar 20, 2008 7:34:06 AM
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