This is a research paper I wrote in 2016.
What Right Do We Have to Healthcare?
The 2016 election is once again shining the political light on healthcare in the United States. On Hillary Clinton’s website, the headline concerning the issue of healthcare reads, “Affordable health care is a basic human right.” Her competition in the Democratic race, Bernie Sanders, similarly says on his website, “Health care must be recognized as a right, not a privilege.” This idea that healthcare is a right is not new. As Sanders states on his webpage, universal healthcare has been a goal of the Democratic Party since Franklin D. Roosevelt. By examining what a right is, what a right to healthcare implies and what it looks like, and then compare healthcare to what rights are it can be determined that publicly funded healthcare is not a right.
A right must be defined before making the decision of whether or not healthcare qualifies as a right. The root of the study of human rights can be traced back to the ancient Greek philosophers. A more focused view of the subject however can start a little more recent than that. In 1625, Hugo Grotius in his work The Law of War and Peace put forward the idea of the need for mutual consent in people’s interactions. In his essay “Why Human Rights are Called Human Rights,” Alan Sussman explains that Grotius’ idea of consent comes from the ownership of our own bodies. With that control we are capable of influencing our interactions with those around us (176). This idea of ownership of our bodies and interaction through mutual consent is a good start on the journey to discover what a right is.
The next step is to look into a man named John Locke. In his book Launching Liberalism Michael Zuckert does a very in depth study of Locke’s philosophy. In his study of Lockean Natural Rights, Zuckert points out that instead of using the word “rights” Locke talks about “property”. While the word “right” had already been used in many different ways, property still held the notion of ownership that was exclusive to the owner (194). Much like Grotius before him, Locke came to the conclusion that people owned their own bodies. Part of Locke’s theory of people’s ownership of themselves is that people’s choices throughout their lives connect to form who that person is. He describes this as the “I”. This ownership is the beginning of a person’s property (195). Zuckert goes on to point out that if one person can claim the right to personal ownership, then everyone else can claim ownership of themselves as well (196). While previous philosophers were trying to look to nature for law and justice, Locke put forward the idea that if someone decides to violate another person’s property that creates conflict based on the ownership rather than some natural form of justice. To prevent this kind of conflict, Locke would use a proper government whose purpose it was to protect the property of the individuals under that protection (196).
Immanuel Kant came after Locke with an expansion to Locke’s description of rights. In an article titled “Rights,” authors Manuel Velasquez, Claire Andrea, Thomas Shanks, S.J., and Michael J. Meyer explain Kant’s idea. They explain that Kant believed that people have a “dignity” that must be respected by others. For this reason people cannot control other people by force. So where Locke said people were property of themselves and so could not be controlled by others, Kant believed that people have dignity which needs to be preserved and so they cannot be controlled by others. Kant’s theory goes a step further though and introduces the idea that self-ownership is not enough and that dignity requires that a person is entitled to certain basics, if that dignity is to be maintained. This is where Locke and Kant go their separate ways.
The article “Rights” goes on to explain that there are two different types of rights that come out of Kant’s theory. They separated into positive and negative rights. According to Zuckert, Locke’s theory is negative rights only (196). “Rights” explains negative rights are rights to your own property. The only requirement from others is that they not interfere with these rights. Positive rights on the other hand are the rights, that Kant talks about that require something from other people. “Rights” also refers to positive rights as “welfare rights.” This refers to the basics of Kant’s theory that are required to maintain a person’s dignity. If universal healthcare is determined to be a right, it would be a positive right because it requires action from others.
In 2011, there was a Senate subcommittee hearing discussing emergency room usage and costs. In this hearing Senator and Medical Doctor Rand Paul laid out what a right to healthcare really means:
With regard to the idea of whether or not you have a right to health care, you have to realize what that implies. It is not an abstraction. I am a physician, that means you have a right to come to my house and conscript me. It means you believe in slavery. It means that you are going to enslave not only me but the janitor at my hospital, the person who cleans my office, the assistants who work in my office, the nurses. If you have a right to their services basically once you imply a belief and a right to someone’s services, do you have a right to plumbing, do you have a right to water, do you have a right to food, you are basically saying that you believe in slavery. You are saying you believe in taking and extracting from another person.
