While I am getting back up to speed here, I will sometimes go back through my files and republish older writings which seem oddly relevant now. Annoyingly, I apparently failed to put a date on this one, but I know for a fact it was before 2003 and probably after 2000. Not too bad a window, I suppose. At any rate, it was written somewhere in the neighborhood of 10 years ago and I have changed nothing in it (though I may have corrected some punctuation last night - I was half asleep, so don't quote me on that).
Getting Rights Right
Do People Have a Right to Services?
Here lately, I’ve lost track of how often I hear people talking about rights. Every time I turn around, someone is screaming about his right to this or her right to that. Frankly, it’s gotten to the point where I cringe every time I hear it, which is pretty sad considering how ardent a supporter of rights I am. My apprehension with this, however, is understandable when considered in the proper light. It is virtually impossible to defend rights to the fullest when people can’t even agree on how to define them.
One of the most visible examples of this in the current public discussion is the so-called Single Payer Health Plan. This plan, under various modified forms and differing names, is basically modeled after the socialized medical systems that can be found in such countries as Canada and England (though it is interesting to note that both of these countries have actually been moving or considering moving away from this system and toward more privatization in recent years). The central point of any such plan is tax-subsidized medical services that allow all people to have at least basic access without payment rendered at the time of service or due at a later date. I won’t just say “without payment” because, unless one doesn’t pay taxes, the service has actually been paid for, only before the fact. In this way, it is similar to an insurance plan, though usually without a deductible or co-pay. The only significant differences are that the payments are controlled by the government through taxes and that no one is allowed to opt out, neither the patient choosing to not use this form of insurance nor the doctor choosing to not accept this form of payment.
Also central is the justification for the control issue that is necessary for the plan: everyone has a right to medical services.
This is difficult to argue against without sounding like an ogre. Whenever we see someone who is sick or in pain, most of us want that person to have the necessary help. We don’t tend to think past that point. With Step One right in front of us, we often don’t think we have time to worry about Step Two and we’ll just deal with that when we get there. While wanting to fix the immediate problem is a natural human desire, refusing to look past the immediate problem frequently gets us into more trouble than it’s worth.
What if the solution we demand in Step One creates a problem in Step Two? In this case, we haven’t really solved anything; we’ve only postponed the problem. Postponing the problem is exactly what we’re doing when we confuse the issue and assign the value of “this is a right” where it does not belong.
In the example of Single Payer Health Plans, if everyone has a right to medical services, someone MUST provide those services. In Step One the patient has received service, but in Step Two the provider has been forced to render service, regardless of personal choice. Can it really be a right if it forces the violation of another person's rights? A carpenter has a right to not build a house. A farmer has a right to not grow crops. Does a doctor not have the equivalent right to not provide medical services? Why can I force a doctor to operate on me when I can’t force a farmer to feed me? Has the very act of graduating from medical school somehow changed the doctor’s rights and, if so, why aren’t students warned of this before they enroll?
While some may argue that it is issues of health or “quality of life” that alter this situation, I believe that my choice of counter examples demonstrates at least the inequality of this philosophy. Surely we all agree that food and shelter are equally health and quality of life issues. Yet even when we do step into these areas, we do not insist that every provider must play within the same government mandated game. We interfere only on a case-by-case basis where we actually deem it necessary and leave everyone else to play their own game. Why the insistence that health care be given its own all-encompassing set of rules?
Furthermore, if health care is a right, what happens when no one can provide it? If we can force doctors to render service, can we not also force eligible students to enter medical school so that we maintain the necessary amount of providers? If those who believe that health care is a right cannot embrace the logic of this idea, perhaps there is a flaw in their understanding of rights. Why is it appropriate to force one class of people but not appropriate to force another class toward the same purpose? It is an inconsistency that cannot be answered.
The reason for this is a faulty definition of rights. When properly defined, one right cannot cancel out another. I have the right to write this essay and you have the right to not read it. My right to write cannot force you to read and your right to not read cannot force me to not write. That’s the way it works, or at least that’s the way it should work.
By this definition, the only way I have a right to medical care is if I can provide it to myself. A right to health care otherwise would cancel out the provider’s right to free association and remove his right to govern his own labor. In any other situation, we would quite rightly call this slavery.
No one has the right to inflict slavery on another person, regardless of the situation. While it would certainly be nice to help people have access to medical services, we should be careful to not falsely define this generosity as a right. Courtesy isn’t a right, no matter how much better it might make the world.
If one wishes to defend rights, start by defining them correctly and consistently. If one wishes to promote access to health care, start by remembering that there are people with real rights on both sides of the issue. Both of these can be done at the same time, but they cannot be done as the same thing. Doing so is actually a promotion of slavery, and slaves don’t have rights.
Besides, who would you rather have cutting you open: the provider by choice or the provider by force?