According to the Institute of Medicine of the National Academy of Sciences, the United States is the “only wealthy, industrialized nation that does not ensure that all citizens have coverage” (http://www.iom.edu/?id=17848). Obama has pledged to reform the healthcare service by increasing coverage and reducing costs (http://www.barackobama.com/issues/healthcare/). This has reopened the long standing debate over whether America should have a free public healthcare system such as the NHS.
All the Yes points:
- Healthcare is a human right.
- Would cut overall healthcare spending.
- Would shift the onus from profitability to public benefit.
- Would encourage people to go for healthcare when they need it.
- Legal mediator between employer and employee.
All the No points:
- waiting lists
- lack of competition would lower quality of research
- Emergency Medical Treatment and Active Labor Act
- can’t compare statistics from two countries
- lack of confidentiality
- worries over public healthcare becoming compulsory
Healthcare is a human right.
Article 25 (http://www.un.org/en/documents/udhr/index.shtml#a25) can be interpreted as a duty to provide healthcare. The right to life (http://www.un.org/en/documents/udhr/index.shtml#a3) can also be extended to include healthcare, as medical care is the only way that life can be maintained in many situations. Poor people simply cannot afford to pay for healthcare, especially as they tend to have worse living conditions and therefore more medical problems. Their human rights are being violated simply because they cannot afford them.
I keep hearing people claim that health care is a right. And this keeps me wondering how people define “rights”–do people understand what a “right” is? Where do they come from? How do we get them? Do we all have the same rights? Are they given to us or do we just stake a claim to the ones we want? What have claims such as “housing is a right” or “health care is a right” done to our understanding of what constitutes a right.
Books have been written about the nature of rights, so it would be silly for me to attempt an expansive discussion of the subject here. For the purpose of this discussion, I will simply say that while there are many moral obligations, a right is a LEGAL OBLIGATION, and under the philosophy and principles that guided the founding of our country, a right legally and equally obliges government to leave people alone, does not necessitate the violation or infringement of anyone else’s rights, and views all people as equal before the law. In other words, there is no such thing as a “right” to violate someone else’s rights—at least there wasn’t supposed to be. But that is exactly what happens when it is decided that someone has a “right” to health care, a house, a job, a car, or any other thing that requires that it be provided by someone else, because the only way government can “provide” any of these things for some people is by taking them from others, and forcing others to pay for these things necessitates violating other people’s rights to keep their own property.
Again, our genuine “rights” don’t impose an obligation on any one person to provide any other person with anything. As we exercise our rights, the only obligation we have is to not infringe or violate anyone else’s rights. As an adult, my right to life requires only that I be left alone, not that someone else—or an entire community or country of someone else’s–be compelled to provide me with the means for sustaining my life. My right to liberty requires only that I be left alone by my government and everyone else. If I should be kidnapped or held captive, or somehow enslaved, my government has an obligation to see that I am freed because according to our Constitution the purpose of our government is to secure our rights, and my right to freedom would have been forcibly and unlawfully infringed upon. Likewise, my right to pursue happiness requires only that I be left alone, not that anyone else be required to provide me with the means for achieving whatever I determine happiness to be—and, it certainly doesn’t imply any guarantee that I will achieve happiness.
Again, rights entail legal obligations, and while most of us certainly want a moral government, it doesn’t necessarily follow that everything we see as a moral obligation should be a legal obligation, if for no other reason than that our notions of morality change over time. For example, the Inquisition was a time when perceived moral obligations to purify the church became legal obligations giving some humans the “right” to torture and kill other humans. Coming back to the health care issue, I think it can be safely said that most people would agree that each of us has a “moral” obligation to take care of ourselves and our loved ones, physically, intellectually, and emotionally. But do we want that moral obligation to become a legal obligation, giving some people the “right” to force other people to eat a specific diet, exercise, take certain classes, or submit to therapy? However, led by generations of pundits and politicians, it seems most people in this country now believe every moral obligation should also be a legal obligation—a “right,”
As rights are a function of government, they can be secured by force—by compelling people against their will if necessary (think police with guns) to refrain from violating someone’s rights. But moral obligations are a function of some moral authority, usually a religion, of which, especially in this country, there can be many different kinds. My church imposed a moral obligation that its members tithe 10% of their income, but the only thing compelling them to tithe was their conscience, not police with guns. Because tithing is not a legal obligation the church does not a “right” to collect ten percent, or ten cents, by force.
Lastly, rights come with responsibilities, and are held by individuals, not groups, because only individuals can be held accountable for the responsible exercise of their rights. In exercising my free speech right it is my responsibility to see that my speech does not violate anyone else’s legitimate rights, and to ensure that I exercise this right responsibly there are laws against slander, libel, and “yelling fire in a crowded theater.” Likewise, excercising my right to life means I am responsible, to the best of my ability and to the degree that I desire, for maintaining my life, which includes looking after my health.
So, to the question, “is health care a right,” my answer is no. If it should be decided that it is a right, i.e., a legal obligation on the rest of the citizenry to pay for health care, then we should prepare for a whole new cornucopia of “rights,” because if some citizens are to be compelled to provide health care for other citizens, then the paying citizens will have earned the “right” to demand that those excercising their “right to health care” assume the responsibility that comes with this right, by conforming their behavior to standards that will optimize their health—i.e., no smoking, drinking, drugs, excess weight, or risky activities (skiing, skateboarding, sky diving, etc.), no more than one sexual partner, eating only approved food, and daily exercise that is both approved and verifiable (wouldn’t I make a great bureaucrat?). And, what happens to freedom? Just like everyone seems to have forgotten that rights come with responsibilities, they’ve also forgotten that freedom isn’t free–there is a cost, and that cost is the willingness to accept responsibilty for your own life.
