IS HEALTH CARE A RIGHT FOR FREELOADERS?

[Please also read "A Parable: The Right to Health Care"]

Almost all of the people who presently do not have adequate health care insurance deserve to have it. Why? Because the relevant moral principle is "From each according to reasonable ability, to each according to need or reasonable desire with scarce things equitably rationed according to need" and these people contribute (or at least are willing to contribute even if wrongfully denied employment) to society according to reasonable ability. (The reasonable ability of children and of people physically or mentally incapable of doing useful work, or of people past a reasonable retirement age, or of people willing to work but wrongfully denied the opportunity to do so, is of course considered to be zero, which means they are considered to be contributing according to reasonable ability no matter what; also attending school or an apprentice program, etc., is considered doing useful work.)

Today, the only choices for health care policy that the politicians ever talk about are these two:

 

a) A policy (such as Obama Care) that leaves many people without adequate (or even any) health insurance because it denies the principle of "From each according to reasonable ability, to each according to need or reasonable desire" (especially the second part of that principle). 

 

b) A policy (such single payer universal health care for all) that is based on the idea that health care is the right of all (whether they contribute according to reasonable ability or not, i.e., whether they are freeloaders or not). This kind of policy also denies the "From each according to reasonable ability, to each according to need or reasonable desire" moral principle (especially the first part of that principle).

 

Given ONLY these two morally flawed choices, good people (and I) very understandably go with the second choice because they don't want people who truly deserve health care as much as anybody else not to have it when they need it.

But do freeloaders--people who can but who simply refuse to contribute according to ability--have a right to health care? Here's a thought experiment to shed light on the question.

Do you remember that rich woman, Leona Helmsley, who famously declared, "We don't pay taxes. Only the little people pay taxes"?

 

Imagine a freeloader (a person who similarly says, "Work is for the little people; the little people should work for me, but I will never work--and have never worked--because I'm too good for that") in need of medical care arriving at a hospital and demanding that the doctors and nurses and orderlies care for him/her because it is his/her "right."

 

Are those health care workers obliged to agree that they MUST provide the freeloader health care because it is that person's right to receive it? Note that this question is not the same as the question, "Should the health care workers provide the freeloader health care?"

 

Health care workers might decide--for any of a number of reasons*--that it would be a good idea to provide health care to the freeloader. At the same time, if I (John Spritzler, the editor of this website) were one of those health care workers I would make it clear to all concerned that "Even freeloaders have a right to health care" is NOT one of those reasons.

 

If, for some reason such as the scarcity of health care resources (perhaps an organ needed for a transplant or a team of surgeons faced in an emergency with more cases than they can handle), health care workers had to prioritize who would receive scarce health care and who would not, what is the applicable moral principle? I think the priority should be to care for people who have contributed according to reasonable ability, and the freeloader--contrary to the idea that health care is the right of all--has no right to complain about this.

HOW "HEALTH CARE IS A RIGHT FOR ALL" HARMS GOOD PEOPLE

Some good people (i.e., people who are not freeloaders but who for some reason are unable to work) today who have Medicaid health insurance feel guilty for having this insurance, when they have no true reason for feeling guilty, and this is harmful to them emotionally.

These good people feel guilty because they know that other people--taxpayers--are paying for their health care and that they are not paying for it themselves. They feel like a freeloader and they know freeloading is morally wrong.

But these people are not freeloaders and have no reason to feel guilty. These people contribute to the wealth of society according to reasonable ability; what their reasonable ability is varies according to their individual circumstances: some work normally until they become disabled or otherwise incapable of working; some may try but fail to find reasonable employment; some may never be able to work because of a physical or mental illness.

 

In receiving health care according to need or reasonable desire these people are acting perfectly morally, consistent with the moral principle of "From each according to reasonable ability, to each according to need or reasonable desire." These people have a moral right to take health care and other things according to need or reasonable desire. They wouldn't have this right if they had refused to contribute according to reasonable ability (i.e., if they really were freeloaders), but they did not refuse and so they have no reason to feel guilty for getting health care paid for by taxpayers.

