There is a question about whether or not a citizen having health insurance adequate to cover most any operation or medical procedure that is needed or certainly affects the quality of life. You can hear it when a liberal and a libertarian discuss political philosophy and economics. One will say, “No one has a right to receive any good costing thousands of dollars from ‘society’ because they need to work for what they want and need. Everyone is responsible for themselves.” The other will retort “Every other industrialized nation in the world provides medical care to its citizens; it’s up there with a 40-hour work week (or less), maternity leave, and the right to unionize in the workplace.” I mostly side with the latter; I do believe that healthcare is a right. That is, I believe that everyone in the United States should have some form of health insurance, the least of which being some kind of single-payer system (e.g., Medicare). Here are my reasons, and I have some quotes indicating healthcare is a right to back me up.
Libertarians are the likeliest of all Americans to come down on the side of the argument that goes like, put most simply, “Society is not there to give you stuff; you have to work for it.” It is a woefully bad argument.
Before I disarm that argument, let me share this by Avik Roy. It does show some of the nuances, and does give me pause in regard to my sanguine progressive argument:
“What if I smoke two packs a day, and I come down with chronic obstructive pulmonary disease, a costly chronic condition. Do I have a right to the money of other people, in order to care for a disease that I, in all likelihood, brought upon myself?
A progressive might respond that we need to provide basic health care to everyone, so that no one is left dying on the street after getting hit by a bus. But we already provide “free” emergency care to every American. So what else counts as basic health care? Is Viagra health care? Is all health care a right, or just some? And who decides?”
Roy, who is a Forbes editor, is wise to point out the difference between positive and negative rights. Get this: “The progressive conception of health care as a positive right misses something important: that we could provide better, and more affordable, coverage for everyone if we understood the degree to which classical liberal principles, like choice and competition and voluntarism, can achieve a superior form of universal health care. The libertarian conception of health care as a negative right, however, also misses something important: the degree to which it is a worthy thing for us to pool our resources in order to support those who, through no fault of their own, find themselves with disability or disease.”
So these are not cut and dried issues. There is a very strong case, though, that at the very least, America could do much better in providing for the health of its citizens – which libertarians must agree is in society’s top three charges. If we are all unhealthy and dying, what is the point of being a country? Recall that Cuba and El Salvador have a lower infant mortality rate than the United States. Certainly, libertarians aren’t comfortable with that statistic.
Indeed, society IS there to give you stuff – or rather, to provide its productive citizens (and its other ones, too) with goods and services that an advanced, industrialized country is capable of making available to all. And no, it shouldn’t just be those who can “afford” to pay for health insurance (more on that later). Indeed, I believe that healthcare is a right, which means that society is under an obligation to make it available. It only benefits society to do so! Do you realize how much productivity is lost in a given year when people are overworked (like in America), depressed (as is too often the case in America), and when a mother has to worry about childcare issues (as is more often than not the case in America)?
Pet owners, imagine your furry loved one suffering and ailing and even dying because you didn’t have enough dollars. How arbitrary and horrible! Such is the case many, many times a day in this country. With humans, the case for universalized health care is even clearer.
Ask a libertarian who has this bizarrely austere belief if they expect everyone deserves protection from their house burning down (fire department), from assault and to settle disputes (the criminal justice and law enforcement systems), and the military to provide equally for the protection of citizens, don’t they? So how is healthcare any different? One of the primary differences between a libertarian and a more egalitarian liberal position is in regard to the proper role of government (e.g., society as a whole) in the life of an individual. The former tend to believe that “you’re on your own”, whereas the latter often feel that “we’re all in this together.” For a solid treatment of this philosophical difference, see Jared Bernstein’s book All Together Now.
Apart from the “progressive-versus-individualistic” aspect, one could ask, What is a right? A right is something that entails moral desert (pronounced “dessert”). Moral desert means “one has a moral claim to some societal good or status or treatment.” Like when your parent would ask if you had been good all year when you would ask for a Christmas present. Or if you deserve actual dessert as a child (it depends on whether you have eaten your peas). None of this implies that nothing is required of the individual vis-a-vis society for said desert. When I use the term right, I don’t mean a right to free speech that is sacrosanct according to natural law or the U.S. Constitution and Bill of Rights. I mean, do you have a reasonable expectation of something? If you are injured, do you have a reasonable right to have an ambulance show up? Do you have the right to send your child to this school or that (or are you able to homeschool them)? That is what I mean.
