Tibor Machan on the Myth of Medical Care Rights, the Media Frenzy and the Possibility of Backlash
The editors of The Daily Bell are pleased to present an interview with well-known libertarian philosopher Tibor R. Machan.
Introduction: Tibor Machan is currently Professor Emeritus, Department of Philosophy, Auburn University, Alabama, and holds the R. C. Hoiles Endowed Chair in Business Ethics and Free Enterprise at the Argyros School of Business & Economics, Chapman University. He is also a research fellow at the Hoover Institution, Stanford University. Machan, who earned BA (Claremont McKenna College), MA (New York University), and Ph.D. (University of California at Santa Barbara) degrees in philosophy, has written numerous books and papers in the field of philosophy, including on issues surrounding the free-market. Machan was selected as the 2003 President of the American Society for Value Inquiry, and delivered the presidential address on December 29, 2002, in Philadelphia, at the Eastern Division meetings of the American Philosophical Association, titled "Aristotle & Business." He is on the board of the Association for Private Enterprise Education.
Daily Bell: Good to hear from you again.
Tibor Machan: My pleasure. I welcome your interest.
Daily Bell: What did you think of the way the health care bill progressed and finally passed?
Tibor Machan: As most contentious bills go, it was rushed and unexamined, lest folks wake up to its implications before it was locked in. The Tea Party opponents could be marginalized, sadly, because some of them reportedly misbehaved – although that never served to marginalize Leftist populist movements.
Daily Bell: Did the mainstream media do a good job covering it?
Tibor Machan: We can't expect many in the mainstream media to fairly cover the ramifications of this legislation. While it has been available in one form or another for some time, most analysis has focused on the political fight rather than what is in the bill itself, and whether the process and substance is broadly constitutional. The coverage instead has been along the lines of "gossip reporting" – focusing on the personalities involved and their politics. This makes for fascinating reading, for some, but does not generally help foster an understanding of the larger issues.
Daily Bell: What might those be?
Tibor Machan: In the best of all worlds, the controversy over the bill might lead to a better understanding of the relationship between people and their health care. Medical care, in fact, is a value that doctors, nurses and other medical professionals would, if they were free men and women, provide to people they would choose as recipients, on terms they regard as acceptable. But these provisions are not owed to anyone. Doctors, nurses and other medical professionals may not be placed into involuntary servitude to people needing their services. The relationships should be voluntary, no matter how vital the services in question are to the recipients.
Daily Bell: Of course all of this legislation makes providing health care distinctly less free.
Tibor Machan: The belief that people may justly be coerced so as to secure funds to pay medical professionals who then will service those who need their work is an error. In a free country adult men and women must treat each other as ends in themselves, not as unwilling tools, instruments, or means to each other's ends. Just as someone may not go over to his neighbor's home and conscript some unwilling individual to come and mow his lawn or drive him to the hospital but must ask for this and await willingly given help, so any service such as medical care must be obtained without coercion.
Daily Bell: Here's a question bound to provoke a response: Was it a laudable and fair process?
Tibor Machan: Fair? I believe that once you have a feeding frenzy in a bloated democracy, fair is out of the question. It isn't even clear what that would come to. Fair could only apply if the democracy were truly limited. Not only do you have to consider the fairness of the statute, you have to consider the fairness of the law's evolution.
I have to tell you that I have written a chapter in one of my books titled "Against Fairness" because this idea belongs in the home, the dinner table where children will squabble about fairness; or again in the classroom where the professor might favor some students over others. Fairness presupposes the obligation to serve a group equally well. It cannot apply to a country with a highly diverse citizenry confined to protecting bona fide rights, except in how evenhanded that protection is.
Daily Bell: So part of the problem, then, is the democratic process as the US applies it?
Tibor Machan: There are people who believe that once it has been democratically determined that people must pay for medical services to everyone, there is nothing wrong with collecting taxes for this purpose. This view is wrong, because no group or majority of a group may decide to take what belongs to people. It is no less unjust to do such a thing than it is to hang someone because the majority in some town decides it is acceptable to do so, without first following due process, namely demonstrating through a justice system that the hanging is deserved.
Daily Bell: Do you believe society has a moral obligation to cover all people?
Tibor Machan: Societies have no obligations, only people do, based on what they have promised to do. A free government's promise is to protect everyone's individual, human rights does not include placing others into involuntary servitude.
Daily Bell: The idea of a right to medical care is a myth?
