The walls of our campus rumble and resonate with claims to the moral imperative of health care as a human right. Let’s not take the time today to discuss whether or not this is a “correct” view to hold or is in fact compatible with other views folks hold, rather, let’s play on “their” turf and accept that “we” should provide “universal health care.”
Is it too much to ask proponents, and just about everyone on a college campus is indeed such a proponent, to be a little bit clearer on what exactly they are talking about? I know that is asking a lot on a college campus, but it is at least nominally what we say we are all about here. Here are a few questions that you should demand of your “teachers” who tell you it is imperative to support universal health care. Don’t argue with them about whether they are right or wrong, just ask the questions. You’ll get crickets of course.
- What, exactly, do you mean by “health care?” Do you think every single American should be able to get, for free, as much Tylenol as they possibly can consume? I’m all for that! Do you mean that every single American should be able to walk into a primary care doctor’s office at any time for any reason at no cost at all to them? Does every single American have the right to get breast enhancement surgery on a whim at no cost to them? Should every American have the ability to get a new heart at the age of 80 when their current one tickers out? Please spell out exactly what you think people should “have” and what you think they should have to go through to get it. We just want to know what you are talking about.
- Who is included in this right? Why do you limit your claims to universal health-care to just Americans? Don’t you know that in some countries in Africa life-expectancy at birth is still below 50? Don’t you know that there are billions of people around the planet who are immeasurably poorer than even the poorest Americans? If this is the case, then how can the right to health care be justified only for Americans? And if you suggest that indeed it would be consistent to support it on a global scale, please answer question (1) again. And would you argue that some people should have access to more than others? If so, how do you plan on justifying what this amount is, and how you decide (and who gets the power to decide)?
- Who is included in this right? Does everyone have the same rights to free universal health care regardless of lifestyle choices? Mind you, we are not asking here about the truly unfortunate who have lost the genetic lottery, but rather folks who have some say in the matter? Do skydivers have as much of a right as non-skydivers? Why the distinction?
- Do you know if it is even possible, in theory, to give everyone “equal access” to free and universal health care, and to make health care access completely independent of income or other considerations? Have you so much as considered this question? For example, suppose you offer up access to emergency appendectomies free of charge to anyone who needs them. Is the poor person in Kentucky coal country going to have the same chance of getting to the hospital as the rich guy who lives down the street from the Cleveland clinic? What is your solution to the fact that the rich guy is going to get the service quicker, or get it at all while the poor guy in Eastern, KY may die from the burst appendix? Do you plan on forcing the rich guy to wait until both he and the poor guy are standing at the front door of the Cleveland clinic? Then do you have a lottery that each of them enters to see who is taken to the operating room first? What if the rich guy wins that lottery? Or do you plan on banning poverty in Eastern, KY? Or do we have to build world class hospitals in every neighborhood? Should we permit migration? Why or why not?
- Do you know, in practice, how successful existing “universal” health care programs have been able to be at eliminating income and racial gaps in the delivery of medicine? If not, then how can you advocate universal health care here?
- Who do you think should be providing universal health care to all of these people? We clearly need more nurses and doctors. And at current wages and work levels people do not wish to do this right now. Are you going to relax standards and workloads to make those fields more attractive? Will you lighten the licensing load? Will you permit foreign doctors to come in to treat patients here (but what about the impact that has on foreigners?). Will you make my wife work longer hours in the ICU than she is working now? What if she doesn’t want to treat anymore people?
- Who has to pay for it? Do you think universal health care grows on trees? Which people, exactly, in the country, should be providing this universal health care? Is it possible, even in theory, to provide the level of care you envision to all 314 million Americans? And if not, how do you decide how little to give? Do you want ME to pay more taxes to finance YOUR health care? Tell me right to my face that you believe you should be going into my savings account and taking money away from me so that you can spend it on your back treatments? OK, great. Can I therefore also tap into your savings account to pay for my shoulder surgery? Why bother raiding each of our savings accounts when instead we can just do it ourselves? Or do you think that health care is free, that neither of us should have to fork over any of our hard earned savings just to pay for health care? Or do you think that someone else out there, for whatever reason, should be paying for BOTH yours and my health care? (See ques#1 again). I repeat, tell me to my face that you think YOU should take money from me, RIGHT NOW, to pay for your health care? If you don’t think this, then tell me that you want to take money out of my pocket, right now, to pay for someone else’s health care. That’s the only alternative, right? And if so, please explain why you care at all about someone else’s health care? And if you would agree to be financially destitute to make sure that every last person has access to all of the care that you specify in Question 1?
- Are you sure people are not already able to have “access” to universal health care like you agreed to in Question 1?
- If new technologies come available tomorrow that are not available today to treat particular ailments, such as an instant cure for the common cold, then do all Americans have a 100% right to receiving it tomorrow? Why don’t they have that right today? What if that new treatment costs $10 million? If all 314 million Americans got the treatment tomorrow, that would cost over 3 quadrillion dollars? Do you know what world GDP is? About $65 trillion. At what magic price of this treatment does everyone suddenly become entitled to it?
- If we know that jogging for three hours per week, every week, ends up reducing health expenditure demands by 75% over one’s lifetime, will we require three hours of jogging per week for all able bodied people? How would you carve out exceptions? If you don’t agree with enforcing such a rule, why not? Please reference (2) and (3) above in your answer.
- Suppose we were to demonstrate that eliminating all medical regulations and drug regulations today would immediately lower the cost of health care. Suppose further that substantially freeing the American market up with boost economic growth dramatically such that in combination, even the poorest Americans can easily afford to buy all the health care that they could ever want (sort of like our ability to buy mobile phones today). Would you then say that we indeed have achieved universal health care? Would you still require that we tax (who?) for it, collect it centrally, and “let” everyone get as much as they want for “free?” If you answer yes, then what, actually, is your justification for wanting “universal health care?” And why do you treat that any differently than the universal “clothing care” that reasonably free markets have delivered to almost every person in humanity today?
- If, as you suggest, universal health care is so important, please lay out exactly what you are willing to have less of in order to have more health care for everyone? How about an end to universal government schooling? Oh, that’s “too important?” What about ending the police and army? Oh, that’s “too important?” How about ending social security? Or do you just want it all? If you answer yes to the latter, might I set up a playdate with you and my 5 year old son? I think you’d get along swimmingly as you play with your pet unicorns at the (public of course) park.
These are only the beginnings of the questions you should demand be answered. You should note that none of these are arguing against “universal health care”, whatever that term means. They are merely requirements for what must be answered, at a minimum, by folks who advocate such things. Aside from having a good argument, economically, morally and politically against universal health care, these would seem to be quite a challenge. I again would expect crickets. But please do share your experiences in the comments.