Thus, I think health care is a right. That is, no person in society should be denied what could be made commonly available to all, and which is salubrious and necessary and humane. Money is not a fair reason to deny provision of these goods, just as one’s physical appearance, race, or handicapped status should.
You might hear that it is hugely expensive, and potentially could bankrupt us to give insurance to everyone. There are many reasons that this is not so, and the disqualification of this as a reasonable objection provides some support for the position that health care is a right.
Primarily, health care is a right but it is also damned expensive in this country. Incredibly so. Outlandishly so. Why? Our health system is profit-driven. We have private insurance companies to mediate between service providers and patients. They take a huge percentage of what people pay for their care, upwards of 30%. No, Americans don’t “overutilize” doctors; in fact we tend to avoid them if we can! Nor do too many physicians specialize rather than providing primary care. It is true that medical device manufacturers produce the latest and greatest very quickly, and doctors more often use those new-fangled machines on patients. As well, pharmaceutical companies spend a lot of money in R&D, and of course, marketing and pay for executives. Finally, we spend too much on end-of-life care; at some point, rationing is rational.
It all adds up to an expensive system. Try the $25 aspirin on for size (source).
There’s no small-government solutions for globalization. There’s no small-government solution for force five hurricanes. There’s no small-government solution to the health-care crisis. There’s no small-government solution to economic inequality.
However, there are things that can be done to bring costs down. But make no mistake, health care is a right because every person in every advanced country pays for health insurance; it’s not a matter of “the government” “giving” it to citizens “for free.” It is a matter of who pays and when; do you pay Blue Cross or Aetna out of pocket, does your employer pay (which is a “benefit”), or do your taxes fund one main payor of medical expenses (e.g,. Medicare or the V.A.)? In the U.S. it tends to fall to the employer and to the individual, but that is not necessarily the most efficient or the fairest system.
When the government can lean on pharmaceutical companies in price negotiations, the savings can be significant. That’s why elderly folks try to take a bus en masse to Canada – their drugs are the same potency and safety, but Canada negotiates down prices because it buys for its citizens in bulk. “Big Pharma” stateside has neutered that idea and politicians have done their bidding. It’s a great example of crony capitalism.
So, yes we need to remove profit from the equation, just as we should in the military (ever heard of a for-profit military?), schools (don’t tell Betsy DeVos I said so), and prisons (for-profit prisons are a moral catastrophe). Profit is part of these societal goods not because that is appropriate or necessary, but because individuals form corporations who pay lobbyists and politicians to make it so. This is a true moral issue writ large. Don’t let anyone tell you any different.
Remember, cost might equal quality when it comes to diamonds and sports cars, but in health care that is not necessarily true. People in Great Britain are generally happy with their service, as are those in the V.A. In fact, any evidence for why the V.A. is failing has to do with not providing funding, not because V.A. doctors suck or because veterans issues are too complex. These single payer systems work, as does Medicare. Americans like Medicare.
Did you see New York University did us all a big favor (and themselves) by making medical school tuition-free? That allows the brightest future doctors to study primary care and not have to worry about how to pay back a $150,000-$250,000 debt.
Below is a Los Angeles Times story you’re going to want to read (click on it).
The second major factor when asking whether health care is a right is the moral aspects. Let’s say we get costs more under control, like other countries do. Providing health care to the citizens of a country makes great sense from a social efficiency and functionality perspective, but does it not just feel like the right thing to do?
Ask yourself this: Do the rich deserve special things? Yes, of course. This society is based on money, and through hard work, brains, and/or luck, the wealthy have succeeded in gathering much of it. Congratulations to them. They are entitled to eat at restaurants the rest of us would consider too expensive, go to St. Bart’s on holiday rather than having to stay home, and can fly first class. No one should begrudge those in the top 5% their entitlement to have a little extra room and a free drink.
Supporting universal health care does not make you socialist or even a liberal, it makes you a human being. And it makes you an ambassador for the American dream which, in the mind of Thomas Paine, was a dream for every human being, not just Americans.
However, when it comes to other, more fundamental societal goods such as being able to see a doctor (and not have to use the emergency room, followed by bankruptcy), get police and fire protection, use roads, breathe air and drink water, we should all be considered equal. It just makes sense from a moral perspective. To someone rich but selfish I would say a) do you really deserve to have all you do, to enjoy such luxury and power, while millions suffer? And b) didn’t your mom teach you about respect, compassion and goodness? What would you feel if you were left out in the cold and couldn’t see a doctor when you got the stomach flu? (and no, spending $1,400 in cash under the threat of bankruptcy doesn’t count).
