If only my friend Euthyphro were here

I wandered into this contribution on the Huffington Post.  It argues, in a comically bad fashion, that health care is not a "right."  It also argues that the government is bad.  In any case, you know your critical faculties will not be too challenged when you read:

Historically, the huge rise in health care costs began in the 1960s, when Medicare and other programs threw billions of dollars into the industry. Fiscally, Medicare is approaching monumental insolvency, with liabilities in the range of twenty-trillion dollars. To create another bureaucratic labyrinth now — which advocates are proud to say will cost only a trillion dollars over ten years — all but guarantees higher prices, and a greater crisis in the next decade.

Will the advocates of a "bureaucratic labyrinth," different from the bureaucratic labyrinth of the cable TV company or your own private health insurer, please raise their hands.  So no one does.  The fact that this guy had to weasel that one in there gives you the measure of the rest of the piece.

The major problem is yet to come:

The reason is that advocates of government medicine are upholding health care as a moral right. The moral goal of a "right" to health care is blinding people to the cause and effect relationship between government actions and rising prices.

But the very idea that health care — or any good provided by others — is a "right" is a contradiction. The rights enshrined in the Declaration of Independence were to life, liberty, and the pursuit of happiness. Each of these is a right to act, not a right to things. "To secure these rights governments are instituted," which means to secure the rights of each person to exercise his or her liberty in pursuit of his or her own happiness.

I would say in the first place that there is no evidence that the causal assertion here has any purchase on reality. 

Second, as the asinine invocation of the Declaration of Independence makes clear, the author of this piece doesn't care for a serious discussion of rights.  He's content to assert that the rights enshrined in that particular document are exhaustive.  I think that kind of begs the question.  It assumes, in other words, what is in need of proof.  But I also think his conception of what other people mean by rights suffers from a kind of equivocation.  Maybe they don't mean "rights" in the same way he does.  If they mean something else, which they most certainly do, then he's guilty of an equivocation.  

Does this mean that health care is a right?  No of course not.  Does it mean that it is not, not on this argument.  We deserve a better discussion about health care than the one we are currently getting.  This goes for everyone, of course, but in particular it goes for the opposition.

41 thoughts on “If only my friend Euthyphro were here”

  1. The basic argument for no non-enumerated rights is explicitly denied by the 9th ammendment: “The ennumeration of certain rights in this Constitution shall not be construed to deny or disparage others retained by the people.”

  2. One might argue that health care is necessary in order secure life, liberty, and the pursuit of happiness.

  3. I wouldn’t do that Jem.  If you start arguing that, then you’re implicitly saying that the government has the duty not only to protect those rights from being infringed, but to also provide the means of their acquisition.  And it can be very easily argued that government can not do such a thing without quickly arriving at situations where said rights are in conflict.  The standard opposition argument would simply be that in attempting to provide life, the government is imposing upon liberty.  And though the ordering in the Declaration of Independence puts life first, the words of Patrick Henry* are a fierce rivalry to that.  It would do best for those in support of health care reform, to emphasize the savings that the plan is supposed to provide to those who already have health care.  Of course, that first requires that said savings be shown to exist.
     
    * “Give me liberty, or give me death!”

  4. Oh geez.  Now not only does the Declaration of Independence determine which rights we have, but Patrick Henry is its chief interpreter.

  5. The DoI provides some basic contextual structure to the understanding of rights, but it is (in Geoffrey Rush’s immortal words from Pirates of the Caribbean), “More what you might call ‘guidelines’ than ‘rules’.”

    The legal framework is entirely to be found in the Constitution; all other documents and claims are trumped by that. And if one will take a moment to skim some of the salient points of that document, one will come away with the impression (well-founded in the text) that the government was formed precisely to do little odds and ends like “promote the general Welfare.”

  6. Good one, Gary.

    I’d say the discussion of “rights” here is rather misleading.  As you mentioned before, people search original but not currently operative documents for specific enumerated rights in an attempt, a sorry one, to rebut the idea that there is a “right” to health care.  That’s silly.  There is a “right” to an education, in a sense, even though that isn’t specifically enumerated.

