Wednesday, October 14, 2009

A "Right" to Health Care

I recently ran across this article questioning whether defining health care as a basic human "right" has done more harm than good. This article trips on a basic fallacy, however, that I simply don't understand. It jumps on the notion of "highest attainable standard" as though somehow universal access to health care means everybody gets every health service they want regardless of actual need or effectiveness. Some critics of universal health care in this country seem to think that as soon as we allow everybody access to health care, we're allowing everybody access to unlimited, exotic, expensive health care for any and every conceivable "condition", real or imagined. While it's true that for a tiny minority of extremely irrational people, this is exactly what it means, the reality is that there's plenty of middle ground between the position of people can only have the health care they can afford to pay for and the position that everybody gets every procedure and pill they want. I don't understand why this seems so hard for many people to grasp. Perhaps some analogies would help:

-In America it's widely accepted that everybody has a right to a basic education, through secondary school, that should at least give everybody the opportunity to be literate, numerate, and familiar with basic concepts in important areas. This does not mean, however, that everybody is entitled to an Ivy League education.

-We generally believe that every part of America--rich, poor, rural, urban, etc.--is entitled to national defense. A military attack to any American's domestic property will invoke a response by America's military. Yet, I don't know anybody who believes every American is entitled to their own tank, jet, or nuclear warhead.

-Every American has access to the court system if accused of a crime or the victim of a criminal injustice. However, not every American is entitled to the services of Johnny Cochrane.

There are many more examples. So why is it so hard for some people to wrap their mind around the idea that everybody should be guaranteed a certain minimum level of health care services, paid for by their tax dollars, with premium medical services available to those with the means to afford them? I've proposed before that we could simply use our neighbor Cuba as our baseline. How hard could it be for the richest nation on earth to provide every citizen with the same level of guaranteed medical coverage as they would get as a citizen of their third-world neighbor? Obviously, if somebody wants cosmetic surgery or an expensive, unproven procedure, then the Cuban standard will not provide it. But that's where the free market comes into play. If a person wants expensive medical procedures with limited effectiveness, or if they want to go to Harvard, or if they want to hire Ted Olson as their attorney, they can pay the price and receive these services. But for the basic version of these services, everybody in America should have access regardless of means. Why is this such a difficult concept?


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