Healthcare is Not a Right

A reasoned analysis in favor of universal healthcare...

Our nation has long defined health care as an entitlement for the eldery, the disabled, and the very young. We are now involved in a national debate whether this entitlement will be made universal. As you all know, I am an advocate for universal health care. Though there may be an argument for the societal benefit of universal healthcare, or for the relative cost-efficiency of universal healthcare, I support it almost entirely for humanitarian reasons.

Universal health care, or, more precisely, universal health insurance, might improve upon the current state of affairs by ensuring that doctors are always paid for the services we provide, rather than being obligated to give them away to 15-30% of their patients as we now are.

The typical emergency physician provides about $180,000 of free services annually, just for reference.

As for those who claim that the slavery of universal healthcare is rather in the loss of physician autonomy, or in the corruption of the free market, I have one thing to say to them: that ship has sailed. Medical practice is irrevocably governed by a Byzantine maze of laws, regulations and standards set by a veritable alphabet soup of commissions and independent organizations. That is not going to change for the large proportion of physicians who have the need to care for patients in or incident to the hospital setting. Furthermore, there is no free market for physician services as it mow exists. Prices are set by the federal government for about half of Americans, and by a cabal of large insurers for the rest. Doctors can negotiate their prices within a narrow range with individual insurers, but the success of this is determined by the regional strength of each payer, not by the quality of care provided by the doctor, and while you can set the conversion factor for your fee schedule, you cannot set the price for each individual service you provide.

While there is a growing trend towards boutique medical practices and freestanding ERs, these are and will remain small niche players for those patients able to afford them. For the vast majority of physicians, we are stuck with the current system. Universal health care is unlikely to fundamentally change the status quo for physicians in this regard.

Bottom line: No, Health Care is not a right. When advocates of universal health care misuse the language of universal rights to push for health care for all, we fall into the trap of over-reaching and provoke a justified pushback, even from some who might be inclined to agree with us. Universal health care is, however, a moral obligation for an industrialized society, and will not result in the apocalyptic consequences promised by the jeremiads.
(via kevinmd.com)