More and more I come across the feeling that people like the idea of a nationalized health care industry. The debate is not whether health care is a good thing or not; it seems to be more about how much and whether the system works. Wouldn’t it be great if everybody could have access to free health care? More and more I hear an alarming “yes” among Americans. Now, I wouldn’t be surprised if I heard this among the French, the Swedes, the Danes or the British. It is almost written in the social contract there that one has a right to health services (along with a job, a family and maybe a decent haircut).
The American Bill of Rights, I thought, was rather clear on the subject of what is a right. A right is something that you have the potential to do if you so wish. Rights are always rights to action. In the United States, you have the right to life, liberty and the pursuit of happiness. This means, quite literally, that if you so wish you can live, be free and pursue happiness. These are rights to action, not rights to be rewarded by other people. The American system, as I had understood it until now, has been that you have a right to earn things you want, if necessary by a hard struggle, and that nobody has the right to forcibly stop you from earning these things. You have a right to action, and to keep the rewards of these actions. Notice that these rights impose nothing on other people except the obligation to leave you alone if you so wish. The right to life does not impose the obligation on your family or neighbors to feed and clothe you. They may do so, if they wish, but they have no such obligation…
Now this is quite different from the French constitution, for example, where the obligation of fraternitÃ© and Ã©galitÃ© mean that the people via the government must ensure that everyone is fed and clothed properly out of a spirit of brotherhood, however much this brotherhood is coerced.
In America, however, you have no right to the products of the actions of others. You are responsible for your own survival and well-being, and no one else’s. There is a very good reason for this. If your desire or need for something produced an obligation on the part of other people to satisfy you, then they would be put to an unfair obligation. Your “right” to anything at anybody else’s expense means that they lose some of their rights.
Quite rightly, the founding fathers of this country saw this as wrong. What I see today is many people fighting for a new concept of “rights,” rights that nobody who signed the Constitution ever dreamed of. Politicians are telling us that we have a right to something merely because we want it or need it. But where do we get these rights? From the government. And where does the government get them? At the expense of people who have actually worked for them. It is amazing that in this country the more you work, the fewer rights you have vis-Ã -vis those who do not.
In defense of health care, what I hear is that “health is different,” that being granted health care is very different from being granted the right to a trip to Disneyland or the right to a new pair of Nikes. I hear that we have an interest in keeping everybody healthy and alive. And yet I fail to see how we have more of an interest in this than the people concerned. If people truly valued their health, then they would invest in health plans.
Not everybody can afford to, but that is another matter. Most health care spending, around 80 percent of it in fact, is spent in the last six months of a patient’s life. One would imagine that if people wanted to live well those last six months, they could save for it themselves. More importantly, what exactly is the social value of having people live six months longer (or better) if we are taking livelihood away from those in the prime of their lives?
There are many unanswered questions here. The main one, however, is why are we taking away the right and responsibility of people to manage their lives the way they see fit? Who are we to place a value on those last six months that the people concerned often do not? I often hear: “Well, wouldn’t you be happy to be taken care of in the last few months of your life?” Well, sure, but isn’t it my call whether I want to live longer, or better perhaps, and die earlier? If I didn’t think of that, isn’t it my fault? Because if it isn’t, whose is it?
The problem, as I see it, is a stigmatization of human life, a life which is seen by too many as sacrosanct and something to prolong as much as possible regardless of the pain or the wishes of the people involved. Again the answer is harsh yet simple; the right to health care is limited by your potential to afford it. Even if you desperately want to cling on to your miserable life, you have no right to impose the burden of keeping you alive on anyone else who doesn’t want to.