DB’s on Healthcare is Not a Right

Over at DB’s MedRants (a misnamed blog if ever there was one) he’s featuring a four paragraph explanation written by a colleague, Dr. Tom Huddle on why health care is not a right.

I think the first three paragraphs are an excellent explanation to disclaim a general ‘right’ to healthcare, and encourage you all to read it, agree or not.  Well written and well thought out, a true tour de force.

I’m less impressed with the fourth and last paragraph.  Perhaps I’m misreading it, but the author then proceeds to this, which is an unexpected turn, and seems to advocate for just such a right through legislation:

… While advocates for health care as a right press their case for public provision on that basis, their audience listens only because in 21st century America, public provision of some level of health care is thinkable without the consequences that positive rights doctrine would demand in a less wealthy country. That such provision is prudently possible is the real reason why we should now find a way to offer it, given our obligations to the needy. But the decision to do so must be taken in the political arena in which access to health care must compete with other public goods whose advocates scramble for the public purse—it cannot be made by simply appealing to an unjustifiable doctrine of positive rights.

So, I’d take the first three at face value, as they make sense and are internally consistent; the last I’m at a loss to understand in the context of the preceding refutation of a right to healthcare.  Is this advocating for a legislative action to require a right to care?  Are the “we” those who advocate for a positive right to healthcare, or those of us who would be expected to provide this right?

Count me out on the right to healthcare, count me confused at the end.


Comments

  1. (I read DB’s MedRants and commented.) I guess that “technically”, people may be right when they say that healthcare is not a HUMAN right—the reason being that human beings can be careless or selfish creatures, and most are currently not giving much thought as to a viable solution to a health care plan which would help out those without health insurance.

    But….

    There’s another kind of health care “right”. And it’s not a “human” right. It is that type of right under which healthcare for all should reside. It’s that right which fits into that sentence: “My God given right”. Some people aren’t going to like this opinion, but giving my opinion is my American, Constitutional, and Bill of Rights right….

  2. I read it differently; I think he has made a distinction between providing healthcare as an uncondition right, and providing it, not as a right, but as a “conditional and limited duty to help”.

    His fourth paragraph, as I read it, advocates providing health care conditionally, not unconditionally.

  3. He makes the point in a kind of round about way. If health care is an unconditional “right”, then those who can supply health care(ie doctors, nurses, hospitals, etc.) have an unconditional obligation to do so.

    If it is a “right”, and no one wants to be a doctor, then people will have to be enslaved and forced to be doctors.

    The only things that can be unconditional rights, are those things which do not violate the unconditional rights of someone else. If you make health care a “right”, then you make not being enslaved not a right.

  4. There are many facets to the argument – obviously “healthcare” enompasses alot of things, from botox to resuscitation. Obviously, the former is not a “right,” nor is the latter, but most would agree that you shouldn’t turn away someone that’s bleeding to death due to lack of insurance or inability to pay.

    The argument gets lost when one takes the standpoint that providing “rights” for others forces obligations upon the providers, and assumes that society will have to pay the bill. In this case, one must consider everything that society pays the bill for, and evaluate it thusly. Obviously, some things take precedence over others – but if we look at the inordinant amount of money supplied for “defense,” and how much of that money (billions?) is then “lost” by private contractors and unaccounted for, then I don’t think it’s a stretch to argue that some of the billions that disappear in defense could be better applied elsewhere. Should we pay private contractors to ship “sailboat fuel” up and down Iraq in lieu of providing social medicine that will allow a kid’s tooth to be removed? Maybe, maybe not – but when the decayed tooth becomes an abcess and requires brain surgery later, that certainly will not be denied (and wasn’t) and the back-end healthcare strain is exponentially worse on the system (hundreds of thousands) than the initial $75 fee to remove the tooth would have been. And ultimately the patient died anyway, so even more money is “wasted.”

    In accordance with “rights,” does the medical system have the “right” to charge uninsured patients more for the same services provided to the insured?

    However you look at it, there needs to be some kind of common ground, and to argue the inherent “rights” of the potential patient seems to me to be a way to deny the need for change to the system and make those involved feel better about their ideological stance. Ultimately, whether or not you’re right or wrong doesn’t matter, because being right or wrong doesn’t solve the current problems in the system, and by absolving oneself of any wrongdoing, the inherent problems are never acknowledged.

  5. I’m not engaging in any wrongdoing by denying a Right to Healthcare. Would I like to see some perfect system spring out of the system with low actual costs, decent basic services, and fair pay? Yes. Is there one chance in a billion that will happen? No.

    I am being fairly persistent in denying a Right as I see it as a quick slippery-slope to total healthcare system meltdown, financially and emotionally / spiritually; after all, if it’s your right, you can’t be expected to pay for it, somebody else should.

    As for different charges based on insurance status, there have been several attempts to challenge those in the courts, as so far as I know none of them have gotten past the front door of the courthouse. I recall the reasoning (which may strike you as unfair but it’s not) is that insurance carriers can enter into business arrangements with hospitals for certain prices for their covered insured, but this doesn’t keep the hospital from charging more or less to either another insurance company for their insured, or to the uninsured. I don’t know why the uninsured rate would be so high, but I’d bet on poor business sense on the part of the hospital over nefarious attempts to gouge the uninsured.

  6. In a nutshell, I think the last paragraph is poorly written/edited and therefore a bit obtuse.

    What I sense he wants to say is that we need to find a way to deliver healthcare to the needy, and I think he is asking that legislatively this come about, presumably by coming up with financial resources to deliver it.

    Verbose as it is, in the end I think it’s naive. I see many retired and wealthy people who consider themselves entitled and needy enough to get medical care through Medicare without one cent coming out of their pockets.

  7. Trenchdoc says:

    It’s wasted time on a semantic argument. Those who argue for healthcare as a “right” are basically for a universal system and do not mean a unalienable “right” in the Jeffersonian sense: an a priori good which just societies provide or at least the absence of which is a form of injustice. As a fiscal conservative, it is disconcerting to see that we are still shooting holes in that empty barrel.

    The problem is not that those on both sides of the issue disagree that providing healthcare on some level is good… the differences are in the amount we will spend and the vehicle in which it will done and as far as that goes we are as far apart as Marx and Reagan.

  8. Justwondering says:

    I have to agree with Trenchdoc, it seems like any discussion about rights to healthcare is more of a semantics issue. Perhaps the better way to discuss the “right” to healthcare is to use the “right” to security as an analagy. While we don’t all the have “right” to have the best security systems and the best guns paid for by the government to defend out homes, we all have the “right” to expect the police to come when we call 911. That the very minimal safety net exists. Now those who want to pay for better security and better guns can purchase the better security, in the same way that those who can afford to purchase the services of “better” MDs for “better” healthcare. I think it’s reasonable to say that there are those who want a right to healthcare in the same way we have a right to police and fire department protection.

    Of course, the PD and FD aren’t exactly the best paid for their jobs….

  9. While I agree that a lot of the function isn’t really arguable as it stands, the idea of a Right to Healthcare isn’t semantic, or trivial. Rights are things that should be taken very seriously, that confer moral and legal obligations upon everyone in society.

    That’s why I keep beating this drum (underwater, but still) so the idle mantra of a Right to Healthcare is at least openly debated (refuted by me) but ultimately isn’t accepted as fait accompli.