Health care then being expensive, everyone expects somebody else to be paying for their health care. This creates bizarre solutions. For example, the Canada, health care is paid by the federal government.  In order to hold down taxes, access to health care is limited; typically by waiting periods. Or in the USA, most working people have
their health care paid by their employer, except for a very small deductible. This makes it difficult for employees with health problems to switch employers. The government has created a ham-handed solution which permits former employees to continue their health insurance by paying the premium out of pocket.

Health care is important, without doubt. So is food (insufficient calories reduces your resistance to ordinary infections), but we generally don’t expect everyone to be able to dine on caviar and steak every day. Many different kinds of food are available in many different venues and preparation styles, at reasonable prices. Yes, the poor may need to dine on beans and rice, but except for the most indigent, everyone can get enough calories, protein, and vitamins to stay healthy. Health care could be the same way; with cheap, worthwhile health care being available to everyone at affordable prices. We have chosen a different path; much to our detriment.

The utopian vision underlying the plan is a world where everybody can have everything without paying the price. Dr. Kling described an “iron trilemma” in healthcare, but I think that it can be modified and generalized for any type of social program. It is like a three legged stool that needs all three legs to stand. The first leg in the modified version is access. The system must be designed so that nobody is excluded. The second leg is the goods. Participants must be able to get the latest, greatest and best quality stuff available. The third leg is cost. The overall financial burden of the system must be minimized.

It is obvious that you cannot have all three legs at one time. If everybody has access to everything, including the most expensive procedures, goods and services, then the cost will be sky high. If everybody has access and the overall costs are minimized, then, necessarily, expensive goods and services must be cut out, no matter how much some individuals desire them. If, instead, the system provides the expensive goods and services, then in order to keep the overall costs low, some people must be excluded from access to those services. Whichever pair is chosen, the stool must fall over. The three legs, universal access, unlimited consumption and low cost, cannot exist together. The claim that the proposed system will increase the number of people covered without decreasing quality and availability of medical goods and services to each and, at the same time, significantly cut the cost of health care in America is absurd. It is an impossibility. Something has to give.

One of the assumptions is that, under the government plan, waste and fraud will be cut out and greedy profiteers will be reined in. An obvious question comes to mind. If the government is able to root out waste and fraud and greed, why has it not done so with Medicare/Medicaid, the government monetary system, the military, banking, the education system, the bailout fiasco, cash for clunkers, and on and on. Politicians have not done so, and will not in the future, because they benefit greatly from fraud, waste and greed. Saying that government cuts waste and corruption is either a blatant attempt to distort the facts or it is an indication that they are totally out of touch with reality. Either one of those characteristics in our leaders does not bode well for the American people.

The overall cost of the present system is very high because of the interaction of the legs of the trilemma. Employer based insurance and government insurance programs cover a significant portion of the population. There is significant access. Government mandates on insurance plans have forced them to cover a host of very expensive treatments for uninsurable events and diseases. New, expensive treatments are being developed all of the time, which participants, insulated from the true cost, strenuously demand. The participants get the goods. Government’s injection of hundreds of billions of dollars into the health system has caused a rapid inflation in the prices of health services, and has distorted the supply and demand for them. The overall costs, the third leg, must be high.

The central planner’s paradigm is the fundamental error in the present health care discussions, the idea that some smart person can and should design a universal system which will fit every person in the country. In reality, health care is merely a market for goods and services. Nobody plans a market. It is made up of the billions of interactions of the participants as they attempt to achieve what they value the most. Since nobody can know what each individual values most, what sacrifices he or she is willing to make for the things desired, what goals they have for themselves and their families and the assumptions they make about the present and future environment, nobody can make decisions for them better than they can make for themselves. Individuals make tradeoffs every day about what they want and the costs they are willing to incur. The cost tradeoff must be on an individual basis. The aggregated cost of the system is absolutely irrelevant. When people make their own decisions, markets work; they attempt to get the most value for what they give. They try to maximize benefits and minimize costs.

