Is Healthcare a Right?

In Healthcare, Uncategorized, Welfare by Will Luden8 Comments

Before we talk about this health plan and that, we need to answer the first two questions.

  • Is healthcare a right?
  • If so, who pays?

By “right” we mean something that is owed to people, an entitlement that does not need to be earned in any way, and is in place regardless of effort. If we agree that healthcare is a right, then we must decide who pays for that right.

Desired results check (after all, results part of the address of the blog site). The goal should be to come up with a way to allow access to affordable, quality healthcare for those who desire it. The question should not be whether we should have single payer or pure free-market or somewhere in between. (Note the title question is not, “Should everyone have access to healthcare?” The answer to that question is a loud and hearty “Yes. Absolutely!”) To be clear, we are not talking about whether everyone deserves to have healthcare if they choose; we are asking if it is a right, or is it an earned benefit, subsidized when it cannot be earned.

OK, let’s tackle the first question. Is healthcare a right, or is it something that we earn, subsidizing those who can’t pay for it themselves?

I do not see healthcare as any more of a right than, say, adequate food or decent clothing and shelter. All of these should be earned, and subsidized when necessary. As with healthcare, access to these services and products is the key–not making them rights. For those who feel that healthcare is a right, remember that in most cases people can live longer without healthcare than without food. And lack of housing and clothing can easily lead to health problems, as well as a poor quality lifestyle and an unsuccessful life overall. The “healthcare is a right” argument can quickly lead to the conclusion that food, clothing and shelter are also rights.

The second question, regardless of the answer to the first, is who pays? The “who pays” part is bigger if we decide as a society that healthcare is a right rather than a benefit that needs to be earned, subsidized when the recipient cannot produce the necessary funds. That should  be clear: Not only is no one paying personally or corporately, but if something is free, a lot more of it will be requested. And things would quickly go tilt if food, clothing, and shelter were added as rights.

Under the Affordable Care Act (ACA), “Obamacare,” the healthy who can afford to pay subsidize the less healthy who cannot afford to pay their insurance premiums. This observation explains why certain people love it and others hate it. If you were one of the 85% who were covered before the ACA and you do not qualify for a subsidy under the ACA, then your monthly premiums have been skyrocketing while your coverage has been plummeting, and you hate it. If you were part of the uncovered 15%, or were covered before and now qualify for a subsidy, you love it. In significant part, the ACA is an income transfer program, transferring money from the healthy who do not qualify for subsidies to the less healthy who do qualify. The taxpayers are required to kick in with dramatically expanded Medicaid.

If society’s conclusion is that healthcare is a right, then the taxpayers must pay for all of it. Not the government; government has no money unless it taxes people and businesses. Taxpayers must pay.

What’s the solution? Go back ten years or so to where we had 85% coverage with then comparatively reasonably-priced healthcare. Now, make that even better by reducing medical costs with tort reform (not having to pay for excessive settlements and attendant legal fees), and competition across state lines. Imagine, if you will, what would happen to prices at the pump if gas companies were not allowed to compete across state lines? Would anyone stand for that? And why did we with healthcare? The biggest reduction in cost should come from–wait for it–stimulating increases in the supply of medical facilities and providers. We all get it that increasing the supply of anything holds down costs. (Econ 101) Like with gas these days. Adjusted for inflation, the national average for gas was $2.30 a gallon in 1979. Still is. But medical costs during that same period have gone over the moon. Gas prices are low because the US has become more than energy independent (once little more than a dream); it is now the largest producer of gas and petroleum hydrocarbons in the world. We can apply the same principles to healthcare and achieve the same results. And no fracking. This solution will keep the price of medical services down for those who pay for themselves, and for the taxpayers who pay for those who need to be subsidized. And everyone who wishes will have affordable access to healthcare.

What are your thoughts? Comments, questions–emotional outbursts?

Will Luden, writing from my home office at 7,200’ in Colorado Springs.

Will Luden
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Will Luden

As an author, speaker, public company board chair, family man, a man with many friends (and friends-to-be), citizen and a child of God, I am driven to contribute. One way to for me to contribute is to start thought-provoking discussions.My overall objective is to stimulate “Passionate, Relentless, Reasoning.” My specific goals include getting people to act (only) after Reasoning.
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Comments

  1. Will,

    First, as usual, your post targets a hot topic, and is very well thought out and nicely stated.

