NPR’s Fresh Air has an interesting interview with bioethicist Arthur Caplan, a professor from my alma matter the University of Pennsylvania. One key point was that Dr. Caplan said, to paraphrase, that if we can all agree that health care is a right than it will be easier to move forward with health care reform.
The question remains, is health care a right? If it is a right, how much health care is each person entitled to? Who’s responsibility is it to supply this right?
Health care can not be an absolute right; by that I mean it is unreasonable to hold that everyone has a right to unlimited medical care. That line of reasoning would bankrupt the country. However, most “rights” are not absolute.
For instance, the right to free speech is also not absolute; you can not yell “fire” in a movie theater and defamation is not always legal.
So what do you think about the following ideas?
- Is health care a right? Why or why not?
- If it is a right, how much health care is each person entitled to?
I look forward to hearing your responses.
No, clearly. Rights cannot be things that infringe on other people’s liberty. I do not have the ‘right’ to health care because you do not have the ‘obligation’ to treat me. I have the right to privacy, and religion, and freedom of speech, etc. because these rights do not infringe on other’s liberty. Your example of speech is a fine one. That right ends when it starts to trample on the liberty and well-being of others.
Universal health care might be a good idea, and I lean towards thinking that it is, but calling it a right just confuses the issue.
I’ve blogged about this before. Here’s what I thought:
The notion that health care is a basic right is not merely an alternative point of view to the idea that health care is a commodity. The reality is that rights and commodities are fundamentally and objectively different entities, and the differences between the two do not magically vanish just because a person or organization philosophically believes that one can be regarded as the other.
A right is a limitation on coercion. The right to free speech, for example, is a limitation on the power of government to censor and restrict expression. The right of an employee to quit a job is a limitation on the power of the employer to hold him or her in that job. Because rights are abstract, scarcity does not affect them. For example, the citizens of a country of 50 million people do not find their freedom of speech cut in half when the population grows to 100 million people.
A commodity is a scarce resource that has alternative uses. The paper, ink, and intellectual and physical labor that are required to create a newspaper are all commodities. While free speech is an abstract idea, the myriad goods and services that must be allocated and coordinated to create even a single newspaper are concrete realities. Since commodities, unlike abstract rights, require time, labor, and material for their creation, they have intrinsic costs that do not go away simply because someone mislabels them as a “right.”
People who assert that health care is a basic right are doubtless motivated by a commendable humanitarian concern for their fellow man. Unfortunately, the laws of economics have little regard for human sensibilities. A “right” to health care does not and will never mean that the time, effort, and skill of a physician or nurse practitioner or the services of a laboratory or the diagnostic imaging facility or the development of a new drug will suddenly be available free of charge. Nothing in life is free, including health care.
The fundamental issue is one’s position on “negative” vs. “positive” rights.
http://en.wikipedia.org/wiki/Negative_and_positive_rights
I believe positive rights — as the “right” to health care is — are slippery slopes. What about a right to food (i.e. gov’t controls food supply)?
The whole debate on US health care ignores the fact that the current system is very far from a free system. The government already plays a huge role in it through Medicare, Medicaid and the tax code. Most of the problems we see are thus not market failures, but gov’t failures. To me, this implies the solution is not “more government.”
Human rights are what we (or the relevant society or polity) say they are. They are a social construct to clarify what our values are.
The construction of “human rights” as an advocacy tool seems to be able to focus attention on health, health care, and in particular what is going on with regard to poor people and a health system. Which is good.
However, the same social construct often strays into the policy making realm, and when this happens it can narrow analysis and consideration of policy options – which is destructive.
In some developing countries healthcare is a right, and depending on how that is established (e.g. the wording in a provision of the constitution) it has variably:
– cemented in place exclusive consideration of publicly-provided services, and narrowed policy discussion to options for improving access/quality to those which can be implemented within the public sector. I’ve heard policy makers and their advisers say “we can’t consider contracting for health services, because health is a human right, so services have to be provided by the gov’t”
– blocked prioritization of services (e.g. exercises to lead to spending allocations where spending is shifted to more versus less cost effective services). On this point I hear “we have to provide (I should say, pretend to provide) all services because health is a human right”. This leads to gov’ts pretending to cover everything, and in the end, providing remarkably little, and that focused on the better off. So the pretend universality contributes to gov’ts being accountable for nothing in terms of providing healthcare.
