• Town Talk

A popular but flawed argument is that “health care is a right, not a privilege.” Health care is neither a right nor a privilege. Rather, we all have the right to seek medical treatment through voluntary trade or charity.

Ironically, those who claim that health care is a right support policies that make it privilege. When government enforces an alleged “right” to health care, the political class decides when it’s “right” for you to receive it. For example, Canadian authorities deemed Bill Murray of Alberta “too old” for a hip procedure and even prohibited his paying for it himself.

Neither right nor privilege

Health care is not a right. Rights are freedoms of action, not entitlements to what others produce. “Health care” involves sophisticated judgments, instruments, and tests made possible by the efforts of physicians, scientists, engineers, and entrepreneurs. A “right” to health care violates the rights of those who produce it. 

Nor is health care a privilege. A privilege is something authorities permit us to do at their discretion. No one considers auto-repair to be a right, but it’s absurd to consider it “a privilege.” No one grants you the “privilege” of having money to repair your car. Rather, if you want to own a functioning car, you must take responsibility to finance its repair.

The same goes for medical treatment. As Mark Twain said, “The world owes you nothing.” Adults must take responsibility to finance their medical treatment. Those who choose to become parents are also responsible for financing their children’s care.

There’s no right to health care just as there’s no right to happiness. The pursuit of happiness is a right. Similarly, everyone has the right to seek medical treatment through voluntary association with others. We also have the right to protect ourselves against medical expenses as we see fit, for example, with a low-premium catastrophic insurance policy.

Yet, when politicians seek to guarantee health care as a right, they decide what qualifies as appropriate medical treatment. For example, the White House Council of Economic Advisers aims to reduce spending by eliminating “high cost, low-value treatments.” Since government pays the cost, “value” means value to the political class. 

Or consider Oregon’s Prioritized List of Health Services under Medicaid, where the highest priority treatments correlate well with politically powerful interest groups. Or listen to the president’s health advisor, Dr. Ezekiel Emanuel. He suggests that “services that promote the continuation of the polity ... are to be socially guaranteed as basic.” So your health is merely a means to supporting the political power structure, and hence insurance means having politically connected friends. Talk about privilege.

Equal access doesn’t exist

But surely enforcing a so-called “right to health care” provides rich and poor equal access? Not so. The Guardian reports that in England, “the poorer you are ... the worse your care and access to it is likely to be.” The same goes for Canada. The National Bureau of Economic Research concludes that “Canada has no more abolished the tendency for health status to improve with income than have other countries. Indeed, the health-income gradient is slightly steeper in Canada than it is in the U.S.”

One might object that insurers make medical care a privilege by denying care. Yet, we can blame political controls for granting insurance companies such power. For example, tax law punishes us for buying a policy directly from an insurer if we don’t like the one or two insurance plans most employers offer. If you want to purchase insurance directly, you are also forbidden from buying a more affordable policy available in another state. 

Tax law also favors insurers by punishing those who save to pay directly for medical expenses while favoring comprehensive health plans that pay for routine and predictable expenses. Not only does this discourage price competition and prudent consumption of treatment, it further empowers insurance companies over your medical choices.

In a free-market for insurance, we could buy the insurance product that best fits our needs and risk preferences. Absent policies that shield insurers from competition and accountability, insurance companies would scramble to make products to attract customers. Not only would they compete on price and network size, but also on reputation and transparency. For example, consumers might prefer policies that clearly show which procedures and medications are covered, not covered, and objective criteria by which they cover new treatments. 

Health care is neither a privilege nor a right. Yet, individuals have the right to purchase medical treatment and medical insurance products. Politicians should focus on respecting this right.

Brian T. Schwartz, PhD blogs at the Independence Institute’s PatientPowerNow.org website. A version of this article originally appeared at PajamasMedia.com.

The Independence Institute is a Golden-based libertarian think tank. The views expressed in this guest column are those of the Independence Institute and not necessarily those of the Denver Daily News. Respond to this column at editor@thedenverdailynews.com.

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