Diary

THE RIGHT TO HEALTH CARE and its effects.

Thomas Paine (1731–1809) further elaborated on natural rights in his influential work Rights of Man (1791), emphasizing that rights cannot be granted by any charter because this would legally imply they can also be revoked and under such circumstances they would be reduced to privileges:

It is a perversion of terms to say that a charter gives rights. It operates by a contrary effect — that of taking rights away. Rights are inherently in all the inhabitants; but charters, by annulling those rights, in the majority, leave the right, by exclusion, in the hands of a few. … They…consequently are instruments of injustice.

The following are excerpts from a discussion on the effects of health care as a right. The speech was delivered many times in 1993-1994 Source is The Atlas Society I believe delivered by David Kelly.http://www.objectivistcenter.org/cth–14-Is_There_Right_Health_Care.aspx

“Let’s begin by defining our terms. A right is a principle that specifies something which an individual should be free to have or do. A right is an entitlement, something you possess free and clear, something you can exercise without asking anyone else’s permission. Because it is an entitlement, not a privilege or favor, we do not owe anyone else any gratitude for their recognition of our rights.”

“1) To begin with, of course, the government has to tax some people to pay for medical subsidies offered to those it considers to be in need. So the first consequence of implementing a “right” to medical care is forced transfers of wealth from taxpayers to the clientele of programs like Medicare and Medicaid. And this will inflate the demand for health care services. Offering free or heavily subsidized care is inevitably going to increase overall use of the health care system.

2) The cost explosion leads to the second major consequence of implementing a “right” to medical care: restrictions on the freedom of health care providers. During the debate over health care policy in the 1960s, proponents of Medicare and Medicaid assured doctors that they only wanted to pay for indigent care, and had no intention of regulating the profession. Abraham Ribicoff, then Secretary of Health, Education, and Welfare, said: “It should be absolutely no concern to a physician where a patient gets the money.

3) A third major consequence of implementing a right to health care is the increased burden imposed on consumers of health care—the ones who were originally not in need of government subsidies. As taxpayers, of course, they have to pay for all the programs; that’s point 1. But as consumers, they are also affected by all the distortions of the market which these programs create. Everyone pays the higher prices caused by the inflation of demand for medical services, together with the increased costs of regulation and paperwork. As people are priced out of the system, they are forced into managed care systems that limit their choices of doctors.

4) Yet another consequence is a growing demand for equality in health care. If something is a human right, after all, then it should be protected equally for all persons. Our system is based on the idea of equality before the law. Now if we plug into this system the additional idea that we all have a legal right to some good like health care, the natural inference is that we all ought to receive that good on a more or less equal footing.

5) The fifth consequence–the last one I’ll mention–is the collectivization of health care, and of health itself. Just as a mixed economy treats wealth as a collective asset, which the government is free to dispose of as it sees fit for “the common good,” so a collectivized health care system treats the health of its members as a collective asset. Under this regime, physicians no longer work for their patients, with the overriding responsibility to act in their interests. Instead, physicians are agents of “society” who must decide the amount and the kind of care they give an individual patient by reference to social needs, such as the need to control costs in the system as a whole. Indeed, even the individual in such a system is urged to protect his own health not because it is in his self-interest, but because he has a responsibility to society not to impose too many costs on it.

To summarize, then, a political system that tries to implement a right to health care will necessarily involve: forced transfers of wealth to pay for programs, loss of freedom for health care providers, higher prices and more restricted access by all consumers, a trend toward egalitarianism, and the collectivization of health care. These consequences are not accidental. They follow necessarily from the nature of the alleged right.

The long-term direction of public policy is not set by electoral politics, or by horse-trading in Congress, or by this or that court case. In the long term, at a basic level, public policy is set by ideas—ideas about things are just and worthy, what rights and obligations we have as individuals. The idea that people have a right to health care is inimical to our genuine liberties. The policies that flow from that idea are harmful to the interests of doctors and patients alike. To fight against those policies, we have to attack their root.1) To begin with, of course, the government has to tax some people to pay for medical subsidies offered to those it considers to be in need. So the first consequence of implementing a “right” to medical care is forced transfers of wealth from taxpayers to the clientele of programs like Medicare and Medicaid. And this will inflate the demand for health care services. Offering free or heavily subsidized care is inevitably going to increase overall use of the health care system.

It is also worth noting that the Supreme Court has never recognized a constitutional basis for any welfare right, including the right to medical care. The Court recognizes that the concept of rights embodied in our legal system is the concept of liberty rights. Welfare rights are a product of later movements to expand the role of government beyond the original conception of its role. In our constitutional system, there is no requirement that the federal government provide health care. Health care entitlements, unlike fundamental rights like freedom of speech, have to be invented by legislators.”