The current debate over “reforming” health care in America — and lest anyone need reminding, “reform” means more laws dictating our health-care decisions — is a perfect opportunity to start asking important questions about the world around us.
In an essay written in 1973, “The Metaphysical versus the Man-Made,” the philosopher and novelist Ayn Rand spoke about the fundamental and important difference between two opposing views on reality. One view she describes as expressing the “primacy of existence,” while the other upholds the “primacy of consciousness.”
Properly dealing with reality requires a healthy, functioning brain belonging to a person who perceives what is going on around him and attempts to conduct himself in accordance with what Rand called the “metaphysically given.”
“The primacy of existence (or reality),” she said, “is the axiom that existence exists, i.e., that the universe exists independent of consciousness (of any consciousness), that things are what they are, that they possess a specific nature, an identity. The epistemological corollary is the axiom that consciousness is the faculty of perceiving that which exists — and that man gains knowledge of reality by looking outward.”
By contrast, some people believe that consciousness is the ultimate authority on reality, or, as Rand put it, they embrace “the notion that the universe has no independent existence” separate from human consciousness. For those people, merely wanting something to be so should be sufficient to make it so — and that can have dire, even dangerous consequences. Ask yourself whether air travel is a refutation of the law of gravity — or whether it was made possible by first accepting the law of gravity as a fact. Any doubt on the matter will quickly evaporate if you step off of a cliff grasping a cinder block rather than a hang glider — regardless of how much you want to fly.
Can man-made laws alter this state of affairs?
If we can dictate reality — if human volition creates reality, rather than providing us with the means to adhere to it — then anything that people want is simply a matter of choice.
The “metaphysically given” exists outside of any human views on right or wrong. A hurricane, tornado, or a flood are metaphysical facts; no one makes them happen, they simply happen. Men can, and do, make preparations for these “acts of God” — but only by first acknowledging that they are indeed facts of reality.
Another fact of reality is that man is a very specific kind of animal. We use reason and logic to understand reality, but we also require the freedom to act. The need for food, shelter, clothing, et cetera must be understood as requiring corresponding actions aimed at obtaining them.
Which leads us to the most important point in this entire discussion, one constantly overlooked in our modern society of cell phones, personal computers, supermarkets, and skyscrapers: the absence of what we need to satisfy our needs and desires is the metaphysically given! There is no right or wrong here. As free-market economists have been trying to remind us for years, poverty is simply the natural state of affairs.
Laws and government can protect our wealth, but they cannot turn the tide. Laws can prescribe proper human behavior, but they do not refute the laws of nature.
Those who are striving for “universal health care” are succumbing to the “primacy of consciousness” — the erroneous belief that simply wanting something is sufficient to make it happen. For decades they have had their way with implementing healthcare programs — Medicare, Medicaid, HMOs, employer-provided health insurance, prescription drug benefits — but rather than making medical care more available they instead have made it more expensive and harder to obtain, which they then use as “justification” for more laws … and downward we spiral.
It is time to reject a flawed philosophy that sees in government the answer to all our ills. Instead we should embrace the reality that health care, like food, clothing, shelter, and anything else we want, cannot be conjured out of thin air — or a legislator’s magic wand.