Health Care is neither a Right nor a Common Good


Last weekend was a great moment in time for the State of Idaho. Seeing power being transferred to a new generation of Idahoans and fresh young legislators eager to represent their constituents is always uplifting. Unfortunately, we heard the echoes of past debates when proponents of Medicaid Expansion again asserted that all people have a right to health care. What does that really mean? Where do rights come from and who gives us rights.

Conservatives (classical liberals) believe that there are two forms of rights—Natural and Legal. Legal rights are predicated on a belief in the sanctity of The Natural Law and all legal rights are legitimized because they originate from concepts of Natural Law and Natural Rights.

When philosophers talk of Natural Rights they understand that these are rights that are given to us by God (The Judeo-Christian understanding of rights) or that they are rights inherent in our own humanity—an understanding of the ancient Greek and Roman Philosopher’s—Cicero and Aristotle to name a couple. The concept of Natural Rights was further commented upon by the early church philosophers like Augustine and Aquinas and codified in The Magna Carta and refined in concepts of The Common Law and our own Declaration of Independence.

John Locke believed that in every human person there was a desire for liberty and that the Natural Rights of life, liberty, and the pursuit of happiness—through the pursuit of property (Locke’s and Jefferson’s thoughts”) was part of the human soul. It was the belief of our founders that because these rights were given to us by God, they could not be taken away from us by governments.

Aquinas commented frequently on the nature of rights and recognized the need for human actions and interactions to be predicated on and understanding of the duties and responsibilities that are a part of the transaction between the giver and receiver of rights. Natural Rights are based on the concept of “free will” and should be based on conscience and reason and not on emotion and coercion.

Contemporary philosophers of Locke, David Humes, and Thomas Hobbs believed not in reason and free will, but rather that “our reason is slave to our passions” President Barack Obama rightfully sited the fact that our Constitution was predicated on and incorporated the “dispositive nature” of the Natural Law.

When we claim to have a right to something we claim to have dominion over it. We have dominion over our own lives and liberty and property and happiness. By exercising our free will appropriately we can realize our full potentials as persons. Because these Natural Rights proceed the State hey cannot be legitimately taken away from us by the State. “Dispositive rights” place an obligation of others-including governments as defined in our own Bill of Rights, to NOT ACT in any fashion that would forfeit our dominion over our claim to that right.

It is thus in our understanding of Natural Rights that we must ask the question regarding health care as a “basic human right”. If an individual’s health care is a natural right it cannot place an obligation on another person or entity to act in any other way than to not act.

On the other hand, I do believe that health is an individual right the domain of which is the asset of the individual and in that regard, no individual or government has the right to act in a way that takes away the individual’s responsibility for their own health. The obligation is always to not act.

Those who want to argue that the right to health care is a “right” must argue from a “positive rights” position that the state should act in such a way as to force citizens to respond to the demand that someone else’s health care needs—not health which is an individual’s domain, be met. This is a positive obligation and by definition not a natural right.

These agreements grounded in western philosophy and Judeo- Christian thinking should be thoughtfully considered by everyone including those making the arguments that “health care is a right” or that centralized health care systems—single payer is the best way of distributing scarce resources. Any economic system that requires coercion in order to execute compliance is going to fail.

Briefly, I would like to address one other misconception from the political left. Words like “common good” and “public good” are economic terms and as such should be discussed from an economic and not philosophical point of view.

For a good or service—medical care is a good and a service and individuals in that industry need to be paid both for the value of their “human capital” and for the prices of the materials they distribute, specific criteria need to be met in order to be called a “common good”. A public or common good cannot be used or distributed selectively. If one person receives the public good everyone must receive that good.

This leads to the second characteristic which is “jointness of consumption”. This means that when one person consumes the good, a scarcity will not be created—scarce resources will remain the same—think about the air we breathe. When one person takes a breath it does not take away from another
person’s ability to take a breath.

The final criteria would be that the “neighborhood effect” whereas the consumption of or investment in a public good will have an equal benefit to everybody. When the police patrol your neighborhood it benefits all the neighbors.

So health care in the economic sense is not a public good.

The Judeo-Christian tradition of charity is not fulfilled by government welfare programs like Medicaid. Nowhere in the Bible is the government described as being the conduit for charity. In my Catholic Catechism charity is a covenant between the giver and the receiver that God is party too—”What you do for the least of my breather you do unto me”. We are in fact told to “Render unto Caesar that which is Caesar’s”.

So arguments that health care is a “right” or “common good” needs to be understood and confronted.

Finally, the government is the least efficacious means of distributing resources. Today in our country 35million people are voluntarily giving in-home care to 55 million seniors and those with disabilities at an unreconciled cost of over $550 billion/year—no cost to taxpayers or the government and about the same cost of the Feds portion for Medicaid. Furthermore, think about the opportunity costs of unfulfilled income to the volunteers.

Health Care is not a right. Health Care is not a common good.

The private sector and charitable non-profit organizations are the best tools to distribute scarce resources and health care is a scarce resource. Until we understand these basic principles of philosophy and economics, public policy will fail in addressing the health care needs of our people.

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