The “Right” to Health Care
The Senate and House have both passed health care reform legislation. There are quite a few differences in the two bills, and those differences will have to be worked out before a final bill is passed by both houses and sent to the President for signature. At this point it seems likely that the bill will be signed into law in January or February, although it’s not a done deal yet.
An important question has arisen from time to time during the seemingly endless debate over health care reform. Is health care a commodity like food, clothing, and housing — all essential needs of life that are nonetheless obtained by individual citizens consistent with their means? Or is health care a right, however the term is defined? The issue is important because it establishes the extent of our obligations to each other in terms of health care.
The first problem, which can be debated endlessly, is what the word “right” means. The most clear understanding that can be distilled from more than two millennia of moral and political philosophy is that there are two kinds of rights, natural and legal. Different thinkers have described and defined them in different ways, but the distinction remains.
Natural rights, or unalienable rights, are generally understood to be life, liberty, and property. (In the Declaration of Independence, the Founders ducked the concept of property and substituted “the pursuit of happiness,” whatever that may mean.) Those three natural rights can be understood by extension to include other, subsidiary rights.
Legal rights, on the other hand, are provided to citizens by their governments. They can be quite different from one government to another, depending on the nature of the government and the ability of its citizens to claim legal rights. The list of such rights in the United States, generally but not always specified in the Constitution, is very long, and many are not found in other countries.
There are key differences between natural and legal rights. Natural rights are considered to be inherent in person-hood — everyone is born with those rights, particularly the rights to life and liberty. In theory, they can’t be surrendered as part of the social contract that human beings enter into for mutual protection and agreed-upon regulation of their social interactions. In fact, one of the primary purposes of government — again, in theory — is to protect its citizens from denial of their natural rights.
Legal rights are different in the sense that they generally involve government giving something to its citizens. There may be no cost involved, or the costs may be very high. If it is a right, health care is the most of costly of all. If it means anything at all, it has to mean that every citizen has a right to an acceptable level of health care. Taken to its extreme, it would mean that every citizen has the right to the same level of health care that anyone else has.
Here’s an example of how far the concept of health care as a right can be taken:
If health care is a fundamental right, equality under the law would seem to require that everyone have the same level of care, regardless of their resources. That principle was illustrated by the case of Debbie Hirst, a British woman with metastasized breast cancer who in 2007 was denied access to a commonly used drug on the grounds that it was too expensive.
When Hirst decided to raise money to pay for the drug on her own, she was told that doing so would make her ineligible for further treatment by the National Health Service. According to The New York Times, “Officials said that allowing Mrs. Hirst and others like her to pay for extra drugs to supplement government care would violate the philosophy of the health service by giving richer patients an unfair advantage over poorer ones.” The right to health care is so important, it seems, that it can nullify itself.
President Obama and the Democratic Party state that access to adquate health care is a right. Senator Chris Dodd said, “So today we stand ready to pass a bill into law that finally makes access to quality health care a right for every American, not a privilege for a fortunate few in our country.” Senator Harry Reid said that the just-passed Senate health care bill, “…acknowledges, finally, that health care is a fundamental right—a human right—and not just a privilege for the most fortunate.”
Does the Republican Party stand as an obstacle to this new right to health care? Well, as one might expect, they kind of do, but they really don’t. The Republican Party platform doesn’t say that health care is a right, and they’ve published what they call a “Health Care Bill of Rights for Seniors” which would protect at least older people from government encroachment on their health care decisions and coverage. Of course, it relates in large part to Medicare, which has become a right in practice if not in name. Republicans, like all politicians, are concerned about remaining in office, and that goal won’t be furthered by stating plainly that people don’t have a right to health care.
Why does the question of a right to health care matter? Aren’t we going to get the same things, at the same costs, whether health care is a commodity or a right? Not at all. Once it’s accepted that every American has a right to health care, at least at the minimum acceptable level — and, sure as the sun shines, eventually at an equal level to any other citizen — there will be no way to limit the scope of health care programs or enact cost-saving modifications to existing entitlements. After all, that would be a denial of “rights.”
For additional information:
Constitutional Topic: Rights and Responsibilities, U.S. Constitution Online
Renewing America’s Promise: The Democratic Agenda, DNC
Health Care Reform: Putting Patients First, RNC
Health Care Bill of Rights for Seniors, RNC
Should all Americans have the right (be entitled) to health care?, ProCon.org
What ‘right’ to health care?, Jeff Jacoby, The Boston Globe
A Peculiar Concept of Freedom, Tom Bevan, Real Clear Politics
There Ain’t No Such Thing As a Free Lumpectomy, Jacob Sullum, reason.com
Natural Right, LawFolks.com
Natural and legal rights, Wikipedia
(This article was also published at Opinion Forum.)
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