A common argument for a universal (and almost always, government-owned and operated) system of health insurance and/or health care is that health care is an inherent or basic human right. On one level I find these arguments shallow and illogical and on another, I think if properly understood, there is a potential logical basis, but the proposals that inevitably follow for how to achieve the goal are doomed to failure. As far as I can tell there is no such thing as an “inherent” human right; i.e., one that Nature (with a capital N because that is how proponents do it) has endowed us with, except the right to be savaged and eaten by other living things. Nature is sublimely uncaring about the fate of individual humans or even the species. Whatever individual or species wins, wins, is Nature’s motto, and by whatever means is fine. While the opening lines of the Declaration of Independence are stirring beyond what I can adequately express, I see no objective evidence to suggest that Nature or a benevolent creator has endowed us with any particular rights of any type, and particularly not of life, liberty or the pursuit of happiness.
When some people refer to a “basic” human right, I think they mean the same thing as one that is inherent in our existing, and they are just as wrong. But, there is another conception of a basic human right. That conception springs from the fact that humans are intelligent and self-aware (occasionally) and have chosen to organize themselves into societal groupings under which they collectively decide, or are subjected to the decisions of a few regarding, what rights and responsibilities individuals in the societal grouping will have. In this conception, humans could well decide that within their society access to health care is a basic human right and one way or another people should be provided with that access. I think sound reasons can be advanced for that position and for such provision of health care. So I am comfortable with a society making this decision, but there is no inherent or a priori reason why it must reach that position.
A further problem, however, is that those who hold this view, in our country and others, then think that the best way to achieve this is for government to just pay for and/or provide the health care. This is a solution, which despite being used in most developed nations, has not generally worked well. And the reason is obvious. While there aren’t inherent rights for humans, there are rules of human behavior, rules which if ignored in formulating policy, for whatever well-intentioned reason, inevitably lead to failure of the policy. One of those rules of human behavior is that if you give people something that appears to be free (and most people have difficulty understanding that one way or another they are paying for “free” anything), they will use it to excess and not be motivated to take responsible actions in regard to the subject. This is certainly true in regard to health care. Severing the link between actions and consequences of actions is always a bad idea when it comes to humans.
Free health care does not lead to better outcomes because it does not lead to better health or even health care-seeking behaviors. On the contrary, it encourages worse ones. Why eat properly, exercise, drink moderately, not use dangerous drugs, wear bicycle or motorcycle helmets or engage in any healthy behavior if it has no impact on your access to health care or how much you pay for health care. So if we want to recognize access to health care as a basic human right, let’s do so in a way that also recognizes basic human behavior. People should pay to the extent they can. People who can work and choose not to should not get free health care, or frankly, any other government service. People who are relying on the common purse to pay for their health care, should have to receive it at the lowest cost site. And people who don’t change unhealthy behaviors should lose their access to free health care. That is a system that might actually both improve health and lower the costs of providing health care.