The Argument From Morality in Action: The Right to Health Care

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Those who have
read my recent series of articles on know that I
believe that libertarians can achieve great success by using the
argument from morality. This argument demands that those
who propose moral theories must prove that those theories are both
consistent, universal and absolute. Since the only way to know the
difference between an opinion ("I like ham!") and a fact
("Ham comes from pigs") is through consistent logical
analysis, anyone who claims that their moral prescription is a fact
must prove their case.

I thought it
might be interesting to subject a well-known and contentious topic
to the argument from morality, to see how this theory might shake
out in practice. I chose health care, since I live in Canada, where
our friendly neighbourhood state maintains a rigid grip on medical
services. (To my friends in the US, just imagine you are 10–15
years in the future!)

The proposition
that is generally believed here in Canada is: everyone has a
right to health care. (In the US, generally, it is: the poor
have a right to health care.)

Faced with
this proposition, libertarians generally point out that government-run
health care is inefficient, debt-ridden, coercive, unsustainable,
slow and subject to pressure-group influence — and that is all true,
but the sad fact is that these arguments don't work because people
just don't care about efficiency. If the poor have a right
to health care, it doesn't matter if it's difficult to provide.
It's like telling a couple with a new baby that babies are expensive,
exhausting, loud and so on — who cares? They have to take care of
their baby. Practical arguments never trump arguments from

To oppose the
government, then, we have to take aim against the soft underbelly
of the beast, which is the moral absolutes that all government programs
feed on.

So — if you
find yourself chatting with a man who says that the poor have a
right to health care, you can begin by asking him if that is just
his opinion, or if it is an objective fact. If it
is just his opinion, then you can say sure — that you would also
like a Lamborghini and Brad Pitt's washboard abs, and part as friends,
since the law cannot be used to enforce opinions. If, however, he
replies that it is an objective fact, then you can begin
the rather enjoyable process of getting him to prove his thesis.

If a moral
proposition is a fact, than it must be true for all people, and
for all time — just as a physics theory must be true for all matter,
and for all time. If not — if there is a single exception — then
it fails.

Here are some
problems with the proposition that everyone has a right to health

In the realm
of medicine, there are three categories of people. The first is
those who are sick, the second is those who are healthy — and the
third (a subset of the first two) are those who provide health care.
For the sake of brevity, let's call the sick group Joe Ailing; the
healthy Donna Vital and the health care providers Doctor Al Truism.

As long as
Joe is healthy, Dr Al owes him nothing. As soon as Joe gets sick,
Dr Al now owes him a debt which he is morally obligated to pay off.
However, this moral commandment fails the test of universality.
Joe is a man, and Dr Al is a man, and yet they are both subject
to opposing moral rules at the same time, since Joe is ethically
entitled to resources, and Dr Al is ethically required to provide
them. When Joe becomes ill, Dr Al suddenly owes him money, time
and resources, without reference to any sort of contract. How can
that be resolved? How can two men be subjected to both absolute
and opposite moral rules at the same time? Have their fundamental
natures changed? If not, then the moral absolute that everyone
has a right to health care fails, just as a physics theory which
posits that, at the same time, one rock falls down, and another
falls up, also fails.

Ahhh, if only
it were as simple as a single paragraph! Let's continue. What about
the test of time? Theories which claim universal absolutes
must also be true without regard for time. Murder cannot be wrong
today, but right yesterday. This is clearly not the case with Joe.
One day, he has no right to Dr Al's time and money. However,
the next day, he has an absolute right to them. When exactly
does this occur? At what point in time does Al become subject to
these new and opposite moral rules? How many symptoms does he have
to have? What if his illness is imaginary, or psychosomatic, or
he is a hypochondriac? How severe does his illness have to be for
the complete reversal of this moral right to occur? If he has a
cold, can he demand treatment at 2am? Does that right change at
9am? And does Joe even have to be sick? What if he's just curious
about Avian flu? Can he drop in for a nice chat with his doctor
about that? And if he does, what about the right to health care
of everyone else in Dr Al's waiting room?