Tibor Machan: There are many ideas in academia that contribute to the myth of the right to medical care. But government regulators are acting unjustly when they set and enforce standards for other people to follow even though they have not acted in violation of anyone's rights but only might do so. Government regulators follow precautionary principles, which perpetrate a form of prior restraint. What is wrong with prior restraint is that it imposes burdens on individuals without their having been proven to have violated anyone's rights, that is, committed a bona fide crime.
Daily Bell: So you see it as a rights issue?
Tibor Machan: If someone is coerced into making provisions for the health care, social security, or related needs of others, this is forced labor, plain and simple. It should be understood that even if such new rights had been added to the Constitution of the United States, that would not settle the issue of whether they should have been added, or whether they are rights we all have as opposed to ones that have merely been invented.
Daily Bell: From your point of view, government was wrong to even try this sort of regulation?
Tibor Machan: It will be a bureaucratic morass. Just as no one has the intrinsic right to health care, so government has no just authority to regulate medical professionals. The existence of such rights or entitlements implies the treatment of other people as involuntary servants. This is not to deny that there are serious problems facing people in any society pertaining to their medical needs, or that the medical profession requires standards by which to carry out its responsibilities.
Daily Bell: What's the solution?
Tibor Machan: The answer to how to deal with such issues is that a society requires a legal infrastructure that clearly identifies the realm of sovereignty of each individual and spells out the rights of individuals so as to be able to identify criminal conduct, including by people in the medical profession. Once such a legal infrastructure governs the society, the productive, creative, and innovative potentials of those in the various professions, among them medicine, will be more likely to flourish than in a society subject to the injustices of government regulation.
Daily Bell: Does the bill come close in any way?
Tibor Machan: It is nothing more than a means for some to rip off others, period. De Tocqueville warned, I believe, that America will be destroyed when people discover they can vote other people's resources away to make them their own. It's clearly happening and has been happening big time since even before the New Deal.
Daily Bell: What will the backlash be to the bill?
Tibor Machan: There may be a backlash. But Americans are so much better off – in consequence of the substantial measure of liberty that the country has enjoyed – than are those in most other countries, that they are complacent, apathetic, inattentive to the hazards the statists pose to their liberty, such as it is, let alone the prospect of expanding it. There certainly is a substrata of anger as a result of this bill, that can't be denied. It may have to do with the sheer audacity of the power grab. Also the burden imposed on offspring – who aren't even here to vote – pure case of taxation without representation.
Daily Bell: Will the bill be repealed by a Republican Senate?
Tibor Machan: I don't know and am not sure that would help. All politicians, except a very few, are believers in ripping off Peter to benefit Paul. There are many reasons why it would not be repealed even if the Republicans got back into power. The sooner people adapt to the benefits, the more difficult it will be to remove the goodies. Many of the more repressive elements of the bill are back-loaded and don't take place for several years.
Daily Bell: Was the bill an exercise in progressivism?
Tibor Machan: I despise that fraudulent term – progress would be to march toward freedom. This was regress, reactionary politics taking us back to when kings or tsars ruled the realm, indeed owned it, and everyone was a subject to whom some few privileges were extended.
Daily Bell: What will the results of the bill actually be?
Tibor Machan: Massive indebtedness and a slowdown of economic growth and technological progress, unless citizens wake up pretty soon and change it all.
Daily Bell: Is it a step backwards or forwards for American freedom?
Tibor Machan: Clearly, unambiguously, backwards. The American experiment was built on restricting government and government activism. The idea of mandating payments by Americans to the health care industry is a radical new leap forward for government activism. In fact, the Constitution tells us what the government is ABLE to do – and there is nothing in the Constitution that informs us that the federal government is able to mandate citizen payments for health care.
Daily Bell: What does the bill say about the Obama presidency?
Tibor Machan: That he is now an unabashed socialist, nearly exactly like Hugo Chavez. Chavez has done things in Venezuela that Barack Obama would no doubt like to do. The ascension of governmental ambition is the same – the gradual widening of state control not for purposes of efficiency but as part of a larger agenda. It is obvious, having observed Obama during his presidency, that the president's hope and change does indeed expand government's role dramatically on an ongoing basis and one would be foolish at this point to expect anything else from his presidency.
Daily Bell: Then can we expect other bills now to be pushed through such as one having to do with immigration and another on financial regulation?
Tibor Machan: We will certainly see attempts because, as I just stated, this president sees himself as transformative leader like a Ronald Reagan or a Franklin Roosevelt. He may not achieve as much because Americans are still suspicious of massive government and must be made comfortable with it slowly, while they are watching basketball or baseball or sitcom reruns. But that's merely a guess. There is no doubt that President Obama would like to have additional legislative victories in the area of financial regulation and immigration reform if he can.