    The Constitution, as I understand it from Law and Order, provides a kind of general outline within which we can do whatever we want.  Nothing in the Constitution *prohibits* the State with a capital S from offering a service, such as health insurance, or water, or roads, or a Navy marching band.  When it offers these things, of course, it must do so in accordance with the outlines of the document (equally that is).  It doesn’t have to do these things, but if people say, “hey, you know what, let’s all pool our money (in the form of taxes or other) and get this service,” they can do it.  They can even force other people to pay for it who don’t want it or think they need it (think: car insurance).  This is how democracies work.

  7. Fifth Amendment:

    No person shall be held to answer for any capital, or otherwise infamous crime, unless on a presentment or indictment of a Grand Jury, except in cases arising in the land or naval forces, or in the Militia, when in actual service in time of War or public danger; nor shall any person be subject for the same offence to be twice put in jeopardy of life or limb; nor shall be compelled in any criminal case to be a witness against himself, nor be deprived of life, liberty, or property, without due process of law; nor shall private property be taken for public use, without just compensation.
     
    I also suggest you read up on John Locke http://www.johnlocke.org/about/legacy.html

  8. Indeed, “without due process of law” is the operative phrase.  Sheesh.  While we’re recommending books, perhaps you could read John Rawls’ “Theory of Justice.”

  9. Andrew, since you highlighted the very portions that refute your position, I guess it is unclear to me what additional commentary you are seeking. The Constitution provides a systematic outline of what that due process looks like, and even includes the power for the Congress to assign the Executive the authority to take certain types of action w/o constantly returning to the Congress for permission.

    And Locke’s writings, while historically influential, are legally as relevant as the laundry tags in my underwear.

  10. It’s the ptivate proprty for public use part that you are purposefulyl ignoring.  And with good reason, as it’s clearly contrary to your position.

  11. No–even worse for your case.  If you knew anything about the Constitution, you’d know that that’s the “takings clause.”  In short, Uncle Sam can take your house to build a highway, a hospital, a military base, or a park without your permission, but not without compensating you “fairly.”   This capacity is what is referred to as “eminent domain.”  What this has to do with health care is beyond me.

    A word of advice.  The Constitution may seem like a short and simple document, but it comes with 200 plus years of interpretation, which interpretation you must take into account if you’re going to go around citing it as evidence for your position, whatever that position is.

  12. Andrew, I am rather obviously ignoring nothing — obvious, at least, to anyone who is willing to read the text that he himself so carefully highlighted.

    That text — the very text that YOU emphasized — stipulated conditions where such property can be taken. What part(s) of the phrases ”due process of law” &/or “just compensation” do you find so especially confusing or obscure that you apparently can not notice their presence even after you have so carefully put them in boldface?

    Since the nature of that due process and just compensation was left open, the only reasonable conclusion to be drawn is that their specifics are to be determined (&/or revised as needed) by the relevant legal structures. This, of course, is exactly what has happened and continues to happen.

    But one can go much further than just this. Property is not some religious idol to be worshipped and adored, and nowhere is it enshrined as such within the foundational documents of the United States. For example, since you are a fan of the DoI one might hope you’d notice the very calculated choice Jefferson made in abandoning Locke’s formulation of “life, liberty and property” for the quite explicitly Aristotelian formulation of “life, liberty and the pursuit of happiness.” Not even the attainment, mind you, but merely the pursuit. And Aristotle quite explicitly sets aside wealth as at best a minimally instrumental tool in the attainment of “happiness” — “eudaimonia” in Greek, which might better be translated as “human flourishing.” And while people can flourish (“live well, do well” in some translations) with only minimal property, health is a far more basic requirement of “happiness” or even its pursuit.

    So if you wish to dig into source documents and influences, you would do well to crack open a good translation of the Nicomachean Ethics (I recommend the Hackett edition, Irwin translator.) (Also, it should scarcely require mentioning that all of the Founding Fathers were intimately familiar with this text.) If you wish to focus on the legal documents as they stand, then read the entire text that you explicitly quote.

