Universal Health Care Benefits Everyone, Eliminates Free Riders

Positive rights should not just be viewed through the lens of entitlement. Positive rights are similar to public goods in that they provide positive benefits to society as a whole (in economics, this phenomenon is called a positive externality). This is especially true with health care. If everyone has access to good health care, the chance of serious epidemic outbreaks declines. More people are thus eligible to work. American productivity increases because workers require fewer sick days. Healthier people spend more money on other things aside from health care, stimulating the economy. (For good explanations on health care as a public good, click here and here.)

In its proposal for a health insurance mandate, the ultra-conservative Heritage Foundation posed the following hypothetical, illustrating the implicit right to life-saving care in a medical emergency:

If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance. If we find that he has spent his money on other things rather than insurance, we may be angry but we will not deny him services — even if that means more prudent citizens end up paying the tab. A mandate on individuals recognizes this implicit contract.

As the proposal noted, we already pay for health care for “free riders.” Because most of American society consists of people who feel a moral obligation to help one another, we will always try to save the life of someone having a heart attack by allowing them to use emergency room services, regardless of their ability to pay. In 1986, President Ronald Reagan signed the Emergency Medical Treatment and Active Labor Act, which required hospitals to care for anyone needing emergency treatment, regardless of legal status or ability to pay. We pay for uncompensated emergency room care both via increased taxes and health insurance premiums. Some estimates put the additional insurance premium cost per household at around $1,000 per annum. Universal health care eliminates the free rider problem with emergency care.

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