Health Care and ‘Rights’ Talk

I’m becoming more and more convinced that the talk of health care as a ‘right’ is so vague as to border on willful and culpable obfuscation. I certainly advocate a rich and complex description of ‘rights’ talk, such that simply calling something a ‘right’ doesn’t end the ethical or political discussion. Some ‘rights’ are more fundamental and basic than others, and various ‘rights’ require things of various actors.

But when it is asserted that access to health care is a ‘right,’ what precisely is the claim? Is it analogous to the claim that access to food and water, too, are rights? Very often these rights are equated in contemporary discussions: food and water, shelter, and health care.

One the one hand, however, it’s very odd to assert that health care, at least as practiced in its modern form (with X-ray machines and flu shots) is a right, at least in the sense that it is something that the human person qua person has a claim upon. If that’s the case, then all those millions of people who lived before the advent of the CAT scan were all the while having their rights ‘denied’ them (whether by God, fate, cosmic chance, or oppressive regimes bent upon keeping us from advancing medical technologies). It would also follow that all of those living today without access to these advanced technologies, simply by basis of their geographical and cultural location, are having their rights similarly denied. (This raises the troubling implication, not to be explored in any detail here, that the debate about health care in the industrial and post-industrial West amounts to a series of tantrums by the coddled and privileged about the requisite level of health care, which by any standard already dwarfs what is available to the global poor, who do not have access to what has the best claim upon ‘rights’ talk, even the most basic health care services.)

This raises the further question, if it be granted that health care is in some sense a right (which I am not opposed to granting), “What precisely does that right entail?” Clearly we can’t mean, in the context of the history of humankind, that this is a right to arthroscopic surgery or titanium hip replacement. That would be a bit like saying my right to food means that I have a claim to eating filet mignon . Just because someone else can afford to eat filet mignon doesn’t mean that my right to not starve gives me a similar claim upon filet mignon .

Similarly, just because some people can afford the greatest medical care available in the history of humankind (whether by the providence of God, fate, or cosmic chance), it doesn’t follow that I have a right to health care in that particular form. My basic claim to health care merely on the basis of my humanity is something more like the right to ramen noodles than it is to filet mignon .

This only describes what I am due by rights. It’s the least that’s required by the standards of justice .

And what might love require? “He went to him and bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, took him to an inn and took care of him.”

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  • Kathryn

    Health Care isn’t something that it just “out there” like Life, Liberty, and the Pursuit of Happiness. Those items cannot be stolen from anyone, and don’t require anyone to give anything up or expend any energy or material goods so that we can get them. Health Care is different because it isn’t just “out there”. Generally, someone has to train many years in order to provide it for others. Or perhaps, in the case of Health Food stores, the person has to know something about “alternative medicines” in order to be able to make a living selling Tea Tree oil, neti pots, various books on the subject, etc.

    Perhaps what we could say is that we all have a right to “pursue” health care, like we pursue happiness. We all the right to engage in the open market in order to try to aquire those heaalth care things we need, and we should not be discriminated against based on age, skin color, creed, nationality, etc.

    Currently, there are a lot of disruptions in the market: like not knowing what a doctor’s visit or test will cost you, or the various states limiting the number of insurance policies a person can buy within state boundaries–thereby creating a monopoly within the state. There are mandates on insurance (like paying for abortions and sterilzation procedures, etc) and drug coverage (contraception, viagra) that cause the cost of policies to go up.

  • SeanReynoldsNZ

    Looking at the American system as an outsider, I believe that one of the biggest problems that you have there is that employers are generally the provider of health insurance. What this results in is ultimately people becoming slaves to the company doctor rather than the company store. Your employer is probably the one person YOU DO NOT WANT to be your provider of health insurance. Further to that, from reading THE WELLNESS REVOLUTION by Paul Zane Pilzer, from what I can tell there is not much of a marketplace in the USA where health insurance is sold directly to the end consumer, but instead almost all health insurance policies are sold to business owners to cover the employees as a group. This makes it virtually impossible for someone with a pre-existing medical condition (or a dependent with a pre-existing condition) to change jobs or start their own business because they will not get coverage for that from another insurer.

