Sutherland Institute and Conservatives just don’t get it
Written by Craig A. on September 28th, 2008
The title of the latest Op-ed submission by the Sutherland Institute says it all - Not a right: Health care is an opportunity to give. It seems conservatives never tire of reminding us that if it isn’t explicitly written into the Constitution, we are on our own and the Sutherland Institute’s Matthew Piccolo is no exception.
Ensuring the public welfare, not to mention public safety and health, does include taking advantage of the "opportunity to give" to charity and help our brothers and sisters on this planet. However, charity alone cannot meet the needs of a large, complex and vibrant society and never has.
Piccolo points out correctly, Utahns are incredibly generous people giving large amounts to charity and spending more time than most volunteering for causes they believe in. I join him in his praise for our level of giving in both time and money.
However, in spite of the huge hearts and open wallets of so many Utahns our state has up to 300,000 people living without health insurance. Piccolo and conservatives would have us believe we are to blame for the failure to provide these individuals with access to affordable health care. While Utahns take more "opportunities to give" than most we apparently still don’t take enough of those opportunities.
All Americans agree when conservative think tanks like the Sutherland Institute parrot the words of our founders conceding "All people have the right to life, liberty and the pursuit of happiness…" My question is how exactly allowing a health insurance company to price me out of my health insurance because I am "high risk" or allowing them to deny coverage on the basis of a pre-existing condition beyond my control enhances my "right to life", not to mention "liberty" or the "pursuit of happiness"?
Why is it reasonable for me to expect the fire department to show up if my home catches fire, a right I can’t seem to find anywhere in the Constitution, but not reasonable for me to expect insurance that maximizes the likelihood I will continue to live should I need medical treatment resulting from burns caused by that very same fire?
Piccolo argues it is unfair to force taxpayers to pay for everyone’s health care. Apparently in his view it is fair for hospitals and doctors to pass on the cost of uninsured patients they are morally or legally obligated to treat to me and my employer when these uninsured patients enter bankruptcy as a result of a health care crisis. Forcing people to carry the burden for others health care costs is fair when these costs are passed on through the private market, but not when passed on through government? This argument seems to be the conservative version of the placebo effect; there is no pain if you can’t see it on your tax bill.
Finally, as with other government services such as roads, public schools, fire and police departments and garbage disposal ensuring every Utahn and every American has affordable health care is in our common interest. We all benefit when a TB patient receives timely, effective treatment for his illness. We all benefit when children receive appropriate immunization and common diseases are not able to spread throughout our communities.
While I would like to think everyone contributes to charities doing good work in the health care field, I know many can’t afford to donate or put their limited resources into other worthy causes. Furthermore, no one wants a volunteer fixing a broken bone or treating their cancer, no matter how well intentioned or trained they may be. At some point in our lives we have to rely on experts when it comes to our health and this costs lots of money, even in cases where the health care system requires everyone to share the expense. Arguing charity can carry the burden is just naive in the extreme.
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Craig, why pick this fight? Did you even read the article? You’re not dealing with crazy libertarians at Sutherland…so why create straw men as if we are? (”If it’s not in the Constitution”…what BS.)
We CAN meet the medical needs of every Utahn that needs help. Your policy dilemma is that you are stuck in this “insurance” groove…that the problem is the “uninsured”…when the real problem is folks needing medical assistance but who can’t afford it. You think the solution is “insurance”…when the real solution is to get them medical care, no?
Authentic charity care can “carry the burden” in Utah. It is more cost-efficient than government care and builds community in ways that government solutions could never dream of.
Of ocurse, it would put a bunch of 60s reject, hippie-wannabes out of business…but, hell, there’s always other people to find to hate and to put their misanthropic energies into.
Sutherland’s on record about 1) how government will NEVER relieve the affects of poverty using government-only solutions, and 2) how authentic charity care can provide for all of our neighbors in need. Both publications are on our web site.
And, Craig…and all others here you feel likewise…I would invite you to come testify against Sutherland’s charity care plan at the legislature…OR debate me in public ANY time about the best ways to care for our neighbors in need.
Until then I suppose you’ll have to keep creating straw men to knock down to feed your ideology of misanthropy…whereas, if your really trying to be like Jesus, you’ll lessen government’s involvement in our lives…and take matters into your own hands.
