The H-word

Is health care a right, privilege, curse word?

By Sarah Sidlow

Did you ever have a parent, teacher, or mentor tell you, “It’s not a right, it’s a privilege”?

Was it about recess? A driver’s license? What about your health care?

There’s been a lot of kerfuffle about the H-word these days. But as American citizens, do we actually have a right to health coverage?

Lots of people say yes, unequivocally. Exhibit A: The U.S. Declaration of Independence, which states that all men have “unalienable rights” like life, liberty, and the pursuit of happiness; and the U.S. Constitution, whose purpose, the preamble states, is to “promote the general welfare” of the people. For many, these founding documents make it clear that American citizens have a right to health care.

Then there’s the global United Nations’ 1948 Universal Declaration of Human Rights, which says, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing, and medical care and necessary social services…” Case closed. For many—even some lower-income Republicans, according to Pew Research—this is enough not only to argue that citizens have a right to health care, but that the government has a responsibility to provide it.

Still, others are willing to admit a little bit of entitlement envy—if countries like Austria, Germany, Iceland, and Russia can provide their citizens with universal health care, why can’t the “Greatest Country on Earth”?

But there are other people who are pretty sure that’s wrong. For one thing, the unalienable rights of citizens outlined in the U.S. Declaration of Independence are life, liberty, and the pursuit of happiness. That’s it. For the rest of it, you’re on your own. Plus, even this language is up to interpretation. For example, if pursuing your happiness involves murder, arson, or public nudity (we’ll tackle that one in another debate), you’re probably not covered.

To many, health care is an economic activity, not a guarantee. That means we should focus on how to make it accessible for the masses, through the same economic channels we use for things like the internet.

And when it comes to health care, the big question is: if it’s your right to have it, whose responsibility is it to provide it? It’s becoming clear that the government can’t keep up with demand (thanks, Baby Boomers). And even if it could, universal health care has a number of economic consequences (like lower doctors’ wages, less specific coverage, and fewer pharmaceutical options). But some say to place the burden on private companies or employers is also unfair—and detrimental to the economy, which would benefit from those dollars big employers push toward employee health care benefits.

Maybe it’s better to just stay healthy…

Reach Dayton City Paper forum moderator Sarah Sidlow at SarahSidlow@DaytonCityPaper.com.


 Question of the Week: Is health care a right?


To do what’s right

Access to health care is a human right

By Lela Klein

Human rights are basic standards that allow people to live in dignity. Cultural and political differences between countries may impact the shape of how these rights are realized, but the global community has coalesced around fundamental rights that guide us towards a free and just society. Among these are the freedom of conscience and thought, freedom from slavery, freedom to participate equally in and be equally protected by government, freedom of life, liberty, and the pursuit of happiness. The concept of human rights is way for our country to look in the mirror and ask how well we are living up to our hopes and aspirations towards the dignity of our citizens.

I believe access to affordable health care services is essential to human dignity and therefore is a fundamental human right. Article 25 of the Universal Declaration of Human Rights, adopted in 1948, reads (in part), “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing, and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age, or other lack of livelihood in circumstances beyond his control.” So long as people in our nation die because they cannot afford quality medical care, we cannot as a society say that we are protecting their basic dignity.

This right to access medical care is not independent of other widely agreed upon fundamental rights or our overall wellbeing as a society. People cannot participate fully in the political and economic life of the nation if they are overwhelmed by their own or a family member’s untreated illness or the extraordinary medical debt that comes along with accessing treatment. Uninsured or underinsured people facing serious illnesses lose their basic dignity when they can’t get treatment or when they are financially ruined by medical debt. And we as a society lose out on the intelligence and hard work of those people who are unnecessarily bogged down in the arbitrary patchwork that is our current health insurance system.

I think it is telling that Article 25 of the Universal Declaration speaks to “circumstances beyond [a person’s] control.” At the most basic level, humans form societies and governments in order to work together to solve problems better addressed collectively than individually, including accounting for circumstances that individuals cannot personally control. In most cases, the things we come together to do through government (local or national) are things that facilitate human dignity and a free society. For example, our government builds roads between cities, facilitating trade and exchange.

Health care is one of those things that individuals are poorly positioned to manage on their own. Every one of us is going to need medical care at one point or another, and no one can perfectly predict who is going to need the most care and who is going to be relatively healthy. Insurance helps people spread and share the risks, but our market-based insurance model, where we have to choose plans based on ability to pay or we choose jobs based on their benefit allocation, forces people back into the position of having to predict how much medical care they’ll need and when. We’re just not good at this guessing game.

The ideas that health care should be handled through the “free market” and that “government has no role in health care” are wrongheaded. A truly free market assumes rational buyers and sellers with full information and without any coercion. But we humans are not particularly rational—and when it comes to our own health, we can be especially irrational. We make decisions colored by fear of our own mortality or, for the young and healthy, a false sense of immortality. We can’t possibly have full information, and what could be more coercive force than looking down the gun barrel of a serious or terminal diagnosis. And when insurance is tied to employment, people become stuck in jobs they might otherwise leave, an undoubtedly inefficient outcome even from a so-called free market perspective. Simply put, health and illness are terribly unsuited to being handled by the free market.

