History shows us that civil rights can exist as nothing more than legal fiction. Take, for example, the right to vote. Although suffrage was extended to African-Americans under the Constitution in 1870, that right was little more than a nice idea until the Voting Rights Act of 1965. With many activists and politicians calling for America to recognize the “right” to health care, it is well worth looking at what this means. Making promises that cannot be met is a betrayal of the public trust, and the integrity of the government depends on its ability to hold to its word. In many other economically-developed countries, the “right” to health care coverage exists, and nearly everyone is enrolled in some sort of insurance or public plan. Unfortunately, coverage is not the same as health care procedures. Many governments insure nearly everyone, but cannot deliver the health care that those insured people need. These governments leave a broken promise in the place of the right that exists in their laws.

Take serious diseases, for example. Although Great Britain professes to treat health care as a right, there is no right to an oncologist. In fact, John Goodman of the Cato Institute reports that only 40% of British cancer patients even see an oncologist. This has had devastating results on their health: 70% more cancer patients in Great Britain die than in the United States. In addition, wait times for free health care in that country are so extreme that 20% of colon cancer cases diagnosed as curable are incurable by the time treatment is available. Great Britain is not the only country that falls short when it comes to treating major health problems. The Heritage Foundation recently created a laundry list of places where Americans, despite lacking the “right” to treatment, still have better health outcomes than other countries with universal health care: “Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher. Breast cancer mortality is 9 percent higher, prostate cancer is 184 percent higher and colon cancer mortality among men is about 10 percent higher (in Canada) than in the United States.” Whether it is cancer, pneumonia, heart disease, or AIDS, Americans have better chances at surviving than Europeans and Canadians. If enshrining a right to health care in the law only eases consciences and not human suffering, then it is a lie on the part of government.

One of the major reasons for America’s advantage in treating major diseases is that our patients have far more access to modern medical technology and diagnostic procedures than other countries. The Heritage report shows that Americans are more likely to get mammograms, pap smears, colonoscopies, and PSA tests than Canadians. Americans have better access to drugs than Europeans: “44 percent of Americans who could benefit from statins, lipid-lowering medication that reduces cholesterol and protects against heart disease, take the drug. That number seems low until compared with the 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians who could both benefit from the drug and receive it. Similarly, 60 percent of Americans taking anti-psychotic medication for the treatment of schizophrenia or other mental illnesses are taking the most recent generation of drugs, which have fewer side effects. But just 20 percent of Spanish patients and 10 percent of Germans receive the most recent drugs.” We also have far more CT scanners, dialysis machines, and MRI machines than Europeans and Canadians, despite the fact that the first two pieces of technology were developed in Great Britain. Here again, the abstract right to health care does not translate into meeting the needs of the sick. It is far more honest and humane to establish a system that delivers health care than to write laws that promise it.

Waiting for necessary procedures also has a lethal toll on the populations of Europe and Canada. Greenwood writes that, “During one 12-month period in Ontario, Canada, 71 patients died waiting for coronary bypass surgery while 121 patients were removed from the list because they had become too sick to undergo surgery with a reasonable chance of survival.” The Canadian Supreme Court recognized this problem. Overturning Quebec’s ban on private health insurance, Chief Justice Beverly McLachlin stated: “The evidence shows that, in the case of certain surgical procedures, the delays that are the necessary result of waiting lists increase the patient’s risk of mortality or the risk that his or her injuries will become irreparable. The evidence also shows that many patients on non-urgent waiting lists are in pain and cannot fully enjoy any real quality of life.” Any time that a “right” to health care means artificially lowering or eliminating its costs, there will be too much demand for too few services. There is nothing moral about a system that trades in real efficiency and comfort for imagined equality.

Even where America does recognize the right of the poor and the elderly to health care, it tends to restrict rather than liberate the sick, as Sue Blevins documented in 2003: “Before Medicare was passed, seniors were promised that the program would not interfere with their choice of insurance. However, existing rules force most seniors to rely on Medicare Part A to pay their hospital bills — even if they can afford to pay for private insurance. Additionally, today’s seniors and doctors must abide by more than 100,000 pages of Medicare rules and regulations dictating what types of services are covered or not under the program.” Even the privacy and family rights of patients in the “care” of the government are violated in the name of the right to health care: “Under Medicare rules established in 1999, patients receiving home health care are required to divulge personal medical, sexual, and emotional information. Government contractors — mainly home health nurses — are directed to record such things as whether a senior has expressed ‘depressed feelings’ or has used ‘excessive profanity.’ If seniors refuse to share medical and lifestyle information, their health care workers are required to act as proxies. This means total strangers will be permitted to speak for seniors.” Rights cannot contradict each other. The “right” to health care means a loss of the rights to privacy, family, and consumer choice. This is no right at all.

