That does not mean that it should be provided at taxpayer expense.

Just because we have the right to bear arms does not mean that the Goverment has to pay for our guns.

Indeed, as Lisa points out, most of the rest of the world seems to find the idea of health care rights not even very interesting or controversial. Of course one would want a fundamental principle of one’s government to be the universal provision of an essential service like health care. Why not? Isn’t health care like fire prevention? Like property protection? Again, explain to me, why not?

Of course, deciding that it’s a right (or, I guess Rick prefers, a duty of compassion) does not give us much help in the debate about how, specifically, to organize our society so that our health care system provides adequate health care for the human beings who live here, while not squelching innovation in medical science and technology. Those are difficult and interesting questions.

We gave good arguments while the medical-industrial complex gave cash dollars. Over $125 million from insurance, hospital, pharma, and medical device manufacturers in 2008 alone. We were smart, they were smarter. We are now on the outside looking in, and no amount of head-scratching will alter the fact that we were simply outspent.

In this situation we were better off with no bill rather than a bad bill, but we didn’t give the cash to make that happen.

Politicians prefer bribes, so the insurance CEOs give cash instead.

Logic is so “yesterday,” and the medical-complex bribes will now keep coming in as long as reform does not happen. Future cash motivates politicians better than historical cash, and that’s why they also prefer private over public services.

There are three critical messages to take from this:

1. Don’t stop here. We must mobilize to throw the b*stards out. Forced term limits is our next “public option.” Politicians must see an immediate response to their favoring money over matter; of selling the country to the highest bidder against the best interests of the nation. All politicians who vote for the current health care bill must be unelected in 2010!

2. That doesn’t free the Republicans of blame, because they will vote against single-payer when it comes to the table. They are as corrupt; they just allowed the D’s to take this hit. But the R’s must also be replaced. We must rid our system of all miscreants.

3. Recognize that this enemy — bribery — is deeply imbedded in our political culture. Over 80% of congressional decisions will favor money over people. It is behind the recent spiral of the nation’s economy. It will remain behind the massive transfer of wealth that eclipses our democracy and capitalism. Our country can no longer sustain political corruption or the massive wealth inequality that has resulted.

If activists can be faulted for anything it is for their naivety. There is only one solution to this quagmire, and that’s to get the private campaign dollars out of the public electoral system. Though in its extreme (forced) it does not pass Constitutional muster, a reasonable solution is available: Optional public funding of campaigns.

CALL TO ACTION: All activists and organizations must ask their congressional members to support the Fair Elections Now Act (S. 752 and H.R. 1826). Healthcare activists must immediately take on this second issue, because it affects all others. We can no longer afford to lose issues because of bribery. See: http://www.fairelectionsnow.org

This bill provides for optional public funding of campaigns for any politician who prefers not to take private or special interest money. A politician who prefers private money can remain on the current system. It is funded by a surcharge on federal contracts. A candidate needs only to acquire a preset number of community signatures to qualify. In Arizona and Maine 70% of their legislators ran and won under public funding, and that included R’s and D’s and Libertarians alike. And it passes constitutional muster, so don’t accept otherwise from your congressman.

I don’t know that an examination of the systems in Canada, Great Britain, etc., “debunks” concerns about government provided health care. I tend to agree with John Major. The American system, he says, provides a much higher quality of care but the British system provides care on a more egalitarian basis.

And that’s where I start to wonder what work is done by referring to health care (much less “health”) as a right. As Tom points out, calling health care a right implies a corresponding duty on the part of someone else to provide it. Because that duty cannot possibly be unlimited, we must now talk about how much to extract from providers and taxpayers in order to provide how much to recipients.

This becomes a rather pragmatic discussion in which empirical claims matter a great deal. The language of rights – with its connotation of a claim that trumps most other considerations or that can somehow be expressed as an enforceable entitlement – does not get us very far – although as I’ll explain in a moment, it may help a little.

Returning to that pragmatic and empirical discussion, my own sense is that the US system provides superior care to the vast majority of citizens and leads the world in innovation. It seems to me highly likely that the amount of money we spend and the market incentives for specialists, medical device manufacturers and pharmaceutical companies.

Believing this, I am concerned that top down systems will stifle innovation and lead to rationing of care based not on what patients demand but on what political rent seekers are able to claim.

This is not to say that there aren’t problems to address. One is access. It’s not as widespread a problem as some suggest, but it is nevertheless a problem. This is where, in my mind, we may be helped a bit by the concept of a “right” or, as I would prefer, the imperative of compassion. We will allow those who don’t have a car to walk, but we aren’t going to just let people die.

Resolving the problem, however, seems to me to require consideration of what structural reforms will do to supply and the need for persons to take responsibility for their own care. This is a far more complex question than simple disdain for free loaders.

The second problem area is efficiency. We don’t really have a market for health care and the anomolous connection of insurance to employment, combined with the unintended effects of regulation and the odd notion that health care should almost always be paid for by someone else, creates further market distortions.

How to address those problems are difficult questions about which reasonable people will differ. We wrestle with them now when we talk about Medicaid, Medicare, anti-patient dumping laws, etc. But, as much as we lawyers like them, I don’t think “rights” helps us much with the answers.

My interpretation of the limited extent of a “right” to health care is shown by the understanding that a person incarcerated by the state has the right to have health care provided by the state. In other words, only when the government has acted to limit a person’s access to health care does the government have the obligation to provide that health care to the person.

The right to counsel would seem to be an example, although that has only relatively recently been read as mandating government-provided counsel if a person cannot afford one. Further, the purpose for that right is largely to give the person the most protection possible from the government taking away other of the person’s rights. Similarly, the other due process rights are safeguards against the deprivation of other rights. I don’t see how those are comparable to health care. That a person may die without health care is not an example of government depriving that person of a right to life.

To say that people have a right to health care does not require government to provide it for them, it only requires that government not interfere with it or take it away without due process. I see government-provided health care as a privilege, then, not a right. Many people think it’s an extremely important service for government to provide, but it’s not a right.

Why a minimum amount of care – isn’t it a “right”?

And it is not 47 million. Even Obama finally admitted that. Out of the 47 million, nearly 1/3 are upper class and need no help with plenty of cash to buy any insurance they may want. Then, another 1/3 are eligible for Medicare, Medicaid, etc., but fail to sign up for some reason. Then there are millions who are immigrants and not eligible. Also millions of young 20′s and 30′s who are single and could care less about insurance. They don’t need any and don’t want any.

This leaves maybe 8 million or so that have a problem….not 47 million. Very significant! Why trash the greatest health system in the world..bar none..when the new bill is not going to cut costs…and that was the whole intent of the bill. Cut Cost!
And don’t blame insurance companies…their costs are tied to the medical profession costs. If hospital stays go up, doctor fees go up, MRI’s cost a couple thousand now…the insurance company must raise their fees to cover these increased costs…no choice!