It’s undeniable that the free-market-driven American health insurance system as it has developed over the past half century has led to higher costs for worse outcomes than any other health care system in the developed world. No one is looking to the U.S. and saying, “Ooh, let’s try what they’re doing.”

Single-payer health insurance schemes acknowledge the basic idea that health care is a societal good, better handled by society than by individuals and employers. Our health care system should be seen as part of the basic infrastructure of our nation, a system that protects a fundamental right and enables people to participate, thrive, and seek fulfillment and happiness.

Lela Klein is a labor lawyer, a native Daytonian, and a mother of two who lives in the South Park Historic district. She is currently working on an initiative to create more worker-owned businesses in Dayton, to drive economic growth from the ground up. Reach her at LelaKlein@DaytonCityPaper.com.


 

Wrong about rights

Your rights end where my wallet begins

By Ron Kozar

No one has the right to health care at someone else’s expense. Just as you have no right to make me pay your medical bill, you have no right to send men with guns to make me pay it through taxation.

You say taxes don’t involve men with guns? Then don’t pay your taxes and see who shows up at your door. Force, or the threat of, it is behind every government program. Any bright 12-year-old can see that the government, when it takes money from someone who earned it and gives it to someone who didn’t, is doing what we throw robbers in jail for doing. When that 12-year-old turns 20, he admits that the government must have that power, that civilized living is impossible unless citizens are compelled to pay for police protection or something like it. And by the time he’s 40, our former 12-year-old realizes how important it is to limit the power to take money from people—to cabin that power the way we cabin nuclear reactors behind leaden walls of concrete—to keep 51 percent of the people from doing to the other 49 percent what muggers want to do to their victims. Limiting the power of government to just a few narrow basics is the way to keep the genie in its bottle. That’s why, a long time ago, a group of bright 12-year-olds who grew up wrote the Constitution of the United States.

To that generation, a right was merely a negative, a shield against the power of kings. The only duty your rights imposed on other people was to leave you alone. In that sense, people do have a right to health care. Government should not be able to stop a willing patient from getting health care from a willing provider even, in my book, if that provider is an unlicensed quack or a pusher selling heroin. What goes on between consenting adults should be no one’s business but their own.

But a government limited to the role of night watchman is not a government that can remake society, and remaking society is something liberals can’t resist the temptation to do. Newspapers and faculty lounges are full of such people, all of them certain that their mastery of subject-verb agreement qualifies them to decide how everyone should live. They’re not greedy. Rather, they’re true believers in social justice, which is worse. They’re horrified that poor people get the health care equivalent of Chevys instead of Cadillacs, and they are eager to use government, with its monopoly on force, to dry every tear anyone sheds over the unequal helpings of brains and luck that nature dishes out.

So removing the limits the founders put on the state is a big priority for Democrats who want to play God. And a surefire way to free the state to use more force more often is to tell voters they have a right to other people’s money, that justice demands it, that the government has a duty to provide things like health care at someone else’s expense. Putting it that way makes it all sound so holy, so American, that decent people who would never dream of robbing others will take to the streets demanding that the government do exactly that.

So it is that when liberals speak of a right to health care, they mean not to restrain the king’s power but to expand it, not to give you a shield but to give him a sword. A state capable of fulfilling your supposed right to health care would wield powers of which ancient tyrants could only dream. And our liberal friends won’t stop at health care. They will all say that housing, food, transportation, and schooling are rights, too, to be handed out regardless of ability to pay. The mega-state powerful enough to sort out all these goodies need not be feared, they say, as long as voters superintend it. But we all know how wise and attentive our citizen electorate is. The more “rights” you have and the more money the government redistributes as a result, the more opportunity there is for the richest, most politically connected to steer all that money when you’re not looking.

That said, we who pay for the “rights” the government dispenses might not be so grumpy if everyone really did get Cadillac health care in the bargain. But look at the government’s management of schools, post offices, and Pentagons. You’re going to end up with a Chevy at the price of a 737. Giving the poor and the aged a “right” to health care in 1965 is what spawned the health care hyperinflation that has afflicted us ever since. More “rights” will only make it worse.

So, please, let there be no “right” to health care. Of those kinds of rights, we need fewer, not more.

Ron Kozar is a lawyer in Dayton. Reach him at RonKozar@DaytonCityPaper.com.

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Lela Klein is a labor lawyer, a native Daytonian, and a mother of two who lives in the South Park Historic district. She is currently working on an initiative to create more worker-owned businesses in Dayton, to drive economic growth from the ground up. Reach her at LelaKlein@DaytonCityPaper.com.

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