Is healthcare a right or a privilege?

Healthcare is probably the single biggest issue in our country right now, as republicans try to dismantle our current system and progressives push for single payer healthcare. Indeed, more Americans than ever are interested in single payer healthcare: 33% say we should adopt such an approach to healthcare (up 14% from 2014), and 60% say that the federal government has a responsibility to ensure its citizens have healthcare coverage (whether that be public or private).

This stands in stark contrast to the current republican government’s approach to healthcare, which, judging by the legislation they’ve written, is that you should only get healthcare if you can pay for it. Naturally, republican politicians have taken to all forms of media to speak out against single payer healthcare.

But really, there isn’t much of a data-driven argument against single payer healthcare. We know that it’s significantly cheaper. We know that the health outcomes for people tend to be the same, if not better. No, people in Canada and Sweden aren’t dying in the streets because of “rationed care.”

The main objection to single payer healthcare, as far as I can tell, is completely philosophical and boils down to one simple question:

Is healthcare a right or a privilege? 

Ask most conservatives and they’ll probably tell you it’s a privilege, not a right. I’ve had numerous conversations about that with people lately, and I’d like to closely examine this argument.

There’s an underlying assumption in this conservative argument that healthcare is a privilege, namely that there is some finite amount of rights in existence, and everything else is just a privilege. The conservative argument that healthcare is a privilege seems predicted on treating rights as if they’re matter or energy–they can be neither created nor destroyed.

To that end, many conservatives use the constitution as the end-all-be-all of rights. If it isn’t in the constitution, it isn’t a right and therefore must be a privilege. This meme perfectly illustrates this line of thinking:

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This is a particularly bizarre argument given that the founding fathers purposely created a constitution that can be changed, amended. And indeed it has been, 27 times. 100 years ago this meme could have said, “Trying to find in the constitution where it says women have the right to vote.” Or you could have run this meme in 1859 to say, “Trying to find in the constitution where it says black people aren’t personal property.” It’s just a foolish argument.

But the point is that rights aren’t some static, finite thing. You’re given new ones all the time. The 26th amendment gave 18 year olds the right to vote. The 17th amendment gave you the right to vote for your own state senators. Prior to those amendments being written, those rights did not exist.

Similarly, rights can be taken away. The 18th amendment took away your right to manufacture or sell alcohol. That one was repealed, thankfully.

The ultimate point here is that rights aren’t written in stone. We give ourselves new rights all the time, as the previous examples showed. So why couldn’t healthcare become a new right?

It almost was. FDR was on the verge of introducing a second bill of rights in the 40’s, shortly before the end of WWII.

Unfortunately, FDR didn’t live long enough to see this enacted, and it became a mere footnote in American history. I’m sure though, that many conservatives would argue that FDR was some kind of communist for this proposal. Ironic, given that in this short speech he seems intent on protecting free markets.

So then, what would be the argument that healthcare is indeed a right? Well, if you’re having a conversation with someone who wants to use to constitution as an argument that it’s a privilege, try giving them this line:

“We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.”

It’s right there in the preamble. “Promote the general welfare.” What’s the argument that single payer doesn’t fulfill this part of the constitution? Or, conversely, how does a “you can have it only if you can pay for it” model promote the general welfare?

But, one might argue, even if healthcare were a right, that doesn’t mean that government run healthcare is. Perhaps it’s simply a matter of the government ensuring that you have access to affordable care. On the surface, this seems like a valid argument.

Well, this is where I would point out that single payer healthcare is vastly cheaper than the alternative. But even ignoring that point we could still make an argument for it. If we were to argue that “promote the general welfare” means that the government is obligated to look after the health of its citizens, that doesn’t necessarily follow that you need to use it. If you want to buy your own private insurance, you should be free to do so. And indeed, in many countries with single payer healthcare, citizens have every right to buy their own supplemental or private coverage. Just because the government offers a single payer option to its citizens doesn’t mean your right to choice vanishes. Indeed, perhaps a little competition between the government and private industry would be a good thing.

If nothing else, we could look at this issue through an ethical lens. If your neighbor was dying and could be saved, but he doesn’t have the means to save himself and you do, are you ethically or morally obligated to help him? What would you want if you were the dying neighbor?

Ultimately, I think I can walk away from this post to leave you with a couple of ideas. First, in reality, there is very little difference between a right and privilege. Indeed, I might argue that a right is simply a legally protected privilege. Which means, as we’ve seen throughout history, we are capable of being granted new rights if we demand them, if there’s a referendum on them. Second, if a government has an obligation to look after the welfare of its citizens, there is no reason why this should stop at healthcare. We’ll subsidize your education, your protection, your infrastructure–the line drawn at healthcare seems completely arbitrary.

 

Conservatism to a liberal

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I don’t really think it’s a secret that I have viewpoints that many people would classify as liberal in the political sense. I don’t really shy away from that. Indeed, I wholly embrace it. But I’m not ashamed to say that in local elections I’ve voted for conservatives. Because when it comes down to it, I’ll vote for whoever has the best idea, and despite the fact that I overwhelmingly disagree with most of the conservative agenda or platform, they are capable of putting forth good ideas.

