September 14, 2009

What ‘Right’ to Health Care?

During Senator Edward Kennedy’s funeral in Boston’s Mission Church last month, his 12-year-old grandson offered an intercessory prayer:

“For what my grandpa called the cause of his life,” Max Allen said, “that every American will have decent quality health care as a fundamental right and not a privilege, we pray to the Lord.”

Opinions differed on whether a funeral was the right place to importune the Almighty for universal health care. But that He is the source of fundamental rights is in fact a core American belief. The Declaration of Independence pronounces it a self-evident truth that human beings “are endowed by their Creator with certain unalienable Rights” - rights that include life, liberty, and the pursuit of happiness. Health care isn’t on that list. Should it be?

A great deal depends on the answer, for the Declaration’s very next sentence affirms that the purpose of government is to “secure” those rights against infringement. If access to health care is deemed a fundamental right, then the government must be obliged to guarantee that access to every citizen. Medical treatment would have to be available on an equal basis to anyone seeking it, regardless of age or physical condition or ability to pay. Washington could no more entrust the provision of health care to private markets than it does freedom of religion: Your religious liberty, after all, is not a commodity you must purchase - it is yours by right, no matter where you live or how much you are worth. Should the same be true of health care?

Ted Kennedy was hardly alone in saying so.

When Barack Obama was asked during one of the 2008 presidential debates whether health care is a right, a privilege, or a responsibility, he answered promptly: “I think it should be a right for every American.” The 2008 Democratic National Platform avows in its opening paragraph that “affordable health care is a basic right.” When the Harvard Community Health Plan commissioned a survey on the subject some years back, 90 percent of respondents said that everyone had the right to “the best possible health care - as good as a millionaire.”

It is not hard to understand the urgent passion with which so many people approach the issue of health care. And it would take a remarkably cold heart to be indifferent to the desperation of those who need medical help but cannot afford it. But rights do not spring from passion or need. Wanting something does not entitle you to it - not if someone else must provide or produce that something. The rights delineated in the Declaration of Independence and the Constitution are negative rights only - they protect our autonomy, allowing us to peacefully live life and pursue happiness, neither coercing others nor being coerced by them.

My right to free speech or to own property does not give me a claim on anyone else’s time or labor or resources. But if I have a “right” to health care, someone else must be compelled to provide or pay for that care. Compulsion comes in different forms - higher taxes, insurance mandates, health-care rationing, intrusive regulations - but the bottom line is the same: a right to health care would leave society less free.

It may seem noble to declare that health care is a fundamental human right and not a mere commodity to be left to the vagaries of the market. Of course, the same thing could be said about food or clothing - also essential to human welfare - yet not even Ted Kennedy would have suggested that Washington nationalize US food production or overhaul the clothing industry. It is precisely because food and clothing are seen as commodities, because we do leave their availability to the market, that they can be had in such abundance and diversity.

Some people will always need help. No decent person ignores the cries of the sick or hungry or poor. Happily, there is no better system for achieving the widest possible access to health care - or any other good or service - than the one that requires the least degree of political interference: the normal interplay of supply, demand, and competition. Health care is too important to be left to the market? No, it is too important not to be.

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