Thursday, August 20, 2009

Health Care is Not a Right

This last week in the Wall Street Journal, Whole Foods CEO John Mackey managed to cheese off his entire customer base by arguing vigorously against health care reform. His position is that the market should be in control of health care provision, because health care is a service like any other service. It's not a surprising position for the Chief Executive Officer of a for profit corporation, even if the clientele of that corporation happen to be wealthy progressives who are almost universally in favor of a more progressive approach to health care.

In his article, though, Mackey went well beyond arguing for market-based options, and dug down to the philosophical heart of the conservative case against socialized medicine. That case, in his words, rests on this foundation:

While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?

Health care is a service that we all need, but just like food and shelter it is best provided through voluntary and mutually beneficial market exchanges. A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That's because there isn't any. This "right" has never existed in America.

I'm not quite sure how careful a reading of our founding documents went into this statement. As I recall, our Declaration of Independence includes this little statement:

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.
Some folks might argue that medical care, food and shelter are things without which that first little inalienable right is not possible.

But I'm not going to make that case, tempting though it may be.

Instead, I'm going to agree with Mr. Mackey.

Providing health care to all is not a right, at least not as "rights" are shallowly understood among Americans whose sense of moral commitment begins and ends with themselves. It is not something that I demand for myself, because I am owed it. Instead, I view the provision of health care to all as a moral responsibility. Not a right. A responsibility.

In that sense, Mr. Mackey has pegged it. Food, shelter, and medical care are all similar. Food is not a "right," but we as an ethical people would not tolerate folks starving to death in our midst. Shelter is not a "right," but those of us who have shelter recognize that we have a basic moral responsibility towards those who would otherwise suffer. Where the ethic of the market fails, and Lord does it fail, nonprofits and government are forced to step in.

For those whom the market has failed, or who have run out of resources to participate in "mutually beneficial market exchanges" with their oncologist, we a people..morally obligated to provide care. Government, as an instrument in the hands of an ethical people, needs be a significant component of that care.

That option is worth pursuing not because we want it for ourselves. It is worth it because we as moral actors recognize that it is the most effective way to provide care for others.

Why conservative and putatively Christian Americans can't recognize this is beyond me.