Think about it. Our food supply system is incredibly complex, involving hundreds of millions of people with widely varying tastes and budgets, hundreds of thousands of separate farmers, merchants, traders, and restauranteurs, all with their own objectives and needs, and vastly different geographic areas. No central busy-body plans our meals for us, yet Americans get fed every day at a very reasonable price. The overall cost is low because individuals are responsible for their own expenses and decisions. The same could happen with health care if all of the government induced distortions were removed, including pretax employer based insurance plans that get dropped when changing employers, mandated coverage for all insurance plans, which eliminates low cost alternatives to consumers, anti-competitive and monopolistic government programs, and the use of hundreds of billions of dollars of tax money, which inflates prices and distorts the true markets beyond recognition.

Many people bring up the fact that there are families who are so poor that they cannot afford health care, and conclude that the health care system should make special provision for them. They are appropriate targets for the charity of individuals and charitable organizations, and through the centuries, those charitable people and organizations have cared for poor, the disabled, the destitute. Charity is most certainly important, and it is right and good for individuals and organizations to help the poor. Health care and charity, however, are vastly different entities. Mixing them confuses the issues of both and hurts the poor more than it helps.

Our three legged stool in health care is tipping over because it cannot possibly stand over time. If health care in America is to stand strong again, we must throw out the stool and the socialist ideals that support it. We must let Americans stand on their own two feet and take individual responsibility to pay for whatever level of health services and/or insurance that they desire and can afford.

This is opposed to modern liberal thinking, which is the negation of liberty of the individual and imposition of the will of society. Socialist mentality has introduced a whole host of additional positive rights which assume that society owes everyone a minimum standard of living and access to a full slate of services. Those additional rights deserve a closer look to see if they are truly universal and unalienable.

If two people exist on a desert island, both have rights, just as they do in an advanced industrial society. Neither has the right to injure or kill the other person, to enslave him or her or to take property that he or she acquired legitimately through his or her own efforts. These are the basic rules for all human cooperation and for societies based on true justice. It is legitimate to engage in voluntary trade that benefits both parties, but it is not legitimate to use force or coercion to get a benefit at the expense of the other person.

Does either person have a right to food, water or shelter? They do have a right to use their resources, their skills and strength to provide for their own needs, but neither has the right to have the other provide for them. Can person A legitimately force person B to give him medical care? Even if B was a doctor, the only way that A can enforce a right to any level of health care is to violate the rights of B. Thus, that positive right to health care is a spurious and illegitimate claim.

In any society, however, whether made up of two people or billions of people, all parties are better off if they cooperate. B can provide medical services, but A can provide other valuable services, and they will both benefit if they give each other value for value they get. They can each concentrate on the things they do best and depend on the other to provide for other things.

In the event that A becomes disabled and cannot provide any value to the relationship, does A now have a right to the services of B? The answer is unequivocally no. There is no right to violate the rights of others just because one cannot provide for oneself. That does not mean that that B should let A perish just because A has no right to B’s help. Charity and compassion are also important parts of the human condition, religion, tradition and ethics, and it is considered good for B to help A in time of need. The Good Samaritan is a famous and useful analogy that illustrates true charity. It highlights voluntary aid to others, using one’s own resources. It has nothing to do with A having a right to B’s property or service, but only demonstrates the good will of one person for another.

In a larger society, the rights of the individuals hold the same significance. The fact that advanced medical services are available on a wide scale does not mean that any individual has a right to any level of health care. Medicine is merely a valuable service that people provide. Voluntary cooperation is the essential characteristic of any free society, but no medical person owes anyone else medical service. It is based on mutual agreement about value given and value provided.

There are many charitable organizations and millions of charitable people who are willing to give of their time and their resources for the benefit of others. It is fitting and proper that they do that. It is not fitting and proper for organizations or individuals to use the force of the state to coerce others to do charity. Using the government to take money from others for enforced charity is still aggression against the rights of others. It is counterproductive and displaces true charity with violence.

There is no right to health care. The path to a prosperous society where the poor and disadvantaged are most likely to have their needs met is paved with respect for the basic unalienable rights of each individual, being bound only by the equivalent rights of others.