I’m not sure what else Zach Wamp said to incur the wrath of the blue-blog zombies, but he is absolutely right about one thing: Health care is not a right, at least not according to the conception of rights upon which this country was founded. Your rights include life, liberty and the pursuit of happiness. You may not be unjustly deprived of these things. Your rights do not include things that I or anyone else must be forced to provide for you, such as a home, a car, a job, or health care.It might or might not make sense for the government to help people obtain these things, but that’s not the same thing as saying that we all have a right to them. It only takes a moment’s thought to see why this is so. What is meant by people who say we all have a right to health care? Do they mean that we all have a right to any sort of treatment that modern medicine can provide, regardless of cost or necessity? Or do they mean that we all have a right to some basic level of care? If it’s the latter, who decides where we will draw the line?
Take a heavy drinker who develops cirrhosis. He desperately needs a liver transplant in order to survive. But there is a shortage of available livers, and there are many other patients in need. Does he have a right to receive a life-saving transplant, or has he given up his right? Let’s say he has, and we deny him a transplant, but there are still not enough livers to save the deserving patients. How do we decide among them without arbitrarily depriving some of their right to health care?
This is the problem we face when we shift from a negative to a positive conception of rights. We encounter shortages, we face tradeoffs, and at some point we have to make arbitrary decisions. When that happens — well, to quote William Munny, “Deserve’s got nothing to do with it.”
For some time now, the debate over how best to allocate scarce resources has been a settled matter. The market, with its system of price signals, is the most efficient way to direct resources to where they are most urgently needed. We need health-care reform that enables the market for health care to function more efficiently. Removing the distortion in the tax code that favors employer-based health insurance would be a good start.
The last thing we need is public policy based around the idea that health care is a “right” to which we are all entitled. We’ve seen the results when other countries have adopted such policies: shortages, rationed care, higher taxes and a less innovative health-care sector — in short, a state of affairs that infringes on everyone’s right to pursue the best care he or she can obtain.
I’m not sure what else Zach Wamp said to incur the wrath of the blue-blog zombies, but he is absolutely right about one thing: Health care is not a right, at least not according to the conception of rights upon which this country was founded. Your rights include life, liberty and the pursuit of happiness. You may not be unjustly deprived of these things. Your rights do not include things that I or anyone else must be forced to provide for you, such as a home, a car, a job, or health care.
It might or might not make sense for the government to help people obtain these things, but that’s not the same thing as saying that we all have a right to them. It only takes a moment’s thought to see why this is so. What is meant by people who say we all have a right to health care? Do they mean that we all have a right to any sort of treatment that modern medicine can provide, regardless of cost or necessity? Or do they mean that we all have a right to some basic level of care? If it’s the latter, who decides where we will draw the line?Take a heavy drinker who develops cirrhosis. He desperately needs a liver transplant in order to survive. But there is a shortage of available livers, and there are many other patients in need. Does he have a right to receive a life-saving transplant, or has he given up his right? Let’s say he has, and we deny him a transplant, but there are still not enough livers to save the deserving patients. How do we decide among them without arbitrarily depriving some of their right to health care?
This is the problem we face when we shift from a negative to a positive conception of rights. We encounter shortages, we face tradeoffs, and at some point we have to make arbitrary decisions. When that happens — well, to quote William Munny, “Deserve’s got nothing to do with it.”
For some time now, the debate over how best to allocate scarce resources has been a settled matter. The market, with its system of price signals, is the most efficient way to direct resources to where they are most urgently needed. We need health-care reform that enables the market for health care to function more efficiently. Removing the distortion in the tax code that favors employer-based health insurance would be a good start.
The last thing we need is public policy based around the idea that health care is a “right” to which we are all entitled. We’ve seen the results when other countries have adopted such policies: shortages, rationed care, higher taxes and a less innovative health-care sector — in short, a state of affairs that infringes on everyone’s right to pursue the best care he or she can obtain.
Chris Navin
March 5, 2009
From If-Then Knots: Health Care Is Not A Right…But Then Neither Is Property?
Our author challenges a Stephen Spruiell piece from The National Review in which Spruiell claims that health care is not a right because it isn’t one of the “negative” rights of life, liberty and the pursuit of happiness. In other words, neither I nor the government nor anybody else owes you the “right” to health care, because it’s not really a “right” in the first place.
Our author claims that if health care doesn’t meet this “negative right” standard, maybe individual property ownership doesn’t either:
Yet, as for me, I’m still with Locke. My right to property goes deeper than any social contract (Paine’s thinking too). I already trust my government to conditionally maintain such a contract, so why grant it the license mentioned above?
I’m already paying taxes for health, education, welfare and infrastructure anyways.
