The U.S. Citizenship and Immigration Service lists the following as the rights of American citizenship: freedom of expression; freedom to worship as you wish; right to a prompt, fair trial by jury; right to vote in elections for public officials; right to apply for federal employment requiring U.S. citizenship; right to run for elected office; and freedom to pursue “life, liberty, and the pursuit of happiness.”
Actually, the Bill of Rights and other amendments to U.S. Constitution provide many more individual rights, including: freedom of assembly and petition; freedom from unreasonable search and seizure; right to own property and freedom from government seizure without cause; right to keep and bear arms; right to “no-quartering” of troops in peacetime; rights to due process and equal protection under the law and freedom from self-incrimination and double jeopardy; freedom from excessive bail and fines and from cruel and unusual punishment; right to citizenship; freedom from slavery, poll taxes, and involuntary servitude; and voting rights for women and 18-year-olds.
U.S. Supreme Court rulings and Congress have established rights to privacy; freedom from racial segregation, discrimination, and sexual harassment; rights to same-sex conduct and marriage and inter-racial marriage; contract, property, and abortion rights; and freedom from discrimination based on disabilities.
Not included are any rights to government benefits like those provided by Social Security, Medicaid, Medicare, Unemployment and various welfare programs. Since Congress can change or end these programs at any time, they are impermanent entitlements, not vested rights.
What, then, of the popular concept that U.S. citizens should have a right to health care?
Because of Medicaid, Medicare, and Obamacare, health care is well on its way to becoming an entitlement, but not a right.
Given the growing financial burden of existing entitlements, should health care for all become a national entitlement?
The fiscal answer is “no,” entitlements should be trimmed to reduce budget deficits. The emotional answer is often “yes” due to mounting and extravagant costs for drugs and extraordinary care.
These days there seems to be only frenzy in discussions about health care. However, some dispassionate discourse yields interesting ideas like this one. Why not treat and regulate access to health care as an essential public service like utilities and other industries "deemed to be affected with a public interest?"
“Medicine as a Public Calling,” a scholarly article by University of Michigan assistant law professor Nicholas Bagley, informs this idea:
“The debate over how to tame private medical spending tends to pit advocates of government-provided insurance—a single-payer scheme—against those who would prefer to harness market forces to hold down costs. When it is mentioned at all, the possibility of regulating the medical industry as a public utility is brusquely dismissed as anathema to the American regulatory tradition.”
“Closer economic regulation of the medical industry may or may not be prudent, but it is by no means incompatible with our governing institutions and political culture.”
As Bagley points out, this may not be the way to go. But this concept and other out-of-the box ideas should be dispassionately considered, away from raging political ideology, if controlling health care entitlement costs while retaining essential services is our goal.
Crawford is syndicated columnist from Meridian (crawfolk@gmail.com)
Saturday, September 23, 2017
Bill Crawford: Should healthcare become an entitlement?
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19 comments:
Many of the rights listed are not really rights anymore. It all depends on who you are, where you are, and how much money can you spare to prove you have those rights.
As far as health care it will end up as a single payer scheme. It is just a matter of time.
Well if we're bankrupting the government, we might as well get "free" healthcare on the journey.
The banks were nationalized to save Wall Street: might as well get our bailout by truly nationalizing healthcare.
The way it is now is the politicians and their buddies are getting rich while the people try their best to pay the taxes. Maybe it is time the people get something out of the government besides an empty wallet. The politicians are going to borrow as much money as possible. The people should be allowed health care while the politicians become richer.
Let JPS run our healthcare system. The outcome will be essentially the same. Healthcare, whether Obama care is repealed or not, will continue to cost more and you will have higher deductibles, longer waits and poor service. Anyone who has been to a Dr. in the last few years has experienced this.
The insurance companies, lobbyists, AMA, and hospitals are so deep into this that nobody, including our esteemed politicians, can figure out how to fix it.
Too bad we can't shop prices for medical services like everything else in the marketplace. I would gladly pay cash for most service and carry catastrophic coverage but many doctors can't or won't accept cash.
Nationalizing would equal rationing of essential services.
Sooner, or later - it will collapse on itself. All of it.
It has always been a matter of time. The advance of medical technology means that we are reaching a point when lives can be greatly prolonged by expensive medical procedures, most of which the average person cannot afford. The gap between what can be done to save you and what you can afford will continue to expand. When the cost of "essential" treatment becomes unreachable for enough "middle class white voters" you'll see an acceptance of a single payer system and health care becomes an entitlement. It's inevitable. People will simply choose life over death.
A right is by definition something the state will use its coercive powers to enforce.
If there is a "right to health care," the state can force people to attend medical or nursing school if there is a shortage of doctors or nurses.
Presumably those who fail out of school will be placed in some level of confinement or have other privileges taken away.
