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Is Access to Healthcare a Human Right?

February 8, 2012

Welcome to the third installment of The Question: "Is access to healthcare a human right?"

This time around, we kick things off with posts from Simone Childs-Walker ('12), Rachel Levit-Ades ('13), and a joint post by Professor Amna Khalid (history) and Professor Paul Petzschmann (European Studies).

We encourage you to join the discussion with comments or questions of your own. There are various events happening this term, and early next term, related to The Question, including Convocation on May 11th with Carleton Alum, and prominent bioethicist, Peter Ubel. Be sure to check out the EthIC calendar and consider "liking" us on Facebook in order to stay abreast of all EthIC events.

Simone Childs-Walker '12

To me, The Question immediately elicits another question: what is a human right? To answer The Question, we need a definition of “human right,” something that “access to healthcare” is or is not. Philosophers and political philosophers have given various definitions and some deny that there are such things as human rights at all. Unfortunately, I just don’t know what a human right is or whether “access to healthcare” is one.

From a practical, local, perspective, however, I am comfortable giving an answer. Should all members of, for example, the Northfield community (citizens, non-citizens, children, elderly, the unemployed) have access to medical resources to help them overcome illness and stay well in the first place? Absolutely. Were I in any other person’s shoes, I could not but hope and expect to have the same access to health care that I do now. To deny that every member of the Northfield community should have that access would contradict my recognition of myself as a member of that community.

Also, in the US, access to education is generally considered a “right” (whatever that actually means). As I understand things, health is prior to education. Without access to healthcare, access to education may be meaningless; you can’t go to school (or at least, you can’t learn very well) if you’re sick. If we, as a country, value education and make it available to everyone, we should value healthcare and make it available to everyone too. 

Rachel Levit-Ades '13

When we talk about whether healthcare is a human right, it seems we’re asking whether people, just because they’re people, are entitled to receive healthcare. Rights are tricky because they deal with the idea of desert; it seems clear that if I save up and legally buy a car, I have the right to that car. “Human rights” are especially difficult to discuss because they attempt to define what we are owed just because we happen to exist.

We enter the world with bodies—in fact, this seems a big part of being “human.” It seems we have the right to our will/soul/mind, if we have the right to anything upon first entering the world. At the very least, bodies are the devices through which our will/soul/mind exists and we experience the world. In this way at least, bodies define a big part of what it is to be “human.” So if there are any rights that ought to conferred just because you are a “human,” rights that have to do with preserving your body, especially from circumstances outside of your control, fit the bill.

How this right ought to be considered on a political level is an entirely different issue. We may have certain rights, but those rights are restricted by the rights of others; any right I have to swing my arm, for instance, ends when my arm reaches your face. Because providing healthcare involves limited resources, we must assess whether there are therefore competing rights at play; if so, the question then becomes how my right to healthcare compares to someone else's right to her full income. 

Furthermore, it can seem odd to say an institution ought to make judgments about the value of the bodies of individuals, and we can ask interesting questions about whether presumed rights can be "cashed out" (e.g. if I decline healthcare in a universal system, am I entitled to the monetary value of my potential care?). 

Amna Khalid (History) and Paul Petzschmann (European Studies)

Article 25 or the Declaration of Human Rights states, "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including … medical care."

Having lived in Pakistan where the healthcare provided by the state is as good as not; in England where the National Health Service provides healthcare for all free at the point of access (from general taxation); in Germany where universal health care works in tandem with private insurance (a mixed model); and now in the US where the debate about universal healthcare is at the top of the political agenda (especially with the upcoming elections), provides a number of different perspectives on how states have chosen to take the obligations arising from the enshrining of health care as a human right.

So the question arises whether it is meaningful to speak of the universal right to healthcare outside the context individual states who are at differencing levels of economic development and have different spending priorities. For example is it reasonable to demand such an expensive public good in Pakistan which is faced with a myriad challenges to its integrity and viability as a state? Should individual states have the right to determine their own priorities? For instance if the US electorate decided that universal healthcare was not a priority for them then can we delegitimize that choice?

So the question is: Is it meaningful to talk of a universal human right to healthcare in the absence of any discussion of corresponding obligations to provide it?


Links of Interest

Internet Access Is Not a Human Right (New York Times)

Health care is not a human right (British Medical Journal)

Human Rights Missing from Health Care Debate (Huffington Post)

Comments

  • February 14 2012 at 11:05 am
    Hannah Kyle

    To me, asking if healthcare is a human right is akin to asking if those who have the power have a moral responsibility to care for another person who cannot necessarily care for themselves.  I absolutely think this is still a relevant question even if definitions of a human right may vary because if we do not talk about it and dismiss healthcare as too tied to something abstract to have a meaningful conversation around, we inherently are letting people suffer who may not have to. 

    The wording “human right” is tricky and debatable, whereas “moral responsibility of the state” is more subjective and accurately defines my preliminary views.

  • February 14 2012 at 5:21 pm
    Jason Decker (Philosophy)

    [300 words, eh?  A Draconian rule that could only have issued from the mind of Professor Groll.]

    I agree with Simone and others that the place to start is to try to get clearer on what a human right is (as opposed to, say, a *legal* right).  I don't have a simple, elegant, analysis of rights to give.  This would make me less sad if I had a complex, inelegant one to give.  I don't have one of them either.  Maybe it will be enough to observe that:

    (RIGHT) If someone has a right to a thing, then, other things being equal, no one is morally permitted to deprive her of that thing. 

    My right to bodily integrity means that, other things being equal, no one (except perhaps me) is permitted to hurt my body.  Sometimes other things aren't equal.  I might have given you permission to give me a tattoo or have put my body where it shouldn't be---for instance, in a bank lobby with a revolver in hand, pointing it at a teller's head.  Importantly, it's not enough to make things non-equal that you'd very much like to remove my arm, or that it would be very difficult (or impossible) for you to avoid removing my arm while you pursue some other project that you value.

    So consider the following situation: One thousand of us are shipwrecked on an island, and many of us are wounded or sick.  You are the only one among us with any medical training.  Before we shipwrecked, you practiced medicine for a number of years.  You had left the profession because you absolutely loathed being a doctor, and you had gone into carpentry instead.  Now here you are among us on the island.  If each of us on the island has a right to health care, then by the claim that I labeled 'RIGHT', it follows that, other things being equal, no one is morally permitted to deprive any of us of health care.  Now, although most of us aren't giving each other health care on the island, we're not really depriving each other of health care, since most of us have no ability to provide health care.  Except you.  You have the ability.  If you don't provide us health care, then, you are depriving us, and so violating our purported right to health care (especially since your main reason for depriving us of it would be that you hate being a doctor and want to pursue other projects---e.g., building furniture---and we already said above that that's not enough to make things "non-equal").  In order to avoid violating our right to health-care, it seems that you must devote your entire life to our health; for there are many of us with many medical needs.  I find this conclusion absurd.  It would be nice of you to devote your life to our health care, and it might even be true that you really ought to give us some health care, but that doesn't mean that we have a right to it.  If you pursue your other projects, you haven't violated our rights; at most you've been callous or cruel.  If we compel you, though force or threat, to provide us with health care, then we are violating your rights, not just seeing to it that you don't violate ours.

    Health care only happens because some people decide to be doctors, nurses, etc., and to set up hospitals, clinics, pharmaceutical companies, etc.  No one is morally obliged to be a doctor or set up a clinic or to make the pills that I need for my special medical condition.   We have no human right that entails that anyone must forgo other projects to do such things for us.  So we don't have a human right to health care.  Of course, this doesn't answer the question of whether the US, or any other state, should mandate universal access to health care.  It just means that it would be confused to couch the argument for doing so in the language of human rights.

  • February 14 2012 at 7:48 pm
    Daniel Groll

    My esteemed and non-compliant colleague makes a good case for the claim that even if it is true that everyone in the United States *should* have access to healthcare, it is neither true that they have a moral right to it nor helpful to frame the debate about access to healthcare in such terms. That may well be right, but I want to see if a case can't be made for the claim that other things being equal, those in the US who not do have access to (adequate) health care have a moral right to it.