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Healthcare is just one of several rights that Americans should be able to demand from government. Others include education (K-12 and university), housing, transit, food, clothing, and old age services.
We need to stop thinking of “rights” as just traditional civil rights. We have a right to all of the above, and we have a right to demand that the rich pay for it. The rich got to be rich by exploiting those who do not have healthcare, etc.
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Yes Paul, I did read the article. In defense of my “BS” about the Sutherland Institute implicitly if not explicitly arguing if it isn’t in the Constitution we don’t have a right to it, allow me to quote the article directly:
“In American tradition, natural rights are God-given attributes inherent in all people at birth, whether government recognizes them or not. All people have the right to life, liberty and the pursuit of happiness, or the right to act freely in their own best interest. These natural rights do not guarantee a long life, abundant wealth or enduring happiness, just the right to pursue them.
There is no natural right to health care.”
I would highlight and underline that last line if I could just to drive home the point. If this isn’t a quote delivered by a strict constructionist, I don’t what is.
The real problem is people needing health care that can’t afford it - agreed. But non-profit community clinics are few and far between and are not raising sufficient funds to provide health care to those that can’t afford it; namely the uninsured who by definition will not be able to afford a medical emergency in their family unless they happen to be independently wealthy. Community clinics in the Salt Lake area are increasingly requiring at least some insurance due to a lack of needed resources.
Paul, in an ideal world everyone not only would give huge amounts to charity, but could afford to. Perhaps then your charity based solution would work. Then again, if everyone could afford to give to charity on a regular basis there wouldn’t be so many poor needing charity would there?
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Craig,
Thanks for your thoughtful response. Thanks for pointing out where we do agree; hopefully, we can build from there.
As you said, and Paul said, Utahns are very generous. I understand your concern that charity care can’t carry the burden. We’re definitely not carrying it now. The problem, though, is that government has been so involved in helping the poor and needy, including with health care, for so long that we haven’t really allowed private charity to do what it can do. Today, with all of the technological advances that have occurred, I’m confident that people are charitable enough to help everybody.
You are correct that “While Utahns take more ‘opportunities to give’ than most we apparently still don’t take enough of those opportunities.” I think the reason for this is twofold: 1) we need more organization in the private realm to encourage and “distribute” private charity and 2) Utahns need to feel a sense of urgency to give, like in the case of Hurricane Katrina or Bridger Hunt. With these two things in place, I’m confident that authentic charity care can provide all Utahns with a decent level of health care.
I think what is truly naive is believing that government can provide everyone with the health care they need. Not only is government inherently inefficient, yes, even in Europe, but, as the article says, forcing doctors and others to provide medical care for anyone violates their constitutional rights. I think that fact is apparent.
Sure, it is reasonable to expect the fire department to show up at your house to save you…because you contribute taxes for that government service, but you have no constitutional right to be saved. You only have a right to receive the service because you paid for it, not because it’s an inherent right. It’s a government-created right, which means that government can also take it away from you. The same goes for public schools, roads, police, and garbage disposal. So, if government wants to tax us even more than it already does and provide us with health care it can. If it does that, then you and I will have a “right” to it because we are paying for it, but government can remove a right it creates at anytime, and it cannot guarantee it no matter how hard it tries. With authentic charity care, we also can’t guarantee that everyone will get the care they need, but we can certainly do our very best, and do it without violating the natural rights of medical practitioners or further encouraging in people a sense of entitlement to things that they can’t necessarily have.
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Paul Mero wants the benefits of arguing from a libertarian point of view without the label of “crazy libertarian”.
If that works…fine. I’d recommend Sutherland go after people who agree with them even if they happen to be crazy libertarians!
Anyone who demands “rights” from government is looking for something that can’t be. You can get welfare and entitlements from government but never rights. It is important to understand the difference. I think Mr. Piccolo did a pretty good job explaining how that applies to government involvement in health care.
It stinks that so many of us can’t seem to move beyond the argument over socialized health care vs. employer provided insurance. There are other options that we often overlook and I think Sutherland Institute is on to something.
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Craig, Paul is right. You missed the point of the article completely. Matt’s piece was about health care, your post was about insurance.
You can’t equate having insurance with quality health care. However, you can equate health care provided by a medical professional freely volunteering his time to care for someone in need with quality health care.
