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Wednesday, February 22, 2012

What do we mean when we use the word “rights?”


The following quote has often been attributed to Benjamin Franklin. I am not sure who said it, but it certainly fits with the aim of the founders relative to our rights:

The U.S. Constitution does not guarantee happiness, only the pursuit of it. You have to catch up with it yourself." --

Lately this word has been thrown around quite a lot. What do we mean by the word “rights?” Who has them? Who is obligated to see that the right is fulfilled and not infringed upon? Many of us first heard the word “right” as it was used in the Declaration of Independence; we have the right to life, liberty, and the pursuit of happiness.  Let us consider this word “right” as we use it in four ways:

Claim right:  A claim right is a right which entails responsibilities, duties, or obligations on other parties regarding the right-holder. If I hold the “mineral rights” to my property, then I must be paid by someone who expects to extract these minerals. 

A liberty right or privilege, in contrast, is simply a freedom or permission for the right-holder to do something, such as freedom of speech, press or assembly. There are no obligations on other parties to do or not do anything. I can show up at “Speaker’s Corner” in London and talk about anything from the demise of the earth according to the Mayan Calendar to monetary policy in the US. 

Natural rights: Natural rights are rights not contingent upon the laws, customs, or beliefs of any particular culture or government, and therefore universal and inalienable; are rights which are "natural" in the sense of "not artificial, not man-made.”[i] They're sometimes called moral rights or inalienable rights.  John Locke (1632–1704) proposed that there are three natural rights[ii]:
  • Life: everyone is entitled to live once they are created.
  • Liberty: everyone is entitled to do anything they want to so long as it does not conflict with the first right.
  • Estate: everyone is entitled to own all they create or gain through gift or trade so long as it does not conflict with the first two rights.
Legal rights, in contrast, are based on a society's customs, laws, statutes or actions by legislatures. Legal rights are sometimes referred to as civil rights; the right to vote, serve on juries, etc. 

Many people in politics and government routinely refer to healthcare as a right. If healthcare is a right, who is obligated to give you healthcare? How did you earn this right? What are you giving in return? In 2009, John D. Lewis, PhD, at Duke University wrote:[iii]

“…the very idea that health care -- or any good provided by others -- is a 'right' is a contradiction. The rights enshrined in the Declaration of Independence were to life, liberty, and the pursuit of happiness. Each of these is a right to act, not a right to things...”
Professor Lewis elaborates further: 

These two concepts of rights -- rights as the right to liberty, versus rights as the rights to things -- cannot coexist in the same respect at the same time...To reform our health care industry we should challenge the premises that invited government intervention in the first place. The moral premise is that medical care is a right. It is not. There was no 'right' to such care before doctors, hospitals, and pharmaceutical companies produced it. There is no 'right' to anything that others must produce, because no one may claim a 'right' to force others to provide it. Health care is a service, and we all depend upon thinking professionals for it. To place doctors under hamstringing bureaucratic control is to invite poor results."

So if healthcare is not a right in term of rights as defined by the four above, is healthcare a moral obligation on the part of the population who can provide help? Many people would answer “no” and feel that they have given at the office through their taxes. After all, isn’t the government taking care of healthcare now with Medicare and Medicaid? Did we not pass legislation in 1986 that requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay[iv]? So what is the problem? 

Something has happened. My wife’s grandfather was a doctor during the depression. When people could not pay they would bring him a chicken or other food from the farm. Recently, my wife had a two hour stay in the Emergency Department with a kidney infection that resulted in an $18,000 price tag. Of course we were happy that our bill was only $500.00. We will be happy until our insurance goes up once again to pay for a healthcare system that is out of control. Every test known to the medical profession was run. What is worse, this was all predicted to me by a nurse as I was driving to pick my wife up. He told me, “Given the symptoms you have described she probably has an infection. They should call the family doctor for history and give her the required antibiotics.” Instead, he said, “they will run a CAT scan that will add another $3000 to the bill.” So we were more than shocked when the CAT scan test was listed at $8000 as part of the total $18000 bill!