Daily Bell: How will Obama be remembered? Was this a triumph for his administration?
Tibor Machan: By whom? These are matters that will be decided by people in the near or far future and one can only guess, which I don't prefer to do. I'd rather just work in the right direction, as hard as I can and as long as I am able.
Daily Bell: What does the coverage say about our mainstream media?
Tibor Machan: In some cases there was plenty of attention given to critics but mostly just on Fox TV and in a few papers. Certainly nothing was allowed to slow down the train in the pages of the New York Times or Washington Post or on PBS and NPR. The mainstream media took no chances of possibly alienating the administration and missing out on being invited to The White House.
Daily Bell: Thanks for commenting on this most important topic.
Tibor Machan: Happy to do so.
Tibor Machan's points on the health care bill ring true to us. Tibor is a proponent of freedom and one of the founders of Reason magazine. He understands rights within this context and in the interview, above, he makes the point that health care is not a right, as rights have been commonly defined within the context of classical liberalism.
What is a right within the Anglo-American Western tradition of past centuries? A right is in fact inherent to the human condition – and was defined as such by the US Constitution. But this is not comfortable for the ruling class generally. In the European Union, the rights conversation has veered toward what the state itself can provide. This is the point of view that the Obama administration seems to have adopted as well.
While the latest assault on natural rights has taken place within the ambit of the recent American health care bill debate, the approach taken is not unfortunately a new one, even for America. Anyone casually familiar with these sociopolitical conversations will recall other efforts along this line. What those in the US government, especially, have been doing for the past many years is attempting to redefine rights so that they are bestowed on the populace by corporate or government entities.
Simply put, the idea of natural rights – the kind of rights on which America was founded – come from nature and a "creator." Legal rights come from government or other aspects of human endeavor. US founders, Thomas Jefferson especially, understood the slippery slope on which one stood when acknowledging that the larger human institutions – public, private, or both – had the right to bestow or remove "inalienable" rights. It is, the thinking went, the fastest route toward totalitarianism and arbitrary bureaucratic decisions having to do with the fundamental human condition, including life and death.
Here is a Wikipedia definition of natural rights versus legal rights:
Natural rights are rights which are derived from Nature or God. They are universal; they don't depend on the laws of a specific society. They exist necessarily and can't be taken away. For example, it has been argued that humans have a natural right to life. They're sometimes called moral rights or inalienable rights.
Legal rights, in contrast, are based on a society's customs, laws, statutes or actions by legislatures. An example of a legal right is the right to vote of citizens. Citizenship, itself, is often considered as the basis for having legal rights, and has been defined as the "right to have rights". Legal rights are sometimes called civil rights or statutory rights and are culturally and politically relative since they depend on a specific societal context to have meaning.
The issue of "rights" is probably the most important one when it comes to the US health care debate and subsequent legislation. Unfortunately, the mainstream media has not focused on whether the government has the right to impose a particular medical scheme on the populace – one justified by rhetoric about "universal rights," etc.
One can parse the recent legislation – and the argument – anyway that one wants. But at the end, it is the government itself (and the private, mercantilist forces behind the government) that are mandating a plan that demands that Americans pay for health care. Additionally, the plan sets up various bureaucratic solutions and mandates these solutions above others. The federal government in this case is the "decider" when it comes to the "rights" that have been defined and enforced by the same entity.
It is most dangerous to civil society when government is able to set a precedent of first defining what a "right" is and then acting on that definition via specific mandates that must be obeyed under threat of punishment. The problem comes when unscrupulous individuals ascend to power and begin to enact "rights" according to their fancy that they then enforce using the full power of the authoritarian state. This has happened too many times in history to count.
The health care legislation, with its various mandated payments and solutions, can be seen as an admirable effort to insure "30 million uninsured" in America. But the larger issue – leaving aside the debate itself – is the underlying assumption that government has the power and ability to pass such laws. The health care bill in America is yet another statement that government DOES have the power to define and enforce "rights." This bureaucratic stance, in fact, brings the US political system more in line with that of the European Union.
"Some material in this interview first appeared (in some form) In a recent article by Tibor Machan entitled "Values, Regulation and Health Care" published in The Journal of Value Inquiry.
Posted by Gooarby on 03/28/10 06:20 AM
Tibor is always a great interview. Thanks for the analysis.
Reply from The Daily Bell
Posted by Puzzled on 03/28/10 08:11 AM
What is this man doing in 2012? There are so few like him, in our world. But I'm sure he doesn't want to go the way of the Kennedy's!
