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Commentary By Caroline Baum

Why Health Care Is Not a Right

Economics, Economics Tax & Budget, Healthcare

Last week's first Democratic debate featured five candidates offering lots of free stuff. From health care to tuition to paid family leave, the Democrats, with the exception of former Virginia Senator Jim Webb, who just dropped out of the race, tried to outdo one another on what the government owes its citizens. (How to pay for all of it was a secondary issue at the debate.)

Vermont Senator Bernie Sanders, a Democratic Socialist, was at the head of the pack in declaring that health care should be a right of citizenship. 

"When you look around the world, you see every other major country providing health care to all people as a right, except the United States," Sanders said.

The problem with his statement is that rights aren't the government's to give. John Locke, the 17th century English philosopher, wrote about inalienable rights: God-given rights that can't be taken away. (Agnostics and atheists may prefer to think of these rights as inherent in nature.) Locke considered life, liberty and property to be among such natural rights. 

A century later, Thomas Jefferson adopted Locke's definition when he drafted the U.S. Declaration of Independence, citing "life, liberty and the pursuit of happiness" as inalienable rights. Government's role is "to secure these Rights," Jefferson wrote, not to create new ones. 

The Bill of Rights, the first 10 amendments to the U.S. Constitution, enumerates some of these natural rights: freedom of speech and religion; a free press and free assembly; and freedom from unreasonable search and seizure. Even more important, the Bill of Rights prohibits Congress from enacting any law interfering with the exercise of these freedoms. (I'll leave the interpretation of the 2nd Amendment's right to bear arms to Constitutional scholars.) 

That hasn't stopped Progressives from creating all kinds of new rights: a right to a job, a right to a minimum wage, a right to health care.

These aren't rights as conceived by the Founding Fathers. A right is something we can all exercise simultaneously without imposing a burden on someone else. The only obligation, in fact, is that others not interfere with an individual's exercise of his rights. 

That concise concept of rights, sometimes referred to as negative rights, comes from the book, Clichés of Politics, a collection of essays published by the Foundation for Economic Education. It provides a simple basis for determining what constitutes a right.

Many politicians insist on transforming every privilege or benefit or entitlement into a right. What's wrong with providing health care to the indigent as a moral imperative? Even before the enactment of the Affordable Care Act in 2010, the United States didn't allow the uninsured to die on the street. It didn't deny health care to those who couldn't afford it. They could walk into the emergency room of a hospital. 

That's not the most cost-effective way to deliver health care. As it turns out, the State of Oregon's 2008 expansion of Medicaid to the uninsured ended up increasing the number of emergency room visits rather than reducing them, according to the findings of the landmark Oregon Health Insurance Experiment

So let's do a check on all of these new-fangled rights and see how they hold up. A right to a job? That imposes a burden on an employer. A right to a minimum wage? Leaving aside the unintended consequences of mandating a floor on the price of labor, one person's exercise of that right obligates the employer to pay. Besides, mandating a certain wage violates a natural right, under which an individual may voluntarily exchange his labor for a wage he finds suitable. 

And what about health care? It flunks the rights test with flying colors.

Not all the discussion about rights at the debate was misplaced. Webb said the average American should have "the right to be able to protect their family." Asked about the National Security Agency's surveillance program, Sanders said he would shut it down because "we have the right to be free." Hillary Clinton talked about a woman's right to choose, probably the most controversial right separating liberals and conservatives. 

Sanders tacitly acknowledged that not everything we choose to do as a society must be designated a right. For example, he called it a "moral responsibility" to address climate change in order to leave a habitable planet to our children and grandchildren. Agree or disagree on the necessity of supplanting fossil fuels with clean energy, it was encouraging to see Sanders recognize society's moral obligation to address certain issues. 

Then again, I suspect it's only a matter of time before inheriting a healthy planet is elevated to the status of a right.


Caroline Baum is a contributor to e21. You can follow her on Twitter here.

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