Mark D. White

Jonathan B. Wight

I’m a supporter of health care reform, largely for utilitarian
reasons. Expanding access to health insurance will (in theory) lead to greater prevention,
and more kids will be covered in the womb and in infancy—when critical brain
development happens. That is a good thing for promoting long run economic growth,
and will be cost effective. The net benefits of spending on social services in a child's infancy likely far exceed that at any other age (think of the cost of incarceration).

In addition, current health spending is disproportionately geared
to administrative expenses—to identify and avoid clients with pending health
needs.  How many people stay in their miserable
jobs simply because they would lose insurance if they left? With reforms that prevent
denial based on pre-existing conditions, many people may reallocate their labor to pursue entrepreneurial dreams.

Part of making all this work is that everyone will be
required to acquire health insurance, and subsidies will be provided for those
unable to pay full freight. The Attorney General of Virginia is planning to sue
the federal government on this point, claiming that no citizen has previously
ever been forced buy a product.  But is
that true?  Since the 1930s every working
American has been forced to “buy” retirement benefits in Social Security.  Everyone who drives a car is forced to buy
head restraints and air bags.  So, this
argument doesn’t cut it for me. 

However, there is a troubling point for me: Nancy Pelosi and President Obama have argued for health
care based on it being a “right” and not a privilege.  What do you readers think about that?  A negative right (forbidding others from
harming me) is much easier to argue than a positive right (forcing others to give
me a benefit).  Interestingly, the Geneva
Convention on Prisoners of War entails both:
no torture is allowed, and reasonable health care must be provided. 

I like Bentham’s observation that rights theory is “nonsense
on stilts.”  Still, rights theory is a
useful platform for motivating political reforms. In other words, rights theory can be helpful in a utilitarian way.