Over at The Corner, Stephen Spruiell writes a lucid defense of what most people consider to be an indefensible position, that health care is not a right:
Your rights include life, liberty and the pursuit of happiness. You may not be unjustly deprived of these things. Your rights do not include things that I or anyone else must be forced to provide for you, such as a home, a car, a job, or health care...
What is meant by people who say we all have a right to health care? Do they mean that we all have a right to any sort of treatment that modern medicine can provide, regardless of cost or necessity? Or do they mean that we all have a right to some basic level of care?
If it's the latter, who decides where we will draw the line?...
This is the problem we face when we shift from a negative to a positive conception of rights. We encounter shortages, we face tradeoffs, and at some point we have to make arbitrary decisions. When that happens — well, to quote William Munny, "Deserve's got nothing to do with it."...
(T)he debate over how best to allocate scarce resources has been a settled matter. The market, with its system of price signals, is the most efficient way to direct resources to where they are most urgently needed. We need health-care reform that enables the market for health care to function more efficiently. Removing the distortion in the tax code that favors employer-based health insurance would be a good start.
It's good to see the position laid out in all its brutal essence, without the usual hedging and fudging that conservatives usually use to disguise the impact of what they're really saying. It's been said before:
"A man who is born into a world already possessed, if he cannot get subsistence from his parents on whom he has a just demand, and if the society do not want his labour, has no claim of right to the smallest portion of food, and, in fact, has no business to be where he is. At nature's mighty feast there is no vacant cover for him. She tells him to be gone, and will quickly execute her own orders, if he does not work upon the compassion of some of her guests. If these guests get up and make room for him, other intruders immediately appear demanding the same favour. The report of a provision for all that come, fills the hall with numerous claimants. The order and harmony of the feast is disturbed, the plenty that before reigned is changed into scarcity; and the hppiness of the guests is destroyed by the spectacle of misery and dependence in every part of the hall, and by the clamorous importunity of those, who are justly enraged at not finding the provision which they had been taught to expect. The guests learn too late their error, in counter-acting those strict orders to all intruders, issued by the great mistress of the feast, who, wishing that all guests should have plenty, and knowing she could not provide for unlimited numbers, humanely refused to admit fresh comers when her table was already full."
Malthus was forced to withdraw his statement in the face of a storm of moral revulsion in his own time. Our own age is apparently more inured to such moral depravity, since Spruiell's statement produced hardly more than a yawn yesterday.
I think the notorious ultra-liberal Pat Buchanan hit on it exactly when he was talking about the difference between the ultra-rich of the early 1900s and the similar class today:
"The difference is, between J.P. Morgan and the robber barons [and the wealthy of today], is they saw themselves as Americans, as the men responsible for building up the greatest country on earth.
We tend to be more likely to share resources with others we have a bond with, whether it's genetic kinship, culture, tribe, or whatever. What is the point of a country except as a means of bonding disparate people into something with a shared identity, as part of a shared endeavor? According to the anarcho-capitalists, there's no point thinking of yourself as an American. It's everyone for himself and to hell with all the rest of you.
Of course, what's wrong with Spruiell's reliance on the market as the righter of all wrongs, as the most appropriate means of allocating scarce resources, is that it also locks in historical allocations of wealth that are the result not of the brutal effectiveness of markets but of the ill-gotten gains made through crime, force, capital cronyism, genocide, and just plain luck. In the words of Stephen Spruiell, "Deserve's got nothing to do with it."
If we wanted to live in Spruiell's anarcho-capitalist paradise where the market delivers its efficiencies pure, every generation should be stripped of its accumulated wealth to start afresh. Every individual then could start from the same point, clawing his or her way up in life. That should be the corollary of the efficient allocation of resources by the market. What's efficient or market-oriented about inherited wealth? Nothing. So why should it be permitted if other market inefficiencies like pooling risk for health care are not permitted?
One more point. Take morality out of the equation of how people treat one another in society and what are you left with? The morality of mutual obligation is the great restrainer of chaos. When the wealthy care only about themselves and forget that they are members of society and have responsibility to others in that society, let them at least remember that they are few and we are many, and we won't be compliant and disorganized forever.