Just my 2 cents from working in developing countries.
No, health care is not a right. It is a highly desirable state, but not a right. Rights cannot be based upon the action of another. Rights are inherent to an individual and can be carried out by an individual. A right may require inaction on the part of another, i.e. the right to freely exercise religion requires the government NOT to establish a state religion. A right to health care would require the actions of others, namely doctors and tax payers. As soon as your rights require my action, they cease to be rights and become gifts from one person to another, thereby absolving them of the ‘inherent’ element of a ‘right’.
There are many different levels of health care, ranging from basic immunications to highly complex treatments for obscure cancers. I believe that there is a basic set of health services that should be considered a right.
The first and fundamental issue here is: what is health?. Health is a perception. “Health” is in fact a cultural and personal issue. There are several definitions of “health”, that change between cultures, historical periods or even between different people.
Doctors (and in the last times, the pharmaceutical and biomedical industry) have had the power to define the health-illness in recent years.
So any discussion about the “right to healthcare” (it means the right to get care that allows me to obtain the optimal health in terms of our cultural and personal context) might begin with the public discussion about what is health and who should define it.
I do not agree with the idea that “health” can not be a right because a right cannot be based upon the action of another.
Any right needs of others (of society) to be feasible. For example the right to private property.
If there is no a legal system, police or army, your “right” to private property will be broken by anyone more powerful than you. And your rigth to your house (or your car, or any of your resources) is limiting in some way my “right” to posses your house or your car or any of your desiderable resources.
So, in some sense, a rigth is like the “health”. It is a cultural concept. As society we should decide which “rights” we as society will assure.
As society we could decide that health-care should be a right, even in case I don’t need health-care or I can afford the payment of my health-care I could consider that in case I could not access I would like society to provide it.
The humans rigths did not exists until 1948 (ater the second world war). In article 25 you can read: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and MEDICAL CARE and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”. It was supported by USA (among others), but not by Soviet Union (nor Canada at a first glance).
Women had not “right” to vote in USA until 1920.
As you see “rights” are a cultural concept that evolve throught time. I am happy of living in a society (Spain, Europe) where “universal health-care” is a rigth. There are of course many problems about implementing it (starting with the definition of health). But as society we have decided that and I hope it will not change in the future.
I love all the “philosophizing” that has gone on in the above comments, adding intellectual flourish upon flourish to express why some degree of healthcare isn’t a right.
The basic question here is, do you think a society (almost necessarily though government) should provide a basic healthcare package to all individuals in their population?
The answer is: OF COURSE.
Certainly there are many questions about what a ‘basic healthcare package’ entails and how to pay for it, but we can all agree that currently we are not at the point where we have achieved such a state.
Caplan’s point was actually there is a right to healthcare because in the age of terrorism we are all potential participants in an armed conflict (via terrorist attacks), and because soldiers are provided healthcare, so should the rest of the population. This is a bit of a stretch for me, but fair. Another point he makes is that in order for a society to be competitive in the world, healthcare prices should be better regulated (as they currently are not in the US (i.e. no reference pricing for drugs)) and healthcare should be universal, as a constantly sick country cannot bear to have a sidelined workforce and over-burdened business. This point makes good practical sense to me. Consider, for instance, the auto industry and the money they shell out for benefits.
But, most important in the Caplan/NPR discussion is the point that until we as a society decide that healthcare (or at least some minimum standard of healthcare that begins to approach equitable) is a right, it wont be.
And as long as kooks like those above are having their say, the poor and lower middle class will continue to receive substantially poorer care than their wealthier counterparts. This is fundamentally wrong and should be addressed.