MORTAL PERIL

A legal scholar's densely written argument that the good old days of laissez-faire were better. Epstein (Univ. of Chicago) claims that the welfare of the general population has been brought into mortal peril by the assumption that a proper health care system requires government controls. He traces the evolution of ideas of rights from the common-law concept of negative rights (freedom from the actions of others) to the more modern system of positive rights—to life, liberty, the pursuit of happiness, and by extension to health, housing, education, and other desirable ends. The latter system, he complains, targets the state with duties of support, builds in extensive taxation, and forces the redistribution of wealth. In his view, the old common-law rules do a far better job of providing health care than the present complexity of government regulations with their many unintended and harmful consequences. Thus, he sharply criticizes Medicare and Medicaid, with their emphasis on expanding access and subsidizing services, and the Clinton administration's failed health care proposals for further broadening access. A defender of autonomy rights, property rights, and contractual freedom, Epstein next focuses on specific areas in which the state prevents individuals from doing what they want with their bodies and their lives. His defense of baby-selling and surrogate motherhood, his advocacy of a free and open market in organs for transplant, and his arguments for removing the ban on euthanasia and assisted suicide are sure to arouse protests from many quarters. His thesis that an unregulated health care system will ultimately provide better care and better access to greater numbers of people is, if not disingenuous, certainly disputable.