Is Health Care A Right?

As the Obama team huddles to consider health care reform, one of the first posts I wrote as temporary custodian to the Conservative Wahoo dealt with the continuing debate between the opposing forces as to whether health care was a right or a commodity. My own feeling is that we need consensus on this issue before we can address the others. Over at the National Review Online, Stephen Spruiell provides what I think a logical argument against health care as a right:

Health care is not a right, at least not according to the conception of rights upon which this country was founded. Your rights include life, liberty and the pursuit of happiness. You may not be unjustly deprived of these things. Your rights do not include things that I or anyone else must be forced to provide for you, such as a home, a car, a job, or health care.

It might or might not make sense for the government to help people obtain these things, but that's not the same thing as saying that we all have a right to them. It only takes a moment's thought to see why this is so. What is meant by people who say we all have a right to health care? Do they mean that we all have a right to any sort of treatment that modern medicine can provide, regardless of cost or necessity? Or do they mean that we all have a right to some basic level of care? If it's the latter, who decides where we will draw the line?

Take a heavy drinker who develops cirrhosis. He desperately needs a liver transplant in order to survive. But there is a shortage of available livers, and there are many other patients in need. Does he have a right to receive a life-saving transplant, or has he given up his right? Let's say he has, and we deny him a transplant, but there are still not enough livers to save the deserving patients. How do we decide among them without arbitrarily depriving some of their right to health care?

This is the problem we face when we shift from a negative to a positive conception of rights. We encounter shortages, we face tradeoffs, and at some point we have to make arbitrary decisions. When that happens — well, to quote William Munny, "Deserve's got nothing to do with it."

For some time now, the debate over how best to allocate scarce resources has been a settled matter. The market, with its system of price signals, is the most efficient way to direct resources to where they are most urgently needed. We need health-care reform that enables the market for health care to function more efficiently. Removing the distortion in the tax code that favors employer-based health insurance would be a good start.

The last thing we need is public policy based around the idea that health care is a "right" to which we are all entitled. We've seen the results when other countries have adopted such policies: shortages, rationed care, higher taxes and a less innovative health-care sector — in short, a state of affairs that infringes on everyone's right to pursue the best care he or she can obtain.

What do you think?