Keith Burgess-Jackson, J.D., Ph.D.

To the Editor:

“Two Sides to Every Health Care Debate” serves as a microcosm of what is wrong with the dialogue on health care: nonphysician experts each offering inflexible, oversimplified, dogmatic solutions to isolated parts of an infinitely complex problem.

The goals of reform have been well articulated by the president: increase access to health care, improve quality of care and reduce costs. Legislators, providers, hospitals, insurers, lawyers, patients, and drug and device manufacturers must all work together, recognizing the conflicting facets of the debate.

Each party must concede a little to meet these goals, which will strengthen our economy, improve outcomes and recognize health care as a right, not a privilege. To this end, physicians must expect reduced reimbursement, hospitals more cost-cutting, insurers and suppliers lower profits, businesses and individuals higher taxes, and patients more personal responsibility and more realistic expectations of what medical care can deliver.

Through compromise and a shared vision, real reform can be achieved. However, the challenge will be our society’s aversion to sacrifice in the short term for long-term gain.

Edward Fry
Indianapolis, July 14, 2009
The writer is a cardiologist.

Note from KBJ: I am sick to death of hearing health care described as a "right." What sort of right? Legal? Moral? Is it defeasible? If so, what can defeat it? Bad choices? What is the basis of the right? That I need something doesn't give me a right to it. That I want something doesn't give me a right to it. Since rights are correlated with duties, who has the correlative duty to provide health care? Why is someone else's health my responsibility?

Note 2 from KBJ: The letter writer doesn't understand the concept of a privilege. To have a privilege (or to be privileged) is to have something that not everyone has. For example, I have the privilege of using my department's copier. You do not (unless you're my colleague, our secretary, or our work-study student). When people such as the letter writer say that something is a right rather than a privilege, they are saying that it is inalienable. But not all rights are inalienable. Most rights, such as property rights and the right to life, are alienable. One common use of the expression is as follows: "Driving is a privilege, not a right." In fact, driving is both a privilege and a right. To say that driving is a right is simply to say that certain people are entitled, under the law, to do it. But since not everyone is so entitled, it is a privilege.