Our founding documents were very clear about this. You have a right to pursue happiness, but there is no guarantee of physical comfort, there is no guarantee of concrete items. In order to give something concrete or someone’s service, you have to take it from someone. So there is an implied threat of force.
Senator Paul is making the case that defining healthcare as a positive right, requires the negative rights of those required for that service to be violated. He refers to the founding documents, assumed to be the Bill of Rights. He rightly states that the documents do not include things received from others whether it is items or service, but rather protections from government violating the rights of its citizens.
Healthcare is treated as a right in some countries already. One of those countries is Sweden. According to an article on the news site The Local, in 2014 one in ten Swedes had private health insurance even though there was a publicly funded option. The reason for this is that the supply for health care could not keep up with the demand. The wait times in the public system were too long. Under the private insurance those wait times were significantly decreased. If a person was lucky enough to have employer provided health insurance or pay privately then that person was seen and treated in a timely manner. The point of declaring healthcare a right is to make sure everyone gets the care they need regardless of economic class, but even when it is treated as a right by being paid for by the government the privileged members of the society still receive care that the less privileged cannot.
The gray area of positive rights is that there needs to be supply of those declared rights. That is the point Senator Paul was making concerning declaring healthcare a right. Where negative rights come from a person’s ability to do or possess something provided by their own merits, positive rights need to be supplied by another person. When there is not enough supply to provide the declared positive right, the right disappears. If a right no longer exists based on lack of someone else to provide it, the question must be asked whether it existed at all.
It has been established that both Locke and Kant agree that people have ownership of their lives. Both agree that because of that ownership forcing someone to do something against their will is wrong. As a negative right, a right to healthcare means that people should not be prevented from pursuing care. The right to healthcare espoused by many in politics today is a right to have healthcare provided by others. That is a positive right to healthcare. In order for healthcare to be treated in such a way it would require that people’s negative rights be violated. In most cases where this is acted out, such as in Sweden, everybody pays extra taxes to pay for the public healthcare system. According to Kyle Pomerleau of the Tax Foundation, through income and payroll taxes Sweden raises revenues of 22.1 percent of gross domestic product (GDP) versus the United States that raises 15 percent of GDP. Taxes are a type of force by government. The entire population’s negative right to their property is violated by being forced to pay for other people’s positive right to healthcare.
All three of the philosophers looked at believe rights to begin with value in the individual. Consent, property, and dignity all require that people belong to themselves. By that basis people have no right to deny others their basic rights to take by force from the product of their labor and use it for healthcare for others. They do however have a right to deal with others to receive care through mutual agreement. If force is used to prevent such interactions, that would then be a violation of individual rights.
Through study of what rights are, what a right to healthcare implies, and comparison of the definition of rights to application of a right to healthcare, it has been determined that people do not have a right to publicly funded healthcare. It has also been determined that people do have a right to receive healthcare as long as all participants are acting of their own free will. Such a standard ensures that no one has to give up their individual rights for the sake of another.
“Hillary Clinton on Health Care.” Health Care. N.p., n.d. Web. 21 Mar. 2016.
“Medicare for All: Leaving No One Behind.” Bernie Sanders RSS. N.p., n.d. Web. 21 Mar. 2016.
Pomerleau, Kyle. “How Scandinavian Countries Pay for Their Government Spending.” Tax Foundation. N.p., 10 June 2015. Web. 18 Apr. 2016.
Sussman, Alan. “Why Human Rights Are Called Human Rights.” Ethics & International Affairs
Cambridge University Press) 28.2 (2014): 171-182. Academic Search Complete. Web. 1 Mar. 2016.
“Swedes Buy Insurance to Skip Long Health Queues.” The Local. N.p., 17 Jan. 2014. Web. 15 Apr. 2016
United States. Cong. Senate. Health, Committee on Education, Labor, and Pensions. https://www.gpo.gov. 112 Cong., 1st sess. S. Doc. 789. N.p., 18 July 2013. Web. 7 Mar. 2016.
Velasquez, Manuel, Claire Andre, Thomas Shanks, S. J., and Michael J. Meyer. “Rights.” Ethical Decision Making. Markkula Center for Applied Ethics, 8 Aug. 2014. Web. 16 Apr. 2016.
Zuckert, Michael P. Launching Liberalism: On Lockean Political Philosophy. Lawrence: U of Kansas, 2002. Print.