Why Healthcare Should Be a Right, Not a Commodity

Every developed nation except the US treats healthcare as a public right, not a market good—and they get better outcomes at lower cost. A functioning society can't let profit margins determine who lives.

Healthcare is fundamentally different from other markets because:

1. You can't shop around in an emergency. Markets work when buyers have choices and time to compare. When you're having a heart attack, you go to the nearest hospital and pay whatever they demand. That's not a market—it's extortion with a clipboard.
2. Information asymmetry is insurmountable. A doctor knows infinitely more than a patient about what's needed. Pretending the patient is a "rational consumer" making informed choices is fantasy. You don't choose your cancer treatment based on price comparison—you do what the specialist says.
3. The profit motive creates perverse incentives. Insurance companies make money by not paying claims. Hospitals profit when procedures are expensive. Pharma companies charge $10,000/month because they can, not because the cost reflects value. These aren't features of good healthcare—they're bugs.
4. Every other developed country proves it works. Canada, UK, Germany, Japan—all have universal or heavily subsidized healthcare. All spend less per capita than America. All have better life expectancy and lower infant mortality. The data doesn't lie.
5. "Rationing by price" is still rationing. Conservatives say government healthcare means waiting lists and denied procedures. True. But America already rations—just by income. A poor person in the US gets worse care than a rich one and pays more. At least transparent rationing is honest.

The Case for Healthcare as a Right

Part 1: Markets Fail for Healthcare

Healthcare violates every assumption of market economics:

Information Asymmetry

Patients are not experts. A typical person cannot evaluate whether they need an MRI or a CT scan, what drug interactions matter, or whether surgery is necessary. We delegate these decisions entirely to doctors because we must. This destroys the "informed consumer" premise markets need.

Emergency = No Choice

80% of healthcare spending comes from urgent/emergent care. You don't shop around for a stroke treatment. You don't call three hospitals to compare appendicitis costs. Markets require choice; emergency medicine eliminates it.

Inelastic Demand

People will pay anything to not die or suffer severe pain. A person with diabetes doesn't say "insulin is expensive, I'll just let my blood sugar run high." They pay. This isn't rational demand—it's coercion dressed as choice.

Supplier-Driven Pricing

In normal markets, prices signal scarcity and adjust supply. In healthcare, prices are often arbitrary and determined by negotiating power, not actual costs. A CT scan costs $3,000 in one hospital and $300 in another, with no difference in quality. That's not a market signal—it's fraud.

Part 2: Profit Incentives Corrupt Healthcare

When healthcare is a commodity, the business model is: maximize profit = minimize care delivered per dollar spent.

Insurance Companies

They profit by collecting premiums and refusing to pay claims. Their entire legal and administrative infrastructure exists to find loopholes to deny coverage. This is their job. They're not incentivized to keep people healthy—they're incentivized to keep people paying but not using services.

Hospitals & Providers

Hospitals profit by delivering expensive procedures, not cheap preventive care. A patient on insulin is recurring revenue; a patient whose diet and exercise prevent diabetes is lost revenue. The financial incentive is to treat disease, not prevent it.

Pharmaceutical Companies

Patents allow monopoly pricing. A drug costs $50 to manufacture; it's priced at $10,000 because IP law allows it and insurance will pay. This isn't about R&D cost recovery—it's about extracting maximum rent from sick people.

Employer Insurance Tying

Binding healthcare to employment means employers can force workers to stay in bad jobs (wage theft) and workers can't change jobs without losing coverage (coercion). This depresses wages and keeps workers trapped.

Part 3: The Evidence

Every major developed economy has solved this. None use America's model.

Country	System	Per Capita Cost	Life Expectancy	Infant Mortality
US	For-profit insurance	$10,900	78.9 years	5.4 per 1,000
Canada	Public insurance	$6,400	82.3 years	4.5 per 1,000
UK	NHS (public)	$5,400	81.3 years	3.8 per 1,000
Germany	Mandated public	$6,500	81.7 years	3.4 per 1,000
Japan	Public insurance	$4,600	84.6 years	1.8 per 1,000

The US spends double and gets worse outcomes. This is not opinion—it's observable fact.

Why the difference?

1. No profit extraction from insurance middlemen
2. Bulk negotiating power on drug prices
3. Preventive care is incentivized (keep people healthy = lower costs)
4. No administrative bloat (US healthcare spends 25% on billing; Canada spends 15%)
5. Universal coverage means people seek preventive care early, not emergencies late

Part 4: Addressing "But Won't It Be Rationing?"

Yes. Every system rations. The question is how.

Market Rationing (US Model)

• Method: Price
• Result: Rich get excellent care; poor get bankruptcy or death
• Wait times: None—if you can pay
• Hidden cost: Preventable deaths, medical bankruptcy (700,000/year in US), people skipping meds to afford food

Queue Rationing (Canadian/UK Model)

• Method: Medical priority
• Result: Emergencies treated immediately; non-urgent procedures have waits
• Wait times: Yes, but typically weeks/months, not years
• Hidden cost: Some delays for elective procedures; no medical bankruptcies

Which is more ethical? A system that kills poor people immediately, or one that makes wealthy people wait 6 weeks for a hip replacement?

Part 5: "How Do We Pay For It?"

Three mechanisms:

1. Redirect current spending - Americans already pay ~$4 trillion/year for healthcare (public + private). Universal care costs ~$3.5 trillion and covers everyone. We're spending more for fewer people now.
2. Progressive taxation - Higher earners pay more. This is how all public goods work.
3. Eliminate profit extraction - Stop paying insurance executives $20M salaries, pharmacy benefit managers' rent-seeking, hospital administrators' bloat. Redirect that to care.

The money exists. We're just spending it on the wrong people.

The Bottom Line

Healthcare is not a luxury good. It's a prerequisite for living in a functional society. Treating it as a commodity—something only you can access if you can afford it—is both economically stupid (we lose productivity when people die of preventable diseases) and morally obscene.

Every developed nation has figured this out. The only reason America hasn't is political capture by insurance and pharma lobbies, not economic necessity or logical superiority of the market model.

Claiming healthcare is a "right, not a commodity" isn't radical—it's the default position of every peer economy. Claiming it's a commodity is the actual radical position, and it's failing by every measure.