Notes on 2019-2020 NCFCA LD Resolution: Health Care Rights

• Resolved: Individuals have a right to health care.
Consider the language from the Constitution’s Bill of Rights, First Amendment:

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press, or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

No “right to health care” listed, but the Ninth Amendment adds:

The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

So maybe a “right to health care” rests dormant among other rights “retained by the people.” A helpful way to evaluate “rights claims” begins with realizing rights also restrict freedoms. A right not to be hit restricts others rights to swing their arms. A right of ownership to a bicycle restricts others freedom to ride off on that bicycle. If there was a right to health or medical care from falling off a bicycle, then others would have the responsibility to provide medical care for injuries.

These rights claims differ in the kinds of responsibilities they entail. Natural rights as understood by America’s founders are negative: they recognize people have the liberty of doing as they please as long as they don’t harm others in the process. Claims that people ought also to have rights to education, adequate housing, jobs, or health care, create positive responsibilities that would force others to provide these goods and services.

Rights protected by the Bill of Rights are considered “negative rights” or “rightsto be left alone.” They block Congress from enacting laws restricting free speech and freedom of the press. A right to free speech doesn’t mean government has to provide citizens with speech and debate instructions (turning debate instructors into slaves), or an obligation to provide writing lessons so people can get their points across.

In Thor Ragnarok, the rock-monster Korg explains he’s in prison because he tried to start a revolution but didn’t print enough pamphlets and almost nobody came. On planet Earth, the U.S. Constitution protects the right of people peaceably to assemble, but doesn’t pay for printing pamphlets, tabloids, or newspapers.

Voluntary vs. regulated and subsidized health care
Beyond the discussion and debate over rights to liberty vs. rights claims for health care and welfare benefits, are economic freedom complaints about crony capitalism embedded in today’s health care system. The American health care system is heavily regulated and interferes with rights to both provide and access health care.

A claimed “right to health care” could be to understood much as rights to freedoms of religion, speech, the press, and assembly. Governments shouldn’t restrict any of these natural rights. Current state and federal regulations do abridge the establishment of hospitals and health care clinics, and prohibit the free exercise of health care. Existing hospitals, medical associations, and insurance companies lobby state governments to block or restrict innovative surgery and medical centers, plus block new medical schools.

High quality medical services offered in India, for example, are forbidden by state and federal government regulations. Qualifed medical professional trained in other countries are not allowed to come to the U.S. or practice medicine if they are in the U.S. already. Consider, for example:

There are as many as 65,000 unlicensed foreign-trained doctors across the country like López de Padilla who have medical training and experience in their home countries but can’t practice in the US,

Highly trained and educated, some foreign-born doctors still can’t practice medicine in the US (PRI’s The World, March 28, 2018)

Some fifty million people in the U.S. were born in other countries One could argue that their “right to health care” should protect their freedom to contract for medical services from trained doctors already living the the U.S., but not legally allowed to practice medicine in the U.S.. Why should state and federal governments have the power to “establish” some medical providers and prevent others from practicing?

Or consider the twelve millions U.S. immigrants from South and East Asia (twenty million total Asian population in U.S.). Asian have long traditions of health and medical care quite distinct from mainstream European and U.S. care. For back pain and other conditions, needles poked in the right places (acupuncture), seems superior to pain pills or back surgery for many or most.

All states in the United States of America permit acupuncture to be performed by trained physicians only. Some permit them to be performed by lay acupuncturists under medical supervision.

Shouldn’t people have a right to contract with trained acupuncturists for relief of back pain and other ailments? What gives state and federal authorities the just power to decide who can practice acupuncture?

Government regulation and funding of health and medical care should be understood, especially by homeschool students and parents, as similar to government regulation and funding of education. Special interests and state regulations control research and instruction of both doctors and teachers, and control how schools and hospitals are run. Much education and medical care is expensive and high quality. However, much is also ineffective and sometimes harmful.

Is having a “right to health care” the same as having a right to quality health care? If so, who will be the authorities deciding which care is effective? Consider the drop in math and reading skills that followed fads for “new math” and whole language instruction. Once education bureaucracies and teachers are trained and comfortable teaching, it seems not to matter that competencies and test scores decline.

Similar realities abound with health care. When Evidence Says No, but Doctors Say Yes (The Atlantic, February 22, 2017) explains that many of today’s popular, expensive, and sometimes dangerous medical procedures lack empirical (evidence-based) support for their effectiveness:

In a 2013 study, a dozen doctors from around the country examined all 363 articles published in The New England Journal of Medicine over a decade—2001 through 2010—that tested a current clinical practice, from the use of antibiotics to treat people with persistent Lyme disease symptoms (didn’t help) to the use of specialized sponges for preventing infections in patients having colorectal surgery (caused more infections). Their results, published in the Mayo Clinic Proceedings, found 146 studies that proved or strongly suggested that a current standard practice either had no benefit at all or was inferior to the practice it replaced; 138 articles supported the efficacy of an existing practice, and the remaining 79 were deemed inconclusive.

In addition to ongoing debates about which medical treatments are most effective or effective at all, there are deeper debates about responsibilities for health care (as distinct from medical care). For an interesting look at the distinction between health care and medical care, see this 90 second Surgery Center of Oklahoma video.

Physicians, after all, deliver medical care to their patients. They do not deliver “health” to patients. A patient’s health condition is partly their responsibility. It is an individual responsibility for all of us to take the best care of ourselves that we can.

Consider too how much insurance policies along with state and federal medical subsidies and policies raise the cost of quality medical care. From 2012, Oklahoma Doctors vs. Obamacare (Reason), this article and video look at how much less expensive medical procedures could be with less administrators and bureaucracy. Again as with high schools and colleges, dramatic increases in administrative staff and costs leave much less money to provide education and medical services.

The private Surgery Center of Oklahoma does without government subsidies, from Oklahoma Doctors vs. Obamacare (Reason, November 11, 2012):

Except for the clerical staff, every employee at the Surgery Center is directly involved in patient care. For example, both human resources and building maintenance are the responsibility of the head nurse. “One reason our prices are so low,” says Smith, “is that we don’t have administrators running around in their four or five thousand dollar suits.”

In 2010, the top 18 administrative employees at Integris Health received an average of $413,000 in compensation, according to the not-for-profit’s 990 tax form. There are no administrative employees at the Surgery Center.

Oklahoma Doctors vs. Obamacare (Reason, November 11, 2012)