The need for health and the right to health

Bernard Madoff

Source: The Wall Street Journal

There’s something ghoulishly fascinating about pulling off a $50 billion Ponzi scheme. When Bernard Madoff revealed the big secret to his two sons earlier this month, they reported him to authorities, and the chimera collapsed.

It was the Ponzi angle, with its image of collapse, that attracted me to an Eric Novack post on The Health Care Blog, The Medicare Ponzi Scheme. Novack argues that Medicare’s “unfunded liabilities” – the promise to provide benefits in the future – are the equivalent of an $85 trillion Ponzi scheme.

This is not an argument I’d care to meet in a dark alley, but for balance I recommend the Century Foundation’s paper The “Unfunded Liabilities” Ruse.
What I found highly valuable about the Novack post was a reply by Rob Oakley that was a refreshing mixture of honesty and compassion. (You can find the reply by searching for “Posted by: Rob” at this link.)

[T]he value [of technology as a cost-cutting measure] comes from, well, value. We still confuse this with cost, but again I have to ask “how much is a doctor worth when you’re writhing around on the floor having a heart attack?” I think infinite. So how can a market fairly “value” this?

It can’t. Instead we have a futures market that masquerades as insurance. We buy and sell death and disease like pork bellies. We’re no longer sharing the common good and the common risk.

Yes, costs can’t balloon, but nor can we set free the invisible hand of the market on something which is a fundamental need. Housing? We see how well that works. Water? We’ll see that soon enough. A doctor’s care? We’re seeing now what happens when someone speculates in that: People die from neglect.

Notice I said need. Not right, but requirement. We all need air, water, food, shelter, clothing, and, when we fall down, someone to stitch us up.

These things have human value. Why can’t we start with that premise for once, instead of offering “incentives” to do the right thing?

Nah. That’d be crazy talk. No one wants communism. No one wants “lefty” thought. No, we want people to PROVE to us that they deserve to live. Right? Isn’t that the current thought?

Not for long. We’ve let Reaganistic “screw you, I’ve got mine” thought run us for close to 30 years and we now have a near-depression. Let’s try something new. Let’s give a damn about each other.

In the US we hear a lot about the right to healthcare. People usually only discuss a ‘right’ to health when talking about developing countries or HIV/AIDS. The British medical journal The Lancet recently devoted an issue to the right to health. Here’s an excerpt from one of the articles:

[W]hy think of health, rather than health care, as a right, since health care is under the control of policy making, not the actual state of health of the people? … [G]ood health does not depend only on health care. It also depends on nutrition, lifestyle, education, women’s empowerment, and the extent of inequality and unfreedom in a society. … Even the fulfillment of the first-generation rights (such as religious liberty, freedom from arbitrary arrest, the right not to be assaulted and killed) depends not only on legislation but also on public discussion, social monitoring, investigative reporting, and social work.

The right to health has similarly broad demands that go well beyond legislating good health care (important as that is). There are political, social, economic, scientific, and cultural actions that we can take for advancing the cause of good health for all. … In seeing health as a right, we acknowledge the need for a strong social commitment to good health. There are few things as important as that in the contemporary world.