Monday, August 31, 2009

Another Stupid Argument: Heath Care is a Right

Proponents of a government-run health system would like us to believe that universal health care is a right owed to every citizen of the United States of America (and illegal aliens). However, this assertion is plagued with the typical liberal-logic, which is almost always completely devoid of any actual logic and common sense. Let’s examine their notion in greater detail.

First, we must understand what exactly is meant by the “right to health care.” For instance, do they intend that everyone have access to health insurance, health, or health care? Clearly, no one can reasonably expect everyone to have access to “health” because there is no way to control a person’s health, and all of us will eventually die regardless of government efforts. While the liberal mind may actually believe everyone deserves “health” we will avoid discussing this possible interpretation because holding this belief is easily dismissed as lunacy.

In contrast, one is able to make an argument that everyone has a right to health insurance or health care. The latter case is actually useless to argue (from either the conservative or liberal viewpoint) because everyone in America can have health care today – they just have to pay for it. Being unable to afford health care is an entirely different argument than not having health care. (As an aside, the Emergency Medical Treatment and Active Labor Act passed by Congress in 1986 prohibits hospitals from refusing medical treatment to an individual with an emergent medical need, regardless of ability to pay.) In fact, America’s highest-in-the-world heath care expenditures are a reflection of our unabridged access to health care because those figures include cosmetic surgery, cosmetic dental work, and other treatments not paid for by health insurance. In the United States, if you have the money you can have the treatment. In addition, anti-discrimination laws preclude refusing treatment for discriminatory reasons – when discrimination does happen in relation to medical treatment it is not for lack of existing laws. Arguing that the high cost of treatment is discriminatory against the poor is baseless because they can have the treatment if they pay for it, just like everyone else. The corollary would be arguing that a car dealer is discriminating against a poor person by not giving them a Maserati – you have to pay for what you buy.

We can clearly demonstrate that the issue is not about receiving health care; therefore, the government-run health care proponents must be arguing that everyone should be given medical treatment regardless of their ability to pay. In their small minds, this equates to having health insurance; therefore, they argue in favor of health insurance for everyone. Those who cannot afford health insurance should be given it free of charge and those who can afford it must purchase it, plus pay for those who can’t afford it. However, health insurance is not about access to health care. Health insurance exists to protect the insured’s financial well being in the event of an unexpected medical condition. Because insurance pools the risks among all the insured there are limitations placed on what treatments are covered by the policy, i.e. the “pool” of money paid into the plan is finite and not all procedures can be covered without running out of money. It doesn’t matter if the insurance is provided by a massive federal government (e.g. Medicare, VA) or private insurers: resources are limited in both cases. In the macro or national view, there are both the financial constraints and the provider resource constraints (the number of nurses, doctors, facilities, etc.). As a result of financial constraints, insurers (including the government) place limitations on what treatments they will pay for, how much they will pay for those treatments, and how often or under what circumstances you can receive those treatments. The physical constraints in the health care system result in limitations on physician availability, appointment flexibility, and treatment scheduling. In Canada and the UK, the governments’ strict financial limitations results in a lack of physical resources (owing to lack of profitability or even ability to provide salaries and equipment) and consequent scarcity of appointments, general practitioners, and procedure availability. We refer to this collectively as “rationing.”

Therefore, anyone who believes heath care is a fundamental right must answer to what aspects of health care an individual has a specific right? Who decides what treatment is a right and what isn’t? If the government mandates that free health care is a right, then wouldn’t it be denying that right to the wealthy if they are to buy their own insurance and pay additional taxes for health care insurance for the “poor?” Does everyone have a right to stem cell therapy for the treatment of leukemia, or is only chemotherapy a right? How do we know? The danger of declaring health care a right that must be provided regardless of ability to afford it is that it places the answers to these questions in the hands of the government. While some point out that private insurers are already rationing on a financial basis, they fail to realize that insurance is not synonymous with health care. Even though insurance does not pay for everything we are still free to pay for our health care on our own.

When government declares universal access to health care (i.e. irrespective of ability to pay) is a fundamental right, but then defines what will and will not be paid for, it is selectively determining our rights. In addition, will the government then outlaw the private purchase of additional medical treatments? In Canada, the government enacted public health care and quickly banned private insurers from competing because it was deemed “unfair” – a two-tier system where the wealthy got better care than the poor. If the government decides a specific treatment isn’t a “right” then it is likely to ban anyone from receiving said treatment because no one would have a "right" to that treatment.

The cruel irony is those who want health care reform to look like it does in HR 3200 miss the point. Health care in America is too expensive. Health insurance is partly to blame because it isolates the customer from the costs (moral hazard) and allows prices to rise unabated. HR 3200 would expand the role of health insurance and worsen the moral hazard thereby furthering the divide between costs and access. Americans need and want REAL reform that brings costs down and has less government; the Obama – Pelosi - Waxman plan does neither. Remember, if government decides health care is a right then the only change is that government can decide who doesn’t get health care.

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