Medical care and the ability to pay
May 4th, 2009 | by Brian Schwartz |The following passage from Virginia Postrel’s recent article in The Atlantic gets to a central premise, too rarely debated, about health care policy (emphasis added):
allowing patients to buy drugs to be administered within the NHS would threaten the system’s egalitarian ideology. “Two patients with the same condition could find themselves lying next to each other on the same ward, yet receive very different treatments, not because that is what doctors advise, but because one person can afford to pay extra to top up their care while the other cannot,” Karen Jennings, the health chief for Unison, a public-employees union, wrote in a September op-ed. She warned that if such “co-payments are allowed, they will fast become the norm.” But kicking out patients who’ve paid taxes into the system, just because they spend their own money on cancer drugs, has become untenable.
To clarify my point: It is hugely immoral and unjust for government to make insurance and medicine as expensive as it is. For example, medical licensing, the FDA, tax policies that stifle competition between insurers, encourages over-consumption of medicine without regard to price, makes us susceptible to pre-existing conditions, and insurance regulations that turn insurance into mandatory charity.
In the United States today you can work hard and earn a good living, but still not be able to afford medical care because of bad government policies. But if there were a free market, why shouldn’t the ability to get medicine motivate people to be productive members of society so they can afford it? Of course, there is room for charity for those, through no fault of their own, can not earn enough. But to make a blanket statement that ability to pay should not at all impact that type of medical care – this implies that we’re entitled to it, that medical care is a right (it’s not), and that our own medical health is not our responsibility.
This reminds me of what Yaron Brook of the Ayn Rand Institute said about free speech, as people complain about the alleged unfairness that people with money can make themselves heard better than those who do not:
It’s true that in a free system, money does give you a greater ability to get your message out; this is precisely one of the reasons it’s desirable to earn wealth. If this is what campaign finance advocates regard as corrupt, which system would they regard as uncorrupt? One in which a person’s ability to promote his viewpoint is unrelated to the financial resources he’s earned (whether personally or through voluntary contributions).
As I’ve said before, so long as the moral premises behind government health care go unchallenged (the right to health care, that we all have an unchosen obligation to provide medical care for others - and be taxed for it, and that we’re each not responsible for making sure we can get the care we need), government health care will advance.
Of course, it might advance anyway because of the nature of interest groups and our government (see here).
tags: equality, right to health care
