Give Me Liberty or Give Me Health

In the December 15 issue of America's most prestigious medical pubication, The Journal of the American Medical Association (JAMA), Eric Friedman and Eli Adashi write, "In passing The Affordable Care Act, the United States took a giant, if partial, step toward joining nations wherein the right to health constitutes an inalienable moral and legal right."  Notice how the authors replace the term health care with just the term health

As a medical doctor, I strongly disagree that health is or should be a human right.  First and foremost, as a supporter of individual rights and constitutionally limited government, "the right to health" is far too nebulous and necessarily vests the government with unlimited power.

"What is this right [to health] that engenders these bold claims?" write Friedman and Adashi:

It is an assertion of the responsibility of governments to strive for ‘the highest attainable standard of physical and mental health.' It is an asseveration that governments will respect, protect, and fulfill the right to health by ensuring the availability, accessibility, acceptability, and quality of the care required. It is an averment that governments will honor the tenets of accurate information, nondiscrimination and equality, and participation. It is an avouchment that governments will address the ‘underlying determinants of health' such as sound housing, clean water, and adequate nutrition, especially as these determinants apply to the needs of poor and other marginalized populations. As such, the right to health constitutes a concept broader than that represented by the right to health care[.]

Very simply, "the right to health" means the government should do everything required to make sure each individual attains the highest level of health.  Furthermore, since an individual's health is affected by literally every other aspect of his life, government should do everything in each of these areas to make sure they are affecting the individual's health in the most positive way.  In Friedman's and Adashi's point of view, the right to health represents a limitless claim on the government's bounty.  This brings to mind the age-old adage, "a government big enough to give you everything you want is a government big enough to take from you everything you have."

Perhaps more importantly, we should ask the question, "If it is the government's responsibility to see to all these things, why should individuals see to any of them personally?"  While Friedman and Adashi claim the right to health is "an assertion of the responsibility of governments," it can be equally argued that this so-called right is a confirmation that individuals may be irresponsible.  We should expect the provision of health security throughout life to lead to lower personal and national saving, reduced work effort, and the dissolution of social structures (the family) that are conduits for ensuring the health of future generations.

The Declaration of Independence boldly announces that each individual has the unalienable right to life, liberty and the pursuit of happiness.  These rights, known as negative rights, clearly define what somebody else, including the government, cannot do to you.  They are the bedrock of free society.  Health is not a negative right, as it requires that somebody else do something on your behalf, and if all of us were required to support each other's health in any way necessary, then, quite simply, none of us would be free.

The United States Constitution, which affirms the values set forth in the Declaration of Independence, sets clear limits on what the government can do to and for the people.  It was meant not merely as a regulation of the derivation of power, but as a constitution of liberty, a constitution that would protect the individual against all arbitrary coercion.

As a physician dedicated to helping my patients maintain the highest standard of health, I stand by the original intent of the above-mentioned documents and the foundational principles of America, most notably the idea of constitutionally limited government.  I reject the notion that in the name of securing health, government can and should act in an unrestrained and unlimited fashion as Friedman and Adashi advocate.

That being said, in a country as prosperous as the United States, we can act to ensure that each individual has a health care safety net to fall back on, and in the case of minors and those incapable of making responsible decisions, we can go farther.  However, in keeping with the ideal of constitutionally limited government, the provision of a health care safety net must also be limited and clearly circumscribed.  Does the new health care law fulfill this function?  The answer is definitively "no."

Proof that the health care bill is neither limited nor clearly circumscribed can be found in the number of references to the Health and Human Services Secretary -- an unelected government official.  Philip Klein of The American Spectator counted seven hundred references in the new health care law to the secretary "shall," two hundred to the secretary "may," and 139 to the secretary "determines."  What has the secretary determined thus far?  That premium increases next year over 10% are "unreasonable."  We should expect rationing and price controls around the corner as health care premiums are driven primarily by health care spending.

In the New Year, health care providers should continue to push back against the provisions in the health care law and encourage the Republican congress to defund it.  We did not come this far as a nation to give up our liberty in the name of securing health.  We would be wise to remember the words of Benjamin Franklin: "Those who would give up essential liberty to purchase a little temporary safety deserve neither liberty nor safety."

Andrew Foy is a medical resident and the author of the book You've Got to Stand for Something: Understanding and Restoring America's Founding Principles.  He is also a contributor to Jonah Goldberg's new book Proud to be Right: Voices of the Next Conservative Generation.
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