  13. No more ipse-dixitisms please, Andrew. Just because a famous politician or philosopher wrote or said something doesn’t mean his or her statement is true/justified. The issue is whether we, as a society, should provide health care for each other. The Constitution, or the DoI, or Locke, or whatever the hell Patrick Henry had to say is pretty much irrelevant regarding this matter. It’s legal. Get over it. The question is, should we publicly provide health care. I say yes. I think there are many good reasons why we should do so, especially insofar as having access to affordable health care contributes to high quality of life more than almost anything else I can think of.
    I think the reasons against doing so are not as good. The only persuasive argument against providing publicly funded health care is the economic argument. I never bought the whole “selfishness as virtue” routine, and I hold the view that if we can do something to ease the suffering of people in our society and help everyone flourish, then we should do so. So, if you can convince me that a public plan will in fact be bad at providing quality affordable health care and will bankrupt our already bankrupt economy, then I will oppose a public plan. But, most of the economic evidence points toward public health care actually easing health care costs and providing better care.

  14. Jem, if access to basic health care is a right, then  I think one can argue that the government should do everything in their power to provide it.
    On the other hand, if access to basic health care is not a right, it does not mean that the government can’t or shouldn’t provide it. After all, roads and bridges are not a “right”, and the government still provides it.
    So, it seems to me that J.D. Lewis is on the wrong track. Even if he were succesfull in arguing that access to basic health care is not a right (which John correctly points out that he wasn’t), it does not follow that the government should not provide it.
    J.D. Lewis seems to also try to go for a hierarchy of rights in his article: “But consider what a right to a guaranteed outcome would mean. It would require an infringement upon the lives and liberty of those who are forced to provide it. If there is a right to food, there must be farmers to provide it — or taxpayers forced to pay for it.
    I think this can bring an interesting discussion: would the right of access to basic health care trump other people’s right. Anyway, this is not a new discussion. We make judgment calls like these everyday.
    As for the economic point, as of right now this health care reform is not, in my opinion,  feasible: “According to the nonpartisan Congressional Budget Office and Joint Committee on Taxation, the House bill as introduced would add a net $239 billion over 10 years to the deficit, while the HELP Committee bill racks up more, $597 billion over 10 years.” (http://www.factcheck.org/2009/08/seven-falsehoods-about-health-care/)
     

  15. Well, since I’m apparently arguing with people who like to see the Constitution as  living document, I’ll leave the legal arguments aside and point to a logical argument for why government run health care is the wrong type of reform, even within the confines of it being legally allowed and a utilitarian world view (both things that I personally disagree with, but hey I’m trying to convince you not myself.)  I’m not usually a fan of FOX News (They’re just as bias as MSNBC, but in the opposite direction), but this particular clip is pure brilliance.
     
    http://www.youtube.com/watch?v=Er8llKAbjwQ
     
    I know you don’t like me personally.  Let’s face it I’m Objectivist, who believes that morality stems from rational self-interest (see selfish atheist.)  So you probably think I’m an ass.  But regardless, even if your goal is to provide quality health care to more people, the free market is the way to go.

  16. 1.  the adjective  is “biasED”–MSNBC is biasED.  They have bias, but are biased.

    2.  Are they biased?  Well, they have a 3 hour morning show hosted by a former Republican congressman and 3 hours of evening programs by three different liberal types.  That doesn’t seem like bias to me.

    3.  The constitution did not say anything like what you claimed it said.  It said the government can take your property without your permission (but not without paying you) and that you deserve due process.  It doesn’t say the government cannot provide roads, a postal service, a health care system, etc.

    4.  Many other countries have government run health care which costs have as much as our private-government system and produces superior health outcomes.  That means at the very minimum such a thing is a logical possibility.

    5.  It is not unreasonable to suggest that rational self-interest would propel people to choose an effective health care system over an ineffective one.  After all, it could be them on the losing end.  After all, people get insurance out of rational self-interest.   So don’t think, in other words, that rational self-interest is necessarily coextensive with a free market system of health care.

