March 23, 2010
The Moral Case Against Health Care Reform
The greatest expansion of American government and the social welfare state since the Great Society passed the House Sunday night. Opponents recognize that this bill violates the most important principles of American government, and as such, is immoral.
In a free society, does one individual's needs constitute another individual's obligation to provide? The answer is no; rather, it is the duty of free individuals to decide what and whose needs appear most important to them. In a free society, the individual is of supreme importance and should not to be used as a means to society's ends. The individual has the right to order his actions and possessions in the manner most consistent with pursuing his own happiness and values. This view is consistent with America's founding principles. The Declaration of Independence states:
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.-That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed.
The above rights are known as "Natural Rights," and they protect the individual's right to freedom, autonomy, and self-government -- in other words, to take all the actions required to support the furtherance, fulfillment, and enjoyment of one's own life. They provide no material assurances or particular opportunities to the individual, but rather set conditions that allow the individual to decide what use he shall make of the circumstances in which he finds himself -- to act in his own best interest so long as his actions don't infringe on the equally protected rights of others.
Based on this logic, government programs that involuntarily transfer or redistribute wealth are immoral because they violate the individual's natural right to order his own actions and possessions. Theft is immoral. Likewise, theft via the government is immoral.
Karl Marx and Thomas Jefferson highlight the differences between collectivism and individualism. The philosophy of collectivism regards the individual as a means to society's ends and is thus immoral, whereas individualism respects the freedom and autonomy of each member of society.
"From each according to his ability, to each according to his need." - Karl Marx, 1875"A wise and frugal Government, which shall restrain men from injuring one another, shall leave them otherwise free to regulate their own pursuits of industry and improvement, and shall not take from the mouth of labor the bread it has earned." - Thomas Jefferson, 1801
Another important question is: What constitutes a need, and who should decide? Should it be the patient in concert with his or her physician? This seems like the obvious choice. However, if society is paying the cost of whatever service is required to satisfy "the need," then the provision of that service must be regulated to prevent overutilization and runaway costs. In other words, it must be rationed. In a free market, prices perform this rationing function. In the absence of a free market, some third party must ration based on a formula other than price.
Rationing by price is moral because this unbiased mechanism allows individuals to maintain complete freedom and autonomy. A patient who cannot afford a service that he deems a "need" is still free if he can pursue any course of action in order to meet that "need." Likewise, a provider who feels that his patient "needs" a service is free if he can pursue any course of action in order to provide that service.
Some members of society today confuse the concept of true freedom or liberty with the concept of how many options are available to an individual, and this encourages them to advocate for collectivist schemes to help those who may be less fortunate.
"[Liberty] describes the absence of a particular obstacle -- coercion by other men ... the range of physical possibilities from which a person can choose at a given moment has no direct relevance to freedom. The rock climber on a difficult pitch who sees only one way out to save his life is unquestionably free ... if [he] were to fall into a crevasse and were unable to get out of it, he could only figuratively be called 'unfree,' and that to speak of him as being "deprived of liberty" or of being 'held captive' is to use these terms in a sense different from that in which they apply to social relations." - F.A. Hayek
Unfortunately, the only alternative to rationing through price is rationing through the government, and this is immoral because the decision of what constitutes a "need" is made by a third party with no personal connection to the individual or his circumstances. Ultimately, these decisions are made by those with the most political influence -- a situation that inevitably breeds corruption. These governing bodies do not respect the primacy of the individual, but rather view the individual as a means to society's ends. Bureaucrats don't make decisions about health care according to an individual's "need" or preference, but rather, they ration resources based on a social-driven calculus. As evidence of this, the health care bill under consideration has a Medicare board of unelected officials to determine the program's treatment protocols as a method of limiting costs.