While students finish up finals and return home for Christmas break, the U.S. Senate will be engaged in a heated debate over health care reform. In a debate that has raged across America for months, politicians and pundits have thrown out a staggering array of propositions, accusations and figures.  But fundamental to the health care debate is a question that neatly draws a line in the ideological sand: Is health care a right or a privilege? Two Reveille columnists, Mark Macmurdo and Daniel Morgan, both economics majors, sound off on the ideals and realities of health care as a fundamental right.Mark Macmurdo: Health care is currently center stage. We’ve all been watching the drama unfold in Washington, with a thousand-page-plus bill now on the floor of the Senate. While it’s easy to get lost in the details, we should begin by examining one fundamental question: Is health care a right or a privilege? Undoubtedly, this is where the health care debate should begin.Daniel Morgan: I’m not comfortable with the word “privilege,” because it implies only an elite few can have access to it. We don’t have to treat health care like a right in order for access to be plentiful. In fact, I think calling health care a right has disastrous consequences. Calling something a “right” implies it’s absolutely necessary no matter what the cost. Some people can rationally decide their resources are better spent elsewhere. If you say something must be done at any cost, you’re acting irrationally.Macmurdo: When we talk about human behavior, we make assumptions. For example, in economics, we assume individuals are rational capitalists who want to maximize profits. With health care, there’s a much easier assumption — everyone wants to live. If everyone in America wants to live, they should take the rational step of having insurance. I don’t accept your basic premise that a rational person can allocate their resources in a way which doesn’t address their health by having some form of insurance.Morgan:  Even if that’s true, the very nature of insurance is to spread risk around. When I purchase health insurance, I’m also subsidizing other people’s health care. Almost all states mandate what insurance has to cover. I don’t think a non-smoker should be forced to insure against lung cancer. If President Obama mandates that premiums can’t reflect risk, then the younger and healthier have to pay for the older people who are more likely to get sick. This seems even more unjust when you remember that the older generations of Americans are significantly wealthier than the average unemployed twenty-somethings.If I were only one paying for my health risks, then buying health care might be a rational decision. In an insurance market as dysfunctional as America’s, it’s not only rational for young people to not get health insurance, it will even be rational for many people to pay Obama’s penalty instead of taking his health insurance.Macmurdo: I feel any time you want premiums to reflect risk, you have to consider fairness. There is a difference between Type I Diabetes (which is genetic) and Type II Diabetes (which can come from drinking too much Kool-Aid). We need premiums to reflect risk, but only from poor health care decisions. I don’t want to pay for someone else’s health care if they consider going with the McChicken sandwich over the double quarter-pounder a nutritious meal. It seems inefficient though, if we have a goal of universal coverage, to penalize individuals for ailments they could not avoid.Morgan: You’ve switched from talking about health insurance as a right people are entitled to and started talking about health insurance as an obligation healthy people owe sick people. I have a right to free speech, but I don’t get penalized not using it, right? Really, you’re not talking about health care reform, you’re talking about health care redistribution. And as I said earlier, that’s a redistribution from healthier, younger and poorer Americans to sicker, older and richer Americans.Macmurdo: You’ve brought up a good point. We need to make sure we use precise language in these discussions. Health care is not a typical “inalienable” right like those guaranteed in our Constitution. But guaranteeing “life, liberty, and the pursuit of happiness ” was a goal of our country’s founders. Because we now have the ability as an advanced society to take care of everyone, I think it is reasonable that members of our society should be guaranteed health care.Morgan: I agree it’s not fair the genetically unhealthy have to pay higher health bills, but is it more fair for the state to force people to make their neighbors pay? I’m skeptical of these moral obligations that supposedly come bundled with an “advanced society.” If we had a moral obligation to care for anyone, I suspect it would be the malnourished children overseas. Buying one dollar malaria nets would do a lot more good for the world than buying hundred-thousand-dollar MRI machines. I guess I’m just unreasonable.Macmurdo: Well now you’re talking about utilitarianism, which is a different can of worms. To speak to your reform vs. redistribution point, the proposed legislation won’t just be “redistribution.” It will also include fundamental reforms which change the way health care is administered — such as changes in information sharing and collective bargaining.Morgan: I’m willing to make a $10 bet inflation-adjusted health care premiums will be higher three years after the legislation passes. Deal?Macmurdo: Given that we’re all going to die in 2012 according to the Mayan calendar, I’ll take that bet.—-Contact Mark Macmurdo at [email protected] and Daniel Morgan at [email protected]