Recently Pope Francis released an encyclical that includes
his vision that everyone has a right to healthcare, “beseeching politicians to
guarantee all citizens dignified work, education and healthcare.” That healthcare is a right is a common point
of view, but what does it really mean?
The Declaration of Independence tells us that we have a
right to life, yet everyone dies. The
right to life is not unlimited. For the
same reason we don’t have an absolute right to health, itself. To understand a right to healthcare it’s
important to understand the concept of rights.
Rights impose duties or obligations, not on the person claiming
or exercising the right, but on everyone else that they not infringe on that
right. This is not the same as the old
argument about rights coming with responsibilities. Rights are only possible if the rights of one
require all others to act in a way that allows that right to exist. My having a right to life imparts on you an
obligation not to kill me or in some other way cause my death indirectly or by
negligence. Society enforces that right
and others with prescribed punishments.
A right to property implies punishment for theft or vandalism. My right to free speech requires others to
remain observers while I have my say, even if they disapprove. In fact, there is no need to discuss rights
unless people disagree. Indeed, if
everyone agreed on what we owed to them, the claims of women’s rights, gay
rights or animal rights would never be raised.
If two people or two groups disagree, however, and no deal or compromise
is reached, and one side is in a position to block the needs of the other, the
establishment of rights may be the only recourse. In that case rights are established, and
those rights, and the concessions they require from others, become enforceable.
Healthcare is a broad and vague term. It can mean anything from distributing
aspirin to performing a heart transplant.
When the Pope or anyone else says that everyone has a right to
healthcare, that statement has no clear meaning without specifying the duties
and obligations it imposes on others: physicians and other healthcare workers,
hospitals, insurers, drug companies and taxpayers. When rights are established the needs of
recipients automatically take precedence over the choices of providers. How are those needs distinguished from
wants? There is not enough money to give
everyone everything he wants in terms of comfort and life-extending
interventions. People use the internet
(and TV ads) to self-diagnose, then argue with doctors about what costly treatment
may be right for them, especially when someone else is paying. Does society owe the same obligation in terms
of healthcare to those who abuse their bodies as to those who lead healthy
lifestyles? Is it smart for society to
make it more rewarding for the brightest students to become lawyers who help
sue the medical professionals rather than to become doctors and scientists who
provide better services and the drugs?
These important questions about implied obligations
are left open. A right to healthcare is
easy to say, but the devil is in the details.
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