Core Essays

The Right to Health Care

Unlike most conservatives, libertarians, and Objectivists, I am not going to tell you that you do not have a right to health care or to health care insurance.  In fact, you do have a right to both, but not in the sense the Progressives would tell us we have the right to them.  No, our right to them takes the same form that our right to all of our real rights takes.  That right must be one equally held by all men and it must not impose an obligation on others to act to give it to us or to provide it to us.

The legislation before Congress at this time, often called ObamaCare, does not provide Americans with a right to health insurance, though its supporters and some of its enemies often say it does.  We all have a right to life, liberty, and the pursuit of happiness.  This right is a sovereign right which we each hold whether we have a legitimate government or not and it is a right we all hold equally.  Illegitimate government is that government which does not simply defend and protect our individual rights, just as our Declaration of Independence properly observed.  When government acts to provide services beyond the protection of our individual rights, it is impossible for it to do so without violating the rights of some of us and usually of all of us.  Any redistribution of income or any requirement that one of us must serve others of us, must necessarily be a violation of the individual right of some of us and then a violation of the principle that each of us is equal in that we have equal standing in our individual rights.  My freedom of speech is equal to your freedom of speech.  My freedom to take action to preserve my life, such as to make arrangements for the care of my health, is equal to your freedom to do the same.  My freedom to own my own body is matched by your freedom to own your own body.  My freedom to pursue my happiness by preventing pain, is matched by your freedom to do the same.

Obama and most of the Democrats in Congress are working very hard to violate many of our most fundamental freedoms at this very moment.  They claim they are trying to give more Americans a right to health care insurance.  This is transparent nonsense.  They claim that they are giving more Americans the right to medical care.  This is also nonsense.  They are in fact proposing a severe violation of our right to health care insurance and medical care.

Health insurance is a fundamental human right in the same sense that freedom of speech is a fundamental human right.  I have the right to speak or not to speak.  I have the right to speak what I want to speak.  I do not have a right to force someone else to write a speech for me.  I do not have a right to force others to gather around me and listen to me talk.  I do not have the right to take a bullhorn from someone else and use it without their freely given permission.  I do not have the right to force someone to build me an auditorium to give a speech in, or to rent it to me, or to allow me to use it on terms that disregard their interest.  Not only do I not have the right to use force personally to do these things, but neither does any government have that right on my behalf.

I have the right to insure my health care or not, providing I can find someone who will willing come to mutual terms with me on the cost and services to be paid for.  Note that Obama and the Democrat majority in Congress intend to mandate that I must buy health insurance or go to jail.  Note that the government intends, if this monstrous bill is passed, to dictate which health insurance plans are acceptable to it, with complete disregard to my individual right to make that determination.  I have the right to seek out medical care, but not the right to force someone to provide it on my terms.  But note that the government, claiming to act on my behalf, will dictate which medical procedures will be paid for by an acceptable health insurance plan and you can be sure, how much will be paid for it.  What has happened to my right to find a doctor to provide me with the medical care I need, as determined by me, and my right to ensure that he will do the work well because I have adequately paid him to do so?

The Democrat politicians in control of the government are making claims that ObamaCare will reduce the cost of health insurance and of medical care.  First, these costs will in fact increase more rapidly with their plan.  But even worse than that, the response of the government will be that of nationalized health care systems everywhere else.  They will push harder and harder to limit and ration the medical care allowed to moderate the rate of increased costs.  Innovations will be stamped out by the government refusal to allow payments for initially expensive experimental procedures.  Doctors will be paid less than they want to work for as ObamaCare works the inevitable through the dense thickets of government agencies involved in its operations, just as Medicaid and Medicare already pay them so little for many procedures and specialties that many doctors will not take patients with those government programs.  Fewer and fewer doctors will soon be working to handle a much heavier load of work as 30,000,000 Americans start gobbling up more and more health care.  Health care will be rationed by allowing waits in doctor's offices to become so long and waits for appointments to become so long that those of us who lead busy lives will be culled out of the population.  We will not go for checkups and minor pains and will wait until it is too late to save us.  We will be allowed to see a doctor, but no longer on terms acceptable to us.  This is a violation of our rights.