    Are there situations where simply in virtue of needing X one has a claim on it? Consider this: Micah has an excess of X, and the cost to him of dispensing with the amount of X Eleanor needs for some basic level of well-being is negligible. I imagine everyone will agree that Micah *ought* to give Eleanor the X she needs. But does Eleanor have a *right* to that amount of X, even if it is Micah's possession?

    Leaving aside important, but complicating, questions like "Why is Eleanor in the situation that she needs X?" and "How did Micah get so much X?", I think it is not wholly implausible that -- other things being equal -- simply in virtue of Eleanor's great need for X and Micah's excess of X (and the ease with which he can provide it), Eleanor has a right to it.

    The basic thought is this: severe inequality with respect to some resource in a context where greater equality can be secured without great burden to those that already have a lot of the resource in question can ground a right to the resource in those that are deprived of the resource.

    The connection to The Question is clear, though the analogy is hardly perfect. IF (and it's a big "if") some group has access to health care in spades, and it wouldn't be especially burdensome for us (perhaps through taxation or some such) to provide health care to those that do not have it but need it, THEN I think there's a case to be made that those people have a right to health care.

  • February 15 2012 at 8:08 pm
    James Stiles '74

    I would suggest it would be useful to examine the question from a different perspective. Rather than claiming that access to health care is a human right (or claiming that anything is a human right), let us investigate the potential responsibility we (society or us individually) have to provide health care (for example) to everyone. If we have the ability to reduce illness and suffering, then we should be morally obligated to do so, notwithstanding any perceived "right" the recipient may be deemed to have. We must always strive to maximize our contribution towards achieving the greater good. Clearly, in this case, wellness must be preferred over illness. To simplify, the requirement is not for each human to receive health care. Rather, the requirement is for us to proactively provide health care to the best of our ability. The emphasis is on giving, not receiving. We must not wait for requirements, or rights, to be identified before we act. We must constantly be searching for ways we can allocate our resources to better serve our fellow humans. In an ideal world everyone would be so engaged. Ask not what you may need, but what you are able to give (be you an individual, business, or government entity). It is through this sort of synergy, that the overall well being of humanity may be advanced.

  • February 15 2012 at 10:36 pm
    Anna Morrison

    In thinking about rights and responsibilities, I believe James’s point is quite relevant.  Why should we only feel morally obligated to do something or provide a good when somebody has a right to it?  And similarly, why should we feel unequivocally entitled when we do have a right?  The discussion of rights and responsibilities prompts an essentialist element in the provision of health care that I believe is misplaced and overall, harmful.  By thinking in this way, it lends a moral authority to these rights that dominates all other ethical responsibilities we might think we have.  In essence, the existence of rights eliminates the individual’s ethical agency and allows the state/UN/governing body to identify a singular moral code that should be followed rigidly.  Some may argue that the American legal system (and many other legal systems) allows for the petition of rights to be added to this moral code.  This logic guided much of the civil rights legislation and legal decisions.  However, this demands a certain amount of capital and influence of the petitioner that they may not have, rendering this system flawed.

    The rights-based approach carries a certain contractual element, as well.  I have a right to health care as long as I… am a citizen?  Am working?  Have dependents?  This allows a gray area when a breach of contract is committed that excludes those who cannot meet the responsibilities necessary to claim a right.  I believe everyone SHOULD have health care and that those in positions to make that possible SHOULD do that to their best ability.  However, a rights-based approach allows room for the exclusion of those who cannot meet responsibilities and often this excludes those with the fewest resources.

    Though the rights-based system has its flaws, I’m not quite sure how to enforce an ethical standard otherwise.  Would people act ethically on their own without the legal guidance of the state?  Unclear.  Is it fair to give out rights without any responsibilities?  Also unclear.  But by thinking creatively, there could be a better alternative.

  • February 16 2012 at 12:04 pm
    Billy Shapiro

     For the vast majority of human history healthcare was barely better than no healthcare at all.  Leeches, surgery without anesthesia and with dirty implements were what you had to look forward to if you became injured or ill.  Average life expectancy at birth worldwide has exploded since the early 20th century from 31 years in the early 20th century to over 65 years today (http://en.wikipedia.org/wiki/Life_expectancy#Human_life_expectancy_patterns).

    Is that to say that humans were deprived of their right to healthcare in the past? Is that to say that all humans have access to healthcare today? Of course not, it’s all relative and if you were a king in the middle-ages you had better healthcare than the peasants, just like if you live like a king in the 21st century you have better healthcare than a low income family.  So if low income families are living over twice as long today as they were 150 years ago, clearly there have been some advances in health care, and access to health care, for the poor. 

    A sad but true reality is that healthcare is expensive.  It’s not easy to develop the knowledge, equipment, and skills to treat cancer, perform surgery, and administer vaccines.  Everyone should get a chance to live, and no one should be forced to deliver a baby at home or allow their children to grow up unvaccinated because they don’t have the money to pay for basic medicine.  In an ideal and equitable society, everyone would have access to the best healthcare.  But basic human rights deal with the not-ideal society, and in our present (not ideal) society, access to healthcare beyond the basics is not a human right.  Don’t get me wrong: Everyone should have good advanced healthcare, everyone needs good advanced healthcare, but healthcare is not an inalienable right.

  • February 16 2012 at 12:43 pm
    Noah Carnahan
    Jason, I agree that it seems absurd for the doctor/carpenter to be required to devote his entire life to providing healthcare for the new inhabitants of the island. But I do not think that we need necessarily draw the conclusion that health care can’t be a right from this situation. The doctor/carpenter has rights too. One of those rights might be the right to do what he wants with his life or something else along those lines. If this right was more important or more stringent than the rights of the injured to healthcare, then we don’t have to conclude that the doctor is obliged to spend the rest of his life treating patients. In this situation some rights will be violated, so we will be forced to choose the lesser of the two evils. It seems that something may be a right even if, in some situations, it may be morally permissible to infringe upon that right. For instance, it may be permissible to infringe on property rights for some other good. For example, I may need to run across your yard to catch a violent criminal or get to someone who needs immediate medical attention. All that being said, I am pretty skeptical that something that is so difficult to provide as healthcare could really be a right.
  • February 16 2012 at 2:21 pm
    Erik Klontz

    Looking at the The Question from another angle, consider the following premises:

    1. Humans have a right to life.

    2. Access to healthcare is necessary for staying alive.

    3. Therefore, humans have a right to healthcare.

    Very few will argue against the first premise that humans have a right to life.  If you believe this, then the argument hinges on the second premise, that access to healthcare is necessary for staying alive.  As Billy points out, before modern healthcare, life expectancy was dramatically lower.  This suggests that healthcare is necessary for the average people to stay alive (longer).  However, it is unclear if humans have a right to longer lives than our ancestors did, simply because longer life is now possible.

    Even if humans have a right to healthcare, it is obvious that granting this right infringes on the rights of others (for example, the right to spend your money how you please, or the right of the doctor on the island to live how he pleases).  What it comes down to is whether or not the right to healthcare outweighs competing rights.  As Daniel suggests, it turns into a numbers game.  If the cost of providing healthcare is negligible, we should absolutely provide it.  However, if the cost is too high (perhaps in the case of the doctor on the island), it is not so clear that everyone should be granted the right to healthcare.

     

     

     

  • February 16 2012 at 9:16 pm
    Henry Rownd

    I cannot help but think that Health Care is essentially a service that we pay for, and it does not seem correct to think that one has a right to a product regardless of whether or not they paid for it. Imagine that you had to put $1000 into a machine every day in order to sustain your life. If one thinks it is true that humans have a right to Health Care in order to sustain thier lives, than this commits one to the position that one has a right to other people's money in order to sustain you life. Could I rob a bank in order to pay the machine? When we say that one has a right to Health Care, and since Health Care is not an overabundant resource as some have pointed out, then doesn't the almost inevitable inequality of treatment amount to theft? Even if everyone used their care equally, the current tax system requires some to pay in more. Essentially, having a right ot Health Care implies that one also has a right to something that belongs to someone else--and this must be a prerequisite to a Health Care system that is premised upon universal accessibility regardless of one's ability to pay.

    Contrary to Groll's view, it is very implausible that one's excesses give another a right to somthing of hers. If John has 10 kids, and Steve has none but really wants of one John's and could even relieve some of the burden on John in doing so, does Steve have a right to one of John's kids? Cleary not. At the very least, the fact that the loss isn't burdensome is not sufficient.

