But while the primary focus had been on Daschle’s tax problems, Americans should also ask a more fundamental question: Why do we need a health czar in the first place?

The concept of a health czar follows naturally from the welfare statists’ premise that government should guarantee health care to all Americans. Whenever the government attempts to guarantee universal medical care, it must also control its costs. Hence, someone must determine how health care dollars may be spent.

The Obama administration would control costs by creating a new Federal Coordinating Council for Comparative Effectiveness Research to determine which treatments are deemed most effective and thus eligible to be paid for by government. These decisions would be based on statistical averages that cannot take into account specific facts of individual patients.

Yet good physicians must consider precisely these specifics when treating their patients. If you are suffering from abdominal pain due to gallstones, who should decide whether medication or surgery would be more effective for you?

The doctor who has felt your abdomen, listened to your heartbeat, and knows your drug allergies? Or the bureaucrat who got his job by telling the right joke to the right person at the right Washington cocktail party?

Whenever the government controls the medical purse strings, it will inevitably dictate who receives what health care and when. He who pays the piper calls the tune. A Canadian woman who feels a lump in her breast might wait months until the government approves her surgery and chemotherapy. In contrast, an American woman can receive the necessary treatment in days.

The fundamental problem with universal health care is the faulty premise that health care is a right. Health care is a need, not a right. Rights are freedoms of action (such as the right to free speech), not automatic claims on goods or services that must be produced by others.

There is no such thing as a right to a house, or a tonsillectomy. Nor does calling it a right make it so. In socialized medical systems, health care is never truly a right, but just another privilege dispensed at the discretion of bureaucrats.

Patients do have the right to seek health care from doctors on terms they find mutually acceptable. Hence, instead of universal health care, we need free-market reforms that repeal prior government controls, lower costs and allow patients to exercise that right.

Patients should be allowed to purchase insurance across state lines and use Health Savings Accounts for routine expenses. Insurers should be allowed to sell inexpensive, catastrophic-only policies to cover rare but expensive events.

States should repeal laws that force insurers to offer (and patients to purchase) unwanted mandatory benefits such as in vitro fertilization coverage. Such reforms could reduce insurance costs over 50% — making insurance available to millions who cannot currently afford it, while respecting individual rights.

Americans are not serfs in need of a czar. If we value our lives and our health, we should reject both the idea of a health czar and universal health care.

Paul Hsieh, MD, is co-founder of Freedom and Individual Rights in Medicine (FIRM) at http://www.westandfirm.org.