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The Therapy Sessions
Wednesday, January 11, 2006

The right to health care?

Occasionally, I come across someone who proclaims that health care – high quality, universal and reasonably priced - is a “right,” one to which all Americans are entitled.

It sounds perfectly wonderful.

In fact, most Americans believe it to be truth (but of course, most Americans believe in ghosts, UFO’s, Medicare solvency and vote Republican, too).

I hate to be a curmudgeon.

Well, sort of: actually, I relish it. But my response is given guiltily, almost like I’m asking a child why he really thinks there is a Santa Claus.

I ask: “Do you believe that every American has a right to food? Or shelter?”

I go on: “After all, without food or shelter you could be dead in a month! Without health care, you could easily live to be 80. If health care is a right, surely food and shelter are too!”

Most people acknowledge I have point. Upon further reflection, they usually say that government should give people access to a minimum of food and shelter, as well as health care.

Of course, every society that has promised all of these things has been a ridiculous soviet-style failure.

But people who would promise such things are rarely students of history.

Curmudgeon that I am, I press: “If you say that people have a right to food, does that mean they get government vouchers to go to their favorite restaurants?”

The curmudgeon is then looked upon as the idiot.

“No! They don’t get the best food! They are on public support,” comes the usual reply. “They get the basics. Flour, Cheese and milk. They don’t get to eat at Olive Garden on the public’s tab!”

And of course, they are right. I couldn’t have said it better: When people are on the dole, they should not get the best (Whether Olive Garden can be considered “the best” is a matter of opinion…).

If the poor do get the best, you make the millions of people paying their own bills look like idiots. Why would a poor family struggle to put dinner on the table when their section eight neighbors eat at TGIFridays every night for free?

The answer is: they wouldn’t. They too would try to take advantage of their poverty. Poverty becomes attractive (as weird as that sounds).

Shouldn’t that same logic apply to health care?

If you depend on public assistance to pay for your drugs, why should you get the latest and greatest?

Why should you get Lipitor – a state-of-the-art modern statin – that costs $350 a month?

For $30 a month, you could have generic Mevacor – a drug that was “the best” in 1985 (and is still pretty good today).

Modern angioplasty and hip replacements? Those are for paying customers, bub. You're going to have to make do with simple drugs and painkillers, just like the super rich did in 1980.

My point is simple: we can guarantee a right to basic minimum in health care, but it has to be a minimum – something that most paying customers would consider unacceptable (health care a la 1980). If you make the government option too attractive, everyone will take it, and the program will bloat until it is unsustainable.

In the end, the universal health care debate boils down to a lesson in simple economics.

People who want to make health care a right want it to be high quality, universal and reasonably priced.

The unfeeling laws of economics – which don’t care what you “want” - say that you can have any two of those things, but not all three.

You want health care to be high quality and universal?

You will not be able to control the costs.

Not unless you believe in Santa.

The question is: Do you?

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