    Second, as Trump has said, health care is complicated. Not only is this a question of rights versus earned benefits, but it is also a question of how much profit are we comfortable with allowing pharmaceutical companies, insurance companies, and medical service providers to make. And, there are important questions which we don’t have the answers to. For example, what happens to the US population if large numbers of people don’t have health insurance? Do they use emergency rooms (which we taxpayers pay for)? Or do they get sicker and disabled and need to go on other subsidies (which we taxpayers pay for)?

    In my opinion, the entire system needs to be examined and re-worked, not just the government subsidy aspect.

    Years ago, when the Clinton administration was analyzing the health care system, my friend and former client Ken Hess had his company develop a “SimCity” like model for simulating the entire health care system. They offered it up to Clinton and to other countries. He has since retired. I wonder what happened to that software. The system is so complicated that a SimCity like approach is necessary, to understand all the moving parts. [Link to info on Kenneth Hess: https://en.wikipedia.org/wiki/Kenneth_Hess ]

    Best,

    1. Author

      Ann, as always, you comments are well researched and on subject. Watch out, or I will ask you to write guest blog–when the site has enough subscribers to warrant. Cheers, Will

  2. Will,

    I suggest your framing of this issue misses an important.

    Having been in both K-12 education and healthcare, I have come to believe that neither of these are “rights”.

    They are actually deliberate societal investments in the only natural resources that really matter – people.

    Less stratified, but quite successful societies like Canada, the Scandinavian countries, Germany, etc. recognize this, and understand that an ignorant society in poor health results in huge drags on output and productivity.

    How much to invest and how to judge the “returns” in healthcare and education are difficult questions to assess, but should really be the core of the discussion.

    1. Author

      Bill, As always, well researched and thoughtful comments. It appears that you see healthcare as a right, because it is the right thing to do. I applaud you for grappling with the core issue. Would that politicians and others in the spotlight would do the same. Cheers, Will

      1. I agree with Bill. Investing in people’s health and education is a practical, pragmatic thing for a government to do. I suspect that the cost of NOT making that investment is far higher in the long run.

        1. Author

          Hi Ann, I agree. Remember, the point of my email was not to debate whether access to healthcare was a good idea, but how that access should be structured: either as a right, or as an earned benefit, subsidized when necessary. All people who want it should have access to healthcare.

  3. Sorry it’s taken so long to respond; I was away from home and did not have an efficient keyboard. As most have said above, defining health care as a right only opens the door for more billable hours for the legal community. It is, however a basic characteristic of a society to concern itself collectively and individually with the well-being of its members (cue the recent video of the pair of elephants rescuing the little one from drowning). Historically, medical care has been provided through local governments (community hospitals), religious groups (St. Elsewhere) and medical schools. Until the mid-1960’s, that seemed to work pretty well. Then the federal government became involved with the passage of Medicaid and Medicare. As soon as government money became available, the for-profit folks took over the hospitals and insurance companies. Maximizing profit became the primary motivation, rather than the altruism that had previously driven the medical care sector. Fraud became routine. What we ended up with was an unholy alliance of bureaucracy and greed that resulted in soaring costs and inefficiency. The ACA did nothing to fix the problem, but only made it more comprehensive.
    The real question our society should ask is, “What is the most effective, efficient way to make health care available to our community, and how should the costs and risks be shared?” (Really two questions)
    I don’t have a good answer. I do know that I have received good care for the last 50 years through that “socialized” medicine system in the military, now called TriCare. There have been occasional shortcomings, but not more than one would see in the civilian world.
    Things I would like to see tried include:
    -A government run medical system for those who cannot afford anything else.
    -Some sort of safety net system for those affected by extremely expensive treatment costs.
    -Some sort of surcharge for those who partake in unhealthy practices such as drug/alcohol abuse, jackass videos, or telling your spouse he/she looks fat.
    -Going back to the days when there was no prescription drug advertising which results in unnecessary demand as well as the cost of the ads themselves.
    BTW, if the Republicans were serious about replacing O-care, they would have done what DT is now recommending, repeal it as of some date in the near future, which they can do without Dem support. Then the Dems would be forced to participate in formulating the replacement through some common ground.

    1. Author

      Hi Charlie, once again your thoughtful response puts you in line for a guest blog when the time comes…:). Cheers, Will

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