As the current health care reform debate takes increasingly religious and moral overtones, it’s likely we will hear asserted more and more that health care is a basic human right, which the government has an obligation to provide to its people. However, whatever the utility of the kind of health care reform considered in Washington and discussed across town hall meetings across the country –and I think reasonable minds could differ on that– I hope we can dispose of what strikes me as a silly notion that health care is a right.
Certain difficulties of such a right present themselves pretty quickly. Health care is an evolving, improving thing– is my right to health care more substantial than my parents’ right in 1970? How could a basic human right change like this? I suppose we could define this right as entitling us to the best health care available currently. However, it’s clear that in nations with socialized medicine– many who prefer to refer to their care as a basic right of their citizens– the level of care is good, but certainly not the best available (see Canada, Cuba, the U.K., Ireland, etc.). Would this level of health care be practically impossible to achieve? (And if so, how could that then be a right?) Maybe a right to health care bespeaks an “average” or medium level? The practical difficulties of defining such a tranche are obvious. A “basic” level? Keep in mind, hospitals are already required by law to not refuse anyone of emergency care, regardless of lack of insurance. Perhaps we’ve already met this basic level.
When it comes down to it, a right to health care would be a right to someone else’s labor and property– those of doctors and hospitals, and ultimately, other private citizens. Suppose no one decided to go through medical school to become a physician. Would the right to health care allow us to compel a certain number of citizens to become doctors to service the rest of society? After all, health care could not exist without such labor. If enough people did choose to become doctors voluntarily, now the fruits of your labor may help pay for these doctors to treat me, who pays less taxes than you. (Remember, the top 1% pays more taxes than the bottom 95%, which constitutes a moral outrage for another day.) And what about the people who can afford to purchase insurance, but choose not to? Does it make any sense for you to have to pay for the insurance I could already afford, even though you made the “wiser” decision of also purchasing insurance for yourself as well? Is any of this morally right? Do I have a right to your labor and property, even if I don’t need them?
Interestingly, Thomas Jefferson defines inalienable rights (upon which a true democratic society is based) to those of life, liberty and property, which on their face may seem to create tension in our context. (I have a right to life, and thus a right to be kept alive?) Not really, though. As Leonard Peikoff argues in a powerful essay worth reading in its entirety, Jefferson is articulating rights to action:
“Observe that all legitimate rights have one thing in common: they are rights to action, not to rewards from other people. The American rights impose no obligations on other people, merely the negative obligation to leave you alone. The system guarantees you the chance to work for what you want — not to be given it without effort by somebody else.
The right to life, e.g., does not mean that your neighbors have to feed and clothe you; it means you have the right to earn your food and clothes yourself, if necessary by a hard struggle, and that no one can forcibly stop your struggle for these things or steal them from you if and when you have achieved them. In other words: you have the right to act, and to keep the results of your actions, the products you make, to keep them or to trade them with others, if you wish. But you have no right to the actions or products of others, except on terms to which they voluntarily agree…”
The right to the pursuit of happiness advances the argument. You’re not entitled to happiness, whether provided by God or society, but you are free to pursue it for yourself.
Rights to action have a simple elegance to them in that they are not evolving, unlike what a right to health care may be (ex. 1970s vs. now). (Sure, rights to action were gradually recognized throughout history, but that doesn’t mean they didn’t always exist in absolute form.) Rights to action are not imperfect, inchoate or qualified– they are complete and achievable. More importantly, rights to action also have the advantage of not coming into conflict with each other. To simplify, we are free to do what we want, as long as that doesn’t impinge on others’ ability to do what they want. My rights start where your rights stop. Etc. etc. On the other hand, my right to health care would conflict with your right to your own property, the fruits of your labor. How could that be so unless we were to do away with the foundation of democratic society as conceptualized by our founders?
Now, I’m all for charity– I’m not implying that we shouldn’t be looking out for one another on a private, moral level. I understand the very admirable intentions of some who’d like to locate a right to health care in some transcendent metaphysical reality that would compel the government to act– I really do. (After all, I think you can find an obligation to be your brother’s keeper in a transcendent spiritual reality.) But to impose a right to health care on society through public means is inappropriate and undemocratic because it runs against the logic of inalienable rights.