Patient Power

Brian, I did not intend to suggest that all people should have healthcare freely provided to them. The initial intention was to point out that making healthcare more accessible and more affordable to its citizens is as easily rationalized as any other action a government might take, such as spending hundreds of billions of dollars every year on national defense.

Allow me to restate my thoughts from a different angle:

Taxes are what citizens of the U.S. pay every year so that the social contract known as their government can continue to exist. Unless you choose to live in anarchy, you will always have to pay some sort of taxes. How this money is used to ‘serve’ the citizens of any given democratic nation is defined by the laws of that nation.

Ayn Rand wasn’t an anarchist; she simply believed that the laws that men held themselves accountable to should be derived from rational standards of value. What are these rational standards of value? The dollar, or any form of global currency, was a pretty good manifestation in her opinion. This is the main reason why free market capitalism is the most exercisable form of objectivism.

However much objectivists want to imagine that profit-making be 100% of the driving force of man’s actions, Rand admits herself that ‘rational standards of value’ are dynamically defined. Here are a few quotes from her popular 1964 interview with Playboy magazine:

"Objectivism holds that the good must be defined by a rational standard of value, that pleasure is not a first cause, but only a consequence, that only the pleasure which proceeds from a rational value judgment can be regarded as moral, that pleasure, as such, is not a guide to action nor a standard of morality."

She goes on to say:

"It is the province of morality, of the science of ethics, to define for men what is a rational standard and what are the rational values to pursue."

How is making healthcare more affordable, or more specifically, equally affordable to every U.S. citizen regardless of the history of disease, not a rational value to pursue?

We don’t let natural gas companies raise the prices of their products in the winter just because they have local monopolies and thus have the power to do so; we prevent them from doing so by the conclusion to do so would unfairly exploit the people who depend on this essential good. We don’t charge people more for the water than comes out of their faucet depending on how thirsty they are, do we? We could if it were technologically possible and if we, as a group of people making judgments of ethics, decided it were ‘good’ to do so.

I also wanted to revisit your comment that for a government to entitle one citizen to the product or products of other citizens makes slaves out of the producing citizen(s). The salaries of policemen/women, firefighters, public service lawyers, homeless shelter employees, soldiers in the military and so on., are paid for by the government; these people are not ‘slaves’ any more than a member of any trade, profession or line of work is. They choose the work that they do, and can choose to take a different job. Where is the enslavement?

What is consistently left out of the objectivist's rationalization of complete and otherwise unfettered individualism is why government is necessary at all. Yet the ‘reason’ is obvious, and exposes the flaw of arguing against regulating the actions of men so that healthcare can become more affordable.

The objectivist (‘free market capitalist’ is a fair substitute if one wants to speak in economic and not philosophical terms) requires the most basic of laws to operate; namely, those which allow for the fruits of man's intellectual and physical labors to be unregulated in their production; for those products to be freely exchanged; and the returns from selling such products to other men or reason who value them to remain in the ownership of the producer. The objectivist therefore requires protection from the barbarous actions of others -- from murder, from rape, etc.

This requirement necessitates government, a social contract in which every individual agrees to give up some degree of personal freedom so as to achieve an ideal counterbalance of safety (i.e., preserving the personal freedoms of others). What would keep the wealthy merchant from being killed and robbed of all of his fortunes by a poor, unindustrious vagabond? That man can use ‘reason’ as a gold standard for his actions -- where these actions in an industrialized world constitute his manipulation of that within his grasp (an idea in his mind, laborers, financial capital, etc.) -- would simply not be possible if there were not certain fundamental protections enforced by the government.

Why is it that laws can be written to protect the productive capabilities of men from the brutish actions of others and not to protect him from the attacks of germs, pathogens, physical injuries, bodily defects, etc.? Why can a government not establish a justice, equally afforded, for repairing these attacks on one's state of health? There exists a justice, equally afforded (at least in the theory) to victims of murder, of rape, of the stealing of intellectual property, of discriminating on the basis of race and not performance, and so on.

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Brian replies:
Matthew writes: "Why is it that laws can be written to protect the productive capabilities of men from the brutish actions of others and not to protect him from the attacks of germs, pathogens, physical injuries, bodily defects, etc.?"

This reminds me of the comparison of health care to police protection. As I've noted in a previous post, the police does not protect. It engages in law enforcement after the fact. At this point you might say the analogy still holds for government to step in after something "attacks" your health.

Yet this shifts the responsibility of living from yourself to everyone else. As I wrote in that post:

The same applies to health care. If you want to live, you need to take responsibility to do what is required to sustain your life. If something is a necessity for your life, that fact does not impose an unchosen obligation upon your neighbors to provide it for you. Nor does it give government the power to force your neighbors to provide it for you.

Being responsible for your own health care entails proper diet, exercise, buying insurance and fining a physician, Similarly, being responsible for your own defense can entails not jeopardizing your own safety through unwise choices. It can also entail learning self-defense, buying a home security system, or the services of security firms.

Rights are freedoms of action, which obliges others to refrain from acting to violating your rights. It does not obligate others to do anything. They have their own lives to live. A "right" to health care is an entitlement to what others produce, which makes these people a kind of slave.

(The comparison to the fire department is also apt.)

Bailouts aren't the answer either. Why is it the country can buy out the nations largest banks, including half of all American mortgages and one of the worlds largest insurance companies - and Americans still can't get health care or reasonable insurance. This is why the far right is on their way out of Washington for the next 20 years.

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Yes, health care is not a right, and the government's response to the mortgage crisis, which it contributed to by interfering in mortgage markets, is also wrong. For why, see The Ayn Rand Center for Individual Rights on the topic.