  • February 17 2012 at 12:18 am
    Jonah Herscu

    With the question being, is access to healthcare a human right, I would like to present the answer yes. I think it is for several reasons. To start off, if one person (or a group, such as the upper class) has a right to healthcare, then surely everyone does too. For instance, I presume if someone has infinite amount of money, everyone would agree that they have a right to healthcare (because, among other reasons, they can pay for whatever services they need.) Just because one person, A, has more money than person another person, B, A is by no means “better” or more valuable than B. Therefore, in this case, the debate quickly turns to the right to live (or at least live healthily.) Everyone morally is on the same level, and monetary wealth should not determine if someone should die or not (though of course this is not the case in the real world, morally, this point is true.)

    Another reason that everyone has the right to healthcare is by doing a thought experiment. Pretend we found a tribe of humans living in the middle of nowhere. We could prove that they were humans, (though they did not speak any language we understood) and in addition they were way behind first-world countries in the sense of development and technology. However far behind they may be, these “tribal people”
     are still absolutely entitled to health care. (If they would receive it, is a whole different debate, but I am just covering if they have a human right to healthcare.) I feel comfortable making this claim because in the debate of, if eating meat should be permissible, some arguments want to put all animals (including humans) on the same level. If all animals are on the same level morally, then obviously all humans are, and share the same rights (no matter if they are from this newly discovered tribe, from the lowest economic class, or in the wealthiest.)

    I realize that people might argue that just because all people are on the same moral level, it will not actually make everyone get healthcare. In response I would say that all I covered was the question as I interpreted it, is access to healthcare a human right. I did not try to tackle the question in which James Stiles and others have discussed/proposed, on how we as humans/society/individually can make this actually happen.

  • February 22 2012 at 3:37 pm
    Dave Flynn '04

    As others have noted, to answer this question requires first a definition: what do we mean when we say something is a 'human right'? The Universal Declaration of Human Rights was adopted by the UN general assembly on 10 Dec 1948. It contains 30 articles outlining the various rights that are, by definition, possessed by every human being on the planet, by virtue of being human alone. These rights cannot be *granted* - you simply have them, because you are human, or so this document asserts.

    Among the rights outlined in this document are these: - The right to liberty - The right to marry and build a family - The right to due process (which is really many different things; the right to a fair trial, the right to equal protection under the law, and more) And so on. As I read through the list, it occurs to me that all of the articles contain a common element: they describe rights and privileges that cannot be granted (by government) - only taken away. A government cannot grant me freedom; it can only, through its action, take my freedom away (or through its inaction allow another to do so). A government cannot grant me the right to due process; it can only deprive me of same by refusing to honor that right in a criminal proceeding.

    So perhaps we can say safely that a human right, by this definition, is something intrinsic to being human that cannot be denied except through the application of force; and so when we assert that all humans, everywhere, have these rights what we are in fact asserting is that no government has the authority to deprive any person of those rights. Health care does not meet this definition.

    If we assert that health care is a human right, what we are in effect saying is that every government, everywhere, who honors the notion of human rights has an obligation to provide health care for every citizen under its jurisdiction. That is a very dangerous thing to assert. It opens a huge rat's nest of questions. What is health care? How much health care is a human right? Does it include preventative care, like regular examinations? Contraception? Prenatal care? Does it include care for people with high-risk lifestyles (professional athletes, skydivers, whatever)? Do people have to pay for it? Do some people pay more than others?

    A human right is something that no government has the right to deny, by force, to the people under its control. It is not the same as something that a government should provide for its constituents, even though almost all governments are formed with the notion that they will provide something (like a military) to its citizens for the common good. Health care is not, and cannot, be a human right.

    What it should be is the right of every citizen of a civilized and wealthy nation. In other words, it should be an American right, or a Canadian or French or German right - it should be the goal of government to provide health care for its citizens because public health is a public good; the entire society benefits from public health care. But a human right? No.

  • February 22 2012 at 3:54 pm
    Dave Flynn '04
    Sorry, I have a short response to Erik above. He asserts that (1): Humans have a right to life That's true, but it bears qualification. The right to life really means, I think, that nobody else may ethically *take* your life from you. It categorically does *not* mean that everyone everywhere must do everything in their power to keep you alive at any cost, for that would be absurd.
  • February 24 2012 at 4:02 am
    ANDY HARDT
    As stated, this question is absurd. I doubt anyone wants to argue that humans have a fundamental right of access to healthCARE. For instance, if a person is in perfect health, is guaranteed to remain so until an unalterable death, and in general will gain no benefit from healthcare, then the person of course has no right to it. It is not the set of procedures that would be considered a right, but instead the resulting consequences. Therefore, it is more useful to ask whether HEALTH is a human right, and if so, whether it is important enough to remain a right considering the costs involved providing it. The answer of course depends on these costs and the benefits of healthcare. If the cost somehow amounts to many lives for a routine checkup, then of course this checkup is not considered a right. But if a procedure would save a life and only requires a button press, then it WOULD be considered a right because the treatment is so easy. When people say there is a right to healthcare, they rarely mean that there is a right to FULL healthcare. There are some procedures that are so expensive that society could not afford to give them to all those who want/need them. Someone arguing that these procedures are a right would have a harder time, but arguing that important and (relatively) inexpensive procedures are a right is easier. This case is in essence pretty close to pushing a button to save a life in that the costs for those who bear it are very small compared to the benefits for the recipient of healthcare. Just as it's immoral to refuse to push the button, it is immoral to refuse healthcare to some when the infrastructure is in place.
  • February 24 2012 at 4:09 am
    ANDY HARDT
    Dave Flynn '04 -- In defense of Klontzy, he is not arguing that one must "do everything in their power to keep you alive at any cost." He wrote: "What it comes down to is whether or not the right to healthcare outweighs competing rights," which means that he is NOT in Jason Decker's example committing the doctor to a lifetime of miserable service. Healthcare being a right does not have to mean that it trumps all other rights and considerations.
  • February 24 2012 at 4:15 am
    ANDY HARDT
    One more note since I'm sure someone will take issue with my assertion that not pressing a button to save a patient is immoral and a violation of that patient's life. To me, the idea that something like life, which almost all agree is a massive right in a negative context, would have no or little corresponding positive right is absurd. One could argue that the positive right to life is less significant than the negative right to life, but to say that it is insignificant enough not to require the button press -- or indeed, most of the important procedures we have today -- seems silly.
  • February 24 2012 at 3:04 pm
    Henry Neuwirth

    Is it true that regardless of the context someone is born in, and regardless of the decisions they make over the course of their lifetime, every person should have access to medicine? A lot of responders so far have distanced this question of "should" from the essence of what a human right is (something feasible, or some universal truth).  The logic here is often that it is not feasible. Health care is expensive, everyone can't have it, and so we can't say that everyone should. In reality, we can do a ton better. Millions of people die preventable deaths every year. Millions of those millions could be feasibly prevented. If you think that the prevention of those deaths is morally necessitated, don't you also think health care is a human right?

    Can we really say that human rights are ahistorical? Given that human rights are political, I think it is reasonable to say that what is a human right today is not the same as what was a human right  a thousand years ago. Isn't a human right something that everyone deserves at a particular time? There seem to be various things that our time calls for us all to have-- health care, education, sanitation, to name a few. Just because naming them "human rights" is political, and just because they weren't always necessary, doesn't seem to indicate that everyone shouldn't have them.

     

     

  • February 26 2012 at 5:30 pm
    max strand

    People have a right to healthcare, except when they don't.

    Two points*:

    1. Rights-talk is not a constructive way to approach ethics.

    2.While we discuss whether all Americans should be guaranteed comprehensive healthcare we shouldn’t lose sight of the fact that many people go without basic healthcare because of our unwillingness to make small sacrifices to provide it.


    *I’ve been sort of beaten to the punch on both of these but I’ll present my spin on them at any rate


    As Dave Flynn and others have observed, positive rights (rights to something) can often only be guaranteed at the expense of other peoples negative rights (rights to non-interference), but it's also the case that negative rights can't be guaranteed either. Sometimes a trivial (or even non-trivial) violation of some peoples negative rights is necessary to prevent a non-trivial (or worse)violation of other people’s negative rights. Once it’s conceded that all rights are theoretically violable one is reduced to weighing the relative strengths of peoples rights in any given scenario. At that point, why not just weigh to consequences?