People freely giving of their time to care for someone in need are going to provide better quality care than someone who’s in it for the money. This isn’t complex logic. The satisfaction of the charitable provider is that the person in need is fully cared for and looked after. The satisfaction for the provider in it for the money is simply their paycheck.
Beyond this basic reasoning, your comments that “no one wants a volunteer” providing their health care and that “we have to rely on the experts” (implying that volunteer medical providers don’t know what they’re doing) shows that you don’t know what you’re talking about on this issue. Visit one of the several charity care clinics we have in this state (Maliheh Free Clinic, Provo Free Clinic, Shriner’s Hospital, etc.). You’ll find that they serve thousands of patients a year, and that they’re staffed by experienced medical professionals just like the doctors you see through your health insurance (they may even be some of the same doctors that you’ve seen through your health insurance). In the end it’s your argument, not Matt’s, that is the one that qualifies as “naive in the extreme.”
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I think we can all agree that the present “system” if it can even be defined systematically, is not working very well. Its clunky approach to providing a basic human need doesn’t work well for either the rich, the middle class, nor especially for the poor or uninsured. Even a well-to-do entrepeneur with the means to choose and pay, can get wiped out by a health crisis. At times it just seems like you’re lucky if your employer maintains the system for you, but too bad for those outside of that.
I think Sutherland gets into trouble when it tries to lay out it’s undergraduate poli sci framework of rights and fundamental freedoms (is this just a phenomenon of the BYU poli sci dept?).
So, Piccolo’s poli sci 110 term paper argues that health care isn’t a fundamental right–well, hooray for you, you win the logic battle, especially when you frame in terms of fundamental freedoms and civic morality. But you don’t win the reality battle. And reality is what public policy should be about–when the government makes sure your garbage is collected and the pothole is filled it isn’t a triumph of civic virtue–it’s a victory for “we the people” to get something done that benefits all of society.
A system of free access freeways, a local fire dept., agricultural county extension agents, managed wildlife, libraries, publicly provided education, county recreation centers, among many others, are certainly not “rights” either–they’re not even the softer “privileges”, like driving, which isn’t a right either. They’re just something we wanted and felt we needed as a people, as a society.
We the people do not need to be limited by the Constitution. We the people set it up to limit our government and control it to meet OUR objectives as a society, with a careful watch kept on the fragile balancing act individual freedom does between tyranny and anarchy. If we can mangage this today for our generation now, the potential for our society is limitless. The Founding Fathers were trying to set up a successful government that would be strong enough to work, but still respect the rights of individuals.
Government doesn’t have to be the enemy by definition. In the end, government is whatever we the people want it to be–it does whatever we the people want it to do. Of course, we ought to pay for it, but these are issues for public policy debates, not rights.
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In unrelated news:
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I find the criticism I am too focused on insurance interesting. I can think of only two ways to pay for health care. Either through insurance (public or private)or through charitable donations of time and money. Three ways if you include passing on the cost of providing treatment for the poor to those with coverage and we all seem to agree that isn’t working so well.
One post makes the claim the uninsured would likely get better care from a doctor donating his/her time and service than one that provides health care for money. While I find it amusing the right is now arguing doing something for money is less than pure, even if this were true, doctors donating their time would be forced to take patients needing the most care first. Adequate preventive care is rarely if ever donated consistently due to constraints on the doctor’s time and the limited charitable resources available.
Furthermore, for 45 million plus uninsured patients to be “covered” through charitable care virtually every doctor would have to volunteer, and their oath to do no harm not withstanding there seems to be considerable resistance to requiring doctors to care for anyone in these replies. Between work and family doctors already have considerable demands on their time just like the rest of us and expecting more than 10 or 20% of them to do significant amounts of volunteer work is unrealistic under the best of circumstances.
So yes, I am hooked on the notion everyone must have insurance. We can save the debate for whether this insurance is best provided through the public or private sector for later. Regardless, regulation is necessary to ensure people are not discriminated against for pre-existing conditions, etc. As Matthew points out, if I pay for something it is reasonable for me to expect something in return. Let everyone pay something into the system and expect reasonable health care in return.
Finally, disasters like Katrina do create a spike in charitable giving, but this is ultimately unsustainable. Economic conditions beyond our control drive down donations periodically or the sense of urgency fades with the memory of the disaster that motivated the giving. Maintaining a constant sense of urgency about health care to support the large level of charity required to provide health care to everyone would be impossible in the long run. Also lost in this discussion is the impact the high degree of charitable giving to make it work would have on other non-profit programs funded largely through charitable giving.
