Healthcare is Not a Right

 

 

March 20, 2019

 

Healthcare is not a right.  Rights are intrinsic; in general, rights require neither the consistent and specific intervention nor sustained substantive effort of another.  You have a right to freedom of speech and of association.  You have a right to fair and equal treatment under the law.  You have a right to practice your religion, whatever that may be, or simply to practice none at all. 

Our rights are enshrined in our founding documents, crafted to support a system of representative government, codified to enable self-determination and encourage individual productivity & innovation, cemented as fundamental ideals history shows we can ill afford to cast aside. 

Occasionally, however, we as a nation determine that certain causes, certain pursuits – supported by all of us – will constitute a necessary public good, and that we as a nation will benefit from their establishment and practice.  As such, we will publicly fund them.  We do this with Social Security, with Medicare and Medicaid, with Supplemental Nutrition Assistance, and with public works and services, among myriad other programs – including our common defense.  Though it would be a stretch to label us a “socialist” nation (in the spirit in which that term is commonly deployed), these are all, in fact, collectively redistributive programs.  Should we therefore propose to eliminate them?  Where would that leave us? Where would that leave so many of our friends and loved ones?  Those most vulnerable, and in need?

Our private healthcare system in the United States is ranked lower in outcomes, lagging those other developed nations we consider our peers; yet we spend more, covering only a fraction of our population.  A joint study by Harvard University’s School of Public Health and the London School of Economics found that, “In 2016, the U.S. spent 17.8 percent of its gross domestic product on health care, while other countries ranged from 9.6 percent (Australia) to 12.4 percent (Switzerland). Life expectancy in the U.S. was the lowest of all 11 countries in the study, at 78.8 years; the range for other countries was 80.7 to 83.9 years.”

We here in the U.S. have lower rates of physician visits.  We spend more – far more than our peers – on administrative costs and salaries.  We spend more on prescription drugs, and actually spend less as a total percentage than our peer nations on inpatient services.  We are, in a word, inefficient.

And so if our current system can be called redistributive, it is clearly upward.

We are the only developed nation without a public option.  We are the only developed nation that seems to believe that a public healthcare option would somehow infringe upon our natural rights as citizens.  Yet we are also the only developed nation whose citizens routinely go bankrupt due to health problems, losing their jobs, their homes, and everything they have to pay for medical bills, constituting a massive upward transfer to providers and insurers of their increasingly scarce wealth.  As we have established, this country already extends many public options, of varied sorts.  It’s curious that with all our resources as a nation, and with all of the data at hand and all of the clearly visible examples in front of us, that so much of our populace (and ironically the segment which needs it the most) can be convinced to rant and rage against a public program that, if our peer group is a guide, would improve our lives and likely lower our net payments and risks.

And it is curious, as well, that both we as citizens and our politicians seem incapable of discussing healthcare in anything but binary terms.  With so many possible avenues before us, we appear to frame our only choices as either continuing the private system we have today, or scrapping it altogether, and imposing some monolithic and impersonal government bureaucracy.  Why?  This is a false choice… a choice of artificial and mutual exclusivity. 

Perhaps our education system, for all its admitted flaws, is an example to which we should turn. 

We have access to public education.  Centuries ago Scotland began such a system (along with public libraries) and it has served their populace quite well, just as it has in our own country, and many more besides.  This is objectively rational.  An educated citizenry is empirically shown to be happier, more productive, more affluent, and better able to participate in democratic governance.  A healthy citizenry is surely, by logical extension, all of those things as well.  If, however, you do not choose to use our public school system, that is of course your right.  The United States has an unequaled independent and private educational system that is the envy of the world, and that system also has served our nation well over the course of centuries.  What is to stop us from enjoying an equally renowned private health system, alongside a public option, ensuring both healthy competition and improved outcomes for all our citizens?  Why, just as with our education system, can we not have both?

You don’t have a right to healthcare.  But you do have a right to decide.