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.


  1. doesn't the example of the good samaritan give a clear indication in the Bible on the moral obligation you're talking about ?

  2. I'm not too keen on the government being in control of my health care, but I do think when it comes to insurance, there need to be some changes. The whole preexisting conditions crap is ridiculous. Because of it, my wife, who has high blood pressure for no reason, is unable to get on any insurance. And if we could all get on an insurance plan, it would be a heck of a lot more helpful than our state plan, which my wife and daughter are currently on.

    Anyway, I agree. Health care is not a right. I'm not entitled to a doctor's care unless I go to an ER cuz of a true emergency. And even then, cuz I chose to go there, there is a price to pay, although I think it is way too high.

    I find it interesting, too, that liberals and progressives, who call Conservatives "closed-minded" are refusing to allow the CEO of their favorite grocery store to have an open mind and think outside the liberal box. I just find it funny.

  3. Back in 2008, this Whole Foods, CEO John Mackey (how old is this kid?), was caught posting negative comments (trash talk) about a competitor on Yahoo Finance message boards in an effort to push down the stock price. So now I am suppose to take this loser seriously? Please, snore, snore.

    It’s funny we hear Republicans say that they do not want “faceless bureaucrats” making medical decisions but they have no problem with “private sector” “faceless bureaucrats” daily declining medical coverage and financially ruining good hard working people (honestly where can they go with a pre-condition). And who says that the “private sector” is always right, do we forget failures like Long-Term Capital, WorldCom, Global Crossing, Enron, Tyco, AIG and Lehman Brothers. Of course the federal government will destroy heathcare by getting involved, Oh but wait, Medicare and Medicaid and our military men and women and the Senate and Congress get the best heathcare in the world, and oh, that’s right, its run by our federal government. I can understand why some may think that the federal government will fail, if you look at the past eight years as a current history, with failures like the financial meltdown and Katrina but the facts is they can and if we support them they will succeed.

    How does shouting down to stop the conversation of the healthcare debate at town hall meetings, endears them to anyone. Especially when the organizations that are telling them where to go and what to do and say are Republicans political operatives, not real grassroots. How does shouting someone down or chasing them out like a “lynch mob” advanced the debate, it does not. So I think the American people will see through all of this and know, like the teabagger, the birthers, these lynch mobs types AKA “screamers” are just the same, people who have to resort to these tactics because they have no leadership to articulate what they real want. It’s easy to pickup a bus load of people who hate, and that’s all I been seeing, they hate and can’t debate. Too bad.

  4. @ Maya: Yes, it does.

    @ Jeremy: I'd rather you be able to get a doctor's care...and for your wife and wee one to get care...even when it's not an "emergency." And even if she's got that pesky "pre-existing condition."

    @ Paul: I just can't understand how the shouty folks get so convinced that socialized medicine will somehow make us all Nazis. I've been to Canada, and England, and France. They are, if anything, more laid back and less prone to fascistic silliness than we are.

    People are strange, strange creatures.

  5. @ Beloved Spear: Oh I would too. And if it takes a government run healthcare industry to get it, I'm not going to gripe. I would just rather see something like this worked toward rather than sort of forced upon us. I can see that causing a lot of trouble.

  6. Great thoughts. It seems so crazy that one of the richest Countries in the World, would allow 50 Million of it's own Citizens to go without Health Care.

  7. " is the most effective way to provide care for others."

    Now tell me you didn't have to fight back a chuckle whilst typing that.
    Do you honestly in your heart of hearts believe that the US government is the most "effective", equitable means by which to administer "health care"? There are truly no other more viable options?

  8. @Jonathan: Nary a chuckle or a titter. Goverment-run health care is the most efficient and effective way to provide care. It's not perfect, certainly. It may not have the "creative dynamism" of a market-based system, but given that our market-based system is an abject failure, that's not such a big deal.

  9. I don't know if "abject failure" is a completely accurate descriptor, but while you and I more than likely would vehemently disagree as to how much power should be given to the State, we would certainly agree that healthcare reform is neccessary. I, being the good Minarchist I am, am just not sold on the efficiency of the State as much as you would seem to be.