    But maybe the language of rights can still be useful if it’s remembered that rights derive from the good and not the other way around. Perhaps we can come up with a more useful definition of a right:

    Professor Decker offers a definition in which positive rights are framed in the language of negative ones, but his comments after his shipwreck situation essentially do away with the existence of moral obligations to provide to provide goods or services to others which I think is a little too convenient. I’m also puzzled by what the ‘other things being equal’ clause in his actual definition means in this context. Does it mean ‘assuming no other morally relevant considerations’?  That would suggest that rights are only relevant when you are not confronted with an ethical decision.


    I’m going to define rights (because I can) as:  rules of thumb from which deviations must be justified. I’ll call rights of this type ‘soft-rights’.

    Under my definition:
    I think basic healthcare is a human soft-right. Healthcare at all costs, even in countries where it’s feasible, is not a human weak-right due to the opportunity cost of providing it.


    As Henry N. observed, untold numbers suffer and die from preventible or easily treatable conditions because of our unwillingness to make comparatively small sacrifices to prevent it. We are thus violating the soft-rights of many of the poor around the world. Because I don't care about Americans all that much more than non-Americans, I'd like to see us put a healthy share of our GDP into promoting basic healthcare abroad. Think vaccines, contraception, and antibiotics + roads, schools, and hospitals.

     

    ** I’m in two classes that advocated posting to this Question so I think I’m justified in having 2X the desired response.

    *** To respond to Andy Hardt first few sentences: It seems reasonable for me to have a right to free speech regardless of whether it’s actively being infringed upon at any given moment.

  • February 27 2012 at 9:25 pm
    George Wheeler

    A great deal of the discussion so far seems to have focused on whether every person has a right to health care. However, I'm not sure that this is the right question to be asking. In a world where we know that health care will be provided, the question we need to consider is whether any person has more right or claim to this care than any other. My view is that no person does, except as a result of need, and that a system in which access to healthcare is dependent on financial status is therefore morally unjustifiable.

  • March 4 2012 at 10:34 pm
    Daniel Gero
    I would argue that access to healthcare is not a human right. While it may be wrong for someone who is capable of helping a sick or injured person when they are capable, they have no compelling obligation to help. It comes down to the concept of rights and what people owe each other. I believe everyone has an extremely strong right to not be interfered with. However, I do not believe that people have a right to receive anything. If they want a good or service from someone, it is up to them to convince the other party to willingly provide the good or service. If they are in a position where they can not convince the other party, they simply do not get the good or service.
  • March 6 2012 at 2:21 pm
    Hannah Kyle

    My first comment was trying to get at what George Wheeler said.  To me, a healthcare system that relies on financial resources more than need is morally injustifiable.  In that same vain, I believe the health care should be a human right - I would argue that we have the right to live (ie killing humans is illegal) and healthcare is another aspect of the right to live.

  • March 6 2012 at 8:43 pm
    Brian Chesley
    I agree with Andy Hardt that the question, as stated, is absurd. As Dave Flynn noted, healthcare is not something inherent to people because it’s not something you can take away from them. Rather, healthcare is something that can only be given at the expense of other people. In Thomson’s article, A Defense of Abortion, she uses an example of two brothers and a box of chocolates that might aid in this discussion. If one boy is given a box of chocolates, does he need to share them with his brother? While it may be callous, crude, and even malicious, the fortunate boy does not have to give his brother any chocolates because they are his own. Applying this to healthcare, it might be callous and crude for some rich nations to not offer healthcare, but it is by no means a human right.
  • March 7 2012 at 4:21 pm
    Katja Collier

    Being provided with health care cannot possibly be as basic of a right as not being killed, or owning property, but it is a strong enough interest that it should be accounted for where possible.  In developed countries today, quality of healthcare is at least partially determined by wealth, and I see that as unfair to the point of being morally wrong.  Since there is a healthcare system in place, and there are doctors and nurses and hospitals, deciding to provide adequate healthcare to everyone would be a matter of increasing taxes, which would be a relatively small price to pay compared to saving and/or improving many lives.  I think that while healthcare itself may not be a basic human right, equal access to healthcare can be considered a human right, or at least something very close.

  • March 8 2012 at 2:28 pm
    Naomi Fine
    As previous posters have noted, I think to place the right to healthcare access on par with the basic human rights of non-interference such as the right to liberty, the right to not be killed etc. seems like a misnomer. However, I wonder if and to what extent individuals with means to do so, are required to provide health services to others who do not have such means. As evidenced by Jason Decker’s desert island scenario and Noah’s response, there is a limit to a person’s responsibility to help and provide a good to others in need if it comes at a great personal cost. However, in a developed prosperous country like the United States, providing the good of healthcare seems reasonable. Ideally, our system of taxation would work in a way that no one would be unequally or excessively burdened by his or her contribution. If such a just system was in place, it seems to me that providing access to at least basic healthcare is within our means and is reasonable.
  • March 9 2012 at 12:24 pm
    Ted Harrington
    I would lean towards Healthcare not being a right for similar reasons found in the Barlow column. For Healthcare to be a human right, I feel it needs to be easy to define, and draw at least a few, clear cut lines for. However, it seems to be a blanket term for a number of treatments- vaccines, clean water and food, as well as any kind of transplant. So where do we draw the line? I can’t see a clear one to draw. The bigger issue for me is the duty that it places on others. The burden for Healthcare can not be placed on certain individuals or even a distinct group of individuals. We may be able to come up with a clear line for the U.S, but we certainly could not extend that line universally. Article 25 of the U.N. Universal Declaration of Human Rights states that, “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 .” However, who should bear the burden of providing this Healthcare? Making Healthcare a human right would require at least a set of rough guidelines for practical implementation, and it does not seem that we can articulate any.
  • March 10 2012 at 2:54 pm
    Brittney Mikell
    In order to avoid the direction in which this argument is heading-- an economic cost-benefit analysis, rather than a morality-based evaluation of human rights-- I will bid that access to healthcare is a human right. Healthcare is a resource created by humans, for humans. It was created to enhance and to improve the quality of human lives. Therefore, each human should have a right to healthcare. To argue that not all humans have a right to healthcare is to value some human lives (those who should have healthcare) over others (those who should not have healthcare). To value some human lives over others is clearly immoral. I am simply stating what "should be" rather than "what is", which steers this argument in several different directions. Whether or not healthcare is accessible to all humans is not a part of my argument, granted of course that healthcare is clearly not accessible to all humans. However, many things in this life are not accessible to all humans, but are morally justifiable as righteous; take food, for example. Our intuitions most likely tell us that all humans have a moral right to food, but it is not accessible to all humans. This example directly correlates to the fact that in order to stay alive, like Erik suggested, we all have a right to food, and I would argue, healthcare as well. Despite the fact that healthcare imposes financial costs upon certain portions of society, morality is not a economic concept. All humans have a right to healthcare, period. NOTE: The argument presented above is limited to humans that practice life with a righteous moral compass. Considering criminals and the like complicates things immensely.
  • March 10 2012 at 8:49 pm
    Soren Hope

    I think human rights can be defined as what one is entitled to by virtue of being a person. Presumably, one is entitled not to be killed or harmed by another person, not to have things stolen from them, and possibly, to be rescued from danger, if the act of rescuing causes little to no inconvenience or risk. This last right is up for debate in my mind. It does not seem obviously true to me that just because a person is born, and continues to exist, they are therefore entitled to any and all medical treatment, should some ailment threaten their existence. This seems especially true when considering that many medical treatments require a great deal of effort from doctors, and are often very expensive. Even with universal health care, the money would have to come from somewhere. Is a poor person, just by virtue of being a person and not having money, inherently entitled to the use of a wealthy person's money to pay for whatever ailments might happen to befall them? I don't think they are.

    But that doesn't mean I don't support providing universal health care. For me, the question of universal health care is not answered by human rights, but rather, broader considerations of what I want to world we live in to be like. This is also true of my support for public education. I don't intuitively believe that, just by virtue of being a person, one is entitled to having other people go out of their way to teach you things for free. I would, however, rather live in a world where there are opportunities to overcome wealth gaps, and where intellect is not bought.