    You need to look at the reasons this became the case. My understanding is that a company can provide medical insurance for employees out of pre-tax earnings, but if you want to arrange your own medical cover then you need to pay for it out of after tax dollars. This effectively means that for every $1000 of insurance policy you want to take out, you need to earn $2000 whereas your employer could provide it for you at a cost to them of closer to $1000. This produces distortions in the market because of the tax structures that you have. As well as that, my understanding is that very few insurance companies market products direct to the consumer leaving the consumer with very little choice and expensive ones at that.

    A lot of this was caused by high marginal tax rates in the USA leading to medical insurance as a fringe benefit for executives, as well as wage freezes by FDR leading to unions pushing for medical insurance as they could not increase the cash wages / salary paid to workers. Government interference created the mess that the USA has in this regard.

    By contrast, here in Australia, there is a large market for direct to consumer health insurance. You see advertisements for it on TV all the time. You can also get major tax breaks if you have health insurance as if you earn over AU$150,000 per year, you are penalised an additional 2.5% of gross earnings (on top of a 45% marginal tax rate) if you do not take out private medical insurance. Cover is available from as little as AU$500 per annum for an individual in good health. And it means that you can bypass the public system rather than waiting on a waiting list till you either die or your condition gets worse before getting the treatment required.

    There are a multitude of causes behind the problems in the American Health System. I would argue that a public system is a good thing in general (my wife had a baby AFTER I lost my job and our out of pocket expenses was $0.00 and we are uninsured), but you need a system that respects human life. This is NOT what you are going to get with Obama.

  • Big unions want a new National Medical Association and they want to be just like the National Education Association.

  • jvista

    You are absolutely right. TRUE healthcare reform requires that we address the questions and concerns that you bring up. From a Christian perspective, the right thing to do would be to explore these issues, to “get in the weeds.”

    The sad truth is that none of our elected officials today–Democrat, Republican or Independent–will touch any of them with a ten-foot pole.

  • qhrpfu

    My bumper sticker: The Only basis for Healthcare is…..the Right to Life!

    Learn it, love it, live it!

  • My wife was a teacher and a member of the NEA, her bigs complaint was the union large contribution to the Democratic Party in each election, the same ting is going to happen with the new union created for the medical profession. This is all about union dues and who gets the money from dues.

  • elkabrikir

    I’ve tried to have this health care as a “right” discussion with folks, and nobody can seem to define the limits of what is basic health care and perhaps a “right”, therefore. I say, are immunizations basic health care? Is prenatal care basic health care? Is knee replacement basic health care? Is Lipitor basic health care? Are repeated CTs for cancer screening BHC? Are MRIs for injured limbs BHC? How about dental cleanings and fillings? What about contact lens? Or how about vasectomy reversals? Are vasectomies? Repeated by pass surgeries? What if the person continued neglecting their health? Just what is BHC? And where do all these rights to food, clothing, shelter, education, transportation, and cell phones (yes, cell phones. For, if a person on welfare has a private cell phone, it is being subsidized by Daddy Deep Pockets, aka me. Money is fungible. They should pay for needs first and then wants.) end in a Nanny State.

    As far as Sean’s “free” baby. I’m glad his wife got the care she needed, but somebody paid for it. My last baby cost me $5000 and my husband DOES have a job and DOES pay 12 grand a year for health insurance. Why should we have to pay for our baby and somebody else’s baby? I’m going into debt in other places just to pay my health care costs, while somebody eles gets it for “free”.

    Another thing about people who receive gov’t assistance during short term personal economic “down turns”. I think they should have to repay the gov’t the money when their situation improves. I guess the gov’t would become a lender of sorts. But nothing is “free” and nobody “deserves” another money. I just think that wages should be garnished, in a small way, until the welfare is repaid. If for no other reason than the for the dignity of the former welfare recipient.

