Larry Jankens's picture

    Why Healthcare Is NOT a Right

    According to the internet Gods (Wikipedia) a constitutional right is defined as: a freedom granted by a government's constitution (on the national or sub-national level), and may not be legally denied.  So does healthcare fall under this definition as something that should be guaranteed by the government?  In a perfect world yes it should be a right, but in the practical world, no it is far from it.

     

    There are several problems in viewing healthcare as a right that I think folks (Obama, I’m looking in your direction) ignore or refuse to acknowledge.  There are three interconnected reasons that healthcare is not and never should be a right guaranteed to all Americans.

     

    Healthcare is a finite resource

    There are only a finite number of doctors, hospitals, nurses, and medical equipment.  As with any limited resource it must be rationed out to those who seek it.  By virture of rationing something you would have to deny it to some and grant it to others.  The definition above says a right is something you cannot deny to anyone.  Because we cannot provide an infinite amount of healthcare for an infinite amount of people it is foolish to think that an infinite amount of people should be guaranteed it as a right. 

     

    Healthcare is unlike any existing constitutional right

    Unlike other constitutional rights, free speech, religion, etc., healthcare does not exist in the abstract constructs of society, it is a very real and very limited thing.  It costs society nothing or a cost we can easily pay, to allow people to think, act, and speak in certain ways.  Consequently, it makes sense that the Constitution is able to promise citizens these rights.  Other rights, such as the right to bare arms and imbibe in alcohol consist of tangible resources, but unlike healthcare it is optional for folks to partake in these rights. Because healthcare is not free (like the ability to speak your mind) or optional (like the ability to get crunked our of your gord) it does not fit in with current constitutional rights.

     

    Healthcare as a right won’t fix the system

    I support healthcare reform (like most Americans), but I don’t think the argument that healthcare is a right is the right way to view reform.  Obama is correct when he points out that we need to change the injustices and brutality of the current health care system, however, viewing healthcare as a right won’t fix these inequities it only logically undermines the idea of constitutional rights.  What will fix the current system is an honest approach to more efficiently ration care, which has nothing to do with viewing healthcare as a right.

     

    I, like you, would rather live in a world that healthcare is inexhaustible, but we unfortunately do not.  So instead of viewing healthcare as a right (which logically opposes the idea of rights and does nothing to solve our problem), let’s view healthcare as a resource that we as a society need to come together and figure how to mete out.  We can find a better way than faceless corporations trying gouge people to fill the company coffers, can't we?

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    I forgot to add: It drives me bonkers when I hear voices on the right shout (and it is shouting, apparently when thier party is out of power they make up for it in decibles): I don't want the rationing of healthcare!

    Because corporations rationing healthcare has worked out so well: 47 million uninsured, medical bankruptsies abound.  Healthcare must be rationed, whether it's the government or profit driven corporations.


    Before we even get to better/worse, I think we'll make progress if we can even get them to admit that corporations do ration healthcare, let alonw whether they're better or worse at it than the government would be.


    By recognizing healthcare is not a right because it is finite and therefore must be rationed it logicaly follows that any institution (government or corporation) that is in charge of healthcare does the rationing. 

    I think this is a basic distinction between left and right on a number of key issues: The left trusts the government to ration while the right trusts the free market to ration.  In this case I prefer the former.


    It logically follows? Logically follows?

    Are you seriously suggesting that logic has anything to do with their stance?


    Touche


    Rights are positive assertions.  You have the right to free speech until someone comes along and kicks your head in for saying something they don't like.  That's how rights work.

    Maybe the correct frame isn't whether or not access to healthcare should or should not be legally codified as a right, but rather whether or not it's moral to deny someone access to care because they have been priced out of the market.  In this frame, we can easily note several things, not the least of which is that the existing market features prices that are well beyond marginal cost + markup.

    Of course, there are other issues surrounding the healthcare debate that squarely fall into the realm of currently codified rights.  For instance, if I purchase health insurance in good faith, shouldn't I have the right to make a claim on it when I get sick without being summarily denied access to the fulfillment of the contract for which I have paid in good faith, such a denial of my contract also making it impossible for me to purchase insurance from any other provider in the future?  In this instance, we're talking about what my rights as a citizen contract holder should be.

    However, I think that the word "right" in this case is really thrown out there to mean that it is demonstrably true that every other developed nation in the world is able to afford to provide access for all its citizens.  Given that we are many times more wealthy than any other nation on Earth, why do our citizens deserve any less, whether we term this a right or not?  If we look at it in this way, I think that we see that it is reasonable to consider it a right because access can indeed be universal.

    In fact, this puts the lie to the complaint that healthcare is dependent on finite resources, which exclude it from being a right.  We assert rights to life, liberty and property.  All three of these can be said to be finite.  Life most certainly is.  Liberty, while somewhat more abstract, still has its limits.  Real property is absolutely finite.  Yet we make positive assertions to the rights of all three.

