Is Health Care a “Right”, a “Privilege” – or Simply a “Necessity?”

Posted on | April 8, 2021 | 8 Comments

Mike Magee

I am currently knee-deep into preparations for an online lecture at the Presidents College at the University of Hartford on Wednesday, May 5th, at 1:30 PM titled “The Constitution. and Your “Right” to Health Care in America.”

I’ve been at it for over a month. The classic debate centers on the Constitution’s emphasis on negative rights (that is protection of citizen prerogatives from overreaching of their federal and state governments), rather than positive enumerated rights, which carry with them implied obligations of enactment or enforcement (as in The Bill of Rights).

On a practical level, the same debate– from high schoolers to policy elites – reads from one source like this:

“Proponents of the right to health care say that no one in one of the richest nations on earth should go without health care. They argue that a right to health care would stop medical bankruptcies, improve public health, reduce overall health care spending, help small businesses, and that health care should be an essential government service.”

“Opponents argue that a right to health care amounts to socialism and that it should be an individual’s responsibility, not the government’s role, to secure health care. They say that government provision of health care would decrease the quality and availability of health care, and would lead to larger government debt and deficits.”

The 90-minute lecture, presaging a full-blown course this Fall, will place me in the middle of this debate – part practical, part esoteric, legal and nuanced. But the reality that I’m fast approaching is that it really doesn’t matter. That’s because – whether a “right” or “privilege”, universal, accessible, affordable and effective health care in America is now a “necessity.”

Here are three reasons why this is true:

1. Performance: By any measure available, our predatory and profit-driven approach is a 70-year old historic misstep that is roughly twice as expensive and half as effective as most of the 36 OCED comparator nations.

2. Economic: This highly inequitable and remarkably variable system now accounts for roughly 1/5 of our entire GDP, powered by a bureaucratic workforce with 16 workers for every physician, half of which have absolutely no clinical function. The resultant corporatized Medical Industrial Complex supports opaque pricing, legal kickbacks, and an integrated career ladder where medical scientists actively collude with CEOs from health insurance, hospital, pharmaceutical and research arenas.

3. Strategic: Our decentralized approach to care lacks any coordinated national strategic public health apparatus. There is no national plan. When stressed by the current pandemic, it failed on a massive scale resulting in the needless deaths of hundreds of thousands of citizens, vast damage to our economy, and near collapse of our major hospitals nationwide. In the process, it revealed historic underfunding of public health, prevention, and the social determinants of health, preferring instead to rely on last minute, high science intervention come to the rescue.

The question we need to be asking ourselves – whether you align with “right” or “privilege” – is no longer a philosophical debate, but rather a practical question.

“What kind of system do we need to create to make America and all Americans healthy?”

Category: Uncategorized

Comments

8 Responses to “Is Health Care a “Right”, a “Privilege” – or Simply a “Necessity?””

Chuck Fahey
April 9th, 2021 @ 11:19 am

Thanks for the thoughtful approach, friend
Denis A> Cortese
April 9th, 2021 @ 6:07 pm

Agree. A healthy workforce and population is a national security matter. Here are some bipartisan principles to guide insurance for all:

1. Everyone should be insured birth to death in a single insurance scheme (liberal notion)
2. The scheme includes a set of insurance options, everyone can choose and change as they see fit (conservative notion).
3. People should own their insurance (eliminate job lock, COBRA, issues with care continuity); employers could contribute to premiums if they so desire (conservative notion)
4. The government role should be to provide means-tested premium support (liberal notion).
5. The insurance options should be market based (conservative notion).
6. The government should regulate the market with a utility mindset (liberal notion).
Mike Magee
April 9th, 2021 @ 7:26 pm

Thanks so much for this, Denis. As you outline, there is a way forward for bipartisan progress long overdue. Best, Mike
Mike Magee
April 9th, 2021 @ 7:27 pm

Thanks, Chuck. Care across five generations is a moral, ethical, and practical challenge. But with leaders like you, imminently possible! Best, Mike
Lawrence Williams
April 10th, 2021 @ 11:10 am

The Preamble to the United States Constitution sets out the 6 goals that the founders hoped the Constitution would accomplish for the new nation. Among those goals are to “promote the general Welfare” and “provide for the common defense”.

It does not seem much of a stretch to say that providing health care should be an essential part of “the general Welfare” and thus a responsibility of the government. 36 of the 37 OECD nations seem to agree leaving the U.S. as the sole holdout. Why?

As to providing for the “common defense”, I believe that most people would define this as needing armed forces to prevent or fight wars. Very logical. And we are right now engaged in the most deadly war of the last 150 years. More than 560,000 Americans have been killed by the enemy and there are more dying every day. That is more American deaths than in World War I 116,516, World War II 291,557, the Korean War 36,914, and Vietnam 58,220 combined 503,207. And the opponents of universal health care still cry “socialism” and say it is the individual’s personal responsibility to get their own health coverage. Does that make sense? Was it the individual’s personal responsibility to provide for the fight against the Nazis and the Japanese during WW II? Of course not. And it does not make any more sense to say that individuals must provide for their own defense against disease and injury and their own care when they end up sick or injured.

So in the final analysis I believe that universal health coverage is a logical inclusion in the general duties and goals of government as set forth by the founders of our nation.
Mike Magee
April 11th, 2021 @ 10:38 am

As you so well defend, Larry, coverage for all is a “logical conclusion” at this point. Now with Biden, and bipartisan citizen support, we shall see whether logic will prevail. Best, Mike
bionaze
April 15th, 2021 @ 9:41 am

The ability to meet the demands of the population without disparity in distribution and allocation of medical care is essential.
Mike Magee
April 17th, 2021 @ 2:23 pm

Agree, bionaze. They are markers and evidence of a well thought out and executed system that has been built to be scalable and effective.