Obsess with Me a While Please on This: Is Health Care a Right?

Friday, May 25, 2018

“Health care is a right!”

Someone is bound to say that whenever our nation's excessively costly health care system is being debated and pronounced upon. 

But, until early this week, I hadn’t heard it in a while, which meant I had been able to avoid obsessing over it, as I tend to do, for reasons I cannot explain.

Then an email from the campaign of Barbara L’Italien, the Andover Democrat state senator running for Congress in the Third Massachusetts District, arrived in my inbox on Monday, May 21, at 3:57 p.m. I’ve been obsessing ever since. 

In the voice of the candidate herself, this is what that email said:
“Health care is a right, not a privilege, which is why I’ve spent my career fighting for a single-payer system.  With endorsements from Mass-Care and the Massachusetts Nurses Association, I’m proud to be the single-payer candidate in this race.  It will be one of my biggest priorities in Washington…Every single person in this country has the right to accessible, affordable health care, and it’s time for our elected officials to make that a reality.”

All human beings have a God-given right to freedom and equality.  All have a right to think, speak, and worship freely.  We have the right to raise our children as we see fit, within the bounds of safety and reasonable care.  These are things we know naturally to be true.
How can we say the same about health care? 

How can we, with the same degree of human certainty as when we talk about the right to free expression, say that we have the right to show up in a doctor’s office or emergency room and demand our share of care?  
Good persons say exactly that all the time. 

Pope Francis, for example, said, “Health is not a consumer good, but rather a universal right, and therefore access to health care services cannot be a privilege.”  And Franklin Delano Roosevelt, my all-time greatest political hero, said, “We have accepted, so to speak, a second Bill of Rights under which a new basis of security and prosperity can be established for all regardless of station, race, or creed.  Among these are…the right to adequate medical care and the opportunity to achieve and enjoy good health…”
Now, I’m a believer in universal health coverage.  I never want to see anyone denied needed care.  I think it’s simply a matter of creating a smart insurance system that will cover everyone, as many developed countries did two or three generations ago.  It all has to do with smarts and good management, both of the business and political varieties. Universal coverage is not about socialism vs. free enterprise. 

Four hundred years ago, we agreed that insurance is a good thing.  Why in the name of Grey's Anatomy (or Ellen Pompeo, for that matter) are we still arguing about whether health insurance for everyone is worth having?
I agree not with FDR but with U.S. Senator Rand Paul, R-Kentucky, a political anti-hero of mine.  A medical doctor before entering public life, Paul said, “With regard to the idea of whether you have a right to health care, you have to realize what that implies.  It’s not an abstraction.  I’m a physician.  That means you have a right to come to my house and conscript me.”

I also agree with John David Lewis, a professor of philosophy, politics and economics at Duke University, who said, “There is no ‘right’ to anything that others must produce, because no one may claim a ‘right’ to force others to provide it.  Health care is a service, and we all depend upon thinking professionals for it.”
Let’s approach this question from another angle:

When a person stands up to speak at a town meeting, he does not thank the board of selectmen for allowing him to express himself in public.  When that same person is discharged from a hospital after life-saving surgery on his brain, he would not dream of not thanking his neurosurgeon.   

I cannot imagine the philosophy and ethics of "health care is a right" having a bearing on the Third District contest.  L'Italien, however, could gain an advantage by presenting herself as "the single-payer candidate."  Single-payer almost carried Bernie Sanders to the Democratic nomination for president.  Single-payer has only more resonance now with voters -- and especially in a liberal Massachusetts district centered in Lawrence. 

With 12 Dems running in the Third District primary election, scheduled for Sept. 4,  the winner may only need a share of the total vote as low 22% or 24%, meaning a city as populous as Lawrence will have outsized importance. 

...Meantime, I'll keep wishing that L'Italien were talking about health care more in the terms of insurance than of the Bill of Rights.

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