What can we do to bring the patient and healthcare professionals closer together in the service exchange to minimize the influence of structure that is adding cost but not value? Reducing the costs will allow us as a society to better meet our moral obligations to those who cannot pay for care. This will be the focus of our next topic on this blog.



[iii] Aug. 12, 2009 Huffington Post article "Health Care, Why Call It a 'Right'?" by John David Lewis
[iv] Emergency Medical Treatment and Active Labor Act http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act

Thursday, February 9, 2012

Should any nation be poor?

Dr. W. Edwards Deming posed this important question often in his many four-day seminars; should any nation be poor? Deming’s solution was to focus on the improvement of quality and set off his famous chain reaction[i]:
  •  Improve Quality
  • Costs decrease because of less rework, fewer mistakes, fewer delays, snags, better use of machine-time and materials
  • Productivity Improves
  • Capture the market with better quality and lower price
  • Stay in Business
  •  Provide jobs and more jobs
Over the last three decades, I have been privileged to help organizations set off this chain reaction as an improvement advisor. It is one of the principle joys in my work. However, the structure that must exist for individuals to contribute to their organization and society depends on the view of private property and the rule of law in that society. 

The idea of private property and the protection of individual rights for that property had the unintended consequence of establishing the rule of law. Individuals were now separated from the masses. Violating the law could result not only in being thrown into prison, but losing your property and adversely impacting the livelihood and security of your family. 

The rule of law and private ownership of property enables the owner to “bet the farm” and invest capital into a business. Too many underdeveloped countries and massive poverty have made it difficult for the average person to buy a home, a task that many of us in the West take for granted. Facing this challenge, many people are not allowed to build on the land they are occupying. In Egypt it takes between 6-14 years to secure a deed. If, during this process, you tell the bureaucrats that you are occupying the land, you can be fined and arrested. The government bureaucracy becomes a barrier to the people using their property to build and to improve the quality of life for themselves and their children.  

Hernando De Soto[ii] has observed that many of these nations have large percentages of land that is “dead capital,” dead meaning it cannot be used to create wealth. In Haiti, 68% of the urban land and 97% of the rural land are not formally registered. It takes 4,112 days and 111 steps to get land ownership. Until this problem is resolved, Haiti will probably remain poor no matter how much money is provided by the developing world. Unfortunately, tourists will continue to wonder why the housing looks so temporary and shoddy. 

F.A. Hayek[iii] has described the connection of private property and freedom:

What our generation has forgotten is that the system of private property is the most important guaranty of freedom, not only for those who own property, but scarcely less for those who do not. It is only because the control of the means of production is divided among many people acting independently that nobody has complete power over us, that we as individuals can decide what to do with ourselves. If all the means of production were vested in a single hand, whether it be nominally that of "society" as a whole or that of a dictator, whoever exercises this control has complete power over us.
Once the governments of emerging nations establish private property and protect the rights of the individual with the rule of law, their citizens can use the capital to build better lives instead of just sleeping on it. These free citizens can exercise their talents and creative potential to unleash Deming’s Chain Reaction, improving the quality of life for their community and nation.


[i] W. E. Deming, Out of the Crisis MIT, Cambridge, Mass., 1986, p. 3
[ii] Hernando De Soto, The Mystery of Capital – Why Capitalism Triumphs in the West and Fails Everywhere Else (2000), Published by Basic Books, NY. The reader may also be interested in visiting a web site dedicated to helping countries establish the structure necessary to succeed. Please visit the Institute for Liberty and Democracy at: http://www.ild.org.pe/
[iii] F. A. Hayek. The Road to Serfdom: Text and Documents--The Definitive Edition (The Collected Works of F. A. Hayek, Volume 2) (Kindle Locations 1764-1767). Kindle Edition

Wednesday, February 8, 2012

Are We Getting What We Deserve?

