Is Health Care a Right?

I’ve done my best to stay out of the current debate regarding health care reform. Although I’ve tweeted a few things and made some comments on other people’s blogs, I’ve remained relatively silent. In part because I don’t have the time to argue, and also because all the arguments boil down to one specific idea: is universal access to health care, regardless of age / income / race / class, a right? Personally, I say yes, it should be. If we are consider ourselves the leaders of the ‘modern’ world, then we should be more than willing to take care of our citizens, and it not be based on the ‘free market’ or competition. End of story.

I know this isn’t the only issue regarding the debate (if you mention ‘death panels’, I’ll punch you in the throat. Seriously), but it seems to me that at the core, this is what it comes down to. Yes, people make valid claims on both sides regarding how different states have different regulatory setups, making it a nightmare to get a standard setup. And there’s also the little fact about how most of the big insurance companies have 1 or more members of Congress in their respective lobbyist’s pockets. It’s a mess, a broken system that is getting worse.

The American Prospect recently posted an article titled “The 10 Dumbest Arguments Against Health-Care Reform”. It’s a good read, and one that I would suggest folks on both sides of the debate read.

And then ask yourself. Do you think it is a right, or not?


DrJohnDrozdal August 17, 2009 at 11:38 pm

I find it odd that the United States is the only industrialized country where health care is not considered a right. In addition to the American Prospect article, I would also suggest Roger Ebert’s piece from the Chicago Sun Times via @jaywigley.

And think about how much health care could be provided by channeling the dollars the insurance companies spend on lobbying into actually paying for health services!

Lance Haun August 17, 2009 at 11:53 pm

If we agree that it is a right, does that mean we can drop the “death panels” strawman for “all arguments against universal healthcare”? I haven’t heard more than a couple of elected officials use the term as a serious description for what would have happened. Knowing many of the opponents personally, death panels didn’t even play into it for most of us.

I don’t think it is a right. That being said, political reality is that it is probably going to happen so deciding how to implement it is actually incredibly important for the future of the country (as President Obama himself said). One of the many ways we can help competition (the primary reason President Obama has wanted to keep a government option on the table) is by reducing state by state restrictions.

The problem is that no one in the majority would want to admit that increased state by state regulation and differentiation has been a major driving factor behind insurance cost increases (and reduced competition). Also, it wouldn’t be a very popular move with big insurance companies who have used state specific regulation to carve out near monopolies in some states.

So yes, let’s talk honestly about how to implement it effectively but let’s also not pretend that all people that would rather not have the US government in the health care business are Sarah Palin-esq dolts that hate America.

Norcross August 18, 2009 at 12:03 am

I agree 100% that the ‘death panel’ argument is complete bullshit, and that is one of my main points. The discussion that should be taking place (state regulations, access, cost control, etc) isn’t happening, because people with microphones and an audience spout nonsense like that.

My main issue with the insurance companies is that even with competition, they have no incentive to cover anyone other than the healthiest of people. There simply isn’t a profit involved.

Guilherme Cherman August 18, 2009 at 12:01 am

I personally don’t think health care is a right. For me it’s a good, like a car, house, etc.

I am certainly for health reform, but not for more control over private companies. I would rather repeal laws that over-regulate the market.

Plus, we don’t have the money for universal health care. Maybe if we come back from Iraq and Afghanistan…

BTW, people who say Obamacare has death panels are nuts, but it is indeed true that quality may get worse (like in other countries with UHC).

Norcross August 18, 2009 at 8:01 am

That’s one of the things I have to disagree on. Things like cards, a house, etc are commodities, and don’t have a direct correlation and affect on whether or not I live.

Parsing Nonsense August 18, 2009 at 11:45 am

I don’t think it’s a right in the same way that freedom and suffrage are rights. As a modern, developed country, however, there really isn’t any reason why our healthcare shouldn’t be the best in the world.

What it boils down to for me is, What is preventing our healthcare system from being the best?

The answer is health insurance companies. They fix prices, prohibit doctors from innovation, and make it impossible to seek healthcare without them.

The last thing any Americans need is more health insurance. Health insurance companies are corrupt, inefficient, and purely concerned about making a profit, not making healthcare accessible. To be continued…

Parsing Nonsense August 18, 2009 at 11:45 am

Add to that government involvement and you’ve got the worst idea I think I’ve ever heard.

