Abstract

In this essay I argue on essentially classical liberal grounds that free markets are the only means to ensuring a just as well as an efficient distribution of health care; and that, consequently, state intervention in the realm of health care is largely unwarranted and illegitimate. A number of arguments which seek to establish the existence of a right to health care are examined and ultimately rejected as being at odds with individual autonomy. Communitarian, utilitarian, and contractarian arguments are among those considered, as well as arguments for decency and fair equality of opportunity. Consideration is also given to the distinction between positive and negative rights and possible implications for the existence of a right to health care. In addition, the very concept of health is analyzed, with some surprising implications regarding the nature and scope of a putative right to health care. The issue of cash versus in-kind aid is addressed in deference to political realities, despite the claim that compulsory aid is illegitimate. In addition to ethical arguments, a variety of possible economic grounds for intervention in health care markets are also examined. One such argument--that compulsory health care aid promotes economic efficiency--is considered and dismissed. Also considered and largely rejected is the claim that consumer ignorance in the realm of health care undermines economic efficiency and, thereby, justifies requiring professional licensure and eliminating competitive forces in health care delivery. An analysis of health care insurance is also provided in an attempt to determine the extent of economic inefficiencies in such markets and the advisability of state intervention in this realm. Again, it is argued that free markets, by and large, offer the best assurance of economic efficiency. Finally, it is argued that the scope of allowable market activity should include all manner of mutually sought exchanges, including the sale and purchase of human tissue.