It’s a typically cool, cloudless July 4th morning in Colorado Springs, so my mind inevitably wanders to…what else but health reform. When, oh when, will we have the market-based health care system we need so that I can move on to addressing simpler problems? Like world peace. But when better than Independence Day to ponder an important question of the day: Is health care a right?
I wish it were. It would be so much simpler if all Americans could exercise their right to medical care as they do their rights to life, liberty, and the pursuit of happiness. If health care were on a par with, say, the right to free speech, my right to medical care would not limit your access to the same thing. The supply would be free and limitless. Any question of violation of that right would be dealt with by the courts.
A right is the ability of humans to pursue their own ends free of infringement, as long as those pursuits do not infringe on the rights of others. The salmonella in the peanut butter for medical care is that, unlike our constitutionally protected rights, it is hardly free and endless. When I consume a prescription drug, it’s gone and no one else gets to use it. Medical care is a limited resource, like housing, food, and new GM cars. In fact, medical care can be more expensive than all three. So no, health care cannot be a right as we normally use the word.
Perhaps a more relevant question is whether health care is an obligation. We fought a revolution to safeguard, among other things, our right to own and control our own property. Yet it has become virtually noncontroversial for our political leaders to demand that every American hand over a portion of his property to buy health insurance to support an inefficient, overpriced, bloated health care system that provides standard-of-care quality only half the time. Hear this: The United States government has never required everyone to purchase anything as a condition of residency in the land of the free (sorry, but car insurance is not an exception). The purported reason for this unprecedented property taking is that it’s the only way we can fix the health care system. That is preposterous, uninformed, un-American balderdash. We don’t have to do any such thing to fix health care in America.
Another closely-related question is whether health care is a public good that should best be provided by the government. A public good has to satisfy two requirements: It must be non-excludable and its consumption must be non-rivalrous. My apologies, but that’s the way the economists put it. Non-excludability means that a good (or service) can be consumed equally by free riders as well as paying customers. Non-rivalrous consumption means that my consumption of the good does not limit your ability to do the same thing. Put another way, it’s not a public good if its use can be limited to paying customers or if nobody else gets to use it when you do. An example of a public good would be tonight’s fireworks displays—except in Colorado Springs’ where our city fathers have decided we can’t afford it (Do economists also recognize public bads?).
Medical care is an economic good—that is, an “object or service that has value to people and can be sold for a non-negative price in the marketplace.” That’s more economic geek-speak meaning it’s something that somebody is willing to pay for. It has scarcity and a measurable value to each consumer. If we’re going to solve the problems of medical care delivery, affordability, and availability, we must come to grips with this reality.
But let’s forget for a paragraph the questions of necessary medical care as a basic human right, a public good, or an economic good. Shouldn’t it be something available to every American? Yes, in my opinion. I haven’t heard anyone—right, left, or center—say we should let the poor, elderly, and disabled die in the streets for lack of essential treatments. The real question, then, is how should medical care be obtained by everyone in the most efficient and effective way that least infringes on our other priorities for food, clothing, housing, education, fine wine, self-determination and all the other necessary ingredients of a life well-lived?
History—littered with centuries of failed economic experiments—tells us the only known way to do this is by enlisting the invisible hand of properly regulated markets. But the central problem in medical care is that it suffers from a fundamental market failure that has prevented such a solution (a subject I deal with in my book Cured! and will in my blog on other occasions). It’s a failure that the government could have identified and easily corrected at any time over the past 80 years but, tragically, didn’t. Instead, it has repeatedly dived in to try to replace the market function—with predictably poor results. The fix is still available and will require replacing the mass of dysfunctional government health policies and programs with a far simpler regulatory and safety-net framework that will allow markets to resolve virtually all of the problems of our health care financing and delivery system.
We may not have an unalienable right to receive medical care, but we do have a right to demand our government of the people, by the people, and for the people to allow us all to seek and get it in a uniquely American way. Happy Independence Day.