7.29.2009

On Health Care and Chicken Kiev

A British doctor asks in today's WSJ, "Is There a ‘Right’ to Health Care?" Although he is somewhat mistaken, or at least imprecise in the formulation of his answer, he covers some of the key essentials:
If there is a right to health care, someone has the duty to provide it. Inevitably, that “someone” is the government. Concrete benefits in pursuance of abstract rights, however, can be provided by the government only by constant coercion. [bold added]
While I think adding the concept of "duty" and assigning it to the government muddies the central thrust of the argument, he correctly identifies that the only way government can live up to this "duty" is by "constant coercion." The problem I have with this particular line of reasoning is that by focusing on duty, he ignores who is being coerced, namely medical professionals primarily, as well as the individual customers, but in light of the rest of his article this is a minor criticism.

Theordore Dalrymple (a pen name) goes on to make some very good points, such as attacking the notion that health care is somehow a special class of good that is an essential precondition for human survival, by comparing it to food and shelter, saying, "everyone agrees that hunger is a bad thing (as is overeating), but few suppose there is a right to a healthy, balanced diet..."

Ultimately, his argument suffers because he does not define the nature of individual rights and why the assertion of a "positive" right to a good provided by someone else is a fundamental violation of individual rights. Still, his examples of the British system are instructional and foreboding considering the path America is on, and he also gets in some great pithy comments.

The government-run health-care system—which in the U.K. is believed to be the necessary institutional corollary to an inalienable right to health care—has pauperized the entire population. This is not to say that in every last case the treatment is bad: A pauper may be well or badly treated, according to the inclination, temperament and abilities of those providing the treatment. But a pauper must accept what he is given.

Universality is closely allied as an ideal, ideologically, to that of equality. But equality is not desirable in itself. To provide everyone with the same bad quality of care would satisfy the demand for equality. (Not coincidentally, British survival rates for cancer and heart disease are much below those of other European countries, where patients need to make at least some payment for their care.)

In any case, the universality of government health care in pursuance of the abstract right to it in Britain has not ensured equality. After 60 years of universal health care, free at the point of usage and funded by taxation, inequalities between the richest and poorest sections of the population have not been reduced. But Britain does have the dirtiest, most broken-down hospitals in Europe.

There is no right to health care—any more than there is a right to chicken Kiev every second Thursday of the month. [bold added]

Again, not a perfect argument overall, but very good, and the simple statement that "there is no right to health care" is one that needs to be shouted from the rooftops. Now, we just need someone who knows Dalrymple to send him a copy of Leonard Peikoff's "Health Care is Not a Right." Imagine how much stronger this already good article would be if he could fully defend a free market in health care, and the individual rights upon which such a market depends.

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