Of course,
the argument can come back that Joe must be sick, and that
is the substantive difference between Joe and Dr Al, which is why
they are subjected to opposite moral rules. Very well — even though
illness (except for very rare forms of mental illness) does not
change a man's moral nature — let us take it on faith that
there is a substantive moral difference between healthy and sick

In this case,
the proposition that everyone has a right to health care becomes
more problematic, not less! Can the following questions be
answered objectively and rationally? What degree of illness
is required to change Joe's moral nature? Does a cold suffice? What
about stubbing his toe? There is no objective line that can be drawn.
But even if a moral line could be drawn, what about preventative
medical care? If Joe has a right to health care, then we can assume
that he has the right to regular check ups. Thus if Joe goes to
Dr Al for an exam and is pronounced perfectly healthy, Joe is not
sick — and so the presence of illness cannot be used to claim any
substantive moral difference. How, then, can Joe and Dr Al, as healthy
males, be subjected to diametrically opposite moral rules at
the same time and in the same room? The question cannot
be answered.

And what about
Dr Al himself? Doubtless he also has the right to health
care, and so can go to Dr Bob for a check up. Thus one day, Dr Al
is morally obligated to provide heath care to Joe. The very next
day, Dr Al has the moral right to demand health care from Dr Bob
— and while he is being examined, is not required to provide health
care to anyone else. Thus moral absolutes are constantly changing
— and sometimes for the same person overnight — which makes no sense,
and invalidates the moral absolute that everyone has the right to
health care.

The wonderful
thing about false moral premises is that, no matter how they are
approached, they always fall apart. So let's take another tack and
see how this nonsense unravels.

Let's say that
all the above problems and contradictions have been magically solved,
and we have justified the premise that the sick have the right to
health care. In other words, we accept that, when Joe gets sick,
Dr Al owes him a debt. So what? That doesn't mean that the government
should take control of anything. We already have a legal system
in place to facilitate debt collection — and so we don't need any
additional agencies. Since Dr Al owes Joe a debt, Joe can just use
the legal system to collect it! If Dr Al doesn't u2018pay' Joe the services
he is u2018owed,' then Joe just takes him to court and all is well.

All right —
let's just see where this little premise takes us. If everyone who
is sick is u2018owed' services by everyone who can provide health care
— if it is a universal moral absolute — then everyone with any form
of ailment — or who desires any form of check up or preventative
care — can take any doctor to court for restitution. Given
a world population of 6 billion, we can assume that hundreds
of millions of men, women and children are in need of health
care at any given time — all of whom have the absolute moral right
to sue Dr Al for what he u2018owes' them (and so the justice system
also u2018owes' them resources as well!). Does that sound like a good
idea? Yet that is where the moral theory takes us.

If that doesn't
sound like a good idea, how about this? If someone has stolen my
car, I am completely within my rights to go and get it back — using
force if necessary. Thus if Dr Al owes his services to anyone who
is sick, then hundreds of millions of people have the right to go
and extract those services from him — by force if necessary! Sound
like a good idea? Yet there it is.

And why would
the theory that everyone has the right to health care apply
only to services provided by doctors? What if I possess some kind
of medical knowledge that might be helpful to anyone out
there? What if I've gone on a diet and know what works? What if
I'm an athlete who's learned about sports injuries? What if I'm
a diabetic who's learned how to manage my symptoms? Does everyone
who can benefit from my medical knowledge have a right to my expertise?

Let's take
another angle. Those who provide health care services u2018owe' health
care to the sick. But who is that exactly? Doctors, sure
— but what about nurses? Receptionists? The phone companies who
maintain the lines? The petroleum companies that supply the gas
that powers the ambulances? The janitors who nightly clean up the
offices of the insurance companies? The investors who lend money
to pharmaceutical companies? The teacher who instructs the computer
programmer who writes a medical billing system? What about the babysitter
who looks after the kids of the nurse so she can work a night shift?
Does the babysitter also u2018owe' services to the sick? Can she be
sued if she doesn't show up, and the nurse has to cancel her shift?
Where can the line be objectively drawn between those who provide
health care services and those who do not? Isn't the moral theory
of a u2018right' to health care obviously foolish, illogical, subjective
and unworkable?

But let's say
that somehow the above problems have all been solved — here's another
problem. When does a woman in the process of becoming a doctor switch
from someone with a right to receive health care to someone with
an obligation to provide it? In other words, since from one day
to the next she becomes subjected to completely opposite moral absolutes,
what changes in her nature? Does she somehow become a different
species? And at what objective point does it occur? It's certainly
not the first day of her classes — and yet it is also not
ten years into her career. Is it at 12:01am on the day before she
sees her first patient? Is that when she flips into this alternate
and opposite moral universe? Think about how silly this is as a
moral theory — 12:00am, she is owed health care — 12:01am, she owes
everyone else health care. Madness!

