The debate in Congress on the Patients’ Bill of Rights legislation sent me back to my notes on a Rice University lecture series of several years ago on ethics in today’s society. The subject then was “Hillary Care”, but the questions remain. The most basic one is “is there a right to health care?” You may suggest that the American people have already answered this question in the affirmative. I’m not so sure. A corollary question railed in our lecture group was “of all the unfortunate circumstances in the world, which ones constitute unfairness and generate a set of rights, therefore claims on society?” After all, you can’t have a right without a legitimate and enforceable claim to satisfy that right. The rights that our founders believed government were instituted to secure included life, liberty, and the pursuit of happiness (the latter generally considered to include property rights). They were also very clear about the source of these rights (“endowed by our Creator”) and they agreed with President John Kennedy who said, “The rights of man come from the hand of God, not the state.”
So how have we arrived at this notion of a right to health care? I suggest that this perversion of the Constitution began with Franklin D. Roosevelt’s 1944 State of the Union message, in which he proclaimed a second bill of rights because, he said, the original set “proved inadequate to assure us equality in the pursuit of happiness.” These new rights included “the right to adequate medical care…” which, of course implied a claim on society. I mention this because I believe it is important to have more of a national dialogue on these philosophical questions before we proceed to adopt universal health care. And make no mistake: Hillary Clinton and Ted Kennedy have every intention of succeeding with incrementalism where they failed with the comprehensive plan in 1994.
In my view, the pending legislation (as I write, it has just been approved by the Senate) is a good place to start refocusing the dialogue, with a veto by President Bush. Then we can get on with the business of transforming health care policy by empowering individuals with Medical Savings Accounts, making insurance premiums tax deductible by individuals, providing for coverage portability, phasing all employers out of the health insurance business so that the insured own their policies, and returning individual responsibility and cost/benefit considerations to the system. Health care is a contractual relationship between providers and consumers, not a right.