Maverick Philosopher: Strictly Philosophical

Is There a Right to Health Care?

(Written November 2013)

Food, shelter, and clothing are more important than health care in that one can get along for substantial periods of time without health care services, but one cannot survive for long without food, shelter, and clothing. Given this plain fact, why don’t the proponents of ‘free’ universal health care demand ‘free’ food, shelter, and clothing? In other words, if a citizen, just in virtue of being a citizen, has a right to health care, why doesn’t the same citizen have the right to what is more fundamental, namely, food, shelter, and clothing?

I mean this as a reductio ad absurdum.  I fear that liberals, being liberals, may just bite the bullet and embrace rights to food, shelter, and clothing.  But then the next move down the slippery slope would be for these liberals to insist that these rights are unconditional and not dependent on anything the recipient does or does not do, such as work.

Why isn't health care a commodity in the way that automotive care is? If I want my car to run well, I must service it periodically. I can either do this myself or hire someone to do it for me. But surely I have no right to the free services of an auto mechanic. Of course, once I contract with a mechanic to do a specified job for a specified sum of money, then I have a right to his services and to his services being performed correctly. But that right is contingent upon our contract. Call it a contractually acquired right. But I have no right to free automotive services just in virtue of the fact that I own a car. So why is it any different with my body? Do I have a right to a colonoscopy just in virtue of my possession of a gastrointestinal tract?

Negative and Positive Rights

Of course, I have a right to life, and I cannot live without health care most of which, by the way, I provide for myself via proper diet, exercise, and all the rest.  But the negative right to life does not entail the positive right to be given the services of doctors and dentists.

If you insist that people do have a right to medical and dental services, then you owe us an explanation of why they do not also have a right to food, shelter, and clothing, as well as to a vast array of other things that they 'need' such as cars and cell phones.

I've heard Hillary Clinton say that health care is not a privilege but a right.  First of all, who ever said it was a privilege?  Second, it needs arguing that it is a right.  And good luck with that.  Besides, it is the fallacy of false alternative to say or imply that health care is either a right or a privilege.  It might be some third thing.

My view is that health care is a commodity. You either provide it for yourself or you hire someone to provide it for you. In the latter case, you must pay for it. It is no different in principle from housing. Just as there is a 'housing market' there is a 'health care market.' If there were a right to health care, then there would also be a right to housing. But there is no right to housing. Therefore, there is no right to health care.  Do Obama and his supporters have a reasoned response to this argument? 

Talk of this and that as a right is mostly empty blather.  One ought to reflect on what it could mean to call something a right. 

The Correlativity of Rights and Duties

Rights and duties are correlative. My right to X generates in others the duty to either provide me with X or not interfere with my possession or exercise of X. Thus my right to life induces in others the duty or obligation to refrain from injuring or killing me. So if I have a right to health care, then others have the duty to provide me with it. Think about that.  But who are those others? The government? The government has no money of its own; its revenue comes from taxing the productive members of society. But why are these productive citizens under any obligation to provide 'free' services to anyone?  Taxation is by its very nature coercive.  How does one justify morally the taking by force of money from one person to give it to another? Why should productive citizens who take care of themselves pay for those who abuse their bodies?  There is also the practical question of whether the productive will allow themselves to be fleeced.  Not to mention the fact that the government infantilizes the population by doing for them what they ought to be doing for themselves, and by removing their incentives to taking care of themselves.

Socialized Medicine is Anti-Liberty and Weakens the Citizenry

Government should do no harm. Primum non nocere.  But a government that weakens and unmans its citizens, turning them into dependents on the state, does harm.  This is entirely consistent with people caring about one another and taking care of one another within the free associations of civil society that lie between the  individual and  Leviathan.  It is also consistent with a modicum of regulation, oversight, and mandating from the side of the state to prevent the truly needy from ending up on the skids.

If we meet in the desert and you are out of water and food, I will give you some of mine, ceteris paribus. But I am under no moral obligation to help you; you have no right to my supplies. My helping you will be supererogatory and reflective of my compassion and Christian upbringing.  Similarly, you have no right to insurance or medicine or a pap smear or a sigmoidoscopy, and I have no obligation to contribute via taxation so that you may get these things.

Nor do you have any right to contraceptives or abortifacients or outright abortions to be supplied at taxpayer expense.  Besides, forcing people to pay for what violates their moral sensibility is a moral outrage.  Abortion is a very great evil even if liberals are too morally obtuse and willfully stupid  to understand that fact.

Positive rights, rights to be given this or that,  need arguing, but I hear precious little by way of  argument from liberals.

A government big enough and powerful enough to provide one with ‘free’ health care will be in an excellent position to demand ‘appropriate’ behavior from its citizens – and to enforce its demand. Suppose you enjoy risky sports such as motorcycling, hang gliding, mountain climbing and the like. Or perhaps you just like to drink or smoke or eat red meat. A government that pays for the treatment of your injuries and ailments can easily decide, on economic grounds alone, to forbid such activities under the bogus justification, ‘for your own good.’

But even if the government does not outlaw motorcycling, say, they can put a severe dent in your liberty to enjoy such a sport, say, by demanding that a 30% sales tax be slapped on all motorcycle purchases, or by outlawing bikes whose engines exceed a certain displacement, say 180 cc.  In the same way that governments levy arbitrary taxes on tobacco products, they can do the same for anything they deem risky or unhealthy.

The situation is analogous to living with one’s parents. It is entirely appropriate for parents to say to a child: ‘As long as you live under our roof, eat at our table, and we pay the bills, then you must abide by our rules. When you are on your own, you may do as you please.’ The difference, of course, is that it is relatively easy to move out on one’s own, but difficult to forsake one’s homeland.  