If people have
a right to health care, then can Dr Al take a vacation? Can he retire?
Is he obligated to answer health questions while on vacation? What
if he doesn't? What if he decides to quit medicine and become an
actor? Is he no longer required to provide health care? Why not?
What has changed? How can moral rules switch so randomly for the
same person? How can this be called any kind of consistent and logical
moral theory?

So far we have
only been talking about the sick and the doctors — Joe and Dr Al
— but usually at this point in the argument, we see the entrance
of Donna Vital, the healthy taxpayer. In order to solve the above
problems, it turns out that Joe does not have the right to Dr Al's
services, but rather has the right to Donna's money so that he
can pay for Dr Al's services. This solves some of the problems
outlined above — but raises even more substantial silliness!

The transactional
sequence of the "taxpayer" solution is that sick people
have the right to the money of healthy people — including those
who provide health care — as long as that money is used to pay for
health care. Thus it doesn't matter how much money you pay into
the system — you are owed health care even if you're a new immigrant,
or a baby. Very well. What are the results of this excellent moral

So Joe gets
strep throat, and wants to see Dr Al. On the way, he just has to
make a quick stop at Donna's house to pick up the cash. He can take
a gun if he wants, since his right to health care is a moral
absolute. Doesn't that sound like a fabulous idea? What
if she's not home — should Joe go to her neighbour? What if her
neighbour doesn't have the money?

Of course,
it's never presented that way. Cloaked in the magical fog of government
force, the problem of individual use of violence is bypassed and
buried in sentimental rhetoric. So let's take that as an
axiom, and say that the government has the right to take Sally's
money and give it to Joe to pay Dr Al — or pay Dr Al directly after
Joe visits him. What could be wrong with that?

Well, nothing
at all — except that the above is a mere description of the uses
of violence, and has nothing to do with any moral theory whatsoever.
If I say that stealing is wrong for everyone, that's a moral
theory. If I say that stealing is wrong for everyone except for
people named u2018Joe' between the hours of nine to five, I've expressed
a random and rather silly opinion, not a moral theory. If I say
that everyone has a right to health care, that's a moral
theory which can be examined rationally — however, if I say that
some people have a right to limited degrees of health care under
certain circumstances, and that only certain other people have a
right to procure that by the use of force while wearing certain
blue-colored clothing, and then only to a certain degree, and that
doctors must provide health care, unless they're on vacation, or
it's after 5pm, and so on and blah de blah — then that's not
any sort of moral theory, but just a bunch of silly and self-contradictory
statements that don't even add up to a coherent subjective opinion,
let alone a consistent and objective proposition. It would be like
proposing a scientific theory which says that sometimes rocks fall
up, and sometimes they fall down — and sometimes they fall up and
down (and sideways!) at the same time! A person proposing such a
theory invites a prescription for lithium far more than a rational

Let's take
one final example. If something is moral, then it must have been
moral for as long as men have been rational. Murder cannot be wrong
today but right yesterday. Thus the poor have always and
everywhere had a right to heath care. Does that mean that
any doctor throughout history who ever charged a patient was immoral?
Dental care is health care, but here in Canada dentists charge for
their services — are they then immoral? My wife charges her patients
— is she immoral? Is every American doctor immoral relative to Canadian
doctors? If not, why not?

And finally,
if the belief that everyone has the right to health care is based
on people's right to goods and services that give them life, then
food and water are more critical than health care — and yet no one
is advocating that the government take over all the farms and supermarkets?
Why not?

Why is this
so important? Why bother with all this logical analysis? Well, because
the power of the State rests entirely upon supposedly-universal
moral theories. Opposing the consequences of government
programs has no effect — as we have seen for decades — if people
believe that government programs are moral. If someone claims
a moral absolute, they must be responsible enough to know
what they are talking about. A moral absolute puts guns on the street
— it puts people in jail, and sets the whole machinery of state
violence in unstoppable motion. If you meet a man who advocates
the use of violence to solve social or economic problems, you must
insist that he must submit his moral premises to rigorous and relentless
logical examination — if he does not, then he is just calling for
universal violence to enforce his opinions, which is a very
great evil.

beliefs are irresistible universal absolutes, and must be opposed
at their source if we are to begin reshaping the fundamental decisions
of mankind. Ethics is the hidden physics that shape the world of
the mind, and we can only truly oppose the power of the state by
attacking the false moral premises that support it.

30, 2005

Molyneux [send him mail]
has been an actor, comedian, gold-panner, graduate student, and
software entrepreneur. His first novel, Revolutions
was published in 2004, and he maintains a

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