Health care is not a right. Since we have such a murky understanding of what rights are in today’s world, many governments still pretend that it is, only to see increased regulation and bureaucracy stifle the delivery of good care. Outdated technology, rationing of time and services, and intrusive government follow the “right” to health care. Declaring health care to be a right puts it under the government’s supervision. Unfortunately, health care itself can never be a right. Coverage might be, as evidenced by how many countries have insurance rates near 100%, but there are still limited health care resources out there. The best that we can do is to let them be distributed in the most efficient way possible, which remains the free market. Trying to follow in the steps of Europe and Canada by making health care a civil right is a nice intention, but it will never amount to anything more than another broken promise by the government.


  • Price

    FYI, John Goodman is the president of the National Center for Policy Analysis. He does not work for CATO.

    Great post though!

  • http://cchconline.org vbmpls

    Good point about rights promotion as the way to enlist the government (and everyone else’s money.) Today “rights” are more about entitlement. Thus the coming end of liberalism as practiced in America, as they’ll eventually run out of golden eggs.

    CCHC advocates for patient and physician freedom, medical innovation, and the right of citizens to a confidential patient-doctor relationship.

  • Mark

    It seems like for this article you have picked your statistics to prove your point.
    What about the infant mortality rates: the US is 33rd with most European countries well ahead of them.
    Life expectancy 45th overall, again most countries ahead of them, including Great Britain.

    I don’t know if that makes a case for Obamacare, but that’s not the point I’m trying to make. You make it sound like it would be awful to live in England (I wouldn’t know, because I don’t live there) because you have a much higher risk to die of all these awful diseases, because of their screwed up healthcare system, yet, what you fail to report is that, on average, people live longer there.

  • J. Krutsinger

    An old favorite from The Economist:

    “Rights being good things, you might suppose that the more of them you campaign for the better. Why not add pressing social and economic concerns to stuffy old political rights such as free speech, free elections and due process of law? What use is a vote if you are starving? Are not access to jobs, housing, health care and food basic rights too? No: few rights are truly universal, and letting them multiply weakens them.”

  • Tom Wood

    Your post detailed the case against government provided health care nicely. However the issue or what constitutes a “right” was not properly addressed in my opinion.

    Rights are what we are due just because we are human and live in a community. Some might say we are “endowed by our creator” with these rights. What these rights are is up for debate no doubt but that debate is valid since the notion of what those rights are change as a culture evolves. A black mans right to vote seemed ridiculous to many in our countries past for example. Today most agree that voting is their right.

    All rights come at the expense of someone else it seems. A slave owner looses some of his power by letting his slave vote. However, the society as a whole benefits by everyone having a say in how we are governed. The slave owner’s loss is everyone’s gain.

    Few would argue that our right to liberty is a given. We have the right to do what ever we want to do as long as it dose not inhibit someone else’s right to do what they want. The liberty we all enjoy comes at a cost. We are not free to do anything we want, steal for example, because it damages the property owner’s right to be free to keep his property. It attack’s his liberty.

    As we embark on the debate of health care in this country. I think we benefit from the notion of what is a persons right. Health care as a right comes at a cost. I wonder if our nation’s culture has matured to a point that will allow us to pay the cost for the greater good.

  • Jeannine

    Our infant mortality rates look excessively high because we count very small premature babies as infants. Other countries do not. I believe that in most European countries, only babies born at 30 weeks’ gestation or more are counted as “births.” When looking at statistics, we need to know a little bit about how the stats were collected.

  • Timothy

    Is Acton going to even pretend to be an institute anymore? Or just trumpet right wing talking points. All human rights are rights of access, not consumption. And as for comparing American cancer treatment to Great Britain or Canada, your argument lacks the necessary context. The truth is, if you get cancer in the US and you can pay for treatment then you probably have a better chance of living than your British counterparts. However, if you can’t pay for it, which a lot of people even with insurance cannot, well then…you’re dead.

  • Roger McKinney

    While I am a libertarian, I actually support the administration’s health care policy.

    1) It does something. Inaction is not acceptable. The current healthcare mess has festered too long while Republicans did absolutely nothing about it. And opponents have very little to offer even today as alternatives.

    2) The gov insurance plan is what the insurance industry has needed for a very long time. Real insurance insures against random catastrophic events. But insurance companies bought of legislators in most states who enacted laws mandating ever more luxurious coverage. Mandated coverage guaranteed that upstarts couldn’t compete with large insurers, but it also drove the cost of health care and insurance to ridiculous, unaffordable levels. The federal insurance plan cuts the legs off those greedy large insurers and returns health care insurance to its rightful state.

    3) Opponents are stupid enough to believe that the federal government isn’t involved in health care today. They simply can’t see Medicare, Medicaid, the FDA, state regulation of insurance companies, government licensing of doctors, and the government sponsored AMA. Talk show hosts have convinced people that we have a free market in health care. Instead, our healthcare system is a socialist as anyone’s, just different in details. I think the new plan is a better form of socialism.