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Health Care and the Separation of Charity and State

From The Objective Standard, Vol. 6, No. 1.


If someone in America needs medical care but cannot afford it, should he rely on charity or should others be forced to pay for it? President Obama and his political allies say that Americans should be forced to pay for it. Forcing some Americans to pay medical bills for other Americans, says Obama, is a “moral imperative”1 and “the right thing to do.”2

Throughout the health-care debate of 2010–11, Obama repeatedly referred to government-run health care as “a core ethical and moral obligation,” arguing that, “No one should die because they cannot afford health care, and no one should go broke because they get sick.”3 In speeches, he repeatedly cited the story of Natoma Canfield, an Ohio cancer patient without health insurance, as a justification for his health-care legislation.4 Many of Obama’s supporters on the political left made similar moral claims. Vanderbilt University professor Bruce Barry wrote in the New York Times that, “Health insurance in a civilized society is a collective moral obligation.”5 T. R. Reid, former foreign correspondent for the Washington Post, called universal health care a “moral imperative.”6 Ezra Klein, another writer for the Washington Post, agreed that it is an “ethical obligation.”7

But all such claims are wrong—morally wrong.

There is no “right” to health care. Rights are not entitlements to goods or services produced by others; rather, they are prerogatives to freedom of action, such as the right to free speech, the right to contract, or the right to use one’s property. Any attempt to enforce a so-called “right” to health care necessarily violates the actual rights of those who are forced to provide or pay for that care.

If a patient needs a $50,000 operation but cannot afford it, he has the right to ask his friends, family, neighbors, or strangers for monetary assistance—and they have the right to offer it (or not). But the patient has no right to take people’s money without their permission; to do so would be to violate their rights. His hardship, genuine as it may be, does not justify theft. Nor would the immoral nature of the act be changed by his taking $100 each from five hundred neighbors; that would merely spread the crime to a larger number of victims. Nor would the essence of the act change by his using the government as his agent to commit such theft on an even wider scale. The only moral way for this patient to receive the assistance he needs is for others to offer it voluntarily. Morally, he must rely on charity.

Fortunately for him, there is no shortage of people willing to offer charity, nor is there a shortage of reasons why one might self-interestedly wish to do so. . . .

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