And that’s the thing, there are certain conservative principles that most people, even staunch liberal democrats, could probably get behind. The problem for many voters is the way in which the GOP approaches those issues. So, since we’re in the middle of election season, I thought I would take the time to enumerate the things that do and don’t make sense about the republican party from the point of view of someone outside of it.

So let’s take a look at some issues and areas where there is a lot of overlap between parties and where conservatives lose a lot of moderate and independent voters–and perhaps even voters on the other side of the aisle.

1. The size of government and government spending.

Where we could agree: Can the government get too big? Sure, absolutely. Is it too big now? It probably is in some places. I don’t think there’s an American of voting age who would argue that there aren’t programs that could be combined, reduced, or cut somewhere in the federal government. If something could produce a similar result using less resources, I’m all for that. And I would argue that spending money that doesn’t produce results is indeed wasteful. There is probably a lot of spending in government that is unnecessary or ineffective/inefficient. I would not be against a cost/benefit analysis of each dollar spent by the federal government to ensure that we were getting the biggest bang out of buck, so to speak.

Where they lose people: Where they propose shrinking the government. As long as conservatives continue to write blank checks for the military without oversight on how the money is spent, they’ve completely and utterly lost any chance they had of getting me to listen. It’s incomprehensible to me that many conservatives want to gut the EPA, the Department of Energy, and the Department of Education because they’re “unnecessary and wasteful” yet can’t wait to just fork their tax dollars over to the military for planes and tanks and boats we’ll never even use. Cut the defense budget in half and then maybe I’ll give you enough credit to listen to ideas you have about reforming entitlements. And speaking of the military…

2. War. 

Where we could agree: I don’t think anyone wants to see America attacked again. I think we could all agree that national defense is an important issue, because there certainly are real threats out there, people who do really want to harm us.

Where they lose people: But the way to keep us safe isn’t by fighting endless wars in the middle east. It isn’t by “standing up to Putin” with tanks and missiles and troops. It absolutely blew my mind during last night’s GOP debate when Carly Fiorina went on and on about how we need a heavier military presence in Europe to keep Putin in check. No thanks, because I remember reading about the Cuban Missile Crisis in history class.

Conservatives are right in that the nation needs to be defended, but they’re wrong about how to do it. The next war isn’t going to be won with battleships and tanks. It’s going to be won with computers. Cyber security is the next big frontier, and America is woefully unprepared because a lot of our politicians are still trying to fight Gorbachev in the 80’s. China and Russia could cause much more damage to the US by compromising our electronic infrastructure: water, power, communications–they could even hack into our cars. That’s much more devastating and quite frankly a lot more cost effective than spending hundreds of billions of dollars a year building war machines.

And enough about America “leading.” That was also a resounding theme last night. America “doesn’t lead” when it comes to military issues around the globe. I don’t care. We don’t have to. Other nations have just as much military capability to respond to issues as we do. I never thought I would agree with Donald Trump, but he said something last night I thought rang true: European and Middle Eastern countries (like Jordan) are probably laughing all the way to the bank because we’re fighting the wars in their own backyard. Let them clean it up for once. The German, French, and British governments are more than able to respond to ISIS and other threats in the region.

3. Tax cuts. 

Where we could agree: Conservatives could probably find common ground with the average voter when it comes to taxes, at least when it comes to small businesses. I could very easily see how tax cuts and credits would help a small business out tremendously. So I could probably get on board with something like that. I could also see the argument that letting middle class folks keep more of their money means more money for them to pump back into the economy.

Where they lose people: The problem is that the conservatives running for office think those cuts should also extend to wealthy individuals, which is where they lose me. Giving breaks to a small business is very different than giving breaks to the CEO of a huge conglomerate. Giving a tax break to a small business could mean that more people are hired by it; giving a CEO a tax break means he or she is probably just going to invest that money and effectively take it out of economic circulation. Wealthy people aren’t wealthy because they spend all their money, they’re wealthy precisely because they invest it rather than spend it. And that’s within their purview, but giving them a break on taxes isn’t going to magically filter down to the rest of us, because Tim Cook doesn’t pay Apple employees out of his own personal checking account. So, to recap: conservatives could make huge gains for reforming the system for small business if they just stopped trying to lump wealthy individuals into that plan as well. 

4. Government is always the problem.

Where we could agree: I’ve said on this blog numerous times that a government is only as effective as the people elected to office. So if we put incompetent people in the government, it shouldn’t be shocking that we then end up with an incompetent government. Could an incompetent government “get in the way” of growth and progress. Yes, absolutely. Conservatives are fond of saying that government never generates solutions; solutions are the domain of the private sector.