Reply from The Daily Bell
Like many other people of quality, Dr. Machan cannot stay silent.
Posted by Robert on 03/28/10 09:23 AM
It is unfortunate that in all the debate leading up to the criminal vote that it was not forcefully pointed out that this was not a healthcare bill but rather a healthcare and tax increase bill. The estimates that this bill reduces the deficit over ten years are absolutely in error.
The tax bill portion was $406 billion so by itself would have reduced the deficit, but the providing of a major new welfare entitlement program to those who "can't afford it" is clearly unconstitutional. Let's get our Supreme Court into the act.
Posted by Ken on 03/28/10 09:28 AM
The State has only increased its power through this bill, it has always regulated the supply of medical people through its licensing, limiting it and so ensuring a premium income for medical specialists.
Posted by Charles Smyth on 03/28/10 09:38 AM
A major complication for the 60 of Americans who do not vote, either on principle, or because they cannot see anything in it for themselves, is that the Constitution and Bill of Rights has been consigned to the dustbin of history decades ago, and have been replaced by the Federal government and its institutions. This means that the limits of democracy are not at all tested, and everyone's freedom is subverted to the majority of a minority of eligible voters.
Posted by Nanoo Visitor on 03/28/10 09:49 AM
It has already been suggested that agents provacateur may have been used in an attempt to marginialize the Teat Parties. Try the google search: "agents provacateur" "tea party."
Posted by Nanoo Visitor on 03/28/10 09:52 AM
People who would normally keep well away from politics are now entering the fray. Dr Arthur Robinson (Petition Project, Access to Energy, Click to view link) will run against a 12-term incumbent in upcoming US congressional elections.
Posted by BILL WOLF on 03/28/10 09:59 AM
Thank you Mr. Machan, you right on about how freedoms are being taken away, an as something is given to people, it will be hard to ween them off of free health care at the expense of others.
We need to send this article to every politician in every state, and at every level of government, to teachers in every school, so they can read, and hopefully teach the future leaders to remember how our system of government was designed to work,and not fall into these progressive teachings that will bring our way of life down.
Posted by Sharon Blake on 03/28/10 10:55 AM
Excellent article. I fear we here in America will never see freedom again. Definetely not as our founders thought of it. We lost the Republic long ago.
Obama has taken over because our Congress and Senate has been bought off and we simply don't have enough educated voters left to turn this mess around.
It would take an all out war and i'm not so sure that would do any good at this point. God Bless America, the America I used to know. Thank you for a very good article.
Posted by Duane Bass on 03/28/10 11:39 AM
I trust this man, and his opinion. . .
Posted by Sosad on 03/28/10 11:42 AM
I still wonder if health care isn't a natural "moral" right like the right to live. I think health and life are quite related....If it is not the case it would mean that if one can't afford health care by his own means so he won't get it...I am wrong?
Reply from The Daily Bell
Health care would seem to be a service, like any other service. An important one of course.
Posted by Steve on 03/28/10 01:30 PM
On a plate in front of me is a razor blade and a what once was a single small round tablet now has been sliced into quarters, and each piece has been divided into two. Thus the 40mg tablet of Crestor has been reduced to 8 pieces, each about 5 milligrams, which is the dose I need.
Unlike some drugs precision is not necessary. (Do not slice and dice meds unless you have your medical practitioner's approval.)Crestor 5 and 40 milligram tablets cost the same, about $4.50@.
Yet I am paying 1/8th of what others are who take 5mg a day when they simply do as the Pharmakings desire and buy the 5mg tablets. So I pay 56 cents a day instead of $4.50 a day, and were I to import the exact same brand med, made from the same manufacturer, from New Zealand, or Singapore I could half the cost again.
That this bill does not even glance at such absurdities shows the depth of obliviousness that the sheeple have fallen into.This bill is not insurance for the people, it is insurance to the medical industry to make sure that profit is maximized.(Note for the knowledgeable: There is a good reason that I cannot take one of the other generic anti-lipid meds.)
Reply from The Daily Bell
Thanks for the lucid post, and good luck.
Posted by Mpresley on 03/28/10 01:39 PM
First, this has little to do with health care, although it will certainly affect health care. It is about the government controlling life and death, and controlling the economy. From a practical standpoint, as the government sets universal medical prices (as they already do with Medicare) lower than current market values, it will result in an influx of marginally qualified foreign doctors.
These doctors will be willing to escape their home countries and emigrate to the US for just about any salary. Then, one can expect to be treated very shabbily by these people (it's not like there will be any alternative providers, and they know it), and even less qualified will take up positions in the allied fields and as care givers.