That's what a "right" to healthcare entails, taken to its logical conclusion.
Healthcare is a "utility."
We don't let electric companies gouge for services because electricity is essential to life. Healthcare is even more essential but we have to be able to determine what healthcare entails.
Healthcare has to be quantified from its expansive definition now.
Basic healthcare will expand and be covered. Elective procedures will be available at private rates
What healthcare do the politicians have?
Why can't the common citizen have the same?
Free health care should be no different than public education. And paid for by a mix of Federal , state and local funding. And if one desires to
have private health care let them pay for it just as those choosing private school.
Truth in Billing is paramount. Any provider who accepts public compensation or favor should have to charge each person the same rate for each service. We do not know the true cost of what we are getting. Most people need catastrophic insurance plans and could easily afford the niggling cost of basic treatment if they knew what those cost sre.
9:50 - they're already rationed. If you can afford insurance, you get a chance to live. If you can't, then you don't.
I think education is covered in the Constitution. Healthcare is not.
If you really want to see the hidden greed, ask your primary physician how many MRI machines and other expensive devices and specialty places he has a monetary investment in and income from. But don't expect him to level with you.
Then take a hard look at where all you have been referred and by whom and tell yourself those making the referral are not monetarily invested in that referral. None of them gives one whit about your health.
The "Bill of Rights" isn't a Bill - it is the first 10 amendments to the US Constitution - and it does not enumerate or convey any right(s) to anyone. It is a list of restrictions on the Federal Government.
So, for the "Bill of Rights" to have anything to do with health care there would need to be words such as, "the right of (all, certain, ???) people to have the Federal Government provide all manner of care, including health, by taxing (people, entities as Congress shall deem appropriate, ???) shall not be infringed..."
The founding fathers are all dead, but I believe I can provide the gist of their reaction to the suggestion that the above language not being included was a mistake: "ARE YOU OUT OF YOUR F'ING MIND?!?!?!"
Bend Please, Palms Flat.. said...
"I think education is covered in the Constitution."
Well, sort of, but as a right to education for each citizen.
Education isn't guaranteed, protected, etc., in and of itself, and in fact, the founding fathers specifically left things like "public education" out of the Constitution and the original ten amendments (the "Bill of Rights").
However, the Supreme Court's interpretation of the 14th simply requires that the states educate all people equally. If a state simply says it isn't going to provide ANYONE with an education (you know, sort of like JPS), that would be equal treatment of everyone. See Brown v. Board of Education of Topeka, 347 U.S. 483 (1954) and Plessy v. Ferguson, 163 US 537 (1896) - Brown over-ruled Plessy.
One can argue that The Declaration of Independence are the principles upon which the Constitution is based.
Inalienable rights are " life, liberty and the pursuit of happiness".
It's interesting to see those who didn't object to pro-lifers claiming a Constitutional right to life ( to be born) but not a right to life once a citizen is out of the womb.
I would also remind everyone that BCBS started out and continued to be for quite a long time as a non-profit.
Changing medicine to a business model took place in the '80's.
I would also remind everyone that our Founders did not imagine that we'd be so stupid as to not recognize the realities of our times . They certainly weren't stuck in the past and knew not to take words and sentences out of context.
10:03....what a foolish assessment you have provided. The next time your company receives a notice of discrimination charge from the Federal offices of the EEOC, how about you just tell them, "Hell, I didn't discriminate against her individually. I discriminate against everybody equally". Let us know how it goes.
Anonymous at 6:25 am wrote:
"...discriminate against everybody equally..."
I'll probably regret asking, but if the writer is reading this, please explain this phrase. The more in-depth you can make the explanation, the better it will be.
In any event, however "foolish" one might think Brown v. BOE, it is the current 14th/Constitutional law, as interpreted by SCOTUS, insofar as state-sponsored education. In fact, the educational system in the US - compulsory, public and tax-funded, is a 20th century development (and any "public education" at all, for anyone, is mostly an 19th century development).
There is no "right" to a state-sponsored/public education, nor is there a "right" to any particular content or level of such an education. The only way "rights" get involved is that if a state provides an opportunity for a public education, race is prohibited from being a factor in segregating schools. Note that "segregated schools" are very common in the US: lower/elementary, middle/jr. high, and upper/high schools. However, age is not a prohibited basis for "segregation."
As an aside, I think "education" is much like health care: neither are "rights," simply good public policy, but both have become huge centers of taxpayer money overseen by folks not qualified to oversee it and who have no incentive to be fiscally-responsible or prudent. Look no further than the post on JJ comparing the Desoto and Jackson schools' budgets and that assumes the Desoto schools are at least moderately cost-effective and prudently operated. It may well be that Desoto schools are a taxpayer ripoff and JPS is just an exponentially bigger ripoff.
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