Wednesday, August 12, 2009

Evasion in the Health Care Debate

Sunday's Chronicle carried an OpEd article that demonstrates the equivocation, gross evasion, and emotionalism dominating the appeals to nationalize health care. In the article, Dr. John C. Baldwin writes:

In the continuing absence of universal access to health care in the U.S., terror abounds. The terror of being uninsured if you become ill, the terror of personal bankruptcy due to health care costs, the terror of pre-existing conditions that prevent obtaining health insurance — all have led to a state of fear in this country. Having reconsidered the previous administration's “war on terror” that led to so much abuse of power and loss of domestic freedoms and so little success in the Middle East, we should now commence a national effort to combat this real form of terror in our own country.
Extending his argument, Dr. Baldwin claims that "health care security" is as important as national security. We cannot field an army without a healthy populace. We cannot support that army without a healthy work force. Dropping context further, he argues that we would not agree to have our defense services provided by private companies, and therefore, it makes no sense to allow health care to be provided by private companies. To Dr. Baldwin, fear is fear. Its source, nature, and legitimacy are irrelevant. Protecting Americans from calculating mass murderers--which he implies is not a real threat--is the same as protecting them from disease.

National defense is a proper function of government, as it is the means by which government protects individual rights from foreign threats. But to argue that "health care security" is equivalent to national defense is to ignore the source and meaning of those rights.

Rights pertain to action--they are a sanction to act without interference from others, so long as one respects the mutual rights of others. Rights protect one's freedom to act as one chooses, to select one's values and act to attain them. Rights place boundaries on others; they may not interfere with your actions, just as their rights prohibit you from interfering with theirs.

Rights do not guarantee success. They do not guarantee that we will attain the objects of our desires, only that we will be free to take the necessary actions. There is no such thing as a right to haircuts, television sets, Internet connections, or health care. There is only the right to take the actions to acquire these values through voluntary trade with those who produce such values.

Claims that health care is a right obliterates the entire concept of rights. As Dr. Leonard Peikoff writes in Health Care is Not a Right:
You are entitled to something, the politicians say, simply because it exists and you want or need it--period. You are entitled to be given it by the government. Where does the government get it from? What does the government have to do to private citizens--to their individual rights--to their real rights--in order to carry out the promise of showering free services on the people?

Both theory and practice provide the answers: The government must take from some to give to others. The government must force doctors to provide their services to those who have not earned them. Doctors must become servants of the state.

Decrying the high cost of health care in America, Dr. Baldwin argues that we must reform the system to reward "better decisions" rather than the number of procedures performed. He doesn't tell us who will make these decisions or by what standard, but he makes it clear that it won't be patients and their doctors. Doctors, he tells us, are motivated by "perverse economic incentives". Removing these incentives will drive down health care costs and improve quality.

This argument evades basic economic truths. Nationalized health care will increase the demand for health care--when a product or service is provided for "free" demand always increases. Indeed, increasing access to health care--which means increasing demand--is a common refrain among universal coverage advocates.

At the same time, these advocates want to reduce costs and remove decision making from doctors. The results will be predictable. Cost reductions in the face of soaring demand can only be achieved by dramatically reducing the procedures performed--that is, rationing.

While these economic arguments against nationalized health care are important, they are not the fundamental reason to oppose a government take over. The fundamental reason is moral--the moral right of doctors and patients to act according to their own judgment. And this is precisely what Dr. Baldwin and "reform" advocates are explicitly attacking. They seek to "free" patients and doctors from economically based decisions, and drive both into the strangling hands of government bureaucrats.

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