    6.  Finally, on that clip–the guy just asserts “free market awesome,” gives a very misleading example (his dad), and an irrelevant comparison (elective cosmetic surgery).  I mean, please.  You have to be more discerning than that.

  17. Wow, most of those points were completely off topic, and your post resembles the Gish Gallop, but as I am not limited to real time discussion, I will respond to each point one at a time.
    1) Yes, I make typos.  It’s the internet.  No relevancy to our discussion.
    2) I submit the following as evidence of MSNBC’s biased opinion.
    http://www.youtube.com/watch?v=8i-OWDjOQfI
    But again, this was an aside comment that I made to show that I wasn’t some FOX News lackey, and bringing it up as some kind of point against me is not relevant to our discussion.
    3) I abandoned making any sort of legal argument because it was clear that (mush like members of the supreme court) we have differing interpretations of it.  So bringing it back up again (after I’ve already conceded that we will not find any resolution that way) is a dirty tactic as it’s no longer relevant to our discussion.
    4) This is relevant to our discussion, but if you’re going to say that there are examples, then please list the specific examples that you are referring to, so that I actually have something to respond to.
    5) Good point.  I pointed out that Utilitarianism could still lead to free markets, you pointed out that self-interest could still lead to government run (or at least government managed) health care.  The important question is not ideological, but simply what works.
    6) I’m not sure I really understand why you are saying that his points are irrelevant.  Why is a non-insurance based medical field (cosmetic surgery) not relevant to discussing how free market health care would work?

  18. BN,
    Exactly -it doesn’t matter whether health care is a right or not, and I find the whole debate tedious. I hope everyone can agree that it is a good thing to reduce the amount of suffering in our society and to provide everyone with an opportunity to flourish. And I hope everyone can agree that health care is an important, if not essential service toward that end. So, the issue is what is the best way to provide this service for the good of our society, without limiting the other public goods we also desire.
    Since there are many folk out there like our friend Andrew who pulled themselves up by their own bootstraps and don’t want any government telling them what to do with their money which they earned all by themselves without assistance from anyone else, especially no filthy public assistance, the only way to sell health care is to appeal to their rational self-interest. Hence, the economic arguments must be analyzed.
    Now, I am no economist. So, the only thing I can do is appeal to reasonable authorities whom I trust (with good reason). If a Nobel prize-winning economist [Stiglitz] says public health care is the best way to go because our current system is driving us bankrupt, I will take him at his word. And if factcheck.org says that we can’t pay for the proposed plan, then I think we should revise the current plan. But, like I said, I’m no economist. I just want cheap health care that won’t drop me if I’m sick.

  19. 1.—that’s a mistake you’ve been making forever.  Now perhaps you won’t make it again.

    2.  3 solid hours of Joe Scarborough makes it obvious that MSNBC is not the complement to Fox.

    3.  Sorry to beat at dead horse on the legal arguments, but you suggested there was something “activist” about my (our?) interpretation of the Constitution.  I think the point is–sorry to repeat this, but you don’t appear to understand it–that the Constitution says nothing that would prevent some kind of health care system.  Besides, your interpretation of it was crazily wrong.

    4.  Britain, France, Germany, Japan, Switzerland, Italy, Canada, Sweden.  They have systems (of various types) that cost as much as half what ours does for a better result.

    5.  ok.

    6.  I’d say elective cosmetic surgery is an option, unlike, say, necessary heart surgery, or basic health care.  I can do without my much longed for eyebrow lift, but I can’t do without medical care if I have an accident (knock knock).

  20. “Now, I am no economist. So, the only thing I can do is appeal to reasonable authorities”
     
    Jem, I understand your reasoning there, but (as usual) there are many authority figures that don’t agree.  That’s actually why I enjoy this site, because there are people here who understand the rules of logical discourse, but also tend to disagree with me.  This forces me to better explain my own positions and exposes me to information and arguments that I might not have heard otherwise.  I know it can be tempting to rely on authority figures, but if we’re going to have an opinion on something with such potentially powerful consequences as changing the structure of our health care system, then I think we owe it to ourselves to really put in the effort to try to become as informed as possible.