    Well, we at CE have discussed this longer than Congress wanted to debate 1/5 of our nations GDP! And, golly-gee-whiz we STILL don’t have a solution.

    Maybe Obama and his cronies shouldn’t have tried to ram this down the throats of the American people. We might, just MIGHT, have trusted him and the process more.

    And before I sign on to the “public option”, Sean, when you and your wife are delivering baby #9 I want to know if “Daddy Deep Pockets” is still forking up the dough! (Up here, I’ve no doubt that in a matter of years, she’d be sterilized after #2 or #3) Blessings. Glad you’re doing well. Kisses to Little Bloke!

  • elkabrikir

    And here’s another thing peope can’t define, “Public Option”. Some people think it means poor people will FINALLY have their “Basic Health Care” needs met by the Scrooges of society.

    To others it means the government will undersell the private insurer that they currently have (And WOW!!! They’ll still receive the SAME coverage, I guess the government knows how to stretch a buck!)

    Others have no clue, they’re just “for it” because Obama knows what he’s doing. Okay…..

    The issues have been poorly defined, therefore, the solutions are also scattered and ill conceived. I have no clue what is trying to be “solved” by this mega bill. I know one thing though, it looks like a giant, expensive power grab.

    Power corrupts and absolute power corrupts absolutely. (wish I had said it first.)

  • GaryT

    There are so many wring things in this debate it is hard to decide where to start…

    1. A fundamental right must be a right that can be available to all people throughout all time. I agree that this excludes modern medicine. It also excludes a “right” to health insurance.

    2. The debate seems to be around health care or health insurance. Shouldn’t the debate be around how we get the country healthier? Isn’t health the ultimate desire, even more so than medical care? Healthy people don’t generally need as much medical care after all. Yet we subsidize corn, which is used to produce high fructose corn syrup…which makes people unhealthy. How about shifting the primary objective to health?

    3. Rather than access to modern medical care, the fundamental right is to be cared for when sick. Let’s look at Mother Teresa for an example here. She often lacked the means to cure her patients, but instead “merely” cared for them as they died. For this she will be a saint. It is in the compassion (i.e. Christian love) that makes caring of the sick noble. And a sick person needs at least someone to give them basic care – perhaps a warm blanket or a glass of water. If a medical cure is available, all the better.

    4. Universal access to health care certainly is a noble goal. But this does not immediately imply socialized medicine. It can also be achieved through charitable medicine – providing discounted or free care from healthcare workers and other benefactors to those who cannot afford it themselves – and totally without government intervention.

    5. A socialized healthcare system that runs up large debts to be paid for by future generations is patently unjust. It is stealing from our children. It is also taxation without representation.

    6. If healthcare is to be truly about being between the doctor and the patient, then the patient must control the funding. Otherwise, the doctor is financially accountable to someone who is not the patient. And that someone (whether private insurance or the govt.) might not have the same interests in mind as the patient. And that can be unjust too. If it is my money and my health, then I can spend MY money to achieve the desired health I want for myself.

    7. Our current system where insurance covers very predictable expenses like annual checkups, braces, and birth control, simply puts the insurance companies in the middle of every normal transaction – and they get their cut. Insurance is normally only used for catastrophic events that we cannot afford – such as fire insurance for our house or life insurance. We typically insure against the unlikely event. Could you imagine if we paid for our groceries through insurance? Sounds silly doesn’t it. Yet that is what we do with our medical insurance – paying for everyday, predictable bills, with the insurance company getting their cut. The proposals for expanding coverage all seem to take this absurdity a step further!

    The Aussie model sounds much closer to sane to me. Control costs, give control to the individual for his or her own health and healthcare. And then put a safety net in place for those few who need it, funded largely through charitible giving of individuals and companies within and outside of the healthcare industry.