Addition: A Susan Pashkoff, who seems to know a lot about Locke, responds in the comments. Well worth a read.
by stnastopoulos
Our author claims that if health care doesn’t meet this “negative right” standard, maybe individual property ownership doesn’t either:
“The establishment by governments and quasi-governments of a regime of individual ownership has costs and benefits. On the one hand, it creates the incentive to make the land more productive. On the other hand, it creates an elite class of property owners and deprives others of opportunity to use resources that are naturally held in common”He quotes much Thomas Paine to arrive at his position, summarizing Paine thus:
“Individual property rights are here recognized as “of a distinct species” from the “common right of all” to benefit from natural resources. Paine is commenting directly on the Lockean standard and fairly clearly rejects it.”That’s John Locke. (See Also: Jean-Jacques Rousseau “man is born free and everywhere he is in chains…”) After Paine, our author offers that property ownership “rights” perhaps don’t meet the natural right standard either. He finishes with:
“I am with Paine that government is not only justified but obligated to provide compensation. Taxation supported public services like health, education, welfare, and infrastructure fulfill this obligation.”This is a not entirely unreasonable argument (a decent one in light of Milton Friedman in his later years) and I think the main goal here is to challenge Spruiell’s in the box, partisan thinking.
Yet, as for me, I’m still with Locke. My right to property goes deeper than any social contract (Paine’s thinking too). I already trust my government to conditionally maintain such a contract, so why grant it the license mentioned above?
I’m already paying taxes for health, education, welfare and infrastructure anyways.
Addition: A Susan Pashkoff, who seems to know a lot about Locke, responds in the comments. Well worth a read.
by stnastopoulos
June 17, 2009
From The New Yorker: Atul Gawande On Health Care-”The Cost Conundrum”
Full post here (once archived, it won’t be free)
McAllen, Texas, Gawande argues, could learn a lot from the Mayo clinic’s method of de-incentivizing some ways doctors make money, and feel pressure to make money:
McAllen, Texas, Gawande argues, could learn a lot from the Mayo clinic’s method of de-incentivizing some ways doctors make money, and feel pressure to make money:
“Whom do we want in charge of managing the full complexity of medical care? We can turn to insurers (whether public or private), which have proved repeatedly that they can’t do it. Or we can turn to the local medical communities, which have proved that they can.”Some collectivism may be necessary, and practical, to reduce wasteful spending. It also could help to keep the discussion away from the top-down, and often once removed, visions of politics and political ideology.
December 11, 2009
Atul Gawande At The New Yorker: ‘Testing, Testing’
Gawande likens the state of health care to farming at the beginning of this century and what’s happened since. Individual doctors, patients and communities must make their own decisions, and work constantly to innovate, share knowledge, and solve the problems they have, alongside government officials (but not top-down mandates).
Anyways, a libertarian friend makes the argument that while this would be nice if it worked, it’s simply more of the same: extending health-care to is akin to extending home-ownership to all (Fannie Mae and Freddie Mac)…or college education to all. That’s too much egalitarianism, and look for the political and social consequences.
I don’t think she’s winning the argument right now…
“At this point, we can’t afford any illusions: the system won’t fix itself, and there’s no piece of legislation that will have all the answers, either. The task will require dedicated and talented people in government agencies and in communities who recognize that the country’s future depends on their sidestepping the ideological battles, encouraging local change, and following the results. But if we’re willing to accept an arduous, messy, and continuous process we can come to grips with a problem even of this immensity. We’ve done it before.”Like NOAA maybe? It’s a fine line to walk and maybe we can do it.
Anyways, a libertarian friend makes the argument that while this would be nice if it worked, it’s simply more of the same: extending health-care to is akin to extending home-ownership to all (Fannie Mae and Freddie Mac)…or college education to all. That’s too much egalitarianism, and look for the political and social consequences.
I don’t think she’s winning the argument right now…
January 19, 2011
Atul Gawande At The New Yorker: ‘The Hot Spotters’
Post here (abstract only, full article requires a subscription)
Gawande points to a study recognizing a group of people that disproportionately uses medical resources:
A door to single-payer? What about rising costs?
A reader sent in two quotes from Henry Hazlitt, libertarian economist:
Gawande points to a study recognizing a group of people that disproportionately uses medical resources:
‘His calculations revealed that just one per cent of the hundred thousand people who made use of Camden’s medical facilities accounted for thirty per cent of its costs.’And a potential solution for these ‘super-utilizers:’
‘In addition to physicians and nurses, the Center employs eight full-time “health coaches,” who help patients manage their health.’‘Health-coaches’ frightens me a bit. I’m still worried about politicizing the issue further; entrenching health-care as a right, which will also make it a political football (soon to be third-rail), potentially unionize it, open it to many more forms abuse and fraud (and diverging political and healh-insurance goals).
A door to single-payer? What about rising costs?
A reader sent in two quotes from Henry Hazlitt, libertarian economist:
“The art of economics consists in looking not merely at the immediate but at the longer effects of any act or policy; it consists in tracing the consequences of that policy not merely for one group but for all groups.”and
“The first requisite of a sound monetary system is that it put the least possible power over the quantity or quality of money in the hands of the politicians.”
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