    Similarly, I would prefer to live in a world where corrupt insurance companies are not profiting from others' misfortune, and where people without expendable incomes do not suffer unnecessarily from treatable illnesses.

  • March 11 2012 at 3:56 pm
    Vaughn Schmid

    After reading through all of these comments, I think I'd have to agree with those who say healthcare access isn't a human right.  When I think of a human right, it needs to be taken in context of everyone's rights.  In the case of healthcare, there is an action, a use, required of others in order to fulfill the rights of someone else.  By this, I mean to say that the doctor, the nurses, the taxpayer all need to give something up in order to fulfill the right of the patient.  I don't think I agree that only wealthy people should receive healthcare, but I think it's a stretch to make the claim that someone has a Right to healthcare based on the simple fact they are human.

  • March 11 2012 at 3:58 pm
    Kellan McLemore
    On a basic level I would not consider access to healthcare as a human right as healthcare in general is not a necessity to survival and could vary in form from culture to culture. Rather I would argue that civic equality is a human right and as healthcare is a part of our civic life all members of our society should have equal access to healthcare. This bypasses the uncertain nature of healthcare as a human right or not and instead places healthcare under an umbrella of civic equality that should be accessible to all members of our society equally. Civic equality should be considered a fundamental human right on the most basic level and I believe any aspects of civil life that fall under the umbrella of civic equality should be protected as if they were just as fundamental.
  • March 11 2012 at 9:45 pm
    Miles Silbert
    I find the right to access of healthcare to be relative, similar to what Amna Khalid (History) and Paul Petzschmann (European Studies) discussed in their post. When looking at a country like the United States, it seems to me that it should be every person’s right to have access to basic healthcare (I have to admit I’m not positive on what defines “basic healthcare”). We as a country, in my opinion, should be able to provide basic healthcare to anyone who needs it. That does not mean everyone should have access to the top doctors in the country for every health issue that springs up, but everyone in this country, for example, should be able to get vaccinated and get other forms of simple preventative care. Other countries may not have the resources to supply basic healthcare to everyone in their country but I believe we, as human beings should strive for it. I also agree with Simone, if education is a “right” in the United States it seems to me that healthcare should be as well. We don’t say that only the wealthy are allowed an education. Why should we make it that only those who are capable of buying healthcare get that as well?
  • March 12 2012 at 1:40 pm
    Turner Wadington
    In my opinion, the access to health care should be considered to be a human right, but it doesn’t seem like this is anywhere close to an economically feasible goal. For example, according to data from 2010 presented in http://www.consumerhealthratings.com/index.php?action=showSubCats&cat_id=206, the average cost of an outpatient surgery was $6,100 and the average inpatient procedure cost upwards of $40,000. To me, it does not seem that being able to provide everyone with healthcare is realistic given that the cost to provide it is so high. Above, I claim that it doesn’t seem that granting access to healthcare a human right is a realistic goal. However, again, I do believe that in principle, it should be a human right. I think that Erik’s principle does a good job laying out this rationale. He states that since humans have the right to life and since healthcare seems necessary to stay alive, everyone should have the access to it. Then again, it surely seems that some people are worthier of healthcare than others. For example, let’s say that the Wellness Center only has one pill of ibuprofen left. Person A comes in asking for the pill because he has a small sliver in his foot and although the pain is minimal, he wants to be relieved of it. Then Person B comes in with a gaping gunshot wound. She would also like the pill to help with the pain. It certainly seems that Person B should be given the pill because her pain is seemingly much worse than Person A’s pain. However, it seems that not giving Person A the pill would be denying him the right to have access to this version of healthcare in pill form. Again, I do believe that access to healthcare should be a human right, but I feel that it is fairly unrealistic in practice.
  • March 13 2012 at 12:22 am
    Rebecca Feldman

    A lot of the previous posts have discussed how it is impractical to say that healthcare is a human right for monetary reasons.  I do not believe, however, that a human right should at all be related to things that are out of our control.  If I was born into a royal family, does that give me more of a right to healthcare than if I was born into a family that lives below the poverty line?  I do not believe that this is true.  While the income that you personally make is partially in your control in terms of how hard you work, a lot of it is out of your hands.  Our income is based on multiple outside factors, such as our family's income (because that is often where we start), the connections that we have, the opportunities we are given, etc.  I think that healthcare is a human right despite the fact that many are unable to afford it and that if health care was a human right, people who are making above a certain income would have to pay even more taxes to cover those who cannot pay for it on their own.  I think that a right is something that each and every person is born with, regardless of any outside sources.  Healthcare should be a human right even though in practice, it would be difficult to accomplish.

  • March 28 2012 at 12:36 pm
    Daniel Groll

    The discussion so far has been really excellent. Thank you to all who have contributed! To this point, there has been a lot of focus on the question of what makes something a right. In light of that discussion, a number of people have wanted to say that even if access to healthcare is not a basic human right, it is nonetheless true that everyone, at least everyone in the United States, should have access to healthcare. We might even say that it is a right of all citizens (or all people in the country), even if it is not a basic human right.

     In light of this idea, and the fact that President Obama's healthcare bill is in front of the Supreme Court, let me then shift the discussion slightly by asking two questions:

    1. If it is true that everyone (more or less) in the United States should have access to healthcare, what does this mean (i.e. what should they have access to exactly)?
    2. To what extent is it legitimate to demand that some people's access to *some* services be limited, or even taken away, so that everyone (more or less) can have access?
  • April 3 2012 at 1:46 pm
    Katie Benson

    I agree with Daniel Groll that a useful discussion to have is to return to the United States, where current political and moral discussions make this topic extremely relevant to the well-being of all the people posting here. Both of the questions he raises seem to bring up the idea of the overall health of the population, which can be distinguished from the health of the individual. To propose a third (perhaps linked) question, I think it is important to consider the case where what one individual perceives as their “health” conflicts with the health of another person, or to make a stronger example, the population.

    An example of this is the current debate on vaccination and links to autism. Some individuals claim that receiving a vaccine is against their health (or, more typically, the health of their children) because of speculation that vaccines can cause autism, which negatively impacts the health of a child. However, this has implications for “herd immunity,” which is where enough vaccines must be given to provide protection for those individuals who either cannot have the vaccine (e.g. allergic) or for whom the vaccine does not work. If too many people elect not to get vaccinated, this compromises herd immunity and can infringe on the rights of an individual for whom the vaccine failed or, more seriously, cause a deadly epidemic of a disease. In this case, does the health of the population supercede the right of the first child to their health (as they perceive it)?

    Obviously, this is a case of someone electing out of receiving health care. But in other cases, where the desires of one individual might impact the population as a whole, is it their right to have that provided by the government? What about if the impact on the population (as is relevant here) is the monetary cost?

    I think this last issue (cost) can prompt a discussion of personal choices and how they are linked with health care. One major component of the current healthcare debate has to do with the responsibility of an individual for their own health. For instance, does an individual have the right to be obese by personal choice (e.g. provided no metabolic disorder preventing them from losing weight) and then have a heart transplant provided by the government or the money of other citizens? What about a woman who wants to have children but cannot afford to pay for their healthcare or her own? What about someone who smokes a pack a day and gets lung cancer? What about an “average” person who could run for an hour a day but chooses to watch television instead? What about a scientist who in the race for a cure for AIDS accidentally pricks themselves with a needle loaded with HIV and contracts the disease?

    All of these people made choices that could have limited their health. If it is agreed upon that there are cases when one is responsible for their own illness (a view that I by no means necessarily endorse), this raises the discussion of who is at “fault” for disease, and whether they should therefore be financially responsible for that disease. is a difficult question because disease would happen even if everyone behaved “ideally.”

    Therefore, where does one draw the line between the fault of the individual in failing to protect their own health and the right of that individual to autonomy? Surely we could all do things better for our health, but who decides when someone is not doing “enough” for their health?

