Health Care, Moral Rights, and Selfish Action

Yaron Brook has an excellent article in Forbes titled “The Right Vision of Health Care.” Here’s an excerpt:

Prior to the government's entrance into the medical field, health care was regarded as a product to be traded voluntarily on a free market—no different from food, clothing, or any other important good or service. Medical providers competed to provide the best quality services at the lowest possible prices. Virtually all Americans could afford basic health care, while those few who could not were able to rely on abundant private charity.

Had this freedom been allowed to endure, Americans' rising productivity would have allowed them to buy better and better health care, just as, today, we buy better and more varied food and clothing than people did a century ago. There would be no crisis of affordability, as there isn't for food or clothing.

But by the time Medicare and Medicaid were enacted in 1965, this view of health care as an economic product—for which each individual must assume responsibility—had given way to a view of health care as a "right," an unearned "entitlement," to be provided at others' expense.

This entitlement mentality fueled the rise of our current third-party-payer system, a blend of government programs, such as Medicare and Medicaid, together with government-controlled employer-based health insurance (itself spawned by perverse tax incentives during the wage and price controls of World War II).

Today, what we have is not a system grounded in American individualism, but a collectivist system that aims to relieve the individual of the "burden" of paying for his own health care by coercively imposing its costs on his neighbors. For every dollar's worth of hospital care a patient consumes, that patient pays only about 3 cents out-of-pocket; the rest is paid by third-party coverage. And for the health care system as a whole, patients pay only about 14%.

The result of shifting the responsibility for health care costs away from the individuals who accrue them was an explosion in spending.

In a system in which someone else is footing the bill, consumers, encouraged to regard health care as a "right," demand medical services without having to consider their real price. When, through the 1970s and 1980s, this artificially inflated consumer demand sent expenditures soaring out of control, the government cracked down by enacting further coercive measures: price controls on medical services, cuts to medical benefits, and a crushing burden of regulations on every aspect of the health care system.

As each new intervention further distorted the health care market, driving up costs and lowering quality, belligerent voices demanded still further interventions to preserve the "right" to health care. And Republican politicians—not daring to challenge the notion of such a "right"—have, like Romney, Schwarzenegger and Bush, outdone even the Democrats in expanding government health care.

The solution to this ongoing crisis is to recognize that the very idea of a "right" to health care is a perversion. There can be no such thing as a "right" to products or services created by the effort of others, and this most definitely includes medical products and services. Rights, as our founding fathers conceived them, are not claims to economic goods, but freedoms of action.

You are free to see a doctor and pay him for his services—no one may forcibly prevent you from doing so. But you do not have a "right" to force the doctor to treat you without charge or to force others to pay for your treatment. The rights of some cannot require the coercion and sacrifice of others.

So long as Republicans fail to challenge the concept of a "right" to health care, their appeals to "market-based" solutions are worse than empty words. They will continue to abet the Democrats' expansion of government interference in medicine, right up to the dead end of a completely socialized system.

By contrast, the rejection of the entitlement mentality in favor of a proper conception of rights would provide the moral basis for real and lasting solutions to our health care problems—for breaking the regulatory chains stifling the medical industry; for lifting the government incentives that created our dysfunctional, employer-based insurance system; for inaugurating a gradual phase-out of all government health care programs, especially Medicare and Medicaid; and for restoring a true free market in medical care.

Read it all.

Brook here focuses primarily on the impracticality of socialized medicine and on the fact that no one has a right to the commodity that is health care, and he addresses these points soundly. I’d like to add that the producers of medicine and the providers of health care and health insurance have an absolute moral right to trade their products according to their own judgment. The reason why no one has a right to health care or health insurance is that these things morally belong to those who produced them—those who did the thinking and exerted the effort to get through medical school, to start a medical practice, to develop an insurance business, to create products that enhance and often save human lives. Their efforts do not render them slaves of the needy; rather, their efforts render them the rightful owners of the products of their efforts. So says the law of causality—and so says a proper morality.

The moral is the practical; respecting the rights of producers makes possible their productivity and thus our ability to trade the products of our efforts for the products of theirs. Violating the rights of the producers of health care and health insurance is not a way to acquire these goods and services; it is a way to diminish and eliminate them.

For more on this pressing issue, read “Moral Health Care vs. ‘Universal Health Care’” in the Winter issue of TOS—and pass the URL along to every active-minded person you know. With the exclusively statist field of candidates running for office in the coming elections, the only way to stop health care and health insurance from becoming fully socialized—and the only way to begin moving in the direction of a rights-respecting, flourishing, free market in these industries—is to generate sufficient principled advocacy of capitalism and opposition to socialism among the active-minded public.

These two articles—“The Right Vision of Health Care” and “Moral Health Care vs. ‘Universal Health Care’” are excellent tools for introducing people to the moral and practical nature of genuinely free markets. It takes only a few minutes to email a URL or two to all your thinking friends. Take action now. You may need a good doctor some day.

About Craig Biddle

Craig is cofounder and editor of The Objective Standard, cofounder and director of education at Objective Standard Institute, and executive director of Prometheus Foundation. He is the author of Loving Life: The Morality of Self-Interest and the Facts that Support It; Rational Egoism: The Morality for Human Flourishing; and the forthcoming Moral Truths Your Parents, Preachers, and Teachers Don’t Want You to Know. He is currently working on his fourth book, “Thinking in Principles.”

View all articles by Craig Biddle →