Logic Applied to Healthcare

I thought the following post from ex Duke Review Editor Alex Epstein on the healthcare debate captured the essence of the premises involved in the debate. As I comment upon these issues in online circles I have become fascinated by the number of large, crucial premises that are unconsciously and inexplicitly smuggled into the healthcare debate. The different positions one may hold on these assumptions largely determines what your position on public healthcare. Alex Epstein, using his philosophical training, uncovers what I believe to be the most important healthcare premise that often goes undetected, undiscussed, and unchallenged. Whatever your stance on the issues, Alex's piece is worthwhile...

How to eliminate health care injustices (part 2)
August 28, 2009 by Alex Epstein

In Part 1, I raised the common argument that “We as a society must make ‘tough choices’ about who gets health care and who doesn’t…. Since ‘we’ have finite medical resources, we inevitably have to sacrifice some people’s care to others, whether young to old or old to young.”

No “we” don’t.

Medical care is not something that “we” collectively own, that “we” collectively have a right to receive, and therefore that “we” collectively must ration. Medical care is something that is created by individual medical professionals, who have a right to decide what to offer, how to do so, and how much to charge. And the money to pay for medical care (whether directly or via insurance) is something that must be earned by productive individuals—just as individuals must earn the money to pay for food, clothing, shelter, and everything else life requires. (Of course, medical professionals can and do give away their time and products to those who cannot afford it, just as millions in other professions generously give charity. Nevertheless, a person is responsible for his own life and health—and those of his children.)

Because health care is created by individuals, it is wrong to look at it as a finite, zero-sum pie in which one person’s kidney dialysis is necessarily another person’s untreated diabetes or uninsured child or higher tax bill; human beings can produce as much health care as people are willing to earn and pay for. Because health care is created by individuals, it is wrong to look at it as some collective good that the state has the right to control. The government has no right to dictate what services medical professionals can produce or how patients spend their money; it cannot properly force a young couple to pay for the scooter or Viagra or an MRI of an 85-year-old at the expense of their child, nor can it restrict an 85 year-old from saving his money and buying as much end-of-life health care as he can.

We can bring an end to the sacrifice and injustice in health care by recognizing that health and health care are not collective rights, but values that each individual has the right and responsibility to pursue freely. We are responsible for taking care of our bodies (and our children’s bodies) and we have a right only to the health care we can obtain in a free market—which, when it was genuinely free, included ultra-cheap, high-deductible health insurance and ample private charity.

In a free society, no one would need to sacrifice; there would be no collective health care costs that we all (resentfully) bore together as tax payers, there would only be costs that we would be responsible for as individuals. That would be real health care reform. Anything else is health care, deformed.

Credit to Alex Expstein http://blog.aynrandcenter.org/author/aepstein/