(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.