Why Healthcare Cannot Be a Right--In a Free Society

There is a proposed constitutional amendment in our state (New Mexico) to recognize Healthcare as a basic human right. Dr. Bruce Trigg, a local physician and colleague wrote an editorial in our local newspaper titled "Make Healthcare a Right For All". The following is my response:

I have read my esteemed colleague’s (Dr. Bruce Trigg) editorial today (2/25/11), titled “Make Health Care a Right for All.” While I have the utmost respect for Dr. Trigg, I must answer with the counter argument that health care is not a right-- in a free society.

This nation was founded on the principle of “self evident truths” that each of us as individuals are born equal (not that we should share in all equally) and “endowed’” with “certain unalienable rights”, including the right to “life, liberty, and the pursuit of happiness”. Nowhere did our founding fathers mention “health care” or “good health” as a right, neither in our Declaration of Independence nor in our constitution or its Bill of Rights.

Now some would argue that in 18th and early 19th century America, “Health Care” was nothing to brag about and certainly, nothing to pursue as a fundamental right for all citizens. Others would argue that it was simply an oversight that the founding fathers did not include our health as a fundamental right. I would counter the first of those arguments by asserting that many Americans would travel back to Europe for their “health care” which had to be extraordinarily expensive and inconvenient and yet, there was no clamoring to have the fledgling American government, or rather, its citizens pay for such care. As far as the second argument goes, it is incredulous and inconceivable to consider that considering the collective wisdom of our founders who included Benjamin Rush and other physicians, they would have overlooked something as important as a basic and fundamental human right.

I believe that it was with foresight from our founding fathers that “health care” as a right was purposely excluded as a basic and fundamental right. Unlike, our current politicians, our forefathers were well read and versed in history, philosophy, law, economics, and theology and understood the dangers of the government picking and choosing certain rights arbitrarily and compelling the citizenry to pay for such rights. They understood human nature and man’s natural tendency to want and desire what others have and he doesn’t have and they understood how that very human nature could be exploited by politicians and tyrants for political expediency and political power by providing those things as “rights”.

They recognized that man could conjure up an endless list of needs and desires and rationalize any one of them or all of them as being indispensable as basic human rights. Yet, they carefully selected only three basic “unalienable rights” or “natural rights”, none of which another man could provide to another nor could be compelled to pay for or provide to another. These rights are negative rights in that the right is not in the power or the purview of the government (or fellow citizens) to provide such rights, but rather places in the government the power and responsibility to protect such rights from being taken away from us. The government nor our fellow citizens cannot give us or ensure us life, liberty, the pursuit of happiness-- or good health!

Our government may only protect our rights from such things being taken from us and it is our individual responsibility to respect the rights of others and not take such rights from each other, but nowhere in our constitution is it stated or expressed that our government must provide us with anything or compels us to provide our neighbors with anything! They understood that to compel us to provide for the needs and wants of our neighbors would be antithetical to the very principles this country was founded on and for which we fought a war of independence for: That no man should be in servitude to a tyrant, a tyrannical government, or to each other and that no man should be beholding to or dependent on another man or government for his life, liberty, or pursuit of happiness!

Now some would argue that the Bill of Rights and subsequent amendments to the Constitution is where we derive our positive rights from, or those rights that by “social contract”, obligate us or our government to provide us with certain “rights” pertaining to our “general welfare”, yet the first ten amendments, or the “Bill of Rights” were added to further delineate—and limit—the power of the government with respect to both protecting our natural rights of life, liberty, the pursuit of happiness and the right to attain and own private property as well as to define and specify certain liberties, such as the freedom of speech, the freedom to keep and bear arms, and etc. Again, nothing in the Bill of Rights or subsequent amendments explicitly or implicitly allows for or compels the government to provide the citizenry with a minimum standard of welfare or for the citizens to provide for the general welfare of each other for to do so erodes our individual freedoms and places us in the servitude of our government and/or our fellow citizens.

