He says the notion of expanding federally funded community health centers is not constitutional. Paul: 'Right to health care' is slavery

A hearing of the Senate HELP Subcommittee on Primary Health and Aging looked at emergency room use and took an odd turn Wednesday when Sen. Rand Paul compared the “right to health care” to slavery.

“With regard to the idea whether or not you have a right to health care you have to realize what that implies. I am a physician. You have a right to come to my house and conscript me. It means you believe in slavery. You are going to enslave not only me but the janitor at my hospital, the person who cleans my office, the assistants, the nurses. … You are basically saying you believe in slavery,” said Paul (R-Ky.), who is an ophthalmologist.


Paul, who is the subcommittee ranking member, said he believed that the notion of expanding federally funded community health centers to ensure that everyone had a “right” to care was not constitutional and would enslave doctors. Doctors, he said, should care for patients because of their own moral code.

“Our founding documents said you have a right to pursue happiness, but there’s no guarantee about physical comfort. When you say you have a ‘right’ to something there is an implication of force. ... I will always treat people who come into the ER because that is what we always have done and because I believe in the Hippocratic Oath.”

Sen. Bernie Sanders (I-Vt.), who chairs the subcommittee turned to one of the hearing witnesses, Dr. Dana Kraus and asked her if she believed she was a slave working at a federally qualified health center.

“I love my job. I do not feel like a slave,” Kraus said.

The hearing looked at the ways community health centers could help cut down on emergency room use.

One of the witnesses was the Government Accountability Office’s Debra Draper who provided testimony based on a report that looked at the different strategies community health centers were using to address the problem of ER use.

“Our work found that health centers have implemented three types of strategies that may help reduce emergency department use. These strategies focus on (1) emergency department diversion, (2) care coordination, and (3) accessibility of services. For example, some health centers have collaborated with hospitals to divert emergency department patients by educating them on the appropriate use of the emergency department and the services offered at the health center,” she said in her prepared remarks.

Draper noted that many of the health center officials interviewed found the greatest difficulty was changing patient behavior and finding doctors who would treat patients in a community health center setting.

Kraus, who runs community health centers in a poor area of rural northern Vermont, said her health centers had better access, and better quality measures than many other parts of the state because the centers work hard to coordinate care, follow up with patients and engage them to be proactive with their care.

The committee was exploring ways to expand federally qualified health centers to provide better access. Sanders recently introduced legislation for a single-payer system, and called access to health care a “fundamental right”

This article first appeared on POLITICO Pro at 3:16 p.m. on May 11, 2011.