Healthcare and Rights vs. Priorities

It’s common to hear that someone in America believes that ‘healthcare should be a right’. This is usually met with a chorus of agreeing and dissenting opinions, but it shouldn’t be, because almost nobody agrees with that statement, per se.

A big part of the problem is that people are throwing around the word ‘right’, when it isn’t what they mean at all. Here is a list of rights. It includes a lot of general things:

  • No one shall be subjected to arbitrary arrest, detention or exile.
  • (1) Everyone has the right to freedom of movement and residence within the borders of each state.
    (2) Everyone has the right to leave any country, including his own, and to return to his country.
  • Everyone has the right to rest and leisure, including reasonable limitation of working hours and periodic holidays with pay.

That list even touches on healthcare, which says:

Article 25.

(1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

Even in this list that should be considered extremely progressive, you’ll notice the generality of the statements — it’s a huge leap from agreeing that basic medical care should be available, perhaps subsidized for the very poorest, to agreeing that ‘Universal Healthcare’ is desirable. It certainly doesn’t specify the extent of the medical care in dollar terms.

Healthcare is extremely expensive, even (especially?) for developed nations. In 2011, France spent about US$4,000 per person on healthcare. If that’s a right, are poorer countries like India or Vietnam, where GDP per capital is about US$4,000 depriving their citizens of their rights by not doing similar? The answer is obviously not. The fact that this argument can be made is prima facie evidence that describing healthcare as a ‘right’ is at best a poor decision and at worst an attempt to manipulate the discussion.

What people actually mean, in my experience, is that they believe healthcare spending should be a priority. This is exactly the same discussion, but once you re-frame it, you have to acknowledge opportunity costs associated with it. When talking about a true “right”, like free speech, it’s self-evident to most that no cost-benefit analysis need be made, because the benefits of free speech are so great.

But, when you’re in an economy and the government has priorities, either imposed via taxes or via mandates to employers, you start to see them affect the economy. This article about the razor thin margins of even the most successful restaurants comes to mind (h/t Josh Brown).

A related discussion about healthcare benefits as part of income is in this great econtalk podcast.

I’ll leave it here for now — an accurate description of the actual debate (priority vs. non-priority instead of right vs. non-right) is vital to productive discussion.

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