September 17, 2011

Liberty and Health Care and Stuff

We had a campus speaker for Constitution Day today! Ken Cuccinelli spoke to a crowd of a half-dozen supporters and about 60 protestors in our science building today, inspiring some fabulous chants like "If you don't believe in science, get out of our building!" While I disagreed or was baffled by a lot of what he said, he made one particular argument about health care that I found curious, because I'd seen it just yesterday being argued by Ron Paul.

The idea, as Cuccinelli and Paul explained it, is that back in the good old days, hospitals would provide free health care to those who could not afford it, and then the government stepped in and ruined it by making it law that they HAD to provide emergency room care to anyone who needed it. Cuccinelli argued, in particular, that not only should government completely be out of health care, so that the poor rely on generosity of hospitals, but that hospitals should be able to turn away people whose concerns weren't serious enough and only give free care to cases they deemed emergencies.

The financial problems with Paul's idea that we should get rid of Medicaid and Medicare and people should save for medical emergencies on their own is broken down in this fabulous analysis at Mother Jones, but there was something else about this idea that was just rubbing me the wrong way. Cuccinelli kept talking about how government shouldn't have the right to compel us to buy a product - that requiring people to buy health insurance is taking away our freedom. (He also said that choosing not to buy insurance isn't economic activity. I think the emergency rooms that pay for it would disagree, but that's beside the point.) That's how he kept framing it - our "liberty" to not buy a product, regardless of the consequences to ourselves or the community at large.

What I kept wondering was... is health care really a product? Or if it is, should it be? When someone is sick, I don't think about my liberty to choose what products to buy to make them better. If the means to make them better are available, I think they should have access to them. They have a right to care. (I feel weird typing that - the part of my brain that's been too long in American politics thinks, 'you don't have a right to be healthy! it's too expensive!' But I know I believe that we as a country have a responsibility to give everyone the best care we can, and that means they have a right to it.)

Thinking of health care as a product we have the choice to buy or not buy, like tea (yes, he compared it to the Boston tea party) seems contrary to how we talk about it and how we feel about it. Clearly, everyone is uncomfortable with the idea of just leaving the uninsured to die - we expect them to have some emergency care available to them, whether ensured by by the government or by charity. So we can all agree that people have some right to care, but above that bare minimum, it's a product? That just feels wrong to me. (Not to mention problematic to implement and expensive - emergency care costs more than routine care, and is higher-risk.) I wonder if, rather than fighting litigation battles over the Commerce Clause as used in the health care bill, we wouldn't be better off agreeing that health care is more than just a product. We can even disagree to what extent, but it'll be a better conversation with that as a starting point, I think.

1 comment:

Foxie said...

I always think it's very telling how the people who argue things like health care are a choice are people who have never had to choose. You know, people who have never had to choose whether to get their prescriptions filled or eat that week, or have put off going to get treatment because they can't pay the bills.

Also, if emergency rooms can turn people away for non-vital conditions, I can't help but be left with the idea that dermis mavro will suddenly become a non-vital condition...