I know this will piss off many of my fellow travelers, but I wanted to come out and say it for the record. Don't worry, I am not about to turn in my credentials as a card-carrying member of the Angry Left. My objection may be more semantic than anything else, but words mean things and it is important to be clear in important in matters like these.
Fellow bleeding heart (and shyster) JimII said it well in the comments the other day: rights are limitations on government power. Exactly. When we use the language of "rights," we are generally discussing very fundamental liberties, which are conferred on us at birth, and which no government is permitted to take away: free speech; religion and conscience; property; assembly and petition; bodily self-determination; self-defense, and the like. Freedoms. Nowhere in that list is there anything which must be given to you by others. These are freedoms which are yours, not obligations which you are due from somebody else. There is no right to an education, nor to a comfortable retirement, nor to otherwise profit by the sweat of someone else's labor.
Now some societies, ours included, from time to time decide that its citizens, or certain groups of them, should be entitled to certain benefits. Sometimes this justified by the common good -- a well-educated populace serves society well, so we guarantee an education to all children. Sometimes this is derived from humanitarian principles -- children should not go hungry, so we create childhood nutrition programs. Healthcare would, in my estimation, fall into the category of an entitlement rather than a right.
Some who claim that healthcare is a right have held out the UN Declaration on Human Rights as a standard, but my reading of the document is that it is admirable but hopelessly muddled on this distinction. I think it's important to be clear on the difference between a right and an entitlement. Rights tend to be more fundamental, more important, and deserving of higher levels of protection and scrutiny. Entitlements shift as social conditions change, as values evolve and as economies grow and shrink. They may be given only to certain defined groups, but rights are universal in their nature, and rights are very infrequently modified. Entitlements differ from place to place and time to time. Entitlements may, albeit rarely, be rescinded or reduced. And they are in most cases paid for by individuals who are not the beneficiaries.
Our nation has long defined health care as an entitlement for the eldery, the disabled, and the very young. We are now involved in a national debate whether this entitlement will be made universal. As you all know, I am an advocate for universal health care. Though there may be an argument for the societal benefit of universal healthcare, or for the relative cost-efficiency of universal healthcare, I support it almost entirely for humanitarian reasons. It needs to be paid for, of course, and that will be a challenge, but as a social priority it ranks as absolutely critical in my estimation. If I, in the future, make the mental error of referring to healthcare as a right, understand that I mean that it is an entitlement, and an important one. (And remind me to be more careful with my verbiage.)
There is a common line of argument against universal healthcare, derived from the (hopelessly muddled) objectivist school of thought. It has been most commonly expressed (or approvingly linked to) as:
[W]ith any good or service that is provided by some specific group of men, if you try to make its possession by all a right, you thereby enslave the providers of the service, wreck the service, and end up depriving the very consumers you are supposed to be helping. To call "medical care" a right will merely enslave the doctors and thus destroy the quality of medical care in this country [...] It will deliver doctors bound hands and feet to the mercies of the bureaucracy.There's a lot not to like about this sentiment, but some limited validity. The argument is somewhat fatuous in that it rails against a hypothetical socialist system which does not actually exist, in which providers are not paid for their services. On the other hand the argument ignores the fact that such a system already exists, and in some respects might be mitigated by universal health care.
For example, as our Dear Leader said, "[P]eople have access to health care in America. After all, you just go to an emergency room," and he was right. You come to see me, and I will take care for you, and any specialist you need will come in to provide whatever service you need. Sure, this isn't any sort of comprehensive health care, and certainly isn't the best way to get health care. But it's there. Only problem is, I and my colleagues are not caring for you out of the goodness of our heart, nor out of charity, but because we are obligated under federal law to do so. While this isn't exactly slavery, this coercion of our work product is essentially compulsory if you work in a US hospital.
Universal health care, or, more precisely, universal health insurance, might improve upon the current state of affairs by ensuring that doctors are always paid for the services we provide, rather than being obligated to give them away to 15-30% of their patients as we now are.
The typical emergency physician provides about $180,000 of free services annually, just for reference.
As for those who claim that the slavery of universal healthcare is rather in the loss of physician autonomy, or in the corruption of the free market, I have one thing to say to them: that ship has sailed. Medical practice is irrevocably governed by a Byzantine maze of laws, regulations and standards set by a veritable alphabet soup of commissions and independent organizations. That is not going to change for the large proportion of physicians who have the need to care for patients in or incident to the hospital setting. Furthermore, there is no free market for physician services as it mow exists. Prices are set by the federal government for about half of Americans, and by a cabal of large insurers for the rest. Doctors can negotiate their prices within a narrow range with individual insurers, but the success of this is determined by the regional strength of each payer, not by the quality of care provided by the doctor, and while you can set the conversion factor for your fee schedule, you cannot set the price for each individual service you provide.
While there is a growing trend towards boutique medical practices and freestanding ERs, these are and will remain small niche players for those patients able to afford them. For the vast majority of physicians, we are stuck with the current system. Universal health care is unlikely to fundamentally change the status quo for physicians in this regard.
Bottom line: No, Health Care is not a right. When advocates of universal health care misuse the language of universal rights to push for health care for all, we fall into the trap of over-reaching and provoke a justified pushback, even from some who might be inclined to agree with us. Universal health care is, however, a moral obligation for an industrialized society, and will not result in the apocalyptic consequences promised by the jeremiads.