Would cut overall healthcare spending.
The US spends more on health care per capita than any other UN member nation (http://www.who.int/whosis/whostat/EN_WHS08_Table4_HSR.pdf). It also spends a greater fraction of its national budget on health care than Canada, Germany, France, or Japan.
Various arguments for universal healthcare center around proposed economic benefits. For instance, running one, centralised healthcare system with one buyer would cost less than keeping open hundreds of health insurance firms. It would also cut down on paperwork, which currently accounts for 24% of healthcare spending in the U.S. People would be more likely to see a doctor sooner rather than later if they don’t have to budget for it, meaning that less serious health problems, which are the most expensive, occur.
In a capitalist system, which the United States has, any one entity having a monopoly can only lead to prices rising. The reason that we allow these hundreds of different healthcare firms to be open is so they can compete with each other. Each struggles to be cheaper than the others so that they can attract customers. If we were to provide a universalizing healthcare system prices would skyrocket.
Would shift the onus from profitability to public benefit.
Removing profit as a motive means that drug companies would be more likely to consider which drugs would actually benefit the most people and less about which would create the most overall profit. For example, pharmaceutical companies have reduced or dropped their research into developing new antibiotics, even as antibiotic-resistant strains of bacteria are increasing, because there’s less profit to be gained there than in other drug research. (http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/01/20/MN1234A1.DTL)
Would encourage people to go for healthcare when they need it.
People are more likely to treat symptoms sooner than later and actually prevent a serious illness if they do not have to budget for it. The corrolary of this means that less time is wasted by people who can easily afford healthcare attempting to be treated unnecessarily. By making necessary treatment free and unnecessary treatment expensive, people will gain a better understanding of what is and is not important to their health.
(Unnecessary) cosmetic surgery is already very expensive.
Most people do not get unnecessary treatment unless they want to fritter away a number of pounds. Most people do not get unnecessary treatment period.
Necessary treatment will not be free. It is likely that cheaper treatment and tests that everyone should get will be free; any problems arising from the diagnosis of rare expensive fatal conditions will/can not realistically be expected to be under this this reform.
This is not about taking from the rich and giving to the poor. This is about slashing minority rights: Less money/funds for research on curing rare diseases.
Legal mediator between employer and employee.
Public health facilities can help a person claim against an employer for industrial negligence. This means that people who are most at risk – those in low paid jobs – are less likely to be exploited at work by being exposed to dangerous conditions. It also means as the facility is not motivated by profit, they will not be motivated to say something that isn’t true in someone’s defense.
One of the chief worries of the public healthcare system is the increased wait times, overcrowding leading to lack of beds and poor quality of treatment. (http://www.cato-at-liberty.org/2006/05/02/depends-on-what-the-meaning-of-universal-is/). The NHS already has huge waiting list problems. In survey data, Canadian and British respondents were three to four times more likely to wait more than 6 months for elective surgery than those in the U.S. (http://en.wikipedia.org/wiki/Health_care_reform_in_the_United_States#cite_note-139).
Well there are two groups of people, those who have health care, and those who don’t. The ones who don’t I’m sure would rather wait for it, than not get it at all. Those who currently do, is it really justifiable for some people to go untreated just so they wealthier patients enjoy shorter waiting times?
I live in the UK, and here if you want, and you can afford it, you can get private insurance. The NHS may have its problems, but it’s a lot better than no health care at all.
lack of competition would lower quality of research
There is a risk that, if there is no factor of profit whatsoever, drug companies won’t put any effort into research at all, or simply put more effort into innovations that affect other countries where they can still make a profit.
Emergency Medical Treatment and Active Labor Act
The Emergency Medical Treatment and Active Labor Act is already in place for medical emergencies. It requires hospitals and ambulance services to provide emergency care to anyone regardless of citizenship, legal status or ability to pay.(http://www4.law.cornell.edu/uscode/42/1395dd.html)
can’t compare statistics from two countries
Many of the arguments for Universal Healthcare compare performance in the US with that of other countries. Statistics for healthcare are compiled differently in different countries, with different criteria and standards.
Statistics are often difficult, but not impossible, to correctly compare. However, if a country has 50 million people without health care, and you compare it to a country with universal health care, it’s pretty easy to see the poorest people are better off with universal coverage, it’s better to have some health care than none.
lack of confidentiality
The Government has the power to demand to see personal information that would be kept entirely confidential if dealt with by a private healthcare agency (http://www.cato.org/pub_display.php?pub_id=3057)
worries over public healthcare becoming compulsory
There are worries that, instead of just being an option available to everyone, the public healthcare system would gain a complete monopoly or even that private health firms would be outlawed. (http://www.cato-at-liberty.org/2006/08/23/revolt-against-canadian-health-care-system-continues/)
This point does not belong on this list. The point of this debate page is “should america have universal healthcare like the NHS in England” which by definition outlaws private health firms. The topic of discussion predisposes a government monopoly. So you don’t have to worry that these things would happen. By definition, they would, so your point is a little pointless.
Maybe you are trying to say that it would be bad for the government to have a monopoly or that it would bad for private health firms to be outlawed which is a point that fits under this discussion. However, debatably, in other countries, a government monopoly works much better than the US system of private health insurance companies. The reasons for this are outlined in the other arguments on this page.
(However, don’t get this page confused with the bills being set forth in the Congress and the Senate right now. No one has proposed universal healthcare in any of the bills currently on the table)