    I think oftimes the assumption is that folks who aren't behind Government involvement are then somehow adverse to changing the healthcare system at all or that healthcare should be denied to those who cannot afford it. That's just not the case. I believe that communities and individuals could do so much more than they do presently to 'bear one another's burdens'. I really believe that would be more equitable and effective than deferring to the Federal government.

  10. By the way, I thought District 9 was really good as well. Well orchestrated and thought provoking Sci-Fi is always such a treat.

  11. It's silly to talk about "market failure." The market is comprised of millions of people engaging in "mutually beneficial exchange." It does not plan, therefore it cannot fail.

    If the market appears to fail, it may be: constrained by regulations, granted inequitable legal protection, or assigned a task it was never intended to accomplish. Such limitations cannot be classified as failure.

    The only reason we're talking about a government option is because the government has interferred with the free market; limiting genuine competition among for-profits and reducing our moral imperative to donate to non-profits.

    The only Christian consideration in this matter is: Why are we seeking a hand from the one who cripples us?

  12. Newworld: Hey! Glad you could drop by!

    In a sense, you are correct. The market cannot possibly fail, because outside of profit, it has no other purpose. If that is the sole ethical standard by which the market is to be assessed, you've nailed it.

    That is, as you know, not the standard by which I determine success or failure.

    Pesky, pesky competing paradigms...

  13. Profit is not the sole ethical standard; it is simply the default metric by which we define success.

    Christianity provides a spiritual dimension to success, but this aspect doesn't nullify the legitimacy of profitability or render unprofitable ventures 'holier' that profitable ones. There is no competition between paradigms (Eph. 4:28).

    My only point is that we should not abandon free market ideals (peaceful, mutually-beneficial exchange) for a system that uses the threat of violence to gain support.

  14. newworld: No competition between paradigms? Heh. Ephesians 4:28 calls for us to stop stealing, and be productive....for the purpose of sharing with others. It is "other" oriented, as is most of the very practical moral teaching you'll find in the letter to Ephesus. The market, on the other hand, is self-oriented, focused on profit maximization. Milton Friedman put it correctly...there is no other ethic in the marketplace. That is the purpose. It is for that reason that Jesus makes it clear that the two paradigms are fundamentally at odds. Either you are defined by one, or defined by the other. Do I really need to give you the cite for this one? ;)

    And there is, in your final riposte, something that is worth debating. Underlying the power of the state is the threat of coercion. On that we agree, and it is the reason that an unrestrained state is dangerous to both faith and freedom. But wealth is just a societally mediated proxy for power, and it is similarly used as a means for controlling and ruling over others. Coupled with it's dominant ethic of self, it is equally antithetical to the teachings of Jesus of Nazareth. Both state and market, as the letter to the Ephesians would put it, are "the powers of this dark world." (Ephesians 6:12)

  15. Implied in Eph. 4:28 is the notion of profit; earning what we need, PLUS something to share with others. (I'm not concerned with the verse's contrast to stealing, since it's ancillary to my point.)

    Productivity to meet personal needs is the default; productivity to meet the needs of others is the spiritual dimension that Christianity brings to capitalism. Still no paradigm clash.

    Now, if you think I'm suggesting that Christians put profit first in all situations, you're mistaken. Certain situations require Christians to avoid any and all involvement, regardless of expected ROI.

    Yes, wealth can act a proxy for power, but what about other sources of power? Beauty, charisma, intelligence? Should we place unnatural restrictions on people with these attributes, or find non-coercive means to help them use their gifts to God's glory?

    I'd be glad to discuss the state more later. Suffice it to say, the state's power is derived from the consent of the governed. Once that consent is withdrawn, the state is powerless. This idea dovetails nicely with Matt. 10:39, in my opinion.

    I think we need to start dusting off some of Ghandi's ideas.

  16. @ newworld: I concur that productivity should be the focus, and am perfectly willing to accept that Christians can be 1) in business and 2) making a profit. But the ethic that makes that possible does not come from the marketplace itself, and stands in tension with what Christ taught.

    I only partially concur with your assertion of the root of the power of the state. Government by mutual consent is a noble thing...but it is, lamentably, not the norm. And even in the face of that ideal, coercive power lies beneath to enforce the balance of individual desires.

    And, yes, yes, absolutely, we could use more satyagraha.