Healthcare is a right, not a privilege.
- Senator Bernie Sanders (I-VT)
With Barack Obama, we will break the old gridlock and finally make health care what it should be in America—a fundamental right for all, not just an expensive privilege for the few.
- Senator Edward Kennedy (D-MA)
I think [healthcare] should be a right for every American.
The ongoing healthcare reform debate has been quite heated, polarizing, and educational. (I bear witness to the passionate "debating," as I had a front-row seat at Representative Jim Moran's Health Care Townhall, and saw hundreds of people yelling -- and not in a good way -- as he and Howard Dean entered the auditorium. Was I one of the yellers? I plead the Fifth.)
As almost everyone will attest, there is a definite need for "health-insurance" reform (not necessarily "health" or "healthcare"). [For the sake of clarity, when I refer to "healthcare," I mean the provision of services from others to improve or manage one's health.] My contributions to the debate can be found here, here, here, and here.
I believe the supporters of the various reform bills have managed to wrest the moral high ground by shaming opponents of reform as uncaring haves, who wish the sick and unhealthy (or soon to be unhealthy) to go without needed care. Of course, that is not the case, but just raising that straw man all but eliminates the ability to have a reasonable, objective debate about the issue.
In this essay, I argue that healthcare is NOT a right; that, in fact, asserting that healthcare is a right is indistinguishable from an explicit support of slavery.
Some ground rules must be stated, such as:
- What are "rights," and what rights do we possess?
- What role does the government have to support, or defend, our rights?
A "Right" Defined
A "right" is not granted by anybody or any body; it is intrinsic in the nature of man. (Thus, "rights" differ from "privileges," which are permissions granted by someone.)
I believe in the theory of "natural rights," that was espoused by the British philosopher John Locke (1632-1704) in his 1689 publication The Second Treatise of Government. In his Second Treatise, Locke stated that every man was entitled to his life, liberty, and property (his "natural rights") provided that exercising those rights does not intrude on others' rights, and that the role of government in natural-rights theory is to protect those rights.
Thomas Jefferson felt Locke was the most important thinker of liberty. Not surprisingly, the Declaration of Independence -- of which Jefferson wrote the initial draft -- echoed Locke by identifying our rights and the role of government:
We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.
That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed....
These rights, importantly, do not grant men the power to have a claim on anyone else. Everyone owns his life and liberty (no one can be a slave), and no one can take away another’s right to try to achieve the life he or she wants (the "pursuit of happiness").
Notice that the Declaration of Independence does not state that men have a right to "happiness"; we do not have the innate right to assume our preferred station in life, or to assume our ownership of any property to which someone else has a rightful claim.
One way to think about this distinction is to follow up the claim of a right with the question, "At whose expense?" According to natural-rights theory and the Declaration of Independence, the answer should be: "No one"; for no one may make a claim at the expense of anyone else.
Is Healthcare a Right, or a Privilege?
Messrs. Sanders, Kennedy, and Obama, and many others, claim that healthcare is a right, meaning it is innate and further that the government's role is to grant and to protect that right.
The assertion appears defensible on the surface, for which heartless person would wish his or her fellow man to be denied healthcare -- especially in the wealthiest country in the world?
Ask yourself the question, "Healthcare ... at the expense of whom?" [Healthcare meaning, again, the provision of medical services from others.] If healthcare is a right, then a sick or injured person can make a claim on a doctor's or nurse's services -- he/she can demand healthcare, whether or not the practitioner is willing to provide it.
Put aside the response that few healthcare practitioners would be unwilling to provide care. I am debating about actions that a person is required to do -- under threat of coercion by the State -- despite objections that he or she might have.
Of course, in America, all people have the privilege of healthcare, as the Emergency Medical Treatment & Labor Act (EMTALA), enacted in 1986, ensures public access to emergency services in Medicare-participating hospitals, regardless of ability to pay. (And, since almost every hospital accepts Medicare funds, we are talking about essentially every hospital in America.)
EMTALA is an example of the danger of accepting payment from a party -- the State -- which also writes the rules. With EMTALA, the government -- which should be protecting the rights of all citizens equally -- has taken sides with a class (patients) that can demand services from another class (providers).
Conclusion
I challenge anyone to explain how the innate ability to demand services (medical or otherwise) from another differs from slavery.
Is the government's role to ensure that all have equal protection to life, liberty, and the pursuit of happiness?
Or, instead, is it the government's role to protect the ability of people to place a claim on another's property (in this case, a lifetime of study, hard work, and expense honing his or her skills as a physician)?
More specifically, is the government's role to force healthcare providers to provide medical services to those needing care?
If you answer "Yes" to the last question, may I introduce you to a text that may speak to you from the heart? It is called Critique of the Gotha Programme, and contains your mantra:
From each according to his ability, to each according to his needs!
It was written by Karl Marx.
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