Health Care--Is It a Right?

Question: Why is there no right to health care?

Answer: The concept of an entitlement to health care has gained widespread support. Article 25 of the UN’s Universal Declaration of Human Rights states, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including … medical care.” Both the Democratic and Republican Party Platforms include language affirming their commitments to maintain “accessible” and “affordable” health care.

First, it is very important not to conflate the right to life with a right to health care. The right to life is central to the Objectivist ethics and politics, and health care is certainly essential to maintaining one’s life. However, as Ayn Rand puts it: “A right does not include the material implementation of that right by other men; it includes only the freedom to earn that implementation by one’s own effort” ("Man’s Rights", The Virtue of Selfishness, pp. 113-114). In this sense, an apt comparison can be drawn to the right of free speech; your right to speak your mind does not create some obligation on the part of others to support that expression, financially or otherwise.

Ayn Rand unmasks the fallacy at the root of the “right to health care” and all other such economic rights: “A single question … would make the issue clear: At whose expense?” ("Man’s Rights", The Virtue of Selfishness, p. 113) Health care doesn’t simply grow on trees; if it is to be made a right for some, the means to provide that right must be confiscated from others.

Health care exists because of the efforts of doctors, nurses, medical technicians, and even the engineers who design and build lifesaving machines. There are really only a few ways, then, that it can be provided. These medical personnel can offer their services as part of a mutual exchange of benefit for benefit, in a system of free, market exchange. Or, they can be forced to provide these services at the point of a gun, as in the movie John Q. Or, the government can arrogate to itself the title of the sole health care provider, funding its operations through forced taxation.

The problems with forcing doctors to treat patients are obvious—first, of course, it requires wanton violation of their rights, and represents government enforcement of the principle that a doctor’s life is not his own, but instead belongs to the state or the community. And no one will want to enter the medical profession when the reward for years of careful schooling and study is not fair remuneration, but rather, patients who feel entitled to one’s efforts, and a government that enslaves the very minds upon which patients’ lives depend.

• Share on Twitter
• Share on Facebook

It is very important not to conflate the right to life with a right to health care.

Ayn Rand points out the contradictions of forced medicine through the character of Dr. Thomas Hendricks, a surgeon in Atlas Shrugged . He says, “I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind—yet what is it they expect to depend on when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of the victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it—and still less safe, if he is the sort who doesn’t” (p. 692, paperback edition).

If a free market in health care is not to be permitted, the only alternative to enslaving—and eventually destroying—the entire range of medical professionals is for the government to take over, i.e. nationalize, the entire health care industry. This has been attempted most thoroughly in Canada where, for cases of serious illness, private insurance and care had to be outlawed to prevent competition with inefficient, slow service at public facilities. Gathering health clinics and hospitals under a government umbrella has the effect of bringing all the efficiency and service of Departments of Motor Vehicles to bear in the provisional of medical care. In Canada, services are paid for not with dollars, but with time—often spanning months—spent waiting in queues for checkups and operations. As P.J. O’Rourke warned, “If you think health care is expensive now, wait until you see what it costs when it’s free” ( The Liberty Manifesto ).

An alleged “right” to health care, like all other economic rights, imposes positive obligations on the parts of others to fulfill that right, and thereby necessitates the violation of other rights like the right to property. A “right” that is in conflict with other rights represents a contradiction that is resolved not by some crude moral balancing act, but by recognizing that economic rights themselves do not exist.

Also, see David Kelley's " Is There a Right to Health Care? "

‍