The idea here seems to be that unless you declare medical care a right rather than a commodity, you are soulless — that as Marx might put it, necessity, rather than autonomy, creates rights.
This is foolhardy, both morally and practically.
Morally, you have no right to demand medical care of me. I may recognize your necessity and offer charity; my friends and I may choose to band together and fund your medical care. But your necessity does not change the basic math: Medical care is a service and a good provided by a third party. No matter how much I need bread, I do not have a right to steal your wallet or hold up the local bakery to obtain it. Theft may end up being my least immoral choice under the circumstances, but that does not make it a moral choice, or suggest that I have not violated your rights in pursuing my own needs.
But the left believes that declaring necessities rights somehow overcomes the individual rights of others. If you are sick, you now have the right to demand that my wife, who is a doctor, care for you. Is there any limit to this right?
…medical care is a commodity, and treating it otherwise is foolhardy. To make a commodity cheaper and better, two elements are necessary: profit incentive and freedom of labor. The government destroys both of these elements in the health-care industry. It decides medical reimbursement rates for millions of Americans, particularly poor Americans; this, in turn, creates an incentive for doctors not to take government-sponsored health insurance. It regulates how doctors deal with patients, the sorts of training doctors must undergo, and the sorts of insurance they must maintain; all of this convinces fewer Americans to become doctors. Undersupply of doctors generally and of doctors who will accept insurance specifically, along with overdemand stimulated by government-driven health-insurance coverage, leads to mass shortages. The result is an overreliance on emergency care, costs for which are distributed among government, hospitals, and insurance payers.
Shapiro’s preceding paragraph reminds me of a clear account of the early days of communism that I read once and it made clear to me why the government cripples things while with good intentions.
To keep food prices cheap for everyone, early communists set price ceilings on grain. We can call this the Affordable Food Act.
Except, the prices were so low farmers couldn’t sell their crop for enough to cover their expenses. What would you do if you were in a money-losing business? Probably the same thing the farmers did, they stopped producing crops to sell.
Then what happened? This caused big food shortages.
How did government try to solve this problem? By sending the military out to force farmers to produce crops, by pointing guns at their heads.
Of course, that didn’t work well either. Who would want to be a farmer at this point? Not only did your fellow citizens expect you feed them at of your own pocket, but your life was threatened if it appeared you weren’t willing to do so. So, it was easier and safer just to walk away from your farm.
I think it’s good to keep this simple example in mind when thinking through government solutions.
In health care, we’ve taken the first step of trying to force prices low.
We’d be better off if more people understood that the reason health care costs have risen is not due to a flaw in the free market, which isn’t present in markets like smart phones, burritos and shoes.
As Arnold Kling would say, it’s because the government has restricted supply and subsidized demand, as Shapiro points out several ways this has happened in his article.
The best policy isn’t to go down the road communists followed by putting in more ways to restrict supply and subsidize demand, like the Affordable Care Act
The best policy is to back out the things that are already restricting supply and subsidizing demand and causing the problems.