Health Care, Human Rights and Government Intervention; G. Kuskey

648 GARVAN F. KUSKEY, DDS "health crisis" in America. This impending action, which has the blessing of both political parties 1 Ludwig von Mises, The AntiCapital istic Mentality, (New York, Van Nos trand Reinhold Company, 1956), p.v. 2 Clarence B. Carson, The War on the Poor, (New Rochelle, N. Y., Arlington House, 1969), pp. 13-24, 69-116, 128-129, pp. 186ff. 3 R. W. Grant, The Case Against Public Education, (Washington, D.C., Free Cam pus News, Vol. 1, No.1, 1969), p. 2. 4 Roger A. Freeman, Dead End in American Education, (National Review, Vol. XXI, No.1), pp. 22-24. 5 See Henry Hazlitt, Man VB. the Wel fare State, (New Rochelle, N. Y., Arling ton House, 1969) for a comprehensive overview, in layman's language, of the en tire gamut of destructive government in tervention into the economy. 6 Martin Anderson, The Federal Bull dozer, (New York, McGraw-Hill Book Co., 1967), pp. 52-70, 229.

7 Murray N. Rothbard, Power and Market: Government and the Economy, (Menlo Park, California, Institute for Humane Studies, 1970), pp. 19-59. 8 William C. Wooldridge, Uncle Sam, The Monopoly Man, (New Rochelle, N. Y., Arlington House, 1970), pp. 11-31.

1973 HEALTH CARE, HUMAN RIGHT~ AND GOVERNMENT INTERVENTION 649 as well as elements in the ADA and AMA, has been given the name "National Health Insurance," a political euphemism for socialized medicine. When exposed to the ample body of evidence which· documents the fact that no such crisis exists 9 supporters of government medi cine generally point out that there are, nonetheless, still those who are not benefiting from our health care system. For examp1e, in our own area of dentistry we are told py our liberal and con servative colleagues alike of the millions of cavities that are going unfilled in the mouths of the de prived and disadvantaged. The fact that there are also millions of unfilled cavities in the mouths of affluent suburbanites does not give them pause; we are still told that our free-enterprise system of health care, good as it is, must be changed, even drastically, in order that the medically indigent receive the care to which they are eni titled. (For example, 95 per cent of all dentists examined in the oral health screening panel by Dr.

Sherwin Z. Rosen at the October 1972 ADA convention in San Francisco had dental disease; 60 per cent had periodontitis. This 9 Marvin H. Edwards, Hazardous To Your Health; A New Look at the "Health Care Crisis" in America, (New Rochelle, N. Y., Arlington House, 1972), pp. 37-128. unusually high incidence of path ology can hardly be attributed to lack of education or financial re sources. What it does tend to con firm is that many Americans, rich and poor, educated and uneducat ed, choose to allocate their time and resources to activities other than achieving proper oral health. A government program of either treatment or education is unlikely to alter this situation. - JADA 86:743, April 1973). Foreign Experience At this point discussions of so cialized medicine usually devolve into pragmatic considerations of whether or not this or that pro gram of government health care will work .. From the abundant evi dence available which describes the experience in other countries which have adopted various plans of socialized medicine, it would appear that government medicine in any form is more costly than privately rendered care, is ineffi cient in its delivery, and often militates against the very persons it is designed to help.lo.ll We com mit a serious error, however, if we focus all of our attention upon these pragmatic considerations without first determining whether or not it is possible for a person 10 Edwards, op. cit., pp. 135-230.

11 Neil McInnes: Sweden's Bitter Pill, (Barron's, 26 June 1972), p. 9.

650 THE FREEMAN November to actually possess a right to health care (or, as it is often more skillfully stated, a right to ac'cess to health care). Before discussing health care "rights" it is necessary to first examine the philosophic underpin nings of the concept of rights it self. Exactly what constitutes a human right? Does a right come into existence because a legisla ture proclaims it? Can a president create human rights? Or a "ma jority"? To answer these ques tions we must begin our logical progression from the irrefutable premise that man ex'ists. Since man exists as a living being, it can be apodictically stated that a human individual's most funda mental right is the right to his own life. From the time of the Greek philosophers to the present no one has stated this fact more concisely than the British political philosopher Auberon Herbert: "The great natural fact of each person being born in possession of a separate mind and separate body implies ownership of .such mind and body by each person, and rights of direction over such mind and body; it will be found on examination that no other de duction is reasonable." Elabo rating on this point, Herbert devastates the argument that "so ciety," the State, or anyone else has a valid claim on one's person: "If there is one thing on which we can safely build, it is the great natural fact that each human be ing forms with his or her body and mind a separate entity from which we must conclude that the entities belong to themselves and not to each other. As I have said, no other deduction is pos sible. If the entities do not belong to themselves, then we are reduced to the most absurd conclusion: A or B cannot own himself; but he can own, or part own, C or D."12 The Right to Produce The right to one's own life im plies a major corollary: the right to engage in the production of values which will sustain that life. 13 . 14 These values are accord ingly the exclusive property of the individual who produces them. If an individual's property is seized from him by force (or threat of force), his right to his property does not transfer to the robber.