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Homer:
You’re right, of course, that we can choose as a society, as the people, to have the government provide any service we want. The problem is that the left constantly asserts that health care is a fundamental right (implying it’s a natural right) and therefore we have a duty to provide it to everyone. We could talk only about what services the government should or should not provide without the rights debate if they would stop making this assertion. I believe that private initiative can do a much better job than government at providing health care. One of the main reasons why our system is messed up is because government has gotten so involved already. Programs like Medicare, Medicaid, and CHIP drive up the costs of health care, along with other factors of course.
Craig:
Thanks for your comments. It’s true that a sense of urgency is hard to maintain. I think it would be a lot more prominent though if government weren’t involved in health care or other welfare programs. Why worry about helping your neighbor if the government is taking care of it?
Also, to reaffirm what I just wrote above, I agree that our system has got lots of problems, but in my view government is harming the system more than helping. The problem is that right now we’ve got a health care system that is about half government funded/regulated and half the private sector (very rough estimate). We either need to leave the market alone and see if it works or go all government like Europe. I think the fact that we currently have the best health care in the world (not system, but care) but are having more and more problems as government intervention has increased demonstrates that government is the problem. Maybe a socialized system can provide decent care, but I’m not willing to give up that much liberty for “security,” not to mention the loss of innovation, technology, and impersonal attention that would result from it. Let’s use free market ideas to fix the current system rather than assume government can fix it.
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Matthew,
I am willing to drop the word “right” from my argument if you are willing to concede we don’t have the “best health care in the world”, an argument the right consistently makes.
Our infant mortality rate is higher than most industrialized countries and our life expectancy is lower, so clearly we don’t have the best health care in the world. You may have a point about the “best health care” for the insured, but we have to look at the outcomes for all members of society when talking about health care.
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Interesting post and wonderful dialouge.
Socialized healthcare is a paradoxical proposition. On one hand you have everyone receives health care and no one directly has to foot the bill to Hospitals and Doctors, and one the other you have and dramatically increased tax burden and (given the lack of efficiency most government agency exhibit) dramatically decreased quality. Charity given to hospitals, helps hospitals improve and perform better. However, I have seldom heard of a hospital truly and purely giving out that charity — although IHC is non-profit it is still a business. For example, Juan A Beanamerican (or Joe Redneck) doesn’t pay the hospital, the hospital gives him care free. However the hospital then charges everyone who can pay and insurance companies extra to recoup what should have been paid for Juan (or Joe) — a double dipping scenario if you will.
I’ll post more on my own site at home.
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Craig,
I see that this post was published in the Trib, and it seems to be word-for-word the same. I’ve already posted some comments here, but I have one more.
This comment is not about your ideas but your approach. In several parts of your article, you make assumptions about my, or Sutherland’s, position on health care. These extrapolations from what I’ve said are not necessarily correct. You create straw man after straw man in order to support your views.
For example, you wrote “It seems that conservatives never tire of reminding us that if it isn’t explicitly written into the Constitution, we are on our own, and the Sutherland Institute’s Matthew Piccolo is no exception.”
I did not say that since health care is not written into the Constitution that we are on our own. I did say that as a people we can create a right to anything, we just can’t necessarily guarantee it. My point is that government should definitely try to guarantee natural, God-given rights, and it’s our choice to try to guarantee other rights if we want to.
“Piccolo and other conservatives would have us believe we are to blame for these individuals having no access to affordable health care.”
I don’t believe I have blamed you or anyone else for this. Yes, we should do more to help people get the care they need, but I certainly don’t blame their lack of health care on you.
You also wrote, “Apparently, in his view it is fair for hospitals and doctors to pass on the cost of uninsured patients they are morally or legally obligated to treat to me and my employer when these uninsured patients enter bankruptcy as a result of a health-care crisis.”
This is the worst infraction. Please tell me when I said or implied this. Craig, I really respect your thoughts and am encouraged that we are having this important debate. But I hope we can address the arguments head on and with accuracy. Sutherland is not a typical conservative think tank. We actually differ in many ways from mainstream conservatism. I hope we can continue to become familiar with each others’ views so we can find common ground and better define our differences. Thanks again for your thoughts.