Unfortunately these good people seldom hear the appropriate moral principle articulated at all, never mind applied to their situation as a person on Medicare. What they hear instead is the wrong moral principle, that "Health care is the right of all." These good people know that if this is the principle by which they receive health care courtesy of the "hard working taxpayers" then they are receiving it for the same reason freeloaders also receive it. This makes them feel as if they were a freeloader because they focus on what they have in common with a freeloader--not working--and lose sight of how they are very different from a freeloader--working according to reasonable ability.

We would do a lot to promote the emotional health of good people by embracing the principle that "Health care is a right for those who contribute reasonably according to ability" so that these good people would know that the health care they receive is deserved by them for the same reason that "hard working taxpayers" deserve their health care, and not because health care is a right even for freeloaders.

THE "HEALTH CARE IS THE RIGHT OF ALL" NOTION MAKES IT EASY FOR BAD PEOPLE TO DEPRIVE DESERVING PEOPLE OF HEALTH CARE IN THE NAME OF OPPOSING SLAVERY 

 

In response to the assertion that "health care is the right of all," some people (such as the libertarian Senator Rand Paul as can be seen in this video here and reported here)  are saying, "No it is not!" Senator Paul argued:

 

"With regard to the idea of whether or not you have a right to healthcare, you have to realize what that implies. It’s not an abstraction. I’m a physician, and that means you have a right to come to my house and conscript me. It means you believe in slavery. It means that you are going to enslave not only me but the janitor at my hospital, the person who cleans my office, the assistants who work in my office, the nurses." He added, "Once you imply a belief in the right to someone's services you're basically saying that you believe in slavery." 

Such people, typically libertarians, add triumphantly that the definition of a slave is a person who is forced to work for another against his/her will. Rand Paul's argument appeals not only to health care providers who don't think it is right that they be forced to work for a freeloader, it also appeals to working class people who don't think it is right that they be taxed to pay for a freeloader's health care.

The libertarian argument derives its substantial persuasiveness from the fact that it takes advantage of the huge weakness in the "health care is the right of all" notion. To see how this is so, imagine if nobody were arguing that health care is the right of all, and instead good people were asserting that our society should be based on the principle of "From each according to reasonable ability, to each according to need or reasonable desire" and that we should all--health care providers and everybody else--enter into mutual agreements to help each other on this basis.

How would Senator Rand Paul (and others like him) respond to THIS assertion? None of his talk about slavery would now apply, and this would be obvious to everybody. He could either agree that society should be based on such mutual agreements (which is what egalitarianism is all about) or disagree, but in either case he would no longer have anything even sounding like a persuasive argument against what good people think about the provision of health care in our society.

"HEALTH CARE IS THE RIGHT OF ALL" IS A DIVISIVE PHRASE

The fact that a fairly popular person such as Senator Rand Paul can take advantage of the weakness of the phrase "Health care is the right of all" to turn a substantial number of good and decent people against it (on the grounds that it promotes slavery, no less!) is very significant. It demonstrates that this phrase, far from unifying the have-nots, actually helps the ruling class divide-and-rule us. This is the reason that the phrase has the blessing of the mass media, and hence why it is so prominently used by liberal/progressive organizations. By using this phrase we are falling into a divide-and-rule trap. To avoid falling into this trap, we need to declare, instead, that the principle regarding health care is the same as the egalitarian principle regarding all goods and services: "From each according to reasonable ability, to each according to need or reasonable desire with scarce things equitably rationed according to need."

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* For example, a national health care system might offer health care free to everybody no matter what, instead of only to people who are not freeloaders, simply because it would cost more to check if a person is a freeloader every time somebody requests health care. Fine. Or the health care workers may not want to live where sick people are dying on the street; or they may just feel sorry for the freeloader, or hope to improve their chances of going to heaven if they give the freeloader care. But note that these reasons have nothing to do with the notion that freeloaders have a right to have health care provided to them by those who do contribute reasonably according to ability.

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