This fact is not altered whether the robber is acting alone or is a member of a gang of robbers. Even if a majority of individuals in a given geographic area sanc12 Auberon Herbert, in Murray N. Rothbard, Man, Economy, and State, (Los Angeles, Nash Publishing, 1970), p.159. 13 Gottfried Dietze, In Defense of Property, (Baltimore, The Johns Hop kins Press, 1963), p. 49. 14 Rothbard, Power and Market, pp. 176ff.

1973 HEALTH CARE, HUMAN RIGHTS AND GOVERNMENT INTERVENTION 651 tions the robbery, the owner has not lost his right to his property.15 We can therefore posit that the right to one's own life, as well as the corollary rights thereof, ac crue to each individual quite in dependent of the will of legisla tures, presidents, or majorities. Rights, of course, cannot exist in conflict. Thus the right to use or dispose of one's property implies a mandate to refrain from physi cal interference, or the threat thereof, with another individual's right to use or dispose of his prop erty. A Right to Health Care? On the basis of the foregoing we can now examine whether a right to health care can exist. Health care is a service provided by doctors and others to people who wish to purchase it. A person in need of health care (or, for that matter, food, clothing, housing, transportation, or recreation) does indeed possess a right to seek to enter into a bilaterally voluntary exchange with a health care pro15 It is interesting to note that if we bestow the name of a government taxing authority (Le., "the School Board" or "the County Tax Collector") upon the gang of robbers, the nature of the act of theft is not at all altered, nor does the proper owner of the seized property lose his right to it. See also Robert LeFevre, The Philosophy of Ownership, (Santa Ana, Rampart College Press, 1971), pp.

23-42. vider (or grocer, clothier, builder, auto dealer, or travel agent). But the mere existence of a need for a service or good does not imply a right to it. In current political parlance, the "right" to health care has come to mean the right to health care at the expense of someone other than the rec'ipient of the service. There are four ways this can oc cur: 1) by the doctor voluntarily giving his services to the patient; 2) by a charitable individual or organization voluntarily donating the cost of the patient's treat ment; 3) by the patient or his agent physically coercing the doc tor into providing the service; or 4) by the patient purchasing the 'service with funds seized from others in the form of taxes. It should be immediately apparent that while the first two examples constitute morally proper trans· actions, the latter two constitute blatant abrogations of genuine rights: either the doctor owns his own life or the patient owns it; and, as in the fourth case, either the individual taxpayers own their own lives, or the patient owns them. The absurdity of a person in need of health care owning a part of a doctor's life, or a part of anyone else's life, has been well demonstrated by Herbert.

To claim, then, that medical care is a right - that a man has a right 652 THE FREEMAN November to be cared for by somebody else - raises the question: What of that other somebody's rights? Since rights cannot exist in con flict, we can arri ve at no other logical conclusion: There exists no such thing as a right to health care. What Can Be Done Once we have disabused our selves of such fallacies as the ex istence of a U.S. "health care crisis," the "right" to health care, or the ability of the government to deliver what the private sector cannot, we can get on with the business of trying to solve those medical and dental problems that are soluble at all. For example, ap proxima tely two-thirds of Ameri can mortalities other than those attributable to the senile cessation of body functions are due to dis eases known to be caused or ex acerbated by such factors of per sonal choice as alcohol, tobacco, or overeating; or due to accidents. 16 What government program, short of outright imprisonment, could change this?

Those who advocate NHI fre16 Department of HEW, Public Health Service, Vital Statistics of the United States 1968, Vol. II. Mortality. Part A, (Rockville, Md. National Center for Health Statistics, 1972), pp. 1-6, 1-7. First pointed out by Robert M. Sade, Medical Care as a Right: A Refutation, New Eng. J. Med. 285; 1288-1292, Dec. 2, 1971. quently attempt to buttress their position by pointing at the catas trophic illness that bankrupts a family; or the seemingly unre solvable "lifeboat" situation wherein a mythical doctor in a sparsely populated rural county demands an outrageous fee to save the young widow's life. Although it is often assumed that only the governnlent can resolve these classical health dilemmas, this as sumption is clearly in error. For example, it is an accepted norm in our society to insure one's house against fire; does not common sense dictate a similar practice with regard to one's own health?

Catastrophic health insurance is readily available for the daily price of a package of cigarettes. 17 For the family that is so destitute that it cannot afford even the most modest health insurance premium, there exist in the U.S. today an abundance of private charitable organizations which offer all forms of succor, including health care, to the poor .18 It is worthy of note that they exist in spite of confisca17 A guaranteed renewable, $2500 de ductible, no maximum limit catastrophic health insurance policy for a family of four, for example, is available at a premi um of 40¢ per day. See Robert J. Myers and E. Paul Barnhart, Catastrophic In surance, (Private Practice, Vol. 4, No. 10, October 1972) ,pp. 23-42. 18 See RichardCornuelle, Reclaiming the American Dream, (New York, Ran dom House, 1966). Cornuelle is chairman of a private charitable foundation. .

1973 HEALTH CARE, HUMAN RIGHTS AND GOVERNMENT INTERVENTION 653 tory taxation on the private in comes that provide the bulk of their support. The "lifeboat" health situations are in actuality so rare that they cannot be used with any statistical validity in justifying a change in our present system of health care delivery. Government-Caused Problems Many of the ills that affect the health of the average American are due to poor diet and inade quate housing; not faulty health care. Those doctors who are will ing to go beyond the confines of their clinical practices to relieve the distress of the medically indi gent should examine the extent to which poverty - and the conse quent inability to purchase suffi cient health care, or the inability to live in a healthier environment - is the direct result of prior gov ernment intervention into the economy. Carson, Hazlitt, Ander son, and others 19 ,20 describe at length how many of the "disad vantaged" in our society are made so because government minimum wage laws have forcibly disem19 Yale Biozen, Ghetto Economics, (Reaso1t Magazine, Vol. 3, No.8: Novem ber 1971},pp. 8-12.

20 Dr.. F. A. Harper, chairman of the ;lnstitnte'F,or. Humane-Studies: .peTsonal communication of November 20, 1972, re la:~ing to cost of ,government as apart of 'each{1oUar of personal income spent: 43 per cent as of '1972. ployed them; how workers, par ticularly minority group members, are excluded from the labor mar ket by government-protected labor unions; how wouldbe entrepre neurs with little capital are de nied entrance to many areas of business by expensive government licensing and government-created monopolies; how many of the poor are torn out of their modest homes and pushed into unhealthy slums to make room for the plush shop ping malls, luxury highrise apart ments, and freeways of govern ment "urban renewal" projects; how inadequate diets are in part the result of government taxes which comprise almost half of the purchase price of food. It flies in the face ,of reason to suggest that medical indigency induced by pre vious government interventions in to the economy be ameliorated by further government intrusion which will of itself additionally pauperize those who are ta}~ed to pay for the new health programs.

Summary and Conclusions While there are indeed some Americans who are not in a finan cial position to fully utilize all of the benefits of our free-enterprise health care system, this in no way indicates the existence ,of a "health care crisis"in this ,country .. T:heir ,ability topurchase.,health care 'wouldbe gre'atly cimproved,how654 THE FREEMAN November ever, if they could obtain relief from the onerous burden of gov ernment taxation they are endur ing. The establishment of a system of socialized medicine is justified by its advocates because they feel some Americans have a "right" to health care at the expense of others. Some feel that the govern ment could provide better health care than do private practitioners and private hospitals. Such justi fication is clearly in error, since there exists no such thing as a "right" to health care, nor is there a shred of evidence to indicate that the government could per form any better in the area of health care than it has in the areas of housing, education, agri culture, and other areas where its failures have been monumental.

In fact, government Medicare and Medicaid programs are among the principal reasons for today's ris ing health care costs and clogged health facilities. Since a medical millenium is an impossibility under any eco nomic system, there will always be that small number of individ uals who are unable to obtain the full services of the health care system. It is understandable, com mendable, and in the American tradition to want to extend a help ing hand to them. But does not prudence, as well as compassion for the overwhelming majority who fall within the existing sys tem, demand that the rational critic of U.~. health care spend his time trying to improve our system, rather than trying to im pose a radical change such as National Health Insurance would bring? If the government succeeds in fastening socialized medicine upon the people of the United States, the quality and quantity of our health care will certainly decline.

This will give future historians the unpleasant task of reporting that von Mises' observation of 1956 had become invalid: that the U.S. government, at least in terms of health care, had succeeded in adjusting the U.S. standard of living downward to match that of the rest of the world. ~ IDEAS ON LIBERTY The AntiCapitalistic Mentality THE PEOPLE of the United States are more prosperous than the inhabitants of all other countries because their government em barked later than the governments in other parts of the world upon the policy of obstructing business. LUDWIG VON MISES Go Commercial I THOMAS L. JOHNSON The fundamental problem in education is not an educa tional problem at all: it is a social one. It consists in the establishment of a new and better relationship between the two great sections of society - children and adults. - Maria Montessori "NOT TOO many of us realize how bad American schools are from the point of view of humanity, respect, trust, or dignity," stated Charles E. Brown, once the Su perintendent of the Newton, Mas sachusetts schools. "The values they transmit are the values of docility, passivity, conformity, and lack of trust," adds Charles E.