This morning, Dr. Walter Williams noted that Social Security and Medicare have run up an unfunded debt of 106 Trillion dollars. Yikes!!!…Our entire Gross Domestic Product for a year is about 14 Trillion dollars and some change. That means if we invest our entire economy’s output, every Big Mac, Boeing Jet and all our movies, it would take us 7.5 years to pay off the debt on these two entitlements! We have not even talked about the 900 military bases around the world for which we are paying when some cities cannot afford to pay their local police.

Williams goes on to say that the Congressional Budget office has come to the rescue with a tax plan that does not sound like anything we are hearing in the campaign speeches: “All that Congress would have to do is raise the lowest income tax bracket of 10 percent to 25 percent and the middle tax bracket of 25 percent to 66 percent and raise the 35 percent tax bracket to 92 percent.” I don’t think I have heard this speech from either political party.

President Franklin Roosevelt knew that Social Security was bankrupt when he signed the legislation. He said as much to Francis Perkins:

“Ah, but this is the same old dole under another name. It is almost dishonest to build up an accumulated deficit for the Congress of the United States to meet in 1980. We can't do that. We can't see the United States short in 1980 any more than in 1935.”

To FDR’s credit he had no idea how later politicians, turned loose with taxpayer funds, would get creative with Social Security and take us into new levels of deficit spending. The program was designed as a safety net and was never meant to be a “retirement plan,” that is why they put the retirement age at 65; very few people lived to that ripe old age in 1935. To get Social Security on the same track, we would have to boost the eligible age into our 70’s. Mention that idea and if you are an elected official, you will find yourself demonized by the other party and unelected.

We now have a perfect storm brewing. We have the Democrats who will not cut any programs and in fact want to add a few more. We have the Republicans who don’t want any new programs (unless it benefits them and their constituents) but refuse to pay for the programs they have voted for in the past with tax increases. According to Williams this will lead to default on our debt.

What is happening?  Harvard psychologist Laurence Kohlberg identified three levels of moral and ethical reasoning that might help define our challenge as a nation:

Level 1: The lowest level defines good as individual well-being, avoiding punishment or gaining rewards. This implies that a person conforms to ethical rules only when an authority is watching or might subsequently learn about an infraction. With this kind of morality, there is no common good. It’s only looking out for number one. It is all about me…like talking to a teenager.

Level 2: The next level defines good in terms of what you consider good for your family or organization as well as for yourself, without concern for the effect of your actions on those outside your circle. This definition can lead to a narrow view of the common good: we vs. others. Or it can be a start of viewing self-interest in terms of the larger community that supports your group. This level is very popular in American politics.

Level 3: A broader definition of the common good is what benefits, or at least doesn't harm, all those who may be affected by your actions. This might include employees, customers, owners, communities, unborn generations and the natural environment. This means doing what is right for the country regardless of the consequences for you and your group. We used to call these people “statesmen.”

When you watch the evening news and hear some woman from the Tea Party saying; “I am against government spending! Take your hands off of my Medicare.” I would say it's safe to say she is operating at Level 1. When we watch the Occupy folks sitting in and when we finally hear their demands, the student Occupiers suggest that the government (me and you) should forgive them of their student debt; is safe to say they are at Level 1.

The politicians are doing a little better; they are concerned about their personal survival and that of their political party, Level 2. This is why Washington in his Farewell Address (1796) warned: “…political parties must be restrained in a popularly elected government because of their tendency to distract the government from their duties, create unfounded jealousies among groups and regions, raise false alarms amongst the people, promote riots and insurrection, and provide foreign nations and interests access to the government where they can impose their will upon the country.”

It appears we have two Presidents that have managed to foretell our future. It is time that we all start taking responsibility for ourselves. As Jefferson noted, “People usually get the government they deserve.” We need to start thinking about our responsibility as Citizens to operate at Level 3 and demand that our elected officials muster the courage to the do the same.