Wednesday, September 04, 2013

Is There a “Right” to Healthcare?

According to the late professor of Philosophy, Politics and Economics at Duke University, John David Lewis there is not, at least as interpreted by Jared Rhoads at The Objective Standard where he reviews a newly published essay that appears in a Medical Ethics text; Medical Ethics, 2nd Edition, edited by Michael Boylan. The key part from Rhoads’ review:

Lewis describes two basic and conflicting views of rights in America today. One is the idea of rights as entitlements to goods and services. The other is the idea of rights as moral prerogatives to freedom of action.

The first view holds that if a person has an unmet human need—a need that could be satisfied by some good or service—then it is incumbent upon others who are able to satisfy that need to do so. In other words, needs impose duties.

Lewis explains that this view fails in two important ways. First, because human needs are boundless, the consistent application of the notion that needs impose duties would lead to an endless creation of duties, and to ever-increasing government control over the lives of citizens, precisely because there is no end to the needs that one person may demand that others satisfy.

The other main problem, Lewis explains, is that imposing duties upon one person in the name of satisfying the unmet needs of another inescapably violates the rights of the first person. Applying this to health care, Lewis writes, “There is no right to medical care because there is no right to coerce medical professionals to provide it.”

The correct conception of rights, Lewis explains, is that rights define the scope of an individual’s freedom of action against which others may not infringe. Health care cannot be a right because health care consists of goods and services that are provided by medical professionals—people who have a right to think and act in pursuit of their own happiness and values just as anyone does. “To claim a right to medical care,” explains Lewis, “is to claim nothing less than a right to run the lives of those who must provide the care.”

I agree with this view. We often use the terms “rights” and “entitlements” interchangeably but they are not any more interchangeable than apples and oranges are. The Lewis essay being reviewed is not linkable but Rhoads’ interpretation is consistent with another (or the same? I don’t know.) Lewis essay, found here. Again, the key part:

These two concepts of rights -- rights as the right to liberty, versus rights as the rights to things -- cannot coexist in the same respect at the same time. If I claim that my right to life means my right to medicine, then I am demanding the right to force others to produce the values that I need. This ends up being a negation of personal sovereignty, and of individual rights.

To reform our health care industry we should challenge the premises that invited government intervention in the first place. The moral premise is that medical care is a right. It is not. There was no "right" to such care before doctors, hospitals, and pharmaceutical companies produced it. There is no "right" to anything that others must produce, because no one may claim a "right" to force others to provide it. Health care is a service, and we all depend upon thinking professionals for it. To place doctors under hamstringing bureaucratic control is to invite poor results.

The economic premise is that the government can create prosperity by redistributing the wealth of its citizens. This is the road to bankruptcy, not universal prosperity. The truth of this is playing out before our eyes, as medical prices balloon with every new intervention, and we face the largest deficits in human history.

If Congress wants to address health care issues, it can begin with three things: (1) tort reform, to free medical specialists from annual insurance costs of hundreds of thousands of dollars; (2) Medicare reform, to face squarely the program's insolvency; and (3) regulatory reform, to roll-back the onerous rules that force doctors, hospitals and pharmaceutical companies (who produce the care that others then demand as a "right") into satisfying bureaucratic dictates rather than bringing value to their patients.

Carried to its logical conclusion, the idea of unmet human needs being “rights” necessarily says that if I need food, another person is obligated to provide it if I can’t (or won’t). If I need shelter, another is obligated to provide me with it, etc. I would also argue that if this view of rights prevails then for actual Constitutionally enumerated rights such as oh, say, if I can’t afford to pay for a gun when the Constitution says (and it does) I have the right to keep and bear arms then I should be able to coerce the government into (read; the taxpayer, otherwise known as you, if you’re in the ~53% of the population that actually pays any) providing me with said gun. Do we really want to go there?


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