Obamacare's Flawed Assumption

With the midterm elections coming up next month, I want to take a look at one of the issues that received heavy focus during the last two years, namely health care. You have probably heard the numbers so many times you can recite them with me: 47 million Americans are without health insurance. The U.S. population is just over 300 million, so about 1 in every 6 people does not have health insurance. In March of this year President Obama signed the Patient Protection and Affordable Care Act (a.k.a. Obamacare) in order to address this apparent crisis.

Let's back up to October of 2008. During the second presidential debate Tom Brokaw asked the candidates the question "Is health care in America a privilege, a right, or a responsibility?" Barack Obama's answer:

Well, I think it should be a right for every American. In a country as wealthy as ours, for us to have people who are going bankrupt because they can't pay their medical bills -- for my mother to die of cancer at the age of 53 and have to spend the last months of her life in the hospital room arguing with insurance companies because they're saying that this may be a pre-existing condition and they don't have to pay her treatment, there's something fundamentally wrong about that.

My question is: Why is health care a right? Is health care a right because it is expensive? Waterfront homes are expensive, but they are not a right. Is health care a right because we think it would be wonderful if everyone had it? It would be wonderful if everyone had a home, three meals a day, a Ferrari, and a 52-inch plasma TV, but none of those are rights.

Some would argue that it is the Constitution that grants us the right to health care – that health care falls under the “right to life”.

My first response to that argument is that the Fifth Amendment to the Constitution says that “No person … shall be deprived of life, liberty, or property, without due process of law”. This statement means that the government cannot take away life, liberty, or property. It does not mean that it is the government’s responsibility to give these things to its citizens. It is government’s responsibility to protect our rights from being taken away by other people. It is not government’s responsibility to take from other people in order to give to us. This includes taking from medical care providers, because if health care is a right, then the government must compel them to provide services to the rest of us.

My second response to the argument is that if health care somehow falls under the right to life and if somehow the government should provide everyone with health care, then what about the numerous other things without which we cannot live? We cannot live without food, water, or shelter. Should not these things fall under the “right to life” as well? Where does it end? A lot of people might claim that we cannot live without love. Should the government provide love to everyone as well?

Though Obama's ideology makes people feel good, it is fraught with peril. The implication in Obama's response is that we as a country have enough money to pay for everyone's health care. As much as I would like it to be true, experience tells us that solving problems is more than just throwing more money at them. At the very least, we know that it depends on how that money is spent. And when money is spent, the one doing the spending is usually the one deciding what is done with it. This means that government, not the person, makes the decision about what the best treatment is for a given condition.


Just what is the "best" medical care? There is no universal answer to the question, and there is certainly no single set of standards that applies to everyone equally well. Which combinations of various treatments are "best" for a given set of health problems? For which of dozens of drugs should the government pay in order to treat a given condition? Which treatments are "valid" treatments and which are not? Should the government pay for Treatment A that is likely to eliminate Condition X, possibly exacerbating Condition Y, or should it seek out a lower cost alternate Treatment B that has a lower chance of success? Should other taxpayers be forced to pay for someone's acupuncture treatment or psychotherapy sessions? Should the government pay for therapeutic massages as a component of "preventative health care" because someone claims to be too stressed? Should not someone with a terminal illness be able to seek out unorthodox or “unproven” treatments? The human body is extremely complex, and health care equally so.

What is really "fundamentally wrong" is that Obama's statements ignore the true cost of medical care in terms of basic economics:

From the standpoint of society as a whole, the COST of anything is the value that it has as in alternative uses.

~ Thomas Sowell

The real cost of medical care is the alternative uses of the resources that it requires. Probably the most important of those resources is people. In order to have more doctors, nurses, and other medical professionals, there must be fewer teachers, policemen, and janitors. Another resource is land. In order to have more hospitals and clinics we have to have fewer houses, schools, and commercial offices. Other items needed for medical care are food, drugs, and equipment, all of which are made from resources that have other uses.

The point here is that despite the fact that we can all claim that everyone deserves health care, and despite the fact that we truly live in a "wealthy" country, we still cannot get around the fact that there are not enough resources to meet all of our needs. Thinking otherwise is a flawed assumption. Money is just a tool for exchanging real goods and services, and health care does not exist in a vacuum.

We should not leave it up to the government to tell us what resources are more important than others. We should not accept, for instance, that doctors and hospitals are more important than farmers and farmland, simply because the government says so. After all, people will die if they don't get food. A small group of "experts" cannot possibly come up with a set of rules that efficiently makes these kinds of decisions for everyone. In reality, you are more likely to find yourself in the best situation if you get to make all these decisions for yourself.