Patient Power

Is health care like police protection?

“Profit is a perverse incentive for quality health care: imagine for-profit fire or police protection,” writes Michelle Swenson in support of single-payer health care.  Louise at Colorado Health Insurance Insider has made the same comparison.  Most notably, Michael Moore has also. 

In this post I’ll address the police analogy. (I address the fire analogy here.)  I figure the line of thinking goes like this: being a victim of a crime is like being a victim of an illness or medical emergency.  We do not wish such events upon ourselves, and we do not have full control in avoiding them.  In many cases, being victim to a crime or having a medical condition is no fault of our own.  Just as government (supposedly) provides police protection to all, government should also provide protection from the harms of illness.

This sounds plausible.  Except for one thing: Do citizens have a right to police protection?

Consider the Wikipedia entry on police functions in the United States.  It cites three functions from the best-selling textbook, The American System of Criminal Justice: order maintenance, law enforcement, and service.  The most relevant one is law enforcement:

Those powers are typically used only in cases where the law has been violated and a suspect must be identified and apprehended. Most obvious instances include robbery, murder, or burglary. This is the popular notion of the main police function, but the frequency of such activity is dependent on geography and season.

Note that the police enter the scene after the crime has been committed. 

Several court cases and statutes assert that the police have no obligation to protect an individual citizen.  For example, The New York Times reported that

The Supreme Court ruled today, in a case closely watched by local government officials and by groups fighting domestic violence, that a Colorado woman could not sue the police for failing to protect her and her children from her estranged husband.

Commenting on the case, Wendy McElroy writes:

local officials fell back upon a rich history of court decisions that found the police to have no constitutional obligation to protect individuals from private individuals. In 1856, the U.S. Supreme Court (South v. Maryland) found that law enforcement officers had no affirmative duty to provide such protection. In 1982 (Bowers v. DeVito), the Court of Appeals, Seventh Circuit held, “…there is no Constitutional right to be protected by the state against being murdered by criminals or madmen.”

Lawyer Richard Stevens, author of the book Dial 911 and Die writes:

A Kansas statute precludes citizens from suing the government or the police for negligently failing to enforce the law or for failing to provide police or fire protection. A California law states that “neither a public entity nor a public employee is liable for failure to establish a police department or otherwise provide police protection service.” As one California appellate court wrote, “police officers have no affirmative statutory duty to do anything.”

A Massachusetts statute spells out the rule there: the government has no legal duty “to provide adequate police protection, prevent the commission of crimes, investigate, detect or solve crimes, identify or apprehend criminals or suspects, arrest or detain suspects, or enforce any law.”

McElroy continues:

Responsible adults — both male and female — have both a right and a need to defend themselves and their families, with lethal force if necessary.

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 sponsible 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.

Stevens concludes:

The drive to prohibit private firearms ownership highlights the statists’ goals in a way everybody can understand. They aim to disarm ordinary nonviolent citizens, even those who face high risk of criminal attack, and substitute police protection in place of self-defense. Meanwhile the police will not be held liable to individual citizens for failing to defend them. 

Government “social programs” and various mandatory “insurance” programs operate in the same way. First, the government programs distort the market forces that provide housing, food, medical care, transportation, and other goods and services. People shift to depending on the government programs instead of taking individual decisions and action. 

(Ben Pugh makes similar points here.)

• Should the legislature “implement the public will”?
• Canadian gov’t: “no freestanding constitutional right to health care”
• Obama: health care should be a “right”
• Jefferson, rights, and health care
• Colorado HB 1273: “Our responsibility” that Coloradans get medical care?