Wednesday, June 28, 2017

Why It's Not a Right

Last month I put up a post on Viewpoint defending the claim that health care (or health insurance) is neither a right nor a privilege. A friend wrote to ask me to expand on my reasons for holding this view, and I thought I'd share on Viewpoint my response to him.

Here's my reply edited and somewhat expanded. The arguments are the same, I think, whether we're talking about health care or health insurance:

If everyone has a right to have health care provided for them then why do we not also have a right to have a home, food, transportation, clothing, etc. provided for us? All of these are just as important as health care to our well-being, but if we maintain that people have a right to these things that implies that others have an obligation to provide them. We may, as compassionate people, choose to provide them for others, but if so, it's an act of personal or corporate charity, not an obligation imposed on us by others.

If we do think of it as an obligation then the recipient need feel no gratitude, nor is the donor being virtuous or compassionate if all he's doing is meeting a state-imposed requirement.

You yourself made a truly wonderful choice a few years ago to donate a kidney to enable someone to live, and what made your decision so marvelous is precisely that you didn't have a duty or an obligation to do it. It was completely gratuitous.

If, however, you had been coerced by the state to provide the organ then compassion would've been no part of your act. There would've been no more virtue in it than there is in paying your taxes. Likewise, though I'm sure the recipient of your kidney was extremely grateful for your sacrifice, if he/she believed that you had a duty to make that donation, gratitude would've been out of place. That's a major problem with our welfare system, by the way, it stifles both compassion and gratitude by making support of the needy something to which they feel entitled.

Parenthetically, if people have a right to health care do people who are in need of an organ have a right to be given that organ? If so, doesn't that mean that we have an obligation to provide our organs to them, at least if, like kidneys, we have more than we need? If they have a right to our money to subsidize their health care why would they not have a right to our organs, especially those organs of which we have a surplus?

Another difficulty is that a "right" to health care is not like other rights that are intrinsic to our being human - rights like the right to life, liberty, etc. Those rights impose no duties upon others beyond obligating them to refrain from impeding us in our exercise of the right (within reasonable limits, of course). A right to health care, however, imposes an obligation on other people to provide it.

Suppose I live an irresponsible lifestyle that causes me to develop diabetes with all its concomitant health complications. Then you, essentially, have a duty to subsidize my irresponsible lifestyle by providing insurance for me against those complications. In my opinion, you should be no more required to pay for my irresponsible lifestyle choices than you should be required to pay my grocery bill or mortgage. You may choose to do so (and you, being the sort of man you are, probably would), but it would be an act of grace, not of duty.

Suppose, too, that society can't afford to pay for health care for everyone and can no longer insure it without bankrupting itself. What are the reasonable limits on one's right to health care? If no money was available to fund it we wouldn't claim that individuals' rights were being denied because their health care was no longer being subsidized, but then health care would be a basic human right only if our nation can afford it.

At what point, then, do we decide that providing health care for others is no longer affordable? Surely, at some point the right to keep one's property overrides another person's right to have health care. If we deny that then we're saying that we must provide health care coverage even if it means confiscating everyone else's property in order to pay for it, or if it means forcing medical professionals to provide care for free.

Health care is like owning a house. We all have the right to own a house - no one can legally prevent us from purchasing one - but we don't have the right to demand that others buy the house for us no matter how badly we might need it. If we can't afford housing then people may wish to provide shelter for us, but we don't have the right to demand it of them.

At least that's how I see it.

Understand, this is not an argument against single-payer or Obamacare. We may as a society comprised of good and generous people decide we want to provide health coverage for everyone, to the extent that a wise, affordable program can be crafted. It is an argument, however, against the assertion that anyone has an inherent human right to such coverage.