    Finally, one additional question I would like to raise is also related to the idea of monetary cost. In the event that healthcare should be allowed for all as citizens of the US, “who pays for what?” If everyone deserves access to healthcare in the United States, is that to say that people who cannot pay for it should have it provided for them (e.g. paid for), or that EVERYONE (including people who could reasonably afford it without great impact to their overall well-being) should have it provided for them? Does someone with less money have more claim to have healthcare fully provided by the state than someone with more money?

  • April 5 2012 at 12:48 am
    Janie Wong

    Although I am not sure it is monetarily feasible, I do agree with many of the others that healthcare is something everyone should have access to.  People should be able to receive vaccines (such as for the flu or for preventing sexually transmitted diseases) that would not only help the individual person but society at large.  People should be able to seek advice from medical professionals but it is difficult on where to draw the line to what a person is entitled to.  People should be examined by a case by case basis but by what factors is unclear.  At the very least I will say that everyone should be entitled to preventative medicine such as vaccines, treatment for minor wounds, etc.

  • April 14 2012 at 1:36 pm
    Diedre Reitz

    In the healthcare debate, I feel there are several distinctions to make. First, we can consider the question of whether access to healthcare is a human right. By access to healthcare, I mean the right to obtain healthcare—that is, to purchase it at a fair price—in the absence of unreasonable prejudices and unnecessary burdens. For instance, in the U.S. today if a father has healthcare from his employer, and his child is diagnosed with a serious, chronic condition (such as pediatric leukemia), if the father loses his job or chooses to leave his job for a position at a different company, it may be excessively difficult for the father to find a new insurer. People in this position often choose to continue working a job which they are overqualified for, dislike, etc. in order to avoid possible loss of healthcare insurance. I feel that this prejudice unjustly restricts the rights of individuals with serious health conditions (and/or their legal guardians), and thus that fair access to healthcare is a human right.

    A second question to ask is whether all humans are entitled to healthcare itself. I would like to leave this question open but suggest that if we assume it is a right, it be a limited right. Many human rights are limited. For instance, we have the right to freedom of speech provided that it does not seriously compromise the safety of others. Similarly, we have access to many public goods and services (roads, parks, the school system, fire and police departments, etc.) but in order to use them we often must comply with set conditions for their use. Healthcare should be treated no differently; if we are to provide all individuals with healthcare, we must also set specific terms for their use in order to maximize utility and justice. For instance, all individuals should have to be properly vaccinated. If individuals refuse to comply with vaccination, as Katie Benson suggested, they pose a risk to other individuals who may not be able to be vaccinated for medical reasons.

  • April 22 2012 at 5:50 pm
    Brianna Engelson
    I think that Katie Benson’s point about the monetary cost of healthcare is a great one. In response to the question, “Does someone with less money have more claim to have healthcare fully provided by the state than someone with more money?”, I am inclined to say that they do. I feel that everyone in the United States should have access to basic healthcare. This would include, as Janie Wong has mentioned, preventative medicine such as vaccines and the treatment of minor wounds as well as easily treatable illnesses. Indeed it is difficult to know where to draw the line, but it seems that a good argument can be made for universal access to vaccines that can benefit the individual as well as the population as a whole. I also agree with Janie that it is not monetarily feasible for everyone to have access to healthcare at an equal cost. For this reason, I feel this service should cost more to those who can afford it.
  • May 7 2012 at 8:48 pm
    Becca

    I think Rousseau's "Social Contract" is helpful when trying to articulate my personal views about healthcare functioning as a human right. When speaking of the individuals that make up a state, the Enlightenment philosopher writes, "As soon as the multitude is united thus in a single body, no one can injure any one of the members without attacking the whole, still less injure the whole without each member feeling it." (Rousseau, 63) Rousseau's point is invaluable in this debate - an attack on one is an attack on all. Our nation is only as strong as our weakest link, and if people aren't getting the medical attention they need, the whole suffers, not just the individual parts. Ideally, healthcare includes preventative measures, therefore keeping the population as healthy, happy, and productive as possible. It should be remembered "a man cannot work for others without at the same time working for himself." (75) Ensuring good health of one’s fellow citizens is crucial in making sure the nation achieves its potential, both ethically and economically. Because "a whole less a particular part is no longer a whole," we must make certain healthcare is available to all. (81) A population consents to live under the same social contract, so everyone should be entitled to benefit from the same rights.

  • May 9 2012 at 11:35 pm
    Lily

    I think Professor Groll poses an important question in regards to the 'extent that it is legitimate to demand that some people's access to *some* services be limited, or even taken away, so that everyone (more or less) can have access.'

    However, I think it is important to point out that such a compromise is not necessarily the product of universal access to healthcare. I recognize that Professor Groll was likely not making such an assumption but I fear, and it seems our voting patterns illustrate, that many Americans are.

    Resisting the temptation to berate this concern in light of the widespread improvement such a system would allow, I would like to turn our attention to certain countries that successfully provide healthcare to all their citizens without limiting access to 'certain services.'

    My Junior year I spent time in Australia and New Zealand studying comparative welfare regimes. Most of of our class discussion and research centered around the provision of healthcare. Healthcare in Australia is available through both private and public institutions (Medicare). As a result of this system all Australians have access to healthcare (including primary, secondary and tertiary care) however, those who have the means to pursue faster treatments or those not offered by the public institutions have the option to do so through private clinics. Australia ranks among the healthiest countries in the world and has successfully kept healthcare costs (for tax payers) relatively low.

    As the discussion continues I think it is important that we keep such examples in mind and remind ourselves that universal healthcare does not inevitably require monetary or physical sacrifices. I apologize for the tangential nature of this comment but maintain the importance of acknowledging the assumptions that serve as obstacles to embracing a universal healthcare system in the U.S.

  • May 13 2012 at 11:55 am
    Rebecca Gourevitch

    I think that Lily brings up an important point about examining the assumptions that underlie our perceptions about what universal access to healthcare would entail. In light of Dr. Peter Ubel's convocation, it is clear that we all have subconscious biases that influence the way we understand health care policies and, subsequently, which policies we support. Framing the issue of access to health care as a human rights issue must certainly influence the way that people understand the debate and the controversy around universal access.

    On the one hand, framing it as a human rights issue might make it harder to create a health care plan that denies any individual access to care. Then, such a plan would not only be taking away a helpful and potentially life saving service, but it would be depriving that individual of a human right. There's not much disagreement in the U.S. about the importance of protecting human rights, so framing the debate this way could increase its appeal.

    However, as is clear from this forum, there is a lot of debate about whether access to health care is a human right. If politicians were to frame this debate in that context, those who disagree may end up attacking that proposal on the grounds that this is not in fact a human right. This type of debate could distract attention from the pressing matter at hand: how to create policy that provides more Americans with guaranteed access to affordable health care.

  • May 13 2012 at 5:15 pm
    Iris Cutler

    When reviewing the above posts, it seems as though humanity has not graduated far beyond the fabled ideal of achieving immortality. The privilege of living long and comfortably preventing/treating illness still depends on the monetary accessibility. Taking care of your health should not depend on your wealth, but cultures do not require the extreme selflessness necessary to provide universal coverage. That is, if money is the only way we can repay physicians for their work, health will always be about money.

    Given the permanence of such an issue, universal health care is an unrealistic ideal. The problem Groll (and students in subsequent posts) highlighted is that US health care is currently not as accessible as it could be. I cannot provide a solution to this, but I can endorse the direction Benson started us in, identifying treatments like vaccines that are necessary for the wellness of a community.

