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    Is healthcare a collective right or individual privilege?

    We, the people, must have an open debate and come to resolution on healthcare: Is it a right or a privilege? A right is something guaranteed, supplied and defended by a higher power. The founding fathers and framers of our country, forcibly seceding from a toxic aristocracy, believed that individuals had rights that were either intrinsic within each individual and/or came from a supreme power or God. 


    Editorial: Physicians, patients must unite for major healthcare change


    We were endowed with freedom and liberty, but must bear the individual responsibility of eternal vigilance to prevent the “necessary evil of government,” from inverting individual rights to government mandates and tyranny. The inversion of “rights” isn't merely a problem found in dystopian novels; such as “Animal Farm” by George Orwell, “Brave New World” by Aldous Huxley and “Atlas Shrugged” by Ayn Rand. [There are real life examples of how this turns out -- Cuba, Soviet Union, Venezuela -- and it never turns out well.]

    Previously, rights had come from aristocracies. Dictatorships, military states and other governments ruled by physical might and power. It was much later in history that leadership came from a mandate from the masses establishing rights were inherent to the citizens as a group. The United States was different as it was founded upon individual liberty, freedom and the pursuit of happiness.

    The U.S. government and mass media tend to conflate terms and use “healthcare,” “health insurance,” “health” and “government health policy” interchangeably when they are certainly not. The new dangerous fad of “population health,” looking at health of individuals in aggregate as groups, becomes superimposed by those in power over “individual health,“ the state of health of individual people, which is the standard from Hippocrates to the present day. They confuse “health policy” with potentially unrelated health outcomes. Spurious correlations become willful ignorance to further an ideology and/or political agenda.


    Further reading: Isn't it time for a 21st Century Pain assessment?


    We must have the open debate whether healthcare, a paid service by individuals and collectives, is to be a right or a privilege. If healthcare is a right to a service, it necessitates rules on who gets which service, when, how often, who pays for it and how it will be documented to prove it was needed; and ask “Why?” for each of those questions. Governments throughout history grapple poorly with the philosophical question and the devil (is certainly) in the details. Human action shows that given theoretical unlimited access, no risk, or cost, people will use more of the service. Who will pay for and provide unlimited services? There will always be someone who dies because of the rules were adverse to them. 

    Next: 10 commandents of healthcare

    Craig M. Wax, DO
    The author is a family physician in Mullica Hill, NJ.


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    • [email protected]
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    • UBM User
      I have said the same thing many times - we need a free and open debate - is healthcare a right or a privilege. Until we answer that question, as a nation, we will keep kicking this can around, making our healthcare system ever more convoluted and dysfunctional. If it is a right, then basic healthcare can be covered through Medicare, with secondary and supplemental policies done through insurance companies and states. Will this require rationing - yes, but as we all know - most back pains and headaches do not require MRIs, less expensive chemo is often more effective than some of the newer, more expensive meds that get chosen for various reasons. I am tired of having a well controlled diabetic lose a job, lose their insurance and not come in for 3 years, come back on Medicaid due to disability because they now have severe neuropathy and retinopathy, and will likely end up on dialysis - all very expensive and very entirely preventable. So yes, I fall into the "it's a right" - the countries that treat it that way live longer, live healthier with better outcomes at 1/2 the cost.
    • [email protected]
      Whenever life, death or pain is involved, emotions usually over-power rational thought. Few, however, would dispute that decisions made on emotion, or emotion-driven "logic" rarely work-out well. The simple fact is that ... there are NO "collective" or "group" rights. Even defining who would belong in such as group or collective is extremely difficult. For example, free medical care for everyone over 65 ... what about people who are 64? Once the over-65's get free medical care, the under-65's will claim they are just as entitled (a much better term than "right") to the same level of free stuff. According to the Declaration of Independence, rights flow solely from God/god. The whole concept of "universal access to healthcare" has evolved from Harvard professor John Rawls who argued for open "access" which really means - they'll let you in the front door, but really means a medical facility cannot deny you anything you want. In practical terms a hospital will give you a round of free treatment, but has the power to deny you on-going treatment. A private practice can refuse to treat pretty-much anyone. But, let us discuss the notion of a "right" that involves denying someone else THEIR RIGHTS. The fundamental question is: if my daughter needs a liver transplant AND your daughter needs a liver transplant; AND I can pay for my daughter's transplant; you can't; do you have the right to take my money and condemn my daughter to death, just so your daughter can live? Let us at least move this "discussion" away from Rights to one of charity: if you can't pay then you (really your daughter)needs a private individual who'll VOLUNTARILY pay rather than use the police power of the Government to force me to pay and lose my daughter.
    • Anonymous
      Obamacare created a system where health care services were a "right" for the poor, the indigent, the working poor, and foreign nationals who demand care upon their arrival to hospitals and public clinics. But while this occurred, simultaneously health care remained a privilege for the middle class who were mandated to pay massive amounts for insurance policies that were not useful. Even though those policies were purchased, patients could not afford the outrageous out-of-pocket costs to actually obtain health care, and hence went without care. This is outrageous, and created overwhelming public dissent that translated into the election results over the last 8 years.
    • [email protected]
      It's pretty simple: if someone else has to pay for it in some way, it is a privilege, not a right.
    • [email protected]
      After surviving 2 1/2 yrs in a VA hospital a year after WW2 dad was denied service related benefits and remained uninsurable Sis survived polio in an iron lung 9 months and the catastrophic policy was then canceled All later medical bills were paid out of dads preachers salary Our experience said "it is a necessity"--not just a right or privilege
    • [email protected]
      This extreme libertarian view would leave tens of millions of Americans without affordable access to health care, resulting in unnecessary financial hardship, physical suffering and even premature death. Everyone should have essential health care when needed, and we can accomplish that only by making health care a right guaranteed by our government. Every other civilized nation does that. We should too.
    • Anonymous
      Your “right to health care” would require some other person to give up a portion of their life or their property to either treat you or to provide you with drugs or medical implements. The Constitution does not provide for another individual to be indentured to you in this manner. Therefore, you have no “right” to health care. Deal with it. (Neal Boortz quote)
    • Anonymous
      Dr. Cox, I agree with your comments. However, the majority of citizens do not understand that true rights do not require actions from others to secure new rights. In fact, true rights are just the opposite. True rights require that the individual is left alone to pursue their liberty. The right to life, liberty and the pursuit of happiness - emphasis "pursuit" does not require action from others. Any other "new rights" that require others to produce something for others often infringes on the true rights of an individual or groups of individuals that are compelled to provide a service. In this case, those who may provide health services. Now, as a society if we choose to provide a basic level of healthcare for all citizens, I think this is a laudable and desirable goal. There are many ways to accomplish this goal but by calling something a right doesn't change the fact, that many times it is really charity - and frankly needs to be recognized as such by those who receive it. Alternatively, if you make a new "right", you risk infringing upon the true rights of the individual - in this case physicians and other health care providers. Our medical societies have advocated for universal coverage for all. Ok, lets do that but please be honest. If we are going to do this, we will need to ration care and participation should be voluntary and not exclude the physician from treatment venues (like Medicare does now). Ourgovernment and thought leaders will need to make some very careful decisions. I would suggest the input from those who provide healthcare. Will other patients be able to pursue their own true right to seek out the level of healthcare they want? However, if we concede the concept of a new right at the beginning of the conversation, it will limit options and the true rights of individuals.

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