Look at Lasik. It’s not covered by health insurance. When it first started, it cost a fortune. Thanks to a free market, however, competition for patients and innovation have led to lower costs for the procedure and it’s much more affordable now even with inflation.

A genuine free market, not the government’s idea of a free market, is the way to go with healthcare. Do you want to make healthcare accessible to everyone? Get the health insurance companies and the government out of the way.

Norcross August 18, 2009 at 12:03 pm

So if there are no insurance companies, and no government involvement, then who pays for it? You and I, directly out of pocket?

Consider this: when my wife and I had our first child, we ended up having to have an emergency C-Section. If we had been responsible for paying for the entire thing (most likely up-front), would they have stopped the process, and asked for the extra money?

Something like Lasik isn’t a valid comparison, given that it is 100% optional. My wife had it, because we could afford it. I’d also like to have it, but we don’t have the money right now. That’s OK with something like Lasik, but what if it were treatment for cancer?

Parsing Nonsense August 18, 2009 at 12:09 pm

Think of how low healthcare costs would be if health insurance companies weren’t involved, though. Back in the 50′s, everyone paid for all their medical costs out of pocket because medical costs were outrageous.

They worked out payment plans if necessary, but I don’t think they would ever stop a procedure and demand money upfront. That’s crazy! Paying for an emergency c-section out of pocket now would bankrupt you, which is exactly how the health insurance companies have set it up.

Parsing Nonsense August 18, 2009 at 12:11 pm

Wait, sorry. Back in the 50′s they paid for all their medical costs out of pocket because costs WEREN’T outrageous.

Norcross August 18, 2009 at 12:16 pm

Here’s an article that you might find interesting. It goes into how so many doctors now over-provide care, much more than is needed, and certainly more than was done in the 50′s and 60′s.

McAllen, Texas, and the rising cost of health care

And also, keep in mind that there were health insurance companies and HMOs in the 60′s as well. The Harvard Pilgrim plan is a good example of a non-profit health care plan.

Parsing Nonsense August 18, 2009 at 12:27 pm

In regards to over-providing care, could the flawed Torts system be to blame for that? I’ve talked to doctors who say that the majority of their overhead comes not from supplies but from malpractice insurance!

As for the article, that’s pretty awful I’ll admit but it can’t be indicative of the nation as a whole. I think it’s the patient’s job to seek out a practitioner who is on their wavelength with regards to testing and preventive care. To educate themselves on what tests and procedures are intended to be used for and make educated decisions in regards to their care. Medical decisions should not be passive ones.

Norcross August 18, 2009 at 12:36 pm

If you dig into that article, you’ll see that they mention that since Texas had passed a pretty strict tort control law, the lawsuits were almost non-existent.

In regards to that scenario being indicative of the nation as a whole, I can only reference my experience, but I’ve had many doctors order tests that, in hindsight, weren’t needed. But at the time, it was a mystery as to what the problem was. And since most Americans don’t want to be bothered by living a healthy lifestyle and taking care of themselves, doctors have to run tests before they give out the eventual perscription.

As for malpractice insurance…who’s charging them? Insurance companies. With UHC, many of those issues go away. You can’t sue the government.

Rockstar August 18, 2009 at 1:11 pm

Good comments!

I’ve seen these arguments get pretty heated, so bravo for keeping civil!

I took the time to read that article at the American Prospect, and it’s not bad. I think the tone gets a little too snarky (if there is such a thing on the interwebs) to make much impact, though. I think for about %80 it hits the right points, clears out the straw men and red herrings, which is great because we really need to be focusing on the real question!

What is wrong with healthcare in America? (Clearly what we have isn’t working.)

I think we can all agree that the issue boils down to two things.’

Accessibility and Quality.

We have an accessibility problem which centers around cost. The reason we put up with these douchebags at the insurance companies and HMO’s is because we can’t afford healthcare without them.

So we have to ask ourselves, what is causing our costs to increase, and our quality to decrease? Why is it that with all the money in healthcare (2.4 TRILLION dollars in 2008. About $8000 per person), we see almost no innovation, and no increases in efficiency?

Rockstar August 18, 2009 at 1:37 pm

The answer lies in a few areas, but really comes down to control over how healthcare is provided and distributed in the US.

