Health Care is a Liberty Issue

To date, it seems like the recent debate over health care reform has focused primarily on fiscal and accessibility issues, in and of themselves. I certainly agree with the concerns people have about these. I think it’s a bad idea (and I have a gift for understatement) to allow the federal government to usurp authority over a sector that makes up over 15% of our economy, with the attendant taxation and regulation that will come with that takeover. I also am quite concerned about the very real threat of rationing and the life issues involved. However, I think there’s an even more fundamental issue at risk here – and that is the matter of liberty.

Many of you have probably seen those inane left-wing bumper stickers that read, “Health Care IS a right.” This is not going to be what I’m advocating in this essay – just the opposite, in fact. The premise of the bumper sticker rests on the notion of “positive rights” – the idea that people have the “right” to something that other people will have to provide for them. Such “rights” rely upon the supposed obligation of the people through their “general will” to compel individual citizens in a body politic to set aside their personal welfare and “take one for the team”, so to speak. As it applies in this case, “the rich” and all the other evil, greedy, selfish money-grubbers who don’t want to finance the health care of every welfare bum who has drunk himself into liver cirrhosis or who has gotten AIDS through a profligate lifestyle should nevertheless be compelled to do so through the police powers of the state.

This is a perversion of the liberty ideology upon which our social and political system was founded. Rousseau, who was the spiritual father of many bad ideas (including the French Revolution), was the one who twisted the principle of “contract theory” and turned it into a positive demand for the coercion of individual citizens if it’s for “the good of the people.” Originally, however, the contract theory that was pioneered by Thomas Hobbes, and brought to fruition by John Locke, was intended to serve as a safeguard for individual liberty against the demands of the body of the commonwealth as a whole. What Locke envisioned was a commonwealth of individuals banding together for mutual protection and the mutual benefit of civil society, which allows all kinds of good things like property, industry, private contractual protections, and the like.

The liberty that Locke and later classical liberals contended for was a “negative” liberty – the liberty to be free of demands and obligations put upon any individual citizen to the greatest extent possible that would still allow for a mutually beneficial civil society to exist. To the extent that demands could be made upon the individual – such as taxes, adherence to the rule of law, etc. – these had to benefit everyone. For instance, the taxes you pay so that roads can be built and maintained benefit the entire commonwealth since everyone uses those roads. The requirement to obey the law benefits everyone since every citizen profits from murderers, rapists, and thieves being suppressed. Negative rights, however, do not provide for one class of citizens to be able to use the powers of the state to redistribute wealth or services to themselves from another class of citizens. That is the key difference.

This is why health care must be viewed as a liberty issue. We must understand that every citizen of this Republic has the right to obtain whatever health care for themselves they need or desire. At the same time, no citizen has the right to make somebody else pay for it. The problem is that socialized medicine will turn this completely on its head.

First, the sort of plan that Congress and the President are envisioning would hinder the ability of Americans to obtain whatever health care they want. A single-payer system such as Congress is trying to foist off onto us would eventually put every last citizen into the position of having to submit a request for health care to a government panel that is in charge of rationing out health care based upon a budget that has to be met each year. If your request is too expensive to fit into this year’s budget, then onto a waiting list you go, hopefully we’ll be able to pay for it next year (if you survive, of course). The government, not the individual, becomes the arbiter of what health care the individual is able to receive. You no longer have any choice – which is ironic, considering how those on the Left supposedly are so concerned about “my body, my choice.” Under the system proposed by Obama and the Democrats in Congress, the individual loses the fundamental right to determine what happens to his or her own body. While the “my body, my choice” argument is illogical when used to support abortion (since the baby is an individual person, not part of the mother’s body, and hence she has no right, moral or otherwise, to kill it), the argument nevertheless IS entirely applicable with regard to the government withholding desired health care from a person.

This is where the notion of “death panels” comes into play, and morality becomes an issue. For too long, too many conservatives have bought into the notion propagated by both the leftists, as well as libertarians on our own side, that issues of “morality” and “liberty” are mutually exclusive, and perhaps even antithetical. “Enforcing” morality, they say, necessarily infringes on liberty. This argument is nonsense, as can be seen in the present health care debate. Sarah Palin was entirely correct when she stated that this health care plan would create “death panels.” What else would you call bodies of bureaucrats who will (as experience has already show us) make decisions that the old and the infirmed aren’t deserving of any more health care “resources”, and should be fast-tracked into end-of-life “comfort care”? I would argue that each and every last individual in our society, no matter how old, no matter how infirmed, no matter how unlikely to produce a single further dime in tax revenue for the state, ought to have the unimpeded right to obtain whatever medical treatment they desire. That’s a nexus point – just one of many - where liberty and morality are mutually supportive. Every citizen has the “negative” right to get whatever health care they like, while society as a whole does not have the “positive” right to deny it to them on the basis of some budgetary argument.

