Why Health Care is Not a Right

The following is an excerpt from Dr. Michael Hurd’s chapter on health care reform in his book: Bad Therapy, Good Therapy: And How to Tell the Difference (2011). The book is available at Amazon.com, at DrHurd.com, and bookstores.

The notion that health care is a moral right requires vigorous challenge. Politicians like to claim that the so-called ‘national interest’ must supersede ‘narrow’ interests, and that the law must guarantee medical/mental health treatment.

Think carefully about this argument. Is it really in the national interest to alienate health care providers from their patients and clients? Can a managed care bureaucracy (one that many health care providers and patients/clients deeply resent) be improved by a complicated, arbitrary web of government directives designed to institutionalize such a system? Can a National Health Board of six or eight politicians actually succeed where free market mechanisms have supposedly failed?

Many are tempted to believe that national health insurance, especially a single-payer plan such as the Canadian system, will solve the problem of medical inflation. Supposedly, with the stroke of a politician’s pen, (1) the American system would be instantly streamlined, (2) each American would have all the health care he desires just by virtue of his or her American citizenship, (3) insurance paperwork would magically decrease, (4) physicians could regain their professional integrity and, best of all, (5) the kind and compassionate federal (or state) government would forever eradicate from the medical profession what is widely viewed as the stench of the profit motive.

No, no, no, no and no. Consider a more fundamental point: Is health care really a moral right? One might reply, ‘Why, yes, National health insurance means everybody gets the medical care he deserves. Because medical care is a life or death issue, medical treatment has to be viewed as a moral right. The government is obliged to provide its citizens with that right.’

What exactly is a ‘right?’ The morality implied by the American Constitution, although never explicitly stated, is that rights are inherent to man’s nature. As such, then, the government cannot ‘create’ or ‘take away’ man’s rights. It can only protect them or fail to protect them. As the philosopher Aristotle pointed out several thousand years ago, man is a rational animal and cannot survive on mere instinct or biological preprogramming as do lower animals. Man survives through the use of reason—the free and uncoerced use of his individual and independent judgment. I stress the term ‘uncoerced’ because individuals are no longer free to think or reason the moment that force (or even the threat of force) is introduced. No mind can think under the threat of force; an individual can initiate thought only if he or she actively and voluntarily chooses to do so.

Individual rights, then, protect the freedom of an individual to use this method of survival without the threat of coercion from others. Rights apply strictly to freedom of action; there is no ‘right’ to the consequences of someone else’s action. You and I have a right to make bread or to trade with the local baker for bread. But neither you nor I have a right to take the baker’s bread without his voluntary, uncoerced consent. If we did, in fact, possess such a ‘right,’ this would make the baker our slave. The same is true of any commodity or service that an individual creates through his own physical and mental efforts.

If this argument sounds idealistic, consider the utter practicality of freedom and individual rights if they were to be acted on consistently. In a free society (not to be mistaken for today’s mixture of welfare socialism and limited free enterprise), all individuals are free to develop their potential, and then benefit through the voluntary exchange of the product of their efforts. A ridiculous myth persists that nineteenth century capitalism was an era of ‘robber barons’ and cruel indifference. History clearly shows that the Industrial Revolution raised the standard of living for everyone and provided even the poor with a lifestyle that would have been the envy of monarchs two centuries earlier. There is nothing mean-spirited about an economic system that respects the moral dignity and freedom of individuals while simultaneously allowing for unprecedented improvements in the quality of human life.

No government can or ever will be able to create the kinds of technological and medical advances that Americans increasingly take for granted. Governments can only effectively fulfill the role of the jailers, the police officers and the upholders of private contracts. Force, not creativity and ingenuity, is the only arena in which government can excel. Unfortunately, in mixed welfare-market economies such as ours, governments have been given the power to seize, ‘manage’ or redistribute the products of man’s efforts—but only after the products or technologies are discovered and mass-produced by willing, productive individuals.

Most ‘liberal’ and ‘conservative’ politicians understand this fact, which is why so few of them are ideologically committed to full-scale socialism. They realize that productive individuals must be left free enough to produce a sizable tax base so that the enterprise of government may continue at the involuntary expense of those who provide the wealth in the first place.

These same cynical, often shamelessly hypocritical politicians are the inevitable outcome of an economy based on a perverse mixture of freedom and socialistic redistribution, all in the so-called public interest, of course.