  • May 13 2012 at 7:43 pm
    Molly Curtiss
    First of all, when discussing what is or is not a human right, I think we need to set aside considerations of monetary feasibility. While this may seem unrealistic, human rights should be determined and exist independently of financial concerns. Although it is true that many countries are currently in a position in which providing universal healthcare is impossible, this should not prevent us from labeling access to health care as a human right and striving for its realization. Similarly, many of us consider access to education to be a human right, even though universal education is far from being achieved in many places in the world. By labeling health care a human right, we endow it with greater significance and are able to move away from debating who should have access to health care to exploring how we can accomplish the goal of universal access. I think it is essential to clarify that universal access to health care does not mean an unlimited amount of procedures, necessary or unnecessary, for both curable and incurable diseases, at every patient's demand; this would be impossible and unreasonable. Healthcare is a limited right, as Deidre discussed above. What it would mean is that no one would be denied receiving necessary treatment because of their inability to pay for it. When we focus more specifically on the United States, this right becomes even clearer. In a country overflowing with excess, there is no excuse for someone being unable to access a life-saving treatment. It is necessary to name health care as a human right to ensure that individualism or even plain selfishness cannot prevent every person from receiving basic care. Though instituting universal access to health care in the United States would undoubtedly require financial sacrifices on the part of some individuals, in a country of such plenty this could be achieved without depriving anyone of a comfortable life. And when the question comes down to purchasing personal luxuries or paying higher taxes to ensure everyone receives necessary medical treatment, the moral decision seems clear.
  • May 21 2012 at 4:23 am
    Nicholas Ickovic

    I hope it won't upset everyone too much if I problematize things a bit (as I think Daniel Groll was suggesting in both of his questions).  When considering health care as a right, I'm sure that we all have in mind the embarrassingly high portion of the population that is unemployed, struggling from paycheck to paycheck, etc. and now faces a very unfortunate and [plausibly nearly] unavoidable strike of disease.  These sorts of situations are robust, not few, and may well be guiding some of our good policies.

    Molly notes, however, that monetary and pragmatic concerns should be distinguished from the question of whether it is a human right.  I agree.  While pragmatically we may need a blanket cover to ensure these sorts of situations are met, we have others that are not so squeaky clean.  Consider the middle-upper class family that chooses to eat out at a fast food chain every night.  They are not too busy, let us say, to cook; rather, they just love the taste.  Let us further stipulate that they also know the risks of this diet.  When those risks come to fruition, through heart disease, diabetes, and other [let's say] preventable effects, should they have someone else foot the bill? 

    For that matter, what sorts of operations, procedures, etc. should count as proper?  Should a hypocondriac have unlimited access to the valuable and scarce time of a physician? Furthermore, we would probably hesitate including plastic surgery; but the case gets more murky when a patient is in a condition (depends on her looks for her job, fears losing her husband because of a disfiguring accident) when it might be no less appropriate than our paradigm cases for universal health care. 

    Finally, disparate levels of care may well emerge.  What counts as sufficient health care?  What standard of care, funding of hospitals and equipment, qualifications of staff, and so forth are sufficient to cover this human right?  Are we all entitled to the very best doctors?  Or are we entitled to just anything, because that's better than nothing?  What counts as enough health care?

  • May 21 2012 at 7:55 pm
    Matt Hunter
    First of all, I'm going to fully admit that I did not read most of the above posts. This is more of my personal response to the question, which hopefully is still somewhat relevant to the discussion at hand. It seems to me that "The Question" is asking something different than what we really care about when it comes down to it. On the face of the matter, yes, the lack of access to health care is a huge problem, but really, what we want for people, in the end, is not health care; the end goal (at least as I see it) is the quality of life that access to health care provides. With health care, one can get medicine for painful or unpleasant health conditions, procedures to extend their life, and so on. This helps people live longer and happier lives, which is what we really care about. In other words, access to health care is a means to a minimally sufficient quality of life, but it is not an end in of itself. Why does this matter? On the one hand, people generally need some sort of health care in order to meet this minimal standard of living. However, asking whether access to health care is a right implies that all we care about is that everyone has health care, regardless of what that really entails. But if we change the question to, "Is access to a minimally adequate quality of life a right?", we avoid including unnecessary or expensive procedures and medicines in what people have a "right" to. Long story short: Instead asking whether people have a right to health care, let's ask what sort of life we really think every human being should have, or what we believe in necessary for a "good life". Then, we can better determine what parts of health care should be universally accessible, and what parts should not.
  • May 23 2012 at 4:15 pm
    Katie France
    I’d like to start by saying that while I completely agree with many others that the idea of “human right” is near impossibly define, for the purposes of this discussion, I think we are right to consider it as something inalienable that forms a basis of living a human life. However, this debate could The Question in itself, and I think Hannah Kyle makes a good point that given the structure of healthcare within our larger society, access to healthcare should be considered in the framework of whether or not it is a “moral responsibility of the state.” This is a more constructive starting point than “human right,” whatever that is, since that definition is more applicable to the present day. In this connection I am inclined to say that access to healthcare is a moral responsibility of the state, and despite the monetary and political hoopla that implementation of universal healthcare will and has caused, it just doesn’t seem right (as many have said before me) to have something so basic as human life essentially cut short if you cannot afford proper care. I admit that universal healthcare is a pretty lofty goal, but do not think that this should mean that we strive for any less. If this means achieving equality in care by at first providing it by levels so be it, but at the end of the day no one in an organized society should feel the need to suffer because they either do not have the access or the resources to take advantage of healthcare.
  • May 23 2012 at 11:33 pm
    Madeline Arnold

    One thing I’ve been thinking about as I read these posts is the difference between individual rights and responsibilities, and communal or group rights and responsibilities. As many have said, even if healthcare is a human right, it may not be feasible for that right to be realized for every individual in society. James Stiles, at the beginning of the discussion, put it this way, “the requirement is not for each human to receive health care. Rather, the requirement is for us to proactively provide health care to the best of our ability.” So perhaps we should view the collection of individuals who we believe should receive healthcare as a group with a collective right to healthcare, recognizing that there may be instances in which a particular individual does not have the right to healthcare. Similarly, the responsibility to provide healthcare should be viewed as a communal responsibility. Society as a whole should do what it can to keep people healthy, but a specific individual does not necessarily bear this responsibility. Therefore, the doctor/carpenter in Prof. Decker’s island example does not have the responsibility to treat his misfortunate fellows. However, he might not be able to reasonably consider himself part of the community if he does not do his best to heal the others. It might not be the responsibility of a specific wealthy taxpayer to cough up the funds for others’ healthcare, but the community as a whole may decide that healthcare is a priority, and insist that its members share the burden. To me, it seems that healthcare rights and responsibilities are not those of individual humans, but of citizens as part of a community.