The nub of the issue is liberty. Do you value it or not?  And how much?  Which trumps which: liberty or equality of outcome?  

Then there are the practical considerations. Nationalized health care in the UK and Canada doesn't seem to work very well. Apparently some Brits pull their own teeth with such advanced dental appliances as pliers and vodka. That was the way dentistry was done in the days of Doc Holliday who was, as you know, a dentist besides being a damned good shot.

Kenny, Geach, and the Perils of Reading Frege into Aquinas

(Written 23 December 2013)

I have been studying Anthony Kenny, Aquinas on Being (Oxford 2002).  I cannot report that I find it particularly illuminating.  I am troubled by the reading back of Fregean doctrines into Aquinas, in particular in the appendix, "Frege and Aquinas on Existence and Number." (pp. 195-204)  Since Kenny borrows heavily from Peter Geach, I will explain one of my misgivings in connection with a passage from Geach's important article, "Form and Existence" in God and the Soul.  Geach writes,

Frege, like Aquinas, held that there was a fundamental distinction in rebus answering to the logical distinction between subject and predicate -- the distinction between Gegenstand (object) and Begriff (concept). [. . .] And for Frege the Begriff, and it alone, admits of repetition and manyness; an object cannot be repeated -- kommt nie wiederholt vor. (45-46)

So far, so good.  Geach continues:

Understood in this way, the distinction between individual and form is absolutely sharp and rigid; what can be sensibly said of one becomes nonsense if we try to say it of the other. [. . .] Just because of this sharp distinction, we must reject the Platonic doctrine that what a predicate stands for is is some single entity over against its many instances, hen epi pollon. On the contrary:  the common nature that the predicate 'man' (say) stands for can be indifferently one or many, and neither oneness nor manyness is a mark or note of human nature itself.  This point is made very clearly by Aquinas in De Ente et Essentia.  Again we find Frege echoing Aquinas; Frege counts oneness or manyness (as the case may be) among the properties (Eigenschaften) of a concept, which means that it cannot at the same time be one of the marks or notes (Merkmalen) of that concept. (46)

I smell deep confusion here.  But precisely because the confusion runs deep I will have a hard time explaining clearly wherein the confusion consists.  I will begin by making a list of what Geach gets right.

1. Objects and individuals are unrepeatable. 
2. Concepts and forms are repeatable.
3. Setting aside the special question of subsistent forms, no individual is a form, and no object is a concept.
4. Frege distinguishes between the marks of a concept and the properties of a concept. The concept man, for example, has the concept animal as one of its marks.  But animal is not a property of man, and this for the simple reason that no concept is an animal.  Man has the property of being instantiated.  This property, however, is not a mark of man since it is not included within the latter's conceptual content:  one cannot by sheer analysis of the concept man determine whether or not there are any men.  So there is a sense in which "neither oneness nor manyness is a mark or note of human nature itself."  This is true if taken in the following sense: neither being instantiated singly nor being instantiated multiply is a mark of the concept man.

But how do these points, taken singly or together, support Geach's rejection of "the Platonic doctrine that what the predicate stands for is some single entity over against its many instances"?  They don't!

It seems obvious to me that Geach is confusing oneness/manyness as the relational property of single/multiple instantiation with oneness/manyness as the monadic property of being one or many.  It is one thing to ask whether a concept is singly or multiply instantiated.  It is quite another to ask whether the concept itself  is one or many.  It is also important to realize that a Fregean first-level concept, when instantiated, does not enter into the structure of the individuals that instantiate it. 

Aquinas is a constituent ontologist, but Frege is not.  This difference is deep and causes a world of trouble for those who attempt to understand Aquinas in Fregean terms.  For Frege, concepts are functions, and no function enters into the structure of its argument.  The propositional function x is a man is not a constituent of Socrates.  What's more, the value of the function for Socrates as argument is not a state of affairs with Socrates and the function as constituents. The value of the function for Socrates as argument is True; for Stromboli as argument, False.  And now you know why philosophers speak of truth-values.  It's mathematical jargon via Frege the mathematician.

The Fregean concept man is one, not many.  It is one concept, not many concepts.  Nor is it neither one nor many.  It can have one instance, or many instances, or no instance.   The Thomistic form man, however, is, considered in itself, neither one nor many.  It is one in the intellect but (possibly) many in things.  In itself, however, it is neither.  And so it is true to say that the form is not "some single entity over against its many instances."  It is not a single entity because, considered in itself, it is neither single nor multiple.

But this doesn't follow from point (3) above.  And therein lies Geach's mistake.  One cannot validly move from the "sharp distinction" between individuals/objects and forms/concepts  to the conclusion that what a predicate stands for is not a single entity.  Geach makes this mistake because of the confusion  exposed two paragraphs supra.  The mutual exclusion of objects and concepts does not entail that concepts cannot be single entities.

There is another huge problem with reading Frege back into Aquinas, and that concerns modes of existence (esse).  A form in the intellect exists in a different way than it does in things.  But if Frege is right about existence, there cannot be modes of existence.  For if existence is instantiation, then there cannot be modes of existence for the simple reason that there cannot be any modes of instantiation.

I'll say more about this blunder in another post.  It rests in turn on a failure to appreciate  the radically different styles of ontology practiced by Aquinas and Frege.  In my jargon, Aquinas is a constituent ontologist while Frege is a nonconstituent ontologist.  In the jargon of Gustav Bergmann, Aquinas is a compex ontologist while Frege is a function ontologist.