This last week, a serviceman was on Fox News and he claimed that marijuana use helped him greatly to cope with his post-traumatic stress syndrome.  A doctor kept insisting that marijuana had not been proven effective as a treatment for this purpose.  This is a clear clash of the nanny state and progressive viewpoint on medical care and our individual rights.  The fact that marijuana has not been proven effective generally for the treatment of post-traumatic stress syndrome is completely irrelevant.  If it is effective for this one, single individual, then the state has no business interfering with his right to act in the best interest of his health, his right to his own body, and his right to pursue his own happiness.  We already have a health care system which has seriously infringed upon our individual rights and ObamaCare is simply going to provide more power to people such as the doctor in the Fox interview who want to further restrict our individual needs for health care.  We see the federal government also taking the wrong stance on marijuana use to ease pain for cancer patients and others.  We see the federal government adding greatly to the cost of medical devices and drug development and slowing down their introduction to the market.  We see them denying the use of drugs which are critically helpful to some patients, because they are deemed not helpful to enough patients.  We also see them telling doctors that they must try drugs in a certain order and overriding the doctor's knowledge that some of the drugs he must try will not work.  He has to use them anyway and prove they do not work, before he can use the drug that he thinks will work.  These are all examples of the government already badly violating individual rights in the name of some collectivist justification.

The major problems in the health care industry presently are caused by government interference.  Medicaid and Medicare are largely subsidized by people who have to pay higher premiums on their private health insurance.  Young people are especially charged more for private health insurance to cover the costs that get shifted to the privately insured.  This is one of the chief reasons why so many young people choose not to buy health insurance.  Health insurance costs are driven sky-high by the requirements of a great many states that insurance policies offered in that state must cover large numbers of procedures and services which many people in the state do not need.  Sometimes, no one needs them, but those who provide the service as a business want to use the state to drum up business for them.  This is why health insurance in New Jersey costs about twice what it does in Pennsylvania.  Another problem is that the federal government allows insurance provided through a business to be tax deductible, but not when a private individual buys it.  Also, the many small businesses cannot deduct health insurance for employees who own more than 2% of the stock of the company.  For most small businesses, this means that someone with very little wealth is treated as though he is the same as someone who owns 2% of GE.  In fact, a very large fraction of the uninsured are small business owners and this discrimination against them hardly helps.  Then there is the problem of excessive medical care awards and litigation for the special interest group of trial lawyers who have their grips deep into Obama and the Democrat Congress by virtue of buying them with huge election campaign donations.  This leads to excessive clinical testing and more expenses aimed to minimize lawsuits and their losses.  Finally, there are many government restrictions on competition in the medical services.  There are many restrictions on the number of doctors and the number of hospitals.  Government acts to increase the demand for medical services, while at the same time greatly restricting the supply side of medical services.  It is no wonder that medical costs have long been going up in a world where most goods and services go down or go up very slowly.
 
If each individual has the right to life, liberty, and the pursuit of happiness, then many, many more rights are implied than those enumerated in the Constitution.  But one thing these rights all have in common is the fact that they never make anyone else serve us.  They only leave us free to manage the many aspects of our own life and to seek associations with others on mutually agreed terms to fulfill our many wants.  The way we do this is through the free markets of a Capitalist society.  This free market allows us consistently many more individual choices and much more room for our individual differences than government control can ever allow.  We cannot exercise our individual rights by means of government-provided services, income redistribution, and mandates that some must serve others.  We cannot do this if we want "to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the General Welfare, and secure the Blessings of Liberty to ourselves and our Posterity."  The framers of the Constitution had a very sound vision of the proper reach of government consistent with our individual rights and the consent of the governed.