There is more to life than accruing interest and socking away money. I personally feel guilty keeping some of the money that makes its way into my bank account while I know others are suffering. Many of the greatest minds and biggest hearts throughout history have felt similarly. Here are some of those quotes now that speak in favor of the idea that health care is a right:
Rich or poor, we are all born, we all get sick, we all have accidents, we all need health care at the end of our lives, and we all die. And in my view, the function of a sane health care system in this country should be to keep all of our people well in a cost-effective way, not to make health industry CEOs richer or to drive up the stock prices on Wall Street.
We are dividing the people of the world into those who can afford life-saving drugs and those who cannot. This amounts to a systematic denial of people’s rights to life and health in the poorer parts of the world.
Equality of opportunity is not a natural state; it is a social achievement, for which government shares some responsibility. The proper reaction to egalitarianism is not indifference. It is the promotion of a fluid society in which aspiration is honored and rewarded. ~ Michael Gerson and Peter Wehner
Some doctors pocketed over half a million dollars each, and others received millions of dollars in royalties from products they had a hand in developing. Doctors claim these payments have no effect on what they prescribe. But why would pharmaceutical companies shell out all this money if it did not provide them a healthy return on their investment?
The Constitution has long been venerated by conservative business elites like [Trump] on the grounds that it hands them the power to fend off attempts to redistribute wealth and create new social guarantees in the interest of working people. There’s a reason we’re the only developed country without guarantees such as universal health care and paid maternity leave. While preserving and expanding the Bill of Rights’s incomplete safeguards of individual freedoms, we need to start working toward the establishment of a new political system that truly represents Americans. Our ideal should be a strong federal government powered by a proportionally elected unicameral legislature. But intermediary steps toward that vision can be taken by abolishing the filibuster, establishing federal control over elections and developing a simpler way to amend the Constitution through national referendum.
I had a health issue a few years back, and it really made my faith real. It made me think, the things that the Lord would want to be done, let’s do. His heart is with the downtrodden, so let’s help them.
We’ve all heard those who’ve said that we ought to be satisfied with a health care reform plan that doesn’t include a public option. They seem to think that we ought to settle for whatever bill a few Republicans will sign on to, declare it a victory and go home. What they need to learn is that there’s a difference between declaring a victory – and actually winning one.
Christianity bids us to look beyond our superficial differences in order to focus on what it considers to be a set of universal truths, on which a sense of community and kinship may be built. Whether we are cruel or impatient, dim or dull, we must recognize that we are all of us detained and bound together by shared vulnerabilities. ~ Alain de Botton
Concern for the public good must become the animating force of our economic order. ~ Marjorie Kelly
…massive poverty in the modern sense appeared only when the spread of the market economy broke down community ties and deprived millions of people access to land, water, and other resources. With the consolidation of capitalism, systemic pauperization became inevitable. ~ Arturo Escobar
Health care is a right, not a privilege. Let’s be clear; our health care system is disintegrating. Today, 46 million people have no health insurance and even more are underinsured with high deductibles and co-payments. At a time when 60 million people, including many with insurance, do not have access to a medical home, more than 18,000 Americans die every year from preventable illnesses because they do not get to the doctor when they should. This is six times the number who died at the tragedy of 9/11 – but this occurs every year. In the midst of this horrendous lack of coverage, the U.S. spends far more per capita on health care than any other nation – and health care costs continue to soar. ~ Bernie Sanders
Our Gross National Product now is over 800 billion dollars a year. But that Gross National Product counts air pollution and cigarette advertising, and ambulances to clear our highways of carnage. It counts special locks for our doors and the jails for the people who break them. It counts the destruction of the redwood and the loss of our natural wonder in chaotic sprawl. It counts napalm and counts nuclear warheads and armored cars for the police to fight the riots in our cities. It counts…the television programs which glorify violence in order to sell toys to our children. Yet the Gross National Products does not allow for the health of our children, the quality of their education or the joy of their play. It does not include the beauty of our poetry or the strength of our marriages, the intelligence of our public debate or the integrity of our public officials. It measures neither our wit nor our courage, neither our wisdom nor our learning, neither our compassion nor our devotion to our country. It measures everything, in short, except that which makes life worthwhile. And it can tell us everything about America except why we are so proud to be Americans.
Photo credit Andrew Gombert/EPA
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