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The Republican-led repeal of the health care bill in the House has been met with the predictable cheers coming from the Right and the equally predictable groans coming from the the Left. Yet underneath the political surface surrounding the bill, a fundamental question remains largely unexamined, save for those largely from the left side of the political spectrum who answer yes, reflexively. The question is: Do Americans have a Constitutional right to health care?
If one is to take the Constitution as written, there is no such thing as a codified right to health care. On the other hand, one would have to be naive to think that certain rights cannot be extrapolated from certain clauses in the document. Perhaps nothing illustrates this better than the 1973 Supreme Court decision declaring abortion a Constitutional right; it was a decision largely based on the Fourth, Ninth and Fourteenth Amendments’ explicit and implied rights to privacy and liberty.
Thus, the “right” to an abortion, whatever one’s position is on the matter, is seen, like many of our Constitutional rights, as something connected to empowering an individual to act on his or her own behalf. Making health care a Constitutional right, therefore, is something else altogether. If one is entitled to be made well when one is sick, then that right is based on the idea that it supersedes someone else’s right to choose whether or not to provide goods and services to the ill individual. In other words, as totalitarian as it might sound, the “right” to health care implies that one can, for example, compel a doctor to operate, a nurse to perform certain hospital procedures, or a drug company to manufacture a live-saving medicine.
Right now, despite all talk of rights notwithstanding, we are not at the point where, aside from laws which codify that which one must adhere to in the process of providing health care, no one can be forced to provide it per se. This is not to confuse laws in most states which require hospitals to accept and treat anyone who shows up in the emergency room. Such a requirement is based on the idea that if one wants to operate a hospital certain rules apply. But no one is required to operate a hospital. Similar laws regulate the conduct of doctors and drug companies, but again no one is required to become a doctor or open a pharmaceutical business.
Understanding the distinction here is critical. For many years progressives and their followers have long insisted that health care is a right without bothering to explain how a such a right is implemented without the consent of those who administer health procedures. One suspects that such confusion arises from the misunderstanding of the difference between having access to health care and receiving health care itself.
Nothing emblazons this misunderstanding more clearly than the progressive political rhetoric which insisted that Obamacare was an absolute necessity because “45 million Americans had no health insurance” and this bill provided insurance to 32 million of those uninsured. If the goal of Obamacare is providing more Americans with health insurance, one can find no fault with such an argument. On the other hand, if providing Americans with more access to health care itself is the goal, Obamacare is seriously wanting.
First, as Americans staring at fourteen trillion dollars of national debt have learned, and as Ronald Reagan so eloquently explained, “if you want more of something subsidize it.” In the case of subsidizing health care, Americans have learned you definitely get more of it. A Senate Joint Economic Committee report issued in 2009 illustrates how much more:
–Medicare: in 1965 the House Ways and Means Committee estimated that the hospital insurance portion of the program, Part A, would cost about $9 billion annually by 1990. Actual Part A spending in 1990: $67 billion. The entire Medicaid program? 1967, the House Ways and Means Committee predicted$12 billion in costs by 1990. Actual Medicare spending: $110 billion.
–Medicaid DSH program. 1987 estimate of costs by 1992: $1 billion. Actual costs: $17 billion.
–Medicare home care benefit. 1988 projection of costs by 1993: $4 billion. Actual: $10 billion.
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