In the meantime, expect private, off-shore clinics staffed by qualified American doctors to open up. Maybe in resort areas. There, those not willing to put up with shoddy government care will travel to their treatment, and stay in nice surroundings. Maybe they will die there, but they will be happy.
Posted by Mike on 03/28/10 02:58 PM
My only comment is: where were these eloquent speakers before obama was annointed. why are they coming out now. Fox news is the only news pointing out his beliefs and teachings, surely someone of this writers background knew of his socialist upbringing. Why, talking about it now that the fox has raided the hen house, he should have been in the fore front. I agree with him, but, lets not wait so long.
Reply from The Daily Bell
Tibor Machan has been involved in freedom and free-market causes for virtually his entire adult life.
Posted by Bill on 03/28/10 03:09 PM
30 Years ago, a visit with my doctor cost $ 5 (US). By the later 80s he employed his out of work son as a aid so costs went to $ 20. A decade later my doctor visit was ($70) new doc and recently a 5 minute consultation and prescription cost $ 270.
The latter represents a medical system built on corporate profits (insurance corp. and hospital corp.) The doctor's fee for 5 minutes and a prescription was $120. My insurance coverage paid most of this.
Without this giant Insurance paradigm, costs would have risen much slower. As for the moral issues of doctors being coerced to care for patients, one must remember that most of the cost of medical training is paid by the government.
Other government employees do not get to pick and choose their clients. Teachers are a good example. Finally, if people are free to choose their own treatments why do government agencies allow access only to licensed health providers and drug access through those same providers. In other words the government runs the show through the FDA. It is my understanding that the European CODEX is even more restrictive.
Reply from The Daily Bell
"Other government employees do not get to pick and choose their clients."
You are suggesting what? Making a bad situation worse?
Posted by Scott on 03/28/10 05:21 PM
The only appropriate free market response to this legislation is to ignore it and go about the business of finding the highest quality health services you can using whatever means you have at your private disposal.
The lynchpin in this entire debate can be found in regulations concerning the practice of medicine without a license. Licenses are provided by the government.The point is that the US Government has been in the business of providing healthcare since it began issuing licenses to physicians and prosecuting persons who practice medicine without one. A free market finds its own way to identify quality service providers.
Posted by Sosad on 03/28/10 05:44 PM
Some pretend the reason for this bill to pass is (among other things) to bring some fresh new money onto the balance sheet, some kind of accountable theoretical reserve, that can be used to fill the holes or for the ongoing creative finance stuff. To feed the "burning oven" in a sense...
As I am no specialist could someone shortly explain the financial side of this bill in terms of how it could appear in the federal budget in a positive way, if at all? (sorry for my english I hope it's all understandable)
Posted by SP on 03/28/10 06:14 PM
The socializing of heath care is a giant step in the direction towards irreversible Marxism. These are the people that vote in a Social worker to run the country. The union workers, the welfare cases, the lazy, the self infected drug addicts and drunks, the homeless, the military industrial complex the grossly inflated public sector the charities the law enforcement agencies the criminals, movie stars and on and on.
How can the informed compete in a democracy. While these groups that feed off of the motivated free thinking individuals grow in numbers the true leaders and the powerful liberty loving American's segment grows smaller.
How can anyone say they are hungry in the US - food is almost free. How can anyone say there are no jobs when 3 million illegal aliens are working.
America has become a land of complacent TV watchers, racially divided, politically correct, paranoid conformist. Who is not afraid of the government, who is not afraid of the police, is it not true that these people are working for us, they are not suppose to be there to intimidate, they are hired by the people to protect American's rights under the constitution of the United States.
What happened? Obama arrogance is appalling, I actually heard a mainstream reporter call him American royalty, imagine that.
We are starting to see America's frustration coming through in violence, I can't help but think this will get worst, the racial issues that many pretended to see as dissipating are vigorously bubbling to surface because this aggressive Socialist, Obama.
If the right can come together and act as the right, America might have a chance, but there will be a lot of pain and collateral damage done to the heart of the country and America will find its self many steps backwards on the road foreword. I pray that we do not need the troops back home to protect the government from the people.
The world that hates America for good reasons. Thanks to Mr. Tibor for motivating me to express myself.
Posted by Norman on 03/28/10 06:59 PM
It's exactly as Tibor says; The people must act now to reverse this bill. We can not wait until the laws are enacted. So let's go to work.
Posted by Adrian W. on 03/28/10 07:00 PM
So, impeachment has never been brought up. Would that be a viable solution to the illegalities of the government?
Reply from The Daily Bell
Has it ever been?