Following up on Regretting the "Fix" and British Health Care Woes, and indeed many other excellent posts on health care and social welfare in general, let me draw attention to a fundamental philosophical difficulty that explains why health care as well as the debate about it are typically going astray.
If you want to have good health care or, say, a flourishing economy, what you need are good laws - and I am not talking about meddlesome, ephemeral legislation - I am talking about the laws of genuine justice. Genuine justice does not address health care or economic issues directly, it ensures that we approach the challenges in the best possible manner human society is capable of.
Let us think about rights:
I am not suggesting the terms cannot be employed sensibly and responsibly - "right" or "rights," used in the sense of a person being entitled to doing something. Having said that, I tend to avoid the terms, preferring to work with the concept of "rules of just conduct," which imply rights and non-rights.
In a free society, rights are virtually innumerable (for instance, the right to chew chewing gum, or to buy a Michael Jackson CD etc), and new, previously unanticipated rights come into existence all the time, simply by free individuals acting in any manner consistent with adhering to generally applicable "rules of just conduct."
The latter, to avoid detrimental meddling, are very general, abstract and negative - negative in as much as that they do not specify detailed, positive requirements, like "you have or have not a right to buy a foreign car that is not running on ethanol and has only three wheels," but provide merely additional information (like "you must not renege on contractually stipulated promises") for a free person to understand what action she is entitled to take without violating another person's equally delineated and protected liberty.
Using "rights" as a means of legitimising and enforcing concrete wants is incompatible with the original intent of the idea of a right, and indeed supersedes the original notion, which strictly referred to general principles or rules, by its opposite: specific commands, which are either directly expressed and enforced (i.e. "marrying a Jew is prohibited,") or in a round-about manner, by empowering certain agents to take concrete authoritative interventionist action legally protected by a supposed right (i.e. the right of Germans to be protected from Jews).
Rules of just conduct refer to individual human behaviour, equally applicable to all of us. Period.
By contrast, rights in the increasingly abusively expanded meaning of the term refer to desired states of affairs, and legitimise arbitrary and coercive action deemed requisite to bring about such states of affairs, rather than protecting justice conceived of as something more than a mindlessly regurgitate phrase, i.e. a consistently meaningful set of principles.
Bastardised rights of this kind, let us call them social rights (including many so-called human rights), are notable for at least two highly undesirable traits: first, they are not clearly defined - mostly because, in principle, they cannot be clearly and non-arbitrarily defined:
For instance, a just distribution of income: the distribution of income, a state of affairs, cannot be meaningfully captured by the terms "just" or "unjust," only human behaviour can.
If the distribution has been achieved by people observing rules of just conduct, any outcome of the distribution is "just", derivatively, i.e. "just" in the sense of not involving unjust conduct on the part of anyone. More we cannot and should not ask of justice: to see to it that a person, any person, does not act unjustly.
In fact, the better we get at maintaining a consistent notion of justice, the richer we tend to be.
Also, a rich society will always be a society of differential income.
What matters is that the differentiation of income in such a society is a precondition of its growing wealth benefiting all, whereas in a, say, communist country, differential income persists, without serving as a precondition for increasing wealth benefiting everyone - which feature of a command society, in turn, is the always detrimental result of the absence of consistently practiced justice.
Secondly, to the disadvantage of a consistent use of the concept of justice, social rights give precedence to any coercive, arbitrary (as opposed to rule-heeding) concrete measures that happen to be considered conducive to attaining the indistinctly defined, desired states of affairs.
Social rights are the dream of big government - they create (a) the illusory impression of clearly defined, worthwhile "social" goals, and (b) the reality that some agent is empowered to enforce its interpretation of the mandate by such means as it considers expedient for the purpose.
That is to say: some airy-fairy mandate exempts certain parts of society, especially the government of the day, from adhering to rules of just conduct and gives them the power to impose their arbitrary schemes of realisation on all of society.
The result is an instance of what I try to summarise in my motto "freedom or irrationality."
A small, biased, privileged and disproportionately powerful segment of societal actors is entrusted with the solution of a problem that is actually best approached by incorporating the maximum number of players interacting under conditions of sensibly delineated freedom.
For, all big social problems are problems of adjusting successfully to unknown circumstances, so as to be able to ferret out unknown solutions. If we restrict free interplay, by privileging a minor section of the population to act the more powerfully and conceitfully, we make society a lot less intelligent than it needs to be to solve the problems that the anti-libertarian status quo pretends to be concerned about.
If justice is treated as a residual, at best, rather than the most important precondition of our civilisation, the logic of power takes over - and the logic of power is always the enemy of the common weal, which can only be achieved under conditions of freedom.
Here are two very useful articles on rights offered by the Adam Smith Institute - I take an even more radical stance, but the articles are nevertheless good and commendable, in my opinion:
The War on Capitalism - Human Rights, Political Bias, by Jacob Mchangama, and
A Short History of the Social Rights Myth, by Rachel Patterson
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