    At the end of the day, this all that rights are.  The real debate is about the moral values that lead us to make these assertions.


    The correct frame is whether or not it is moral to ration health care the way we currently are (free market) and not whether or not it is a right (which I obviously don't think it is). 

    the word "right" in this case is really thrown out there to mean that it is demonstrably true that every other developed nation in the world is able to afford to provide access for all its citizens. 

    I think using the term "right" to demonstrate a comparison between the US and other developed nations than is a poor use of the word.  If folks want to make the argument that other countries do it and are successful and therefore we should to, than make that argument.  Don't say it is a right in the sense defined by the constitution. 

    As for life, liberty, and property, used in the way they are used above are pretty amorphous and abstract.  Guarenteeing life, i.e. being pro life means two completely different things to the right and the left.  Liberty also is an abstract concept, and no where in the constitution does it say you as a citizen cannot be denied the right to own land (despite what took place earlier this decade, it is legal for banks to deny you a loan for you to buy property).  Healthcare is pretty cut and dry in the way that it's finite and not optional in many cases.

    I absolutely agree with you that healthcare and how it is rationed is a moral debate, not one about whether it should be guarenteed to people.  It can and should be denied to people who don't deserve it or need it so it can be given to those who do and are in need.


    Where is the free market in healthcare currently?  You mean here?  In America?  Contemporaneously?  This is anything but a free market.  Dean Baker explains why this is so.

    Whether it's defined in the Constitution as a right doesn't really seem to jive as a standard.  Let's try thinking about this a little bit.  Prior to the Reconstruction amendments, did African-Americans have rights?  According to the Constitution, they did not.  Of course, this is different than asking whether or not they should have had said rights, which is what I'm trying to get at.  If all you're saying is that the Constitution doesn't explicitly spell out a right to healthcare in the way that we understand it currently, then I have to regard that as a bit of a non sequitur.  Sure, it doesn't say that explicitly, but of what import is that to the debate at hand?

    You say that healthcare is cut and dry in its finitude and optionality, but is this really so?  We also guarantee the right to due process, but this requires resources as well.  It requires judges, lawyers, buildings, holding cells, bailiffs, paper, etc.  Yet we guarantee that this will be provided universally and explicitly.  So, healthcare may at times require finite inputs, but so do other rights that we guarantee.

    Is it optional?  I suppose it's as optional as life, but we guarantee a right to live as well.  Dragging in the abortion argument isn't really germane here.  I don't hear anyone debating that a person, once born, doesn't have a right to live.  There's nothing abstract about that.  It's the very basis for our system of laws.  Given this, you could make an argument that the ability to access affordable healthcare that is widely available in every comparable part of the world is part and parcel of a right to life.

    But, again, I don't think that's really the right frame.  To my mind, the correct frame is the context of what moral values are driving the positive assertions that we call rights.  After all, if the question of what is and is not a right can be resolved by merely querying the Constitution, then all we have to do to make healthcare a right is codify it as such.  Presto.

    Finally, I'm not sure what you mean in your last statement about people who don't need healthcare being denied so that people who do need can have it.  Why is this true?  I think this is exactly wrong.  It's the same false dichotomy that has so many people raving at town hall meetings right now.


    On only one point do I contradict your commentary. Although delivery of health care is a limited resource, that in of itself does not mean that it could not be a right. The quality of health care delivered could easily be dropped to a level of service that would be deliverable to everyone. If doctors or nurses simply answered the phone and listened to your problems for a minute or less and told you which medication to buy, that would be delivery of some form of health care.

    That being said, we likely would not need to step to that level, but more importantly, making health care a right really doesn't mean anything other than that you are provided with some sort of service. For there to be real concern about health care becoming a right, the level of accompanying detail required in legislation would be enormous to fully clarify all the ways that your right to health care could be exercised.

    What's worse, with laws changing at pre-climate-change glacial rates, medical science would easily outpace the laws intended to ensure that delivery of health care was meeting the rights of the citizens. As a result, our rights would too quickly become outdated.


    Larry, something doesn't have to be "constitutional" to be a bona-fide right. In fact, I believe the U.S. Bill of Rights spells out that the rights it enumerates aren't an exclusive list.

    I mentioned in a recent post the Universal Declaration of Human Rights, which Eleanor Roosevelt steered through the UN General Assembly. It states in part (Art. 25): "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."

    So the United States has for six decades recognized such a right on the international stage. What it hasn't done is ratify the covenant accepting that provision as a matter of international law. The handful of other holdouts includes Saudi Arabia and Burma.

    The priority obviously has to be making health care accessible to all, not signing on to some treaty that pays lip service to the concept. But I'm with Eleanor here: medical care is a basic human right, just like education. Every government has to define the limits of what it can provide, and the method of doing so. But all the world's citizens are owed access to a working health-care system.


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