Where they lose people: Conservatives are mostly correct when they say that the job of government is not to be a solution machine. But that doesn’t mean that government doesn’t have a role in creating solutions. It’s the government’s job to be a partner and an ally to the private sector. A competent government would use taxpayer money to invest in and support programs that help the private sector create those solutions. But simply getting rid of all government or all government regulation is not the way to accomplish that. Government support of medical and scientific research taking place in the private sector is an excellent example of what such a partnership should look like. Perhaps we don’t see those benefits anymore because, when it comes to spending, investment in “general science, space, and technology”  is only about 1% of the federal budget:

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It should be clearly obvious that the government doesn’t do innovative and supportive things anymore because we’ve stopped funding those things. The government created the Interstate Highway System and helped put a man on the moon. It could do those things and things like it again.

5. Social Programs. 

Where we could agree: Look, I would love to see fewer people on welfare. I would love it if people made enough money to care for themselves and their families without government assistance. And I think that even the most hardcore conservatives would agree, if pressed, that some kind of a social safety net is necessary.

Where they lose people: There’s no effort on the conservative front to make education more affordable, to implement job-retraining programs, or to address student debt. There’s nothing addressing the fact that parents who try to go back to school to make a better life for themselves and their families need affordable childcare to do so.

The conservative answer is to just lower taxes and privatize everything. And that just doesn’t work. Lowering taxes for everybody might give the average Joe a little more money in his or her pocket, but that won’t make a dent in any tuition. It probably wouldn’t even make a dent in childcare costs.

Privatizing social security and healthcare also doesn’t mean anything if you hardly make any money. Telling people to use Health Savings Accounts is fine and dandy, but for people living paycheck to paycheck, there’s no money left at the end of the month to save; they literally need every penny of their paycheck. Privatization also doesn’t address one of the biggest reasons healthcare costs so much in this country: the government isn’t allowed to negotiate directly with drugs companies and other manufacturers. Which is why medical care is so much cheaper abroad than it is at home.

If conservatives are really serious about getting people off social programs and other “entitlements” (a loaded word) then they sure as hell better show up to the table with a plan to make things more affordable than “Just let the free market work itself out.” And speaking of free markets…

6. Government regulation.

Where we could agree: Is there such a thing as too much red tape? Or too much bureaucracy? Sure, absolutely, and I could see how that could hinder a lot of things.

Where they lose people: The problem is trying to remove regulations that we know provide a benefit to people, which is a popular thing among republican politicians and candidates. Going back to the EPA, getting rid of that agency is a dumb idea. Just ask someone who remembers LA smog. Do environmental regulations make doing business harder? Sure. I can see how they  would. But does that mean it isn’t worth it? No. If Starbucks or Dow Chemical have to pay higher fees so that I can enjoy clean air and water, I’m fine with that, because Dow and Starbucks aren’t going out of business anytime soon because of fees and regulations imposed by the EPA.

Similarly, eliminating regulations on Wall Street is a bad idea. We already know what happens when there are no regulations: economic bubbles and crashes. So why on earth would they want to get remove any regulations that prevent that from happening again?

There probably is a balancing act when it comes to regulations for small businesses and large companies/corporations, but the republican tactic of “cut and gut” all across the board does more harm than good for the average person. Again, it’s a poor strategy to try and lump big business with small business when it comes to regulation.

And while we’re on the subject, if liberals are guilty of trusting the government too much, then conservatives are too guilty of trusting people to police themselves. If people and corporations consistently acted in an altruistic manner, that would be one thing when talking about nixing regulations. But we know that they don’t and that they won’t, at least not across the board. People and companies will cheat and take advantage of others, history has proven this. Even if it’s not the majority, it only takes a few bad apples to fuck it up royally for everyone else. So yes, regulation is necessary; making sure everyone plays fair and by the rules is not a bad thing, and it isn’t antithetical to a free market system.

7. Social Issues. 

Where we could agree: People have the freedom to believe whatever they want and practice whatever religion they want. That’s about as far as I can take that.

Where they lose people: Trying to legislate certain beliefs over others is going to alienate an increasing amount of people as time goes on. Attempting to legislate what a woman does with her womb or who people are free to marry seems antithetical to the idea of “personal freedom” and “keeping the government out of your life.” I just can’t reconcile the two ideas when it comes to conservatives.

Similarly, the war on drugs didn’t work. Enough with it. Can we stop spending money trying to criminalize pot? Half the people on the stage at these GOP debates still think pot is Satan incarnate, but have no problem with alcohol, which kills way more people and ruins way more lives. Again, the delineation here is arbitrary and nonsensical. People shouldn’t be jailed and have their lives ruined for carrying or using a substance that really doesn’t harm anyone (and would stimulate the snack food economy).


I think there is plenty of common ground that liberals and conservatives could find and share. The problem is that much of the discourse in this country tends to be hyperbolic. There was a time, though, when democrats and republicans did work hand in hand in the government, and compromise wasn’t a mythical unicorn within the halls of congress. It could be that way again, but people have to try to start from a point of commonality instead of a point of difference.