Friday, August 28, 2009

Why Isn't Health Care a Right?

Kate Southwood asks that question in this HuffPo puff piece.

The Norwegian health care system is not the best in the world. It was ranked 11th by the World Health Organization in its last poll conducted in 2000. The current American health care system came in 37th. Not only that, WHO found that America pays more, lots more, than any other country: "The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance."

So if America is already spending more on health care than anyone else and if America's health care technology is second-to-none, why isn't health care a fundamental right?

Liberals think health care is a right. More to the point, they think the best health care is a right, regardless of cost. This is different from anyone's thinking about any other issue. Does everyone have "a right" to the best food? No. When we talk about food kitchens or church pantries, we think of food that keeps people from starving, not the best food in the world.

What about housing? Should "a right" to housing include having a huge house with A/C, heating and all the comforts of modern life? It's one thing for Habitat for Humanity to want to build houses like that people, but we don't consider a "right to shelter" to mean a right to 3,00 square feet and ceramic tile.

The problem with this "health care as right" mantra is cost. We simply can't afford for every person in America to have the same level of health care. Exra Klein is right: we do ration.
We ration health care the way we ration other goods: We make it too expensive for everyone to afford.

We don't seem to think it's wrong to use this system for food; if you can afford steak or seafood, you can buy it. If you can't, you buy chicken or hamburger. Nobody's screaming that we need to provide the poor with tilapia on a weekly basis, because we accept that those with more money have more choices. Food pantries usually give clients inexpensive foods: dry milk, canned goods, beans, rice.

But this standard is somehow wrong when we talk about health care. Regardless of what people say, when the doctor comes to them and says, "You have 'X,'" people want to be told that they have the most effective options available for next to nothing. They don't usually admit this, but most people know what they think any given procedure, such as an X-ray, sonogram, or brain surgery, is worth. And that's what they think they should get to pay. It doesn't really matter if that's the real cost of the procedure; this is based on "fairness."

But we know that a "fair price" isn't what most of the procedures we want cost. They can cost much, much more. Liberals will tell you this is just because greedy CEOs want bigger bonuses. But the reality is that the costs of medicine are affected by the markets just like anything else. And if the government gets involved and tells doctors and hospitals and pharmaceutical companies how much they can charge, then that maximum is going to be what will be charged. And since we all don't have money trees growing in the backyard, when the government runs out of cash for medicine, there will be rationing, and that rationing will still be based on what we can afford.

Look, even liberals acknowledge that the rich will always get better health care than the rest of us. The problem is that they want the rest of us to get some minimum care without the ability to have more based on our individual incomes. I'm sorry the uninsured aren't getting optimum care, are going without procedures or medicines or foregoing tests because they find them expensive. But you don't get to complain to the grocer that steak is too expensive and you have a right to it, either.

To answer Southwood's question, health care isn't a right because we can't afford to give everyone the health care they demand for the price they want, and no one wants the stripped down model.

Alexander Muse makes the same point.