  21. John Casey,
    #4 is going to require I do some research into some of those countries, as I am only currently familiar with Canada’s, the UK’s and Sweden’s systems (of the ones you listed.)
    as to #6.  I can see a difference being apparent when it comes to urgency (if I get into a bad car accident I’m going to want care at the nearest hospital possible.)  However, I disagree when it comes to all non-urgent, yet important care.  If I am getting an artificial knee, then yes it’s probably very important, but I can get it from a number of different hospitals.  In fact many people are traveling to South Africa to get medical procedures done.  If people are willing to go to other countries to save on cost, then certainly they’d be willing to shop around within the United States.
     
    http://en.wikipedia.org/wiki/Medical_tourism#Description
     
    Sorry for the wikipedia link.  I know it’s not a reliable source, but that’s why I linked to the general description section, as it just gives an outline.

  22. Andrew,
    I know. There’s an appeal to authority based on evidence of that authority’s authoritativeness, and a dogmatic appeal to authority. We have to appeal to authority sometimes. I take it that a Nobel-prize winning economist is an appropriate authority to appeal to in discussing the costs of health care. I’m not blindly agreeing because there is evidence to suggest that if one wins a Nobel-prize in economics, then one probably knows a lot more about economics than almost everyone else in the world. This does not mean that whatever that economist says is correct. It just means that we should take him or her seriously. If another reasonable authority disagrees with said economist (like, another Nobel-prize winner) then we need to do some more intellectual work to figure out which one we should trust
    But even Milton Friedman thought we should reform health care by either going single payer or by voucherizing health care, so I’m not sure there’s a whole lot of disagreement between economics authorities in this matter: http://www.hoover.org/publications/digest/3459466.html
    This little nugget from that article is most revealing:
    “Our mixed system has many advantages in accessibility and quality of medical care, but it has produced a higher level of cost than would result from either wholly individual choice or wholly collective choice.”

  23. I don’t know if anyone is committed to the position that people do not want an affordable health care option.  The fact that many in our mostly private system seek that option overseas (where they often take advantage of government run systems) underscores the point that there is something wrong with our system.

  24. grr…  There should be another underscore both before and after the ‘in’ at the end.  for some reason the link is getting destroyed when I post it.

  25. Don’t be daft Andrew.  That’s “The Ed Show” which  is a kind of opinion show, like O’Reilly or Olbermann.  It wouldn’t be evidence of bias.  Perhaps you could define–but please don’t actually, I think we’ve exhausted this thread–what you mean by network “bias.”  Does the regard programming balance?  Are the as many liberals as conservatives (as there are on MSNBC, by the way–excluding the inexplicable Chris Matthews–it’s three to three) in the “talk shows”?  Or does their news reporting skew one way?  Those are different sorts of questions.  There are others, but these are the basic ones.

  26. Andrew:  “I can see a difference being apparent when it comes to urgency (if I get into a bad car accident I’m going to want care at the nearest hospital possible.)  However, I disagree when it comes to all non-urgent, yet important care.  If I am getting an artificial knee, then yes it’s probably very important, but I can get it from a number of different hospitals.”
    So, ’emergancy care’ (urgent) is a “right?”
    Apparently, you can afford, or have insurance for, artificial knees… What about those people who cannot afford nor have insurance (as of now, in our ‘free market’)?
    The ‘free market’ currently leaves about 47 million people without proper health care.  The ‘free market’ currently leaves many who needed — required — urgent care with thousands, even hundreds of thousands, of dollars of debt.

  27. If you think that the system we have now is “free market” then you’re buying into some bold lies.
     
    “One of the methods used by statists to destroy capitalism consists in establishing controls that tie a given industry hand and foot, making it unable to solve its problems, then declaring that freedom has failed and stronger controls are necessary.”
    Ayn Rand

  28. “But, most of the economic evidence points toward public health care actually easing health care costs and providing better care.”