Whether or not the government ultimately succeeds in its never-ending efforts to completely nationalize the private practice of medicine, one fact can never be wished away: Only uncoerced individuals, working in the spirit of voluntary and rational cooperation, can create the products and knowledge required for human survival and the luxuries required for the good life. This explains why the protection of individual rights is of paramount importance, and why a free society needs strictly limited government. A free society requires a government to protect the right of individuals to create, keep and dispose of the fruits of their efforts as they see fit. A right is violated only through the initiation of force, the threat of force, or objectively provable fraud or deceit. A police force, a voluntary military, and a civil and criminal court system are all necessary to avoid the chaos that would result in the absence of a government monopoly on force. At />the same time, strict limits must be placed on the government itself to prevent envious or other opportunistic individuals from seizing the reins of power and imposing force on peaceful citizens, as politicians of the last century (in America) have routinely accomplished in varying degrees. The breakdown in social harmony brought about by too much or too little government is exactly what the (original) American concept of limited government was designed to prevent.

Altruistic arguments about compassion, fairness and equality do not work here. One individual’s need is not a mortgage on another individual’s life. I am not morally guilty if I earn a million dollars and my neighbor does not. Nor do I have a right to even one penny of his million dollars if he earns it and I do not. The free individual decides who is worthy of his charity. The government has no right to seize part of his income by force and redistribute it to another who allegedly needs it more. Nor does the government have a moral right to take over an entire profession, outlaw private and voluntary contracts between doctors and patients and then determine, by some incomprehensible bureaucratic formula, what constitutes ‘reasonable’ prices. Whenever there is a so-called ‘debate’ on the role of government in medical care, both sides (liberal and conservative) take it for granted that the physical and mental efforts of health care providers are a national resource to be divided up as any government agent (or ‘community organizer’) who manages to seize power may see fit. These debates are strictly limited to the ‘rights’ of the uninsured, the ‘rights’ of employers, and the ‘rights’ of patients. It is a rationalization of unthinkable proportions to presume that a health care provider’s creative energies and rights can be placed on the auction block of Congress and sold to the highest bidder. It is a still greater travesty when health care providers, the very victims whose lives and energies are being negotiated away by frantic and confused politicians, endorse such efforts in the name of professional self-interest.

What could they possibly be thinking?

Health care providers often do not understand that the government regulation they welcome as the supposed savior of their professional integrity and financial livelihoods is the very monster that created medical inflation and physician-patient alienation in the first place. The evidence of the past seventy-five years suggests that the real causes of medical inflation include: (1) unfair and irrational tax codes (instituted in 1942) which effectively prevent individuals from purchasing health insurance on their own and without relying on their employers, (2) a fifty year spending spree by both doctors and patients under Medicare and Medicaid programs that pick up the tab for many hospitalizations (or, when the government deficit explodes, force private hospitals to cover the losses) and, (3) senseless and outdated licensing laws that grant physicians a monopoly on certain medical treatments that could just as competently, and far less expensively, be performed by other medical professionals such as nurses and physician’s assistants.

These factors are further complicated by the fact that the few remaining ‘private’ insurance companies, operating with full government encouragement and (in some cases) actual subsidies, have adopted the policies of government agencies by managing and, some would argue, actually rationing medical and mental health care. Insurance companies, in my opinion, should not be condemned for merely trying to survive and make a profit in today’s over-regulated medical marketplace, so long as they’re honest and do not demand government subsidies to keep them in business. At the same time, the creation of such a system by government policies obscures the fact that a genuinely free market has not existed in the field of medicine and mental health for nearly a century.

The argument against total nationalization of health insurance is not a ‘conservative’ one. As any health care provider knows, there is precious little that’s worth conserving in today’s government-mandated, government-regulated third-party reimbursement system. Detailed and practical information on free market approaches designed to gradually phase-in a free market in the fields of medicine and mental health are increasingly available to any individual who practices introspection instead of anxiety-driven, range-of-the-moment thinking.

At the same time, one should not consider practical free market solutions until first understanding the morality of freedom and individual rights, as opposed to rule by government force. Only then will one see that the establishment of a free market in medicine is consistent with both the national interest and the ‘narrow’ interest, as politicians so off handedly refer to the private practices and hard-earned skills of health professionals.


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