Dr. Trigg in his essay asks “why can’t we guarantee that everyone has medical care on the same basis that we provide police and fire protection and universal free education”? The answer is that the provision of police and fire protection are governmental institutions specifically created and empowered solely to protect our natural and property rights. They cannot provide us with any material needs or desires nor can they deny us or take away from us our property, our lives, or our freedom. With respect to providing “universal free education”, nowhere in the Constitution is it mandated that we all be provided free education. Education from K to 12 is compulsory by state statutes and certainly is not “free” in that we all pay taxes to fund our public education. Access to higher education is protected by law, again, as a negative right only, in that no one, including the government can prevent us access to education—as long as we have the means and money to pay for it!

So far, I have made the argument that our Founding Fathers and Framers of our Constitution purposely excluded “health care” and an endless list of similar human needs and wants as positive rights based solely on a moralistic philosophy that to compel the government or the citizenry to provide for such rights would create the hypocritical and antithetical situation of protecting our freedoms and pursuit of happiness while at the same time placing us into involuntary servitude to our government and/or our fellow citizens. Although I believe that such moralistic and enlightened thinking was behind the decisions of our Founders as they framed and penned our Constitution, I also believe there were more practical considerations as well that influenced their thinking.

Besides being great moral thinkers and products of “the enlightenment”, our Founders were also businessmen and pragmatists and understood that the provision of most goods, needs, wants, and services—including health care—to the citizenry was best, most fairly, and most efficiently accomplished through the time-honored system of free markets. They understood from Adam Smith that free markets are the engines that drive democratic economies and the most efficient way to provide scarce resources to the greatest number. They also understood (unlike modern politicians) that the “invisible hand” of the free markets worked best unfettered and unrestrained by the “heavy hand” of oppressive government, burdensome bureaucratic regulations, onerous taxes, or union extortion.

Dr. Trigg is correct in asserting that a substantial number of our population already receives “[free] medical care either provided directly by the government (VA, Military, Indian Health Service, etc) or paid for by the government (UNM, Medicaid, Medicare, etc)”; however, he fails to mention that, for the most part, care in those systems, is grossly inefficient, very costly, and burdened by layers and layers of costly and onerous government bureaucracy and would best be provided by independent and competing practices in a free market system!

Dr. Trigg states that the proposed state amendment making health care a human right “paraphrases the words of the late Cardinal Joseph Bernardin” who has called since the 1990s for our government to recognize healthcare as a human right which government must “take responsibility” for. That is an interesting proposition from a religious spokesman from a religion that from medieval times has assumed the responsibility of providing access to healthcare and healthcare directly, through charity and charitable hospitals to millions and millions of sick souls! The Catholic Church and other religions have plenty of assets and money, if they believe healthcare is a right, then let them bear the burden of responsibility of providing it! I’m sure that religious leaders would no more appreciate government fiat compelling them to assume the responsibility of providing healthcare to each and every citizen anymore than any free man or woman wishes to be compelled to assume such responsibility!

I am not arguing that access to healthcare is not a right and I do not believe that our Founders believed that access was not a right; they correctly believed that “healthcare” in and of itself is a service and best provided through the marketplace. Every American has access to healthcare right now and our government has enacted statutes to prevent anyone or any government entity from barring us from such access to healthcare and that is the extent of government involvement that our sage Founders purposely wrote into the Constitution. Unfortunately, from Roosevelt, to Obama, modern day politicians have completely disregarded the thought and intent of our great Founders and have transformed an “age of enlightenment” to an “age of entitlement”.

Now before, I am accused and nailed to the cross as an uncaring and self-serving capitalist or hate-monger, it should be known that I have started a free-clinic for migrant workers in Ohio in 1995 that still operates today and I open my clinic as a free clinic in the South Valley to uninsured and underinsured people every 1st and 3rd Sunday of the month. I also have never turned a patient away from any of my clinics because of their inability to pay and every day I provide free or discounted care. As a physician, I took an oath of voluntary servitude to my fellow man, but, as an American, I must resist any call from my government or otherwise well-meaning citizens for my indentured servitude to them, for I am a free man in a free and democratic society!

John R. Vigil, MD