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Healthcare is a Right
by Max Borders
Healthcare is important. People get sick and injured. As
compassionate human beings, we should do what we can, within
reason, to see that people are treated-especially when they don't
have the means to get treatment themselves. We can build and
support charity hospitals. We can volunteer for free clinics. We
can take sensible policy measures that will reduce the costs and
increase the access to medical goods and services.
But we cannot pretend that healthcare is a right.
This sort of verbiage is just that-verbiage, until it requires
enforcement. And if you have been tempted to think of basic needs
as being rights, remember this: Rights confer duties upon others.
And that has tremendous implications for any healthcare system.
Think about a right of free speech. That right confers a duty
onto others not to interfere with or mute your expression, as long
as you're not harming or threatening anyone. But when it comes to
certain other purported rights involving things that must be
produced by others, like education or healthcare,
that means others have a duty to produce that good or service. And
once we slide from the apparently benevolent talk of people having
rights, to the reality that other people will then have enforced
duties to produce that right, we also slide from individual
compassion to state compulsion. In other words, any such right
necessarily conflicts with others' rights not to be treated as
means to some end.
In the process of outsourcing our sense of compassion to a
central producer of healthcare goods and services, we cede our
healthcare choices-and charitable instincts-to a central authority.
How else is the government going to ensure that healthcare is
produced, by right, for everyone?
This central authority, with its attendant healthcare
bureaucracy, is not very good at figuring out who needs what and
how much they need of it. Socialized, or "single payer" healthcare
systems that are meant to allocate healthcare goods and services
have very different incentives than systems in which people
exchange goods and services freely.
In the Soviet Union, planners had no price system to help them
determine how many shoes were needed in Minsk or boots were needed
in Moscow. Supply and demand was guesswork and "targets"-with all
the attendant problems of political allocation, buck passing and
bread lines. The Soviet economy, marked by shortages and gluts,
could not very effectively be planned. The same can be said about
the modern single payer healthcare system.
Consider our neighbors in Canada. In the Fraser Institute's
annual report, "Waiting Your Turn: Wait Times for Health Care in
Canada," the Canadian think tank says the median wait time in 2013
hit 18.2 weeks, three days longer than in 2012. The average wait
time for orthopedic surgery, in particular, reached 39.6 weeks for
treatment, while patients waited an average 17.4 weeks for an
appointment with a neurosurgeon. During this time, people were
suffering. Some even died. And yet all of this is happening in a
country where healthcare is considered a right that confers duties
on taxpayers. Can the suffering that flows from rationing be
considered compassionate? If treating healthcare as a right has
these sorts of perverse consequences, shouldn't that lead us to
question all such rights talk?
Put another way: Let's grant for a moment that healthcare is a
right, or, at least, let's assume everyone wants healthcare to be
something that our fellow citizens have access to. If we all agreed
to that, what if we determined that a free market in medical care
allowed more people to gain greater access to healthcare goods and
services in a timely manner? Would a "right" to healthcare then
confer duties upon policymakers to introduce measures that would
make the healthcare market freer, for example:
Combined, the measures listed above would revolutionize the
healthcare system in terms of price, quality, innovation, and
access by the least advantaged.
Talk of "rights" is just a rhetorical game progressives play to
get the policies they want (usually a single payer system). But
talk of "rights" does nothing for the goal of actually figuring out
how to get people reasonable access to the healthcare they need. To
do that, we have to deal directly with the problems of
affordability (as in the U.S.) or with the perverse consequences of
rationing (as in Canada). The disastrous rollout of Obamacare just
might stimulate a serious, widespread discussion of these options
for the first time.
Yes, healthcare is something we'll all need at one time or
another. But it is not a right. If we really care about people
getting healthcare, let's focus on how to reform the system for
good-so that free people can generate abundance in healthcare. If
we can do it for mobile devices, we can do it for medicine.
Editor of The
Freeman and Director of Content
Foundation for Economic Education
"Can This Man Save Healthcare?" by Jordan Bruneau:
"Are We Really All Healthcare Collectivists Now?" by Sheldon
"Do We Really Want a Right to Healthcare?" by Theodore Levy:
"A Cure for Obamacare: From Canada with Love" by Gregory
"Healthcare's Muddled Incentives" by Arnold Kling: