Public Healthcare As A Civil Right

July 1, 2011 Category: Healthcare



If there is a moral axiom that should be obvious to anyone, it is that people should go into the medical profession because they genuinely want to help people, not because they want to treat the field as a business.  That is to say: people should be doctors to promote health, not to make as much money for themselves as possible.  The moment medicine is handled as a for-profit venture (i.e. as a business), the profession becomes morally corrupted.  It is no surprise that some of the most lucrative medical operations are the most morally bankrupt.  The explanaiton for this is simple: dubious motives.  The moment the sine qua non of medicine isn’t the maximization of health for all people, public health is no longer an inherent good.  Instead, health is rendered a commodity, to be bought and sold in the marketplace, like just another consumer product.

In a developed nation—especially in a country as wealthy as our own—nobody should ever go bankrupt (or become destitute) from paying medical bills.  Sick people need to be helped, not charged for their illness.  Patients aren’t customers.  Medicine must never be treated as a consumer product.  Why not?  The moment healthcare is treated in this manner, it can’t help but be infested with egregioius conflicts of interest.  After all, the summum bonum of business is to maximize revenue while cutting expenses.  Any service provided is a means to that end.  Any health that ensues is, therefore, a happy byproduct of the profit-maximizing process.

Like war, disease is never something off of which any party should profit.  Those who make money off of sickness (or war, or ignorance) have a vested interest in there being sickness (or war, or ignorance)—not an incentive to eliminate it.  The marketplace operates on the laws of supply and demand, and business always seeks to generate demand.

Relegating healthcare to the private sector, where it is treated as a consumer product to be hawked and peddled in the marketplace, allows corporations to profit off of sickness while leaving tens of millions out in the cold to fend for themselves.  This isn’t right.  In such a system, cui bono?  Nobody but the most wealthy and the businesses making a profit off of the system.

In a society as wealthy as ours, nobody should go broke because they are injured or sick.  To allow such destitution, then chalk it up to the market, is unconscionable.  Certain things must be immune to market forces and corporate interests—quarantined from the ebb and flow of supply and demand.  Such is the reason for the public domain: the commons—the stuff to which ALL people are entitled, regardless of socio-economic status.

After all, civil rights aren’t just comprised of negative rights, they include positive rights as well: the right to a good education, the right to be saved in emergencies, the right to use public roads and bridges, the right to assemble in the public square, the right to vote—even when you’re poor, even when you are black, even when you’ve been to jail, the right to take a stand and speak out, the right to potable water, and the right to quality healthcare. 

Yet, for the right wing, the right to own a semi-automatic firearm is more important than the right to medical treatment.  Where are our priorities when the right to be able to kill trumps the right to be able to be taken care of when one is sick?  We put corporate rights over human rights, and then wonder why our society has so many problems.

The State is in a position to alleviate burdens on the rank and file…OR to doll out favors to corporate power.  It does one at the expense of the other, it can’t do both.  So it must select its priorities.  The preamble to the Constitution is quite clear on this point: the raison d’etre of the State is—among other things—to PROMOTE THE GENERAL WELFARE.  It does NOT say, “to provide for the welfare primarily of those in power.”

 Some point out that the Preamble specifies to “PROMOTE the general welfare,” not “provide”.  (The government provides for the common defense.)

Indeed, there is a distinction between “promote” and “provide”.  The former can be reasonably read to mean “foster” or “facilitate” (which is, after all, the point of public infrastructure and basic social services)…while the latter is–obviously–a matter of giving something wholesale.  (As a personal trainer, I can’t “provide” you with health; what I do is facilitate your health…by making certain–necessary–resources available to you—resources to which you may not otherwise have access.)

The question isn’t whether or not personal welfare is a civil “right”; it’s whether or not access to the things required for procuring that welfare is a civil “right”.  If public health is taken to be integral to the general welfare, then the guarantee of such access is a prerequisite for “promoting the general welfare”.

Welfare, by nature, is not something that can be “provided” (since it is an outcome); it is something that is facilitated / fostered (while national defense, of course, must be provided wholesale to people).  Unless “promote” in “promote the general welfare” is taken to merely mean “give lip-service to”, then certain things (like State-provided, universal public healthcare and universal access to quality education) are prerequisites for “promoting” the common good.

Nobody has a “right” to be healthy; but in a civil society, everyone has a right to (access to) the basic resources necessary to procure (and maintain) basic health.  After all, public health is not a commodity (i.e. something to be hawked and sold in a marketplace); it is a vital public good.  With public health, we’re all ultimately interconnected.  That is to say: It matters to each one of us whether or not the people “down the road” are sick—or if the family “across town” is going bankrupt trying to pay off exorbitant medical bills. 

Large corporations generally don’t need the government’s help; such institutions will do just fine on their own.  Meanwhile, needy people don’t have a powerful lobby on K-Street to fight for them.  They don’t have someone sitting at the table in the Chamber of Commerce sticking up for them.  They don’t give huge campaign donations or engage in quid pro quos.  They don’t have the same voice as do the affluent and the connected.  It is the State’s duty to make sure this disparity does not dictate the priorities in economic policy.

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