Boots & Sabers

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2056, 30 Mar 17

Changing Views on Healthcare

Krauthammer explains.

A broad national consensus is developing that health care is indeed a right. This is historically new. And it carries immense implications for the future. It suggests we may be heading inexorably to a government-run, single-payer system. It’s what Barack Obama once admitted he would have preferred but didn’t think the country was ready for. It may be ready now.

As Obamacare continues to unravel, it won’t take much for Democrats to abandon that Rube Goldberg wreckage and go for the simplicity and the universality of Medicare-for-all. Republicans will have one last chance to try to convince the country to remain with a market-based system, preferably one encompassing all the provisions that, for procedural reasons, had been left out of their latest proposal.

Don’t be surprised, however, if, in the end, single-payer wins out. Indeed, I wouldn’t be terribly surprised if Donald Trump, reading the zeitgeist, pulls the greatest 180 since Disraeli dished the Whigs in 1867 (by radically expanding the franchise) and joins the single-payer side.

Here’s a column I wrote 12 years ago about this issue.

Is There A Right To Healthcare?

One of the major issues facing the country is the issue of healthcare.  The quality of healthcare available today is greater than it has ever been.  We have eliminated diseases that decimated previous generations.  We cure diseases that used to cripple people.  We have not only lengthened the average life span by decades in less than a century, but we have made those later years healthier and more enjoyable than ever before.

All of this comes at a cost.  Healthcare costs much more than it used to because it can do so much more.  In the past, there were many ailments for which there were no treatments.  Now we have treatments for everything from cancer to dry skin.  In the past, a broken bone would have been set to heal back into somewhat the same place and then considered healed.  Now that bone is set to heal back and then the patient often undergoes months of physical therapy to regain full motion.  We even treat things now that were never even discussed in the past, like sexual dysfunctions and emotional instability issues.  All of this means much more healthcare is used for every person at a greater overall cost per person.

That isn’t the only thing driving up the cost of healthcare.  Things like company-sponsored health insurance, which shields the true cost of healthcare from the patient, and the costs of malpractice litigation, also drive up the cost of healthcare.  It is indeed a complex problem.

Because of the complexity of America’s healthcare system and the impact on society, it has become one of the premier political problems of the day.  Liberals argue that the government should take control of the healthcare system to provide equal healthcare to every citizen.  Conservatives argue that more of the free market should be introduced into the healthcare system to enable an efficient and effective distribution of healthcare at a reasonable price.  Before any solution for the healthcare problem can be determined, we must answer this question:

Is healthcare a right or a commodity?

All of the questions about what to do about healthcare stem from this question.  Liberals think of healthcare as a right.  The reasoning is that the right to healthcare is an extension of the right to life.  If one has a right to live, then one must also necessarily have the right to the means to maintain life.  One could also derive the right to healthcare from the right to liberty, or the pursuit of happiness, or any other number of well established human rights, but the right to life is the most fundamental of all of these for the right to life is the wellspring of all other rights.

I do not accept the premise that healthcare is a right.  Rights are based upon the principle that each of us owns our own person.  From this foundation, it is plain to see that if one owns oneself, then one absolutely has the right to live, the right to worship, the right to free speech, the right to property, and all of the other rights to which we have become accustomed.

If one owns oneself, then it is also necessarily true that every other person also owns themselves and is equally entitled to all of the same rights.  As such, by definition, rights can not extend past the boundaries of one’s own person.  One can not, for instance, exercise one’s right to free speech by demanding that one’s neighbor cease speaking, for by doing so, one would deny the neighbor’s right to free speech.  Given that healthcare, for the most part, is the product of someone else’s knowledge, labor, capital, and equipment, it is not within the boundaries on one’s own person.  Healthcare can not be a right because it makes demands on other people.

That is not to say that one can not exercise any form of healthcare one may wish upon oneself.  That is certainly within the boundaries on one’s person, and so, within the definition of a right.  When healthcare demands the efforts of another person, however, it ceases to be a right and becomes a commodity.  At this point, healthcare is subject to all of the same rules of exchange that exist for all other commodities that pass between people.  A fair price must be agreed upon by both the seller and the buyer and then the product may be exchanged.

Some will claim that the normal rules of exchange can not exist in the realm of healthcare because the buyer is under duress, and thus unable to make reasonable decisions.  Although this is true, it does not alter the relationship.  Many commodities are exchanged under duress.  For instance, when I need a server part for a down server and I need it ASAP, I will pay an exorbitant price to have the part delivered post haste because I am under duress.  When I am no longer in duress, however, I am free to make my displeasure with the price of the service known within the marketplace, thus applying normal market pressure to the provider in an effort to control the cost.  On a macroeconomic scale, all of the same forces apply.

As I said before, the entirety of the healthcare debate revolves around this fundamental question.  If healthcare is a right, as liberals contend, then it is the duty of government to ensure that everyone can exercise that right.  If healthcare is a commodity, as I contend, then a free market is the optimum mechanism for ensuring its fair exchange.


2056, 30 March 2017


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