Nowhere else in the world do the corporations which provide a service get more favors, and more anti-competitive rules passed than in the US. Medicare rules alone are 133,000 pages in length! This makes the 10,000-page income-tax code look like a model of simplicity.

What are the effects of this?

The rules and laws of healthcare have essentially set up a medical cartel.

A cartel exists when one group works together to set prices and control all steps in the production and distribution of a commodity or service. Through licensing and other laws enacted in the early part of the 20th century, one group, the American Medical Association, controls how many medical schools exist, how many students enroll, what is taught in the schools, the availability of hospital residencies, and, indirectly through licensing laws, who will get jobs in medicine. It would be difficult to find an industry in America that is more tightly controlled by one group or union.

Alternative therapies and practitioners have been ruthlessly suppressed, their proponents often being run out of the country. Thousands of Americans flee each year to Mexico and Europe to obtain products and therapies banned in the United States but in use for as many as 50 years elsewhere.

The kingpin of the cartel is the restrictive state-medical licensing laws, passed in the early part of the 20th century. Previously, there were no licenses and the health-care system worked well. However, one group of physicians, the allopaths or drug doctors, felt they were not making enough money. The AMA, formed in 1847, was quite candid about its intentions. It sought vigorously to reduce the supply of doctors by eliminating the competition and controlling the number of medical graduates. With backing from the Carnegie Foundation and the Rockefeller Institute for Medical Research, the AMA was quite successful. Because of its efforts, the number of healing schools fell from 140 in 1900 to 77 in 1940.

The purpose of a cartel is to improve the income of its members. From this perspective, American health care is a resounding success. John C. Goodman and Gerald L. Musgrave, in their excellent book Patient Power, explain that “the AMA endorsed the idea of a medical cartel and made participation in it ethically mandatory.”

In his book Price Discrimination in Medicine, Reuben Kessel states,

The delegation by the state legislatures to the AMA of the power to regulate the medical industry in the public interest is on a par with giving the American Iron and Steel Institute the power to determine the output of steel.

Rockstar August 18, 2009 at 1:42 pm

I’d also add some comments on the FDA. Sorry for rambling, but this is a big issue for me.

The large drug companies became part of the medical cartel through their agent, the federal Food and Drug Administration. Anyone who believes the FDA is an impartial or even helpful agency needs to read The History of a Crime; How Could It Happen, by Harvey Wiley, M.D., the first director of the FDA. In the book, he meticulously details how the FDA became infiltrated by food and drug companies and how its mission became completely subverted. As a physician, I believe no other domestic agency has caused more deaths than the FDA.

Physicians are the legal drug pushers in our society. Those who step out of line and prefer to prescribe vitamins, herbs, or non-patentable drugs often lose their licenses, though they do no harm. Only one state, Arizona, has a second medical homeopathic board that allows medical doctors to escape from under the thumb of the state board of medical examiners and practice as they see fit. In the past two years, a few states enacted laws to protect physicians from losing their licenses just because they use methods unapproved by their medical board.

Through physician licensing and hundreds of other rules, only those who practice drug medicine hold licenses, work in hospitals and HMOs, and direct government research institutes. This effectively blocks change. Most alternative-health practitioners who practice a far less expensive type of healing are shut out of the mainstream.

Special-interest laboratory laws also abound. In America one cannot walk into a laboratory and request a cholesterol test. One must first go to a doctor to obtain permission. Results may not be sent to the patient, only back to the doctor. This means another doctor visit. Thanks to these rules, a $10 test may cost $100 or more. The extra cost discourages people from caring for their health. Instead, they wait until a crisis occurs, which further raises the cost of health care. In Mexico, by contrast, one just walks into a laboratory, orders the test, and receives the results.

Corve DaCosta September 13, 2009 at 9:48 pm

health care is not a right in certain conditions. i will support health care4 all if the government can afford it. at this moment, america cannot afford it with the recession and wars they are currently involved in. if the government can institute health care for all without rationing care, raising taxes, raising costs for future generation, then why not?

Norcross September 13, 2009 at 9:51 pm

Government affordability has never been a requirement for anything, whether it was wars, previous tax cuts, etc. The US government has run a deficit for years. The government / public option should decrease costs. As for rationing, we already do that, only it’s done by cost. If you can’t afford it, in most cases you don’t get it. I’m willing to wait an extra hour in the doc’s office if it means that people won’t go without care.