    As a Canadian who has worked behind the scenes and uses the system all I can say is…

    No it doesn’t. In fact, there’s mounting evidence pointing to the opposite of what you claim.

  29. Alex,
    Where is this evidence mounting? I’d love to trust you, but you’re Canadian.
    There already is mounted evidence that American health care is the most expensive in the world. Lots of it.

  30. Hello Jem,
    I’m Canadian. Ugh.
    My inarticulated point is (and I apologize for not making this clearer) you need just examine the runaway mismanagement of our system to know what’s going to (possibly) happen in the U.S. I don’t believe for one second that they’ll be able to control, let alone lower costs.
    By the way, Canada is now (though a distant) second to the U.S. in health care spending per person (roughly $5000) and the system is adequate at best – to some it’s in crisis.
     

  31. Hey Alex,

    I think Jem wanted more specifics about the shortcomings of the Canadian system.

    I would want to know which of the 5 or so proposals before congress is like the Canadian system–or who is proposing the Canadian system for us.

  32. Thank you, John.
    I’m currently living out of boxes as I’ve just moved. I wish to respond to your query but don’t want to respond in haste. Please give me a day or so and I shall do my best.

  33. My apologies for the delay in my response.
    John, I admit that getting handle on the American system is quite the undertaking but fascinating nonetheless. My original assertion to Jem was strictly from a unique Canadian perspective about how public health (or options) can get expensive over time and can witness erosion of quality of care over time. For information on this, I merely focus on places like the Canadian Medical Association, Canadian Independent Medical Clinics Association, the OECD, Statistics Canada and finally a website I worked with called findprivateclinics.ca. With FPC, we got first hand insights from within the system from doctors, nurses and health administrators as well as politicians. Moreover, and just as interesting, was the emails and general contact we had with the public.
    We found there was a discrepancy between the perception we have of our system and what was going on. It’s not a stretch to say it’s Byzantine at this time in its present landscape and direction. Health has become, since it’s a government monopoly, a highly politicized issue in Canada and this prevents any meaningful debates on how to alleviate the massively over burdened public system.
    Then there are the personal experience. But this is for another time.
    As far as I can see, Obama’s plan does have its potential merits:
    http://www.urban.org/UploadedPDF/411754_obama_health_proposal.pdf
    But the Congressional Budget Office also provided ominous warnings about the costs associated with it. Is Obama merely trading an insurance driven system to a government one or is he suggesting one in which “competes” with private insurers? If the former, why? Why not “tailor” the system without too much government intervention?
    I hope America never goes the route of Canada – we in effect weeded out personal choice out of the equation. One size fits all prevails here and people are increasingly questioning this – private insurance is outlawed. Although the province (health falls under provincial jurisdiction) of Quebec in a Supreme Court ruling said this infringed on freedom of choice. To say nothing of long wait times, lack of advanced equipment, difficult access to GPs and so on.
    Now, what’s in the proposal that suggests Obama is heading the way of Canada? Well, he’s repeatedly said he’s in favor of “single payer” and “universal care.” I think this in itself is enough.
    It’s not necessarily the specifics of what’s in the bill but the language used and what it could lead to.
    Maybe the bill lays the groundwork towards this? It’s worth examining.
    I don’t know.
    Last, it’s interesting to observe that while we’re heading towards privatization in parts of the system, you guys are heading public! Maybe we can meet along the way and come up with a healthy -excuse the pun – solution?
    My overall point, I guess, is debate this thing until you’re blue in the face. I fear some exaggerate the bad side of the Canadian system (it is a noble experiment worth exploring or preserving) as well as the good side. However, it’s always good and prudent (to me anyway) to know the shortcomings.
    Hope the wait was worth it. I could expand further but don’t want to fill up the comment section. Sorry if it may seem scattered in my thoughts and grammar but I am writing on top of a box as I’m in the middle of moving!
    Thanks for reading.
     
     
     
     
     

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