If health care is a human right, there are some questions

For those who insist that health care is a human right, rather than a contracted service, here are some questions I think you should try to answer.

Before going to the list below, think about the question I posed yesterday about the Constitutionality of the health care bills in Congress.

1. "How much health care is a human right?" I put the question in quotes because it was first posed by Philip Niles, who continues,

Does one person have a right to $100,000 per year health care over society's right to use that money on other health care expenditures? What if it were $1,000,000 (which is not an unrealistic figure in the US)? Would you rather spend $1,000,000 on curing one person's otherwise terminal disease or on 100,000 people's flu shots? Collectively, we make such decisions, in other words we already practice rationing. While I can understand that the concept of a "human right" being price-dependent is unsettling, it is important that we become comfortable with rationing if we are to have a sustainable system. Yet every politician and their mother is avoiding the "R"-word.

Note that I have not avoided using the "R-word" at all, because rationing is just a another way of saying "allocating" or "distributing." Every economist knows that limited goods are will be distributed somehow. After all, the basic definition of economics is that of Briton Lionel Robbins: "Economics is the study of the use of scarce resources which have alternative uses."

Because we tend to think that scarce means "rare," I prefer using "limited" in its stead. And anyone who thinks that heath care is somehow not limited is not connected with reality.

So, back to Niles' question: if health care is a right, is that right limited in the same way that our other rights are? We have a right to free speech but not under some circumstances, said the Supreme Court. We may want to remember Oliver Wendell Holmes' famous dictum, “The right to swing my fist ends where the other man's nose begins.” Where, if anywhere in health care provision, is the another person's nose? How shall it be established and how enforced?

2. If health care is a right to receive, does that mean that doctors may be compelled to treat? Paul Howard writes in City Journal of "a 2006 survey finding that as many as half of all physicians have either stopped accepting new Medicaid patients or limited the number they’ll see because reimbursements are so low."

Should doctors be compelled by law to treat patients regardless of the rate of reimbursement? If receiving health care is a right, that is.

3. If health care is a right, does that mean that people have the right to every kind of medical care equally? Is there an equal right to dermatology as oncology medicine? And if so, should the government have:

• the power to assign doctors to locations to practice?
• the power to assign medical specialties to medical students rather than let them self-select?
• the power to draft qualified college students into medical education and practice if there is a shortage of doctors?

4. Does someone have the right not to exercise a right? Example: we have a right to vote, but 40-50 percent of us don't in national elections. In some other democratic countries voting is mandatory by law, but not here. We have a right not to exercise our right to vote.

So - if health care is a right, will persons have a right not to receive it? Before you answer, consider this:

Health care reform, as currently envisioned by Democratic leaders, would be built on the foundation of an expanded and more intrusive IRS.

Under the various proposals now on the table, the IRS would become the main agency for determining who has an “acceptable” health insurance plan; for finding and punishing those who don’t have such a plan; for subsidizing individual health insurance costs through the issuance of a tax credits; and for enforcing the rules on those who attempt to opt out, abuse, or game the system. A substantial portion of H.R. 3200, the House health care bill, is devoted to amending the Internal Revenue Code of 1986 in order to give the IRS the authority to perform these new duties.

The Democrats’ plan would require all Americans to have “acceptable” insurance coverage (the legislation includes long and complex definitions of “acceptable”) and would designate the IRS as the agency charged with enforcing that requirement.

That means the personal tax information of millions of Americans would enter the system whether they want it to or not. “There’s a mandate to buy insurance,” says one Republican House aide. “You have to buy it. You have millions of people who can’t buy it without a subsidy, so they will have no choice but to accept the subsidy in order to buy insurance, and then the Health Choices Commissioner will have access to their tax records.”

Do you believe this is fair and just? If so, why? And make sure you explain how someone's rights are protected by restricting their individual freedom to choose their own course, reduction of personal privacy and greater exposure to government control.

What about Sen. Max Baucus's proposal to fine people $3,800 for failing to carry health insurance? Does that make health care a right or a compulsion? Can we truly be forced to exercise our rights and still be considered a free people?