A colleague writes about the right to health care

Dr, Huddle’s argument is very sound given his assumptions about what a right is and how a right could be accommodated. Reading his essay I got the impression that he was fearful that homeless people would start showing up at his practice demanding Botox injections, vision correction surgery, and breast augmentation. Perhaps a different model would help. I suggest he examine the WIC program, the federal program that subsidizes the purchase of specific food items for poor women and their children. The program is fairly narrow in scope in that it seeks to ensure women have access to good nutrition for themselves while pregnant and for their infants and young children, for whom a healthy start is so important. The program has been evaluated and found to be cost effective in that its cost is less than the costs to society of unhealth women, infants and children. This is an oversimplification but, as they say, you can look it up.

Using this model, meeting the “right” of health care might look like–well, Medicaid. The problem with Medicaid is that its income requirements are so low–and health care so expensive–that working people and people who are not otherwise poor but do not have the wherewithal to pay for health insurance are vulnerable to catastrophic health care expenses. And of course it doesn’t take much for health care costs to get catastrophic. And one might guess that these same people probably do not get preventive care either. So expanding Medicaid to cover the “working poor” and provide a limited menu of essential preventive care and acute care services wouldn’t be too hard. What constitutes “essential” care? That decision gets made in all 50 states in the design of their Medicaid programs. Not everyone would agree with everything, no doubt, but clearly there is some consensus. And Medicaid is not responsible for dragging people to doctors’ offices and clinics if they don’t want to go.

Would this be expensive? No doubt. And the way we as a society pay for health care needs more than an expansion of Medicaid–it needs radical overhaul. But the point is, we can acknowledge health care as a right without all those homeless folks camping out in Dr. Huddle’s office.

(Oh yeah, and if you have to think about my comment, it means that you might need to read a Bible, especially the 10 Commandment about “loving thy neighbor as thyself”….)

I would have to agree with Dr. Huddle. While it is difficult to not serve what we perceive as a needy portion of the population there is a great divide between desire and “right.” Many turn to the European model of health care, not realizing benefits are being lowered, and care is in fact rationed.

A common phrase today is that we are a “rich” country. The reality is a very small percentage of people pay the bulk of the tax burden. The type of “rights” most often proposed, will only increase this burden, and thus, at some point make it economically undesirable to offer heath insurance to any person.

We need to measure our desire with our ability to pay.

Steve Lucas

Perhaps there’s nothing I can say that will prevent some from reading my argument as an expression of hardhearted unwillingness to help the poor.

But of course I deny the charge; my point here is not how we should choose to spend our public money—I think we should increase access to health care; programs like WIC sound great, and amenable to just the kind of argument I would wish to make for them; here is a great need; we can meet it in this way, and this is a better use of our money than these other uses; therefore, lets do it.

My point is simply to suggest that how we think about these arguments is important; and that the “positive rights” way of thinking about them is not satisfactory. Pointing out that seeing needs in terms of positive rights leads to conflict with negative rights may seem hardhearted—but in fact it works out otherwise. Production must come before consumption and paying attention to conditions that will promote it in fact makes possible the meeting of needs. We can debate what to do with our public money because we are prosperous enough to have some to debate about. The countries in the world that have the healthiest populations and the best health care are those in which negative rights have been respected. I do not believe that this is coincidence. It is indeed time for us to join other such countries in providing a level of universal access to heatlh care, because the need is there and we can meet it both practically and morally—by respecting negative rights as we do so.

Thank you Dr Huddle for an obviously carefully wrought and well-reasoned argument. It seems to me that the argument boils down to the pragmatist who say “society cannot bear the cost” and the idealists who say “the individual cannot bear the cost”.

When a product becomes free (a right), the demand becomes infinite.

Thank you.
By DEFINITION a positive right results in the enslavement of those who must fulfill that obligation.

Perhaps the bohemian nurse would be willing to accept only 80% of her compensation when she treats a Medicaid patient. That would be charitable.

However, when government coercion forces her to accept 80% (as it does to doctors), that is called enslavement and THEFT.

Wake up! Stop treading on inalienable rights just because you “need” it