An Awkward Fact About Life

There is this internet poster floating around on facebook right now, quoting Sandra Fluke as saying, "Nobody - politicians, bosses, or anybody else - should be able to block your access to essential care."

This sounds lovely, and as far as it goes I don't think anybody would disagree with it - except perhaps Obamacare's sponsors, what with its boards to determine "appropriate levels" of whatever - but if I learned nothing else in school I learned that you need to define terms, and one term in particular is left awfully vague here: "access".

So how does one get "access" to "essential care"?  As it turns out, "essential care" is a thing provided by other people, who have spent large sums of money and long hours of work in training to acquire knowledge that will allow them to take care of you.  Like most other people with jobs, they in return expect to be paid for their services.  What is "access" to healthcare, then?

Money.  Someone has got to pay for these things.

Now, it may be that we as a country or a society have the resources to provide "your access" if you cannot do it yourself.  This is a point worth debating.  But if it is decided that we do not have this, or should not do this, nothing is being "blocked".  Nothing is being "denied".  You did not have it to begin with.

So, let us please conduct this debate on the terms of reality.  You do not have any "right" to the services of someone else whom you cannot recompense.  (It is a more interesting question whether the ability to help another in need brings a duty to do so with it: I would argue it does, but only clearly on a personal level.  Social answers to the question are murkier.)  You cannot proclaim that I, as a teacher, am obligated to help you, who cannot afford a school, simply because of your need.  (You may by all means ask for help, and if possible I should do what I can: but this is charity, not a right of yours.)

(If we are going to provide "essential care" publicly, we should, by the way, do just that.  Public schools may be rather a mess in this country, but their purpose is at least clear.  A public hospital system, I am inclined to think, would also be rather a mess, but at least we would know what to expect.  The current mess of trying to play silly games by over-regulating and (necessarily) increasing the cost of insurance is the most absurd way possible to go about fixing whatever problem exists.)

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