- - Sunday, April 30, 2017

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”

These words in the Declaration of Independence define the “rights” of American citizens. They do not include health care. Yet for over 100 years, some Americans have believed that health care is not only a right, but that the government should provide it and taxpayers should pay for it.

If medical treatment is a right, than what exactly does that mean? Does it mean that your neighbors, through the government, are obligated to provide all health care for you? Does it mean that anyone can demand the government to pay for hospitalization, for prescription drugs, and for specialty treatments such as organ transplants? Does it mean that every American has a right to the skill and knowledge of all physicians and providers?

These questions lead to other questions. How does society pay for health care for all? Who gets to decide who should receive health care and how much? Who gets to decide what the health care budget should be? Who should have the power to make health care decisions for us?

Or rather than confront these issues, do proponents of health care as a right mean everyone should have health insurance? The problem with this belief is that simply having health insurance does not guarantee timely access to actual medical care. Every citizen of Canada has government-paid health insurance, but the long wait times for treatment, most notably for specialty care, would be unacceptable for Americans.

Everyone can agree that health care is a necessity of life. So are food, shelter, and clothing. Yet no one is demanding universal “food care” or universal government housing. The critical issue is that people expect access to food, shelter, and clothing. Americans expect choices and competition when they shop for these necessities of life.

The government exists to guarantee free-markets for Americans when they seek access to virtually any product, but especially access to food, shelter, and clothing. No one would expect society, through government, to pay for these necessities of life for everyone.

If “food care” was controlled, paid for, and regulated by the government, we would have overutilization, fewer choices, and a limited supply. The private system of grocery stores and supermarkets guarantees access, choice, and competitive prices for everyone. The free-market system is efficient, voluntary, and fair.

The critical point is utilizing the best mechanism to allow the greatest number of Americans access to health care. The Canadian single-payer system does not guarantee timely access. The American experience with the Veterans Administration hospital system, a comprehensive government-controlled, single-payer health care program, reveals unacceptable wait times and huge inefficiencies. Fundamentally, these systems ration health care by waiting lists and limited money. The quality of care can be variable.

Because of budgetary constraints, the demand for health care is much greater than the supply in virtually every county with a government-controlled health care system. Even Medicare, essentially a single-payer plan, is not financially sustainable.

Just like in all other economic activities, the free-market offers the best solution to provide the greatest access to health care and to control costs. People freely making their own health care decisions and using their own health care dollars would give Americans the best chance to utilize their “right” to access health care, with safety-net health programs provided for those who can’t afford it.

At the end of the day, health care is an economic activity like any other, albeit with the most personal of interactions between patient and provider. Society should work toward putting patients in charge of their health care, reducing the role of government, and focusing on access, not health care as a supposed “right.”

• Roger Stark, a physician, is the policy analyst for Washington Policy Center’s Center for Health Care.

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