This leads to the second point, which is that the “budgetary argument,” as it has been made elsewhere and will be made here if this boondoggle passes, rests on the flawed notion that the government has the responsibility to make all of us pay for each other’s health care. It does not. But, when it arrogates to itself this duty, then the field is wide open to all sorts of infringements upon our liberty to live our own lives as we see fit, going far beyond just the right to obtain the health care we need and want.

I am against smoking. I, personally, think smoking and other tobacco use is immoral. However, it’s not my business to coerce somebody else to stop smoking because I don’t personally like it. But, when you have a single-payer health care system that forces each of us to pay for everyone else’s health care, then one person’s smoking becomes everybody else’s business. People can be told by the government that they have to stop smoking, or else they will have health care withheld. Likewise, people can be told they have to stop eating fast food, they have to lose weight, they have to start jogging, they have to start eating a mandated diet, they have to [fill in the blank] to be able to continue to get health care – which since the government is the only source of health care, presents a quite powerful coercive force. This represents a gross intrusion of the commonwealth into the personal lives and liberty of each citizen. Yet, this is a natural corollary to the premise that we – as “society” – are paying for each other’s health care. Suddenly, your personal life becomes the business of the rest of us, and a bureaucrat, perhaps backed by a guy with a badge and a gun, will be along shortly to restrain you from the offending behavior.

I think that most all of us will grant that the health care superstructure in this country could be reformed. That much is apparent. However, the type of reform is what is at issue. Currently, the only proposals receiving serious attention are those that will prove to be liberty-unfriendly in the extreme. So what would be some liberty-friendly alternatives that conservatives ought to be pushing for instead?

Well, the first and obvious starting point is to push for a reduction in government involvement in our health care system. “How can you say that,” many would argue, “when the free market has obviously failed and caused prices to be sky high?” Well, I would respond by saying that it is anything but “obvious” that the free market has failed. Rather, I would say that the free market hasn’t been “free” to begin with. How can you say that we have a free market health care system when Medicare, Medicaid, and various other entitlement programs are involved in something like half of all health care transactions in this country? These programs, which do not generally take spending economy into account, serve to help artificially inflate the cost of medical treatment in this country, which drives up prices. Get the government out of the health care payment business, and we would see prices return to reasonable market levels.

This leads to the second way to reduce cost and increase efficiency – actively work to reduce the presence of illegal immigrants in this country, many of whom receive “free” health care that is eventually recouped by one or another of these various government programs. By law, most hospitals cannot turn away anyone who comes to the emergency room to receive treatment, whether or not they have insurance or can pay out of pocket. The problem, as anyone who lives in California, Arizona, Texas, or even North Carolina will tell you, is that illegal immigrants take advantage of this to utilize trips to the emergency room as “free” doctors’ office visits, the cost for which ends up either being made up by the taxpayer, or else is eaten by the hospital itself. In California and Arizona, many hospitals have gone out of business because the financial burden reached the point where even government compensation could not sustain it.

Even in non-border states, emergency room visits for actual emergencies become much longer than they need to be. Hospitals are financially stressed, and are forced by the demand curve to increase the cost of services to try to make up for lost income due to “free” health care for folks who shouldn’t even be here in the first place. And yes, we need to make the case that somebody who has come to this country illegally, who has broken our laws, who is making money without paying our taxes, and who is not a part of our mutual commonwealth of citizens, should not be here – regardless of what their country of origin is (remember, Latin Americans only make up around half of the total number of those here illegally). Let us look to the example of Oklahoma, which enacted some pretty strict laws against illegal immigration, and has seen the demand burden on services, including hospital emergency rooms, drop substantially.

Third, conservatives need to fight for tort reform. While I understand that sometimes there is a legitimate reason for a patient to sue a doctor or hospital for poor or negligent care, the situation we currently find is intolerable. People sue physicians and hospitals for millions of dollars for things that were often completely outside of the care providers’ power to do anything about. Juries, often made up of people lacking a basic grasp of economics, will readily award huge sums since they figure that hospitals and doctors are “rich people” with deep pockets who can “afford” to pay for a large settlement. In other words, ambulance-chasing lawyers and uninformed juries will use malpractice settlements as a de facto form of wealth redistribution. The result is that the rest of us are stuck with higher medical costs because of the skyrocketing insurance costs paid by doctors and hospitals, and the numerous and often unnecessary tests that will be administered so that care providers can cover all their bases. That cost is going to be recouped somehow – and it’s usually made up by the higher costs charged to patients and their insurance companies. We need to affirm the basic principle of liberty that nobody has the right to abuse the legal system to personally enrich themselves at the expense of doctors, hospitals, and ultimately everyone else who requires medical care.

