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The introduction of the American Health Care Act by House Republicans and its subsequent failure to gain enough votes has reignited the debate on how our government should act to improve a healthcare system characterized by deeply rooted problems. A fundamental disagreement between liberals and conservatives that shapes healthcare policy is with regard to political philosophy. Can healthcare be considered a right? Many on the left argue that healthcare is a human right and that government must ensure all people receive quality access. On the contrary, this idea contradicts the traditional American definition of rights and serves us no good in making constructive progress on this issue.
Let’s first define a right. John Locke, the famous 17th century English philosopher, cited inalienable rights, including life, liberty and property. These rights are inherent in nature and cannot be taken away by government or other people. Thomas Jefferson also cited inalienable rights in the Declaration of Independence, writing: “That among these are Life, Liberty and the pursuit of Happiness.” The Declaration goes on to state that the role of government is to “secure these rights.” It does not state anywhere that government should create new rights.
The key distinction between the rights our founding fathers described and purported rights like healthcare is that the former are rights to action. They do not require anything from others except for the obligation to not infringe upon those rights. These “negative rights” emphasize limited government and personal independence, allowing us the chance to be left alone by government and make choices that we determine to be best. To quote Julie Borowski, “A right is not something someone gives you — it’s something that no one can take away.”
Healthcare, on the other hand, is a service and must be produced by others. If we say that healthcare is a right, we imply that someone has an obligation to produce it. As Max Borders writes in an essay on this topic, “Once we slide from the apparently benevolent talk of people having rights to the reality that other people will then have enforced duties to produce those rights, we also slide from individual compassion to State compulsion. In other words, any such right necessarily conflicts with others’ rights not to be treated as means to some end.”
When government has to enforce such things, the incentive for the healthcare industry becomes rationing what is available rather than competing in the market to consistently deliver better results. Looking at current healthcare systems throughout the world, we can clearly see the detrimental effects of over-involvement by government. For example, the United Kingdom’s single-payer system, the National Health Service, is approaching a breaking point. Staff shortages and long waiting times plague customers. A study by the London School of Hygiene and Tropical Medicine determined that there are approximately 750 avoidable deaths per months in NHS hospitals, attributable to sub-par care. “Pressure on all services is rising and care is increasingly being rationed. Waiting lists should not be rising, and yet they are,” said Mark Porter, council chair of the British Medical Association. Similar results have been seen in Canada, where a report by the Fraser Institute suggested the median wait time in 2016 was 20.0 weeks.
Here in the United States, where we are already running with a nearly $20 trillion national debt, the healthcare plan proposed by Bernie Sanders during the 2016 election would have cost the government $32 trillion in addition to what it pays now. Not only is viewing healthcare as a right philosophically difficult to justify, it is also impractical and unsustainable.
One question that’s been asked to counter the conservative argument is, “If you are required to insure your car, why shouldn’t you have to insure your own health?” The two situations are not really comparable. No one is forcing you to have a car in the first place. You know before purchasing a car that insurance is required, so if you don’t want to pay for the insurance, you simply don’t buy the car. The Obamacare model, or going even further, a single-payer system, does not give you this choice. Rather, it is a top-down institution of policy that assumes a one-size-fits-all solution.
Of course, we need to work diligently to improve the state of healthcare and help as many people as possible afford health insurance. But trying to disguise healthcare as a right is only preventing this progress. Following the failure of the American Health Care Act, it is time to draft new legislation that prioritizes the individual and allows patients increased choice over their own care. The focus needs to be on lowering costs, eliminating waste and encouraging competition. Specific policies range from increasing individual access to health coverage by opening up the market across state lines, to expanding health savings accounts and tax credits for HSA contributions and to lowering the standards for association health plans, which allow small businesses to pool together to purchase coverage for their employees and families.
Conservatives too hope to see a day when all Americans can receive the healthcare they need. At the same time, we must keep in mind that this goal should be achieved in a way that is cost-sustainable and respects individual choices.
Corey Pray, president of the Boston University College Republicans, can be reached at cpray@bu.edu
