Slavery and the Right to Healthcare
Tuesday, May 24, 2011 at 09:00AM A lot of fuss has been made over Rand Paul’s inflammatory remarks about universal health care being a type of slavery. Here is Paul:
"With regard to the idea of whether you have a right to healthcare, you have to realize what that implies. It’s not an abstraction. I’m a physician. That means you have a right to come to my house and conscript me…It means you believe in slavery.”
Some libertarians, including Matt Zwolinski and Matt Welch, have taken Paul to task, saying the word “slavery” should be reserved only for the extreme case. But neither of them offers a good argument. Here is Matt Zwolinski:
“However wrongful and coercive universal health care might be, no one’s advocating beating down doctor’s doors and hauling them away, no one’s advocating that they be bought and sold or separated from their families…”
First, this is not entirely true. In Canada in the 1970s, under Bill 41 doctors really were conscripted and forced to work under penalty of jail sentence. Those who spoke out about the law were subject to jail for up to a year and fines of up to $50,000 per day. Even in the United States, under EMTALA, hospitals and ER doctors are required by law to treat every patient who walks into their emergency room.
Second, libertarians commonly use the word “freedom” (i.e., the opposite of slavery) to refer to small changes toward a completely free society. For example, the Cato Institute has a center in which scholars advocate for education policies that don’t necessarily lead to a 100% libertarian society, and yet it’s still called the Center for Educational Freedom. If it’s ok to use “freedom” in this sense, why is it not ok use “slavery” to refer to any policy that moves us closer to a slave society?
Perhaps part of the reason that some libertarians oppose the wide use of the “S” word is that the connection between something like universal healthcare and slavery is difficult to see. That’s because the slavery in welfare programs is more dispersed. In the case of healthcare, it isn’t necessarily the doctors who are enslaved. Instead, it the taxpayers, who are forced to spend a part of the product of their labors on medical care for themselves and others. If the government determined how some small number of individuals were to spend 100% of their money, it would obviously be slavery. The fact that it’s less than 100%, and it’s a large portion of the population makes the case harder to make, but the fundamentals are no different.
Another reason why people may oppose the use of that word, as pointed out by Bryan Caplan, is that most people think of slavery not just as involuntary servitude but as low-status involuntary servitude. Doctors and tax payers are higher status in our society, so it is hard to think of them as slaves.
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