In summation, conservatives need to make the case for liberty with respect to the health care debate. It isn’t just about how much the system will cost, or how big of a bureaucracy it will generate. What’s at stake here is, ultimately, our right to use our own resources to obtain the medical care at a level that each of us, individually, feels is best for ourselves. At stake is our right to live our lives as we see fit – the right to eat cheeseburgers every day of our life while being willing to deal with the consequences, if that’s what we want to do. At issue is the right of each person to the inherent, God-given liberty to life – affirmed in no less a document than our own Declaration of Independence – instead of having some penny-pinching jobsworth decide that we’re just too expensive to keep around anymore. Folks, let’s make the case for liberty, not just economy.

The government, not the individual, becomes the arbiter of what health care the individual is able to receive.

This is a very important point. You cannot go to a court of law and argue that your health care was inadequate or denied when the government decides what is adequate and what is appropriate. As long as the government mandated regulations were observed you have no grounds to claim you should get anything more or anything different. The gov defense would be "you got what everybody else gets. Your universal right to health care was fulfilled as the law requires and says it is to be fulfilled."

An individual cannot base his/her grievances on a collective right. (unless something was done or not done according to the state's mandates) The state decides collective rights in an ever changing flow of legislation and bureaucratic regulations. If the courts accept this new right to health care they will follow the laws and regulations as to what is and is not your right to receive. You will have to prove that you did not violate any of the standards set down regarding your lifestyle or treatments as well. (or hope the gov defense doesn't show that you did)

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Congressman Weiner says that health care is not a commodity. If health care is not a commodity then doctors and nurses are not free and sovereign citizens. If health care is a right then health care workers are slaves who must serve that right for the sick and injured. If health care is a basic human right, as Weiner says, then no health care worker can refuse to provide it, for any reason, because that would violate the patient's rights.

That means that the health care providers have no individual rights. The collective right of the people to get health care would supersede the provider's individual right to set their fees, their hours or change their occupational status or even decide how to apply their skills and knowledge. A collective right, by practical definition, is a state right because it supersedes the individual rights of others.

It may not be stated in any of the bills that patient's rights to care supersede a provider's right to set fees and hours etc, but it doesn't need to. Rights are always adjudicated in the courts. The legislation simply establishes the foundation for the courts to rule in favor of the patient's collective right to care.

Weiner’s view is collectivist, fascist and totalitarian. His view is the underlying philosophy of the entire Health Care Reform legislation the House and Senate have put forth. Consider the setting up of community watch dogs to monitor various health parameters of citizens in the Senate version of the bill. Look at pages 382 - 393.

TITLE I—QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANS

Even the citizens themselves will be subject to state set regulations on their behavior in order to fulfill the human right of universal health care. How much clearer can it be that these bills abrogate the concept of individual rights?

If a person enters into a contract with an insurance provider that requires that person to live a certain lifestyle in order to obtain a lower preferred rate, then that is OK by me.

It would be up to the insurance company to verify that the insured didn't smoke, drink, or whatever else the parties had agreed to.

I would even be in favor of modeling health insurance on something like the car warranty model. Some car warranties require the owner to maintain the automobile at his own expense (e.g. regular oil changes) in order to receive warranty protection. Why can't insurance companies require the insured to engage in similar regular maintenance in order to remain covered?

This way the relatively inexpensive costs of things like eye exams, teeth cleanings, annual check-ups would be purchased in the marketplace rather than paid behind the scenes by the insurance company.

If the insurance companies don't pay for these regular maintenance activities then the insured might not do them on their own and risk more expensive problems later on. If the insurance companies continue to pay for these activities then there is no market pressure to lower cost and improve efficiency.

What do you think?

Thank you! Thank you!

This piece constitutes a level of discourse which can help Americans to evaluate the grave matters before us in terms of:

"1. Does this legislation or idea increase, or decrease, individual freedom and creativity?

"2. Does this legislation or idea increase, or decrease, the power of some citizens over other citizens?

"3. Does this legislation or idea recognize that the persons who will exercise the power are themselves imperfect human beings?

"4. Does this legislation or idea recognize that government is incapable of creating wealth?

"5. Does this legislation or idea authorize taking from some what belongs to them, and giving it to others to whom it does not belong?
If 'thou shalt not steal' is a valid commandment, can we assume that it is meant to apply only to individuals and not to government (which is made up of individuals), even if those persons in power pass laws which sanction such redistribution of the wealth of others?'

"6. Does this legislation or idea encourage, or discourage, the very highest level of morality and responsibility from the individual?
. . .when government makes actions 'legal' by some citizens at the expense of other citizens, the result may be behavior which would not be considered possible by individuals acting alone.

"7. Does this legislation or idea propose that the 'government' do something which the individual cannot do without committing a crime?"**

**7 principles drawn from James R. Evans book, "America's Choice," and reprinted in a Stedman Corporation (Asheboro, NC) booklet entitled "I'm Only One, What Can I Do?"

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