A Libertarian Perspective on Healthcare

A Libertarian Perspective on Healthcare

Part 1: Is Healthcare a Human Right?

Virtually every person wants access to quality health care at an affordable price. Libertarians believe that the best way to achieve this is by removing government interference and enabling free markets. Proponents of state sponsored health care believe that it is an essential human right and therefore every member of society has an obligation to ensure that every other member has his health needs met. This line of reasoning further dictates that the decision must not come from the free market but from a shared moral consensus. The origin of such thought was introduced by the late Cardinal Bernardin, in 1994 in his address to the National Press Club in Washington, DC, but it is common among proponents of state sponsored health care.[1] State sponsored health care ideology is problematic because the “right” to health care doesn’t conform to the definition of inherent natural rights. If Person A has a right to health, this right cannot place an obligation on Person B to act in any way other than to not act, that is, to recognize Person A’s right, to respect Person A’s right, and to restrain from causing Person A to become unhealthy. Health care services can only be provided and can only be properly justified under arrangements that are voluntary and that do not violate human rights.[2]

We are all created free and independent. The words in the Declaration of Independence define the rights of American citizens and nowhere in that document are the words “health care” or anything related. In addition to our defined rights, we have inherent natural rights that precede the State and therefore can neither be granted nor taken away by the State. For over a century, however, there has been an American belief that health care is a right that government and tax payers should provide. Rights by definition should not involve the action of another person; otherwise, your right to have their labor or goods supersedes their right to keep their labor or goods.[3] The forced practice of state-sponsored health care creates an unethical imbalance because it causes one person to have more or differently defined rights, than another. Dr. Roger Stark, policy analyst for Washington Policy Center’s Center for Health Care, states that: “Everyone can agree that health care is a necessity of life. So are food, shelter, and clothing. Yet no one is demanding universal “food care” or universal government housing. The critical issue is that people expect access to food, shelter, and clothing. Americans expect choices and competition when they shop for these necessities of life.”[4]

The mechanisms of providing health care are rooted in the free market system and entail production of goods by the pharmaceutical and technology industries, manufacturing and sales of medical equipment from private companies, and the training, marketing, and practice of medical practitioner skills and labor. Forcing doctors and other medical professionals through legislation to treat or save someone’s life (even if they get paid to do so), versus giving them the option to practice their trade in the free market, is both immoral and potentially unconstitutional.

This brings up the “are you just going to let them die” argument that is often bandied about as justification for forced medical care. If we go back to the construct that labor and money are interchangeable, “just letting someone die” assumes that we owe them their life. This means that the government would get to decide when a doctor may retire or otherwise not work. A governmental requirement/mandate that an individual must be provided with health care and medical services (regardless of Supreme Court decisions) is a violation of the actual enumerated constitutional rights and largely accepted human rights of a large sector of society, in a misguided effort to preserve a non-enumerated “right” of a minority of society.[5] Free market health care is not an attempt to eradicate altruism or dismiss the importance of compassion and humanity in society. Dr. Bill Powell, DO, Family Practitioner states: “Most physicians get into medicine as a result of their altruism and compassion. To mandate altruism and compassion negates the very concept which must be freely given to actually exist.  Any such service given by compulsion is neither altruistic nor compassionately performed but the one giving the service, even if those in government believe that is their motive. Their motives are not mine.” Such necessary societal components, relative to health care, should be encouraged and discussed from a socio-cultural and economic perspective, but devoid of government intervention and forced support from taxpayers.

Health care is an economic activity and just like other economic activities, people have the right to make their own health care decisions and use their own money to drive and influence the market. Society should work toward putting patients in charge of their health care, reducing the role of government, and focusing on access, not health care as a supposed right.[6] Thus, if we believe and honor the preamble to our Constitution and “hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness,” then our obligation does not lie in providing health care at the expense of another’s unalienable rights. It then becomes obvious that health care is, in fact, not a human right. Furthermore, state sponsored health care is not justifiable by a shared moral consensus, because it is not a human right, but rather a product for the free market.

Physician Commentary:  If people believe that health care at my expense is a right, they need to understand what goes into becoming a physician.  Not only does it take significant and intense study and sacrifice, but we have to put off all ability to earn a living, save for retirement, and essentially make a future until after residency.  In some cases, that can be as long as 20 years (starting as college freshmen) for neurosurgeons, oral maxillofacial or plastic surgeons.  Even some advanced cardiac training or pediatric subspecialties can take six to ten years after med school.  For a family doc like me, given the amount of time I put into schooling and post-graduate training, dollar for dollar, I will make less in my entire career than a 5th grade math teacher, and I will have a much busier and less enjoyable home life as I work in that direction.  Furthermore, given the government-sponsored debt repayment/forgiveness options, a 5th grade teacher will be completely out of debt and never in a tax bracket that will take 40-55% of their income away from them, while I will still have over $175,000 of debt all while the government takes from me my ability to pay off my debt so that someone else who does not or will not work can have better health care than I can afford, even with pre-tax deductions.  Essentially, I get to pay twice; once to the IRS, and again in the office as they take money from my pocket to pay me for my services.  That is by definition “Racketeering,” is it not?[7]

 

[1] Bernardin, Joseph. “A Moral Vision for America.” Georgetown University Press, 1998.

[2] Vidal, Gabriel E. “Healthcare is not a Human Right.” www.libertarianstandard.com.

[3] Nolan, Gary. “Is Healthcare a Right.” www.logicallibertarian.com, 2017.

[4] Stark, Roger. “Why Healthcare is Not a Right.” Washington Post, 2018

[5] Nolan, Gary. “Is Healthcare a Right.” www.logicallibertarian.com, 2017.

[6] Stark, Roger. “Why Healthcare is Not a Right.” Washington Post, 2018.

[7] Dr. Bill Powell is a Libertarian and Family Practitioner in Ashland, Oregon.

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