Here is a splendid post about the economics of health care from Ben Shapiro, writing for National Review.
He responds to a view held by those on the radical left: people need health care, therefore health care is a right.
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? Do you have the right to demand that the medical system provide life-saving care forever, to the tune of millions of dollars of other people’s taxpayer dollars or services? How, exactly, can there be such a right without the government’s rationing care, using compulsion to force individuals to provide it, and confiscating mass sums of wealth to pay for it?
The answer: There can’t be. Rights that derive from individual need inevitably violate individual autonomy.
But there are ways to make a commodity less expensive, and of higher quality. It happens all the times in free markets, where innovators are rewarded with profits – just think of the people who sell smartphones.
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.
So, what’s the solution for poor people? Not to declare medical care a “right,” and certainly not to dismiss reliance on the market as perverse cruelty. Markets are the solution in medical care, just as they are in virtually every other area.
Treating medical care as a commodity means temporary shortages, and it means that some people will not get everything we would wish them to have. But that’s also true of government-sponsored medical care, as the most honest advocates will admit. And whereas government-sponsored medical care requires a top-down approach that violates individual liberties, generates overdemand, and quashes supply, markets prize individual liberties, reduce demand (you generally demand less of what you must pay for), and heighten supply through profit incentive.
It’s always a good idea to look at how health care is working in countries that do have single payer health care systems. Canada has a single-payer system. How is that working out?
The Fraser Institute issued a recent report on health care in Canada:
Waiting for treatment has become a defining characteristic of Canadian health care. In order to document the lengthy queues for visits to specialists and for diagnostic and surgical procedures in the country, the Fraser Institute has—for over two decades—surveyed specialist physicians across 12 specialties and 10 provinces.
This edition of Waiting Your Turn indicates that, overall, waiting times for medically necessary treatment have in-creased since last year. Specialist physicians surveyed report a median waiting time of 20.0 weeks between referral from a general practitioner and receipt of treatment—longer than the wait of 18.3 weeks reported in 2015. This year’s wait time—the longest ever recorded in this survey’s history—is 115% longer than in 1993, when it was just 9.3 weeks.
[…]It is estimated that, across the 10 provinces, the total number of procedures for which people are waiting in 2016 is 973,505. This means that, assuming that each person waits for only one procedure, 2.7% of Canadians are waiting for treatment in 2016.
[…]Patients also experience significant waiting times for various diagnostic technologies across the provinces. This year, Canadians could expect to wait 3.7 weeks for a computed tomography (CT) scan, 11.1 weeks for a magnetic resonance imaging (MRI) scan, and 4.0 weeks for an ultrasound.
Research has repeatedly indicated that wait times for medically necessary treatment are not benign inconveniences. Wait times can, and do, have serious consequences such as increased pain, suffering, and mental anguish. In certain instances, they can also result in poorer medical outcomes—transforming potentially reversible illnesses or injuries into chronic, irreversible conditions, or even permanent disabilities. In many instances, patients may also have to forgo their wages while they wait for treatment, resulting in an economic cost to the individuals themselves and the economy in general.
The typical cost of the single-payer health care system to a Canadian family is nearly $12,000.
Socialist Canada has been doing a lot of taxing and spending to try to fix this problem, but the problem is getting worse. And no wonder: when the government controls health care, it becomes a tool for buying votes. Abortions and sex changes are “health care” in Canada. Breast enlargements and IVF are “health care” in the UK. Of course, good luck getting treatment when you are in your old age and will not be voting much in the future : both Canada and the UK have euthanasia programs to get rid of elderly people who are no longer as useful to politicians as young people who still have lots of voting ahead of them.