In my last column, I tried to address the financial realities that explain the need America has for a universal health care system. I ignored, for the time being, another roadblock to socialized medicine: The marketist logic that holds the free market more capable of meeting any social ill. This is a reasonable, thought out opposition to socialized medicine.
I must admit I’m holding certain values to be self-evident. First, I’m assuming all people are created equal, and while not born equal in practice, they’re morally so. The other is that they are endowed by virtue of their humanity with certain unalienable rights, that among these are life, liberty and the pursuit of happiness. If we disagree on these fundamental moral principles, then we’re not going to be able to agree on this issue. I, and the founders of my country, believe in them such that there’s no room to compromise these core ideals.
The second concept I’m assuming is a basic understanding of economics, how producers and consumers act in a free market, and why.
As all people are created equal, we can assume that their right to life is also equally undeniable, that no person has any greater a right to life than another person. Health care, like clean water, is necessary to maintain life. The logic for this is simply that a person afflicted with any disease from mild strep throat to terminal cancer is likely to die if not properly treated.
Market demand, for the consumer, depends largely on two things: the marginal gain in utility from purchasing the good, which determines willingness to pay a certain price for it, and the budget line, or ability to pay. Without purchasing health care, people are deprived of their right to life (Whether the founders meant this is irrelevant, it’s our own morality that dictates our decisions, which relies on the same principles, but does not necessarily proceed to the same outcomes. I consider only the principles themselves, and not who decided them). As their right to life is morally undeniable, their utility from the product is, of right, both infinite and universal (everyone gets sick eventually) to all rational consumers.
Therefore, the demand is expected to be inelastic – that is, as the price increases, the amount of demand won’t decrease much, because consumers require the good. The only thing constraining the consumers’ purchases is thus their ability to pay, and they’ll pay whatever they have to until they literally run out of money. We see this all the time in the market. Undeniable rights make for inefficient markets, but they are, regardless, undeniable.
Real consumers often don’t care about the price of health care, they will purchase it at the point of service no matter if they can afford it or not. This leads to numerous bankruptcies.
It’s fair to say that supply of health care will indefinitely be limited – doctors will always require a certain level of investment in training, equipment will always cost an amount to produce. This will go down with greater efficiency, but there is an inefficient floor to how much producers will charge. If consumers are unable to work – let’s say they get sick – they may never be able to pay the market equilibrium price because of this minimum cost to producers of the good. As a result, there are and will always be some whose ability to pay is exceeded by the price of health care, and so will be denied by the market their undeniable right to sustain life.
This establishes, as their right is undeniable, that they must be provided the product somehow else. This does not necessarily mean the government should do this, but we must acknowledge it as their purpose: that to secure these rights, governments are instituted among men. The market doesn’t – and most argue, shouldn’t – entail moral “rights” other than to maximize profit. It cannot therefore be expected to secure these rights.
We must remember that government health care need not be federalized, like that of the Canadian or German systems. We can and should control our government at the local level, funded by the sovereign states.
A large, unwieldy expansion of the federal government is not required to secure these rights, and doing so could potentially mean our right to liberty overrides our right to life. This is often the case with a woman’s right to choose, and having our government forbidden from torturing its citizens even at the risk of future deaths in terrorist attacks. But with sufficient local control and a continued existence of a health care private sector, we would still have the liberty to make other choices, and our tax burden would only be increased, although currently our tax burden is enough to pay for health care statistically, with local consent.
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