  • May 24 2012 at 3:05 pm
    Galen Ryan
    Health care can mean a wide range of treatments and care. Universal access to all of these treatments is unrealistic. But I think that minimal treatments should be available to all those who seek them. I am not sure how to define these minimal treatments. They would at least be not very expensive and would treat common ailments. I think that common vaccinations could fall very nicely into this category. Vaccinations do not only improve the health of the individual but would also help protect society from such virus. I think access to a simple quality of life should not be restricted from those who seek it. For the most part, I believe one life is not more important than the next and each life should try to be preserved. However, monetary restrictions make me say that only universal access to minimal care, and not all of health care, should be a right.
  • May 24 2012 at 3:35 pm
    Robin Burrell
    I think Katie and Madeline's posts point the conversation in a helpful direction. It is important to distinguish between the broader question of "is healthcare a basic human right?" to "does the state have the responsibility to ensure access to healthcare?" To use Madeline's language - does the state have the responsibility to ensure access to healthcare to its citizens as a feature of their membership in the society? In the British Medical Journal article, posted on The Question's main page, the author argues that healthcare is not a human right. The second justification for this assertion is the idea that rights imply a duty on the part of others and the duty in the case of universal access to healthcare "imposes an intolerable burden on others." I'm inclined to say that it is still the state's responsibility to ensure access to healthcare even if the burdens seem high. In this case, the individual right to access to healthcare, which the individual receives as a feature of her membership in society, supersedes considerations of the burdens placed on the state. Lets take Nick's example of the upper-middle class family's decision to eat fast-food, knowing the health risks involved, that still receives treatment for diabetes, heart disease, etc. How comfortable should the state be with allowing the situation where this family is insured, but a lower-class family does not have access to the most basic of services? Putting aside the question of whether healthcare is a fundamental or inalienable right, we can appeal to a principle of equality to call upon the state to at least equalize the access to the most basic of healthcare services. Under this framework, basic healthcare becomes a fundamental right (not necessarily a human right) by virtue of a person's societal membership as a citizen.
  • May 24 2012 at 11:00 pm
    Chris Wong
    Given that each individual has the right to life, and healthcare preserves life, it does not immediately follow that each individual has the right to healthcare, because the right to life is a negative right and the right to healthcare is positive. However, I argue that we can still maintain that healthcare is a human right by appealing to the value of equality. Life is obviously essential to maintain a life worth living. However, even though no one would argue regarding the right to life, it is not then readily apparent that all individuals have a right to healthcare. This is because the right to life is ultimately a passive right, which is to say that no one has the right to take another person’s life without his or her consent. On the other hand, the right to healthcare is a positive right, which obligates all capable institutions and individuals to provide health services. In order to draw this positive right from a negative right, we have to prove that allowing a person to die or live a poorer, unhealthier life is unacceptable. We can draw this conclusion by appealing to the value of equality. While privileged individuals purchase “Cadillac” insurance plans that cover them for each and every medical treatment, others go entirely uninsured or without acceptable access to healthcare. A meritocracy cannot answer for this discrepancy, because this disparity determines life and bodily health rather than the lack of luxuries and other commodities. Given those with exceptional access to health services, it is in fact unacceptable to let people die or live poorer, unhealthier lives. As such, we are able to bridge the gap between the negative right to life and the positive right to proper medical attention.
  • May 25 2012 at 1:46 pm
    Zoe Suche
    I'd like to further explore the distinct question that Robin mentions above: "does the state have the responsibility to ensure access to healthcare?" Irrespective of the burden placed on the state, as acknowledged above, there is a case to be made the regardless of how heavy the burden appears to be, in the interests of equality between citizens. However, I think the issue can be complicated a little when considering the state's "duty" in the context of the individual health care provider's duty, rather than perhaps in consideration of financial expenditure, which is what the above post brings to my mind. In terms of equality for all members of society, doctors and healthcare providers are members of that society; where do we draw the line for them in terms of reasonable burden? I believe that there is an inevitable point at which the burden placed on the provider outweighs the benefits for the person receiving the care. For example, it's arguably not in the best interests of society as a whole for doctors to take days off, or vacations, or to charge certain amounts for their services; but at the same time, imposing such difficult working conditions on doctors could be detrimental to society by making the medical profession less attractive to prospective doctors, and perhaps exacerbating the shortage of doctors that we already deal with. Overall, although it initially may seem like we should work to provide healthcare whatever the burden imposed upon the provider, taking such a stance could result in alternative negative repercussions.
  • May 25 2012 at 8:43 pm
    Ella Fox
    I think this question is beyond my understanding – what constitutes a human right is obviously central to this question, but I think tackling that is a different story. I’d like to come at this from an angle of community, in a small-scale sense as well as a larger, political sense. I feel that if we are to consider ourselves as part of a community, then caring for one another’s health should be a priority within that community. I feel that access to health care should be available to all members, not just those who are able to afford it. It seems that anything else is counter to what I understand to be the definition of a community. Then, with what limited knowledge I have on the subject – that is, that the US seems to be falling behind the rest of the developed countries in respect to universal health care as available to all citizens – I feel that universal health care should be structured into our government system, to indicate that we value our community of citizens and the well-being of those citizens. While the idea of the wealthy paying for the health care of the poor is probably a point of tension in regards to this matter, it seems to me that another component comes into play: the active role of each citizen in the society. It seems that to deserve any kind of care and support from the community, one must be a functional member of that community. But what if someone does not have the opportunity to actively give back to the community that supports her? I would say that in order to be a productive member of society, being healthy seems to be the first step on the way to becoming an active participant. It follows that universal health care is a good first step towards a more cohesive and productive community. Therefore, regardless of income, health care should be available to promote the highest opportunity for the most flourishing community.
  • May 25 2012 at 8:44 pm
    Ella Fox
    I think this question is beyond my understanding – what constitutes a human right is obviously central to this question, but I think tackling that is a different story. I’d like to come at this from an angle of community, in a small-scale sense as well as a larger, political sense. I feel that if we are to consider ourselves as part of a community, then caring for one another’s health should be a priority within that community. I feel that access to health care should be available to all members, not just those who are able to afford it. It seems that anything else is counter to what I understand to be the definition of a community. Then, with what limited knowledge I have on the subject – that is, that the US seems to be falling behind the rest of the developed countries in respect to universal health care as available to all citizens – I feel that universal health care should be structured into our government system, to indicate that we value our community of citizens and the well-being of those citizens. While the idea of the wealthy paying for the health care of the poor is probably a point of tension in regards to this matter, it seems to me that another component comes into play: the active role of each citizen in the society. It seems that to deserve any kind of care and support from the community, one must be a functional member of that community. But what if someone does not have the opportunity to actively give back to the community that supports her? I would say that in order to be a productive member of society, being healthy seems to be the first step on the way to becoming an active participant. It follows that universal health care is a good first step towards a more cohesive and productive community. Therefore, regardless of income, health care should be available to promote the highest opportunity for the most flourishing community.
  • May 25 2012 at 8:57 pm
    Gilah Benson-Tilsen

    Healthcare is a human right – just one whose implementation and precise definition are complicated. First of all, it seems clear to me that every human being has the right to free information about health, as well as treatment that is highly beneficial without being burdensomely expensive for society as a whole. Along with the general right to protection of life that all people have, access to any easily provided and highly effective treatment should be a right for all. However, this applies to the lowest common denominator of healthcare: anything beyond that is subject to the complications of justice in resource allocation. Defining the lowest common denominator in the U.S., for example, might be done by examining what is already largely covered by most insurance companies. Providing these services for everyone would require reallocation of some resources; and yet, it seems very likely that improving the health of the population would be not only the moral thing to do, but also the economically beneficial action as well. Disease, particularly the easily treatable type, tends to be costly for society and have all sorts of externalities that would make it not only a moral imperative, but also a sound investment.

    Life, liberty, and the pursuit of happiness are severely restricted by the suffering that results from treatable diseases. We admit that human rights include protection from the bodily harm resulting from warfare, torture, etc., and moving forward we might as well include bodily harm resulting from belligerent viruses and diseases.

    As a previous commentator mentioned, “any right I have to swing my arm… ends when my arm reaches your face.” The whole question of basic healthcare becomes tricky when we consider differences in standards of living across countries. What exact standard of healthcare should be a human right? Do we all have a right to the most basic healthcare that our own country can provide? What about effective, very beneficial treatments with prohibitively high costs? No matter what we choose, there will have to be some weighing of practicalities. As of today, most countries ration treatment by income; universal healthcare would require an alternative form of rationing. But it seems to me that the morally reasonable option is to reallocate some money, pay our taxes, and give up some marginal consumer goods to save another’s life.*

     

    * And maybe even our own if it’s contagious.

  • May 25 2012 at 8:59 pm
    Gilah Benson-Tilsen

    Healthcare is a human right – just one whose implementation and precise definition are complicated. First of all, it seems clear to me that every human being has the right to free information about health, as well as treatment that is highly beneficial without being burdensomely expensive for society as a whole. Along with the general right to protection of life that all people have, access to any easily provided and highly effective treatment should be a right for all. However, this applies to the lowest common denominator of healthcare: anything beyond that is subject to the complications of justice in resource allocation. Defining the lowest common denominator in the U.S., for example, might be done by examining what is already largely covered by most insurance companies. Providing these services for everyone would require reallocation of some resources; and yet, it seems very likely that improving the health of the population would be not only the moral thing to do, but also the economically beneficial action as well. Disease, particularly the easily treatable type, tends to be costly for society and have all sorts of externalities that would make it not only a moral imperative, but also a sound investment.

    Life, liberty, and the pursuit of happiness are severely restricted by the suffering that results from treatable diseases. We admit that human rights include protection from the bodily harm resulting from warfare, torture, etc., and moving forward we might as well include bodily harm resulting from belligerent viruses and diseases.

    As a previous commentator mentioned, “any right I have to swing my arm… ends when my arm reaches your face.” The whole question of basic healthcare becomes tricky when we consider differences in standards of living across countries. What exact standard of healthcare should be a human right? Do we all have a right to the most basic healthcare that our own country can provide? What about effective, very beneficial treatments with prohibitively high costs? No matter what we choose, there will have to be some weighing of practicalities. As of today, most countries ration treatment by income; universal healthcare would require an alternative form of rationing. But it seems to me that the morally reasonable option is to reallocate some money, pay our taxes, and give up some marginal consumer goods to save another’s life.*

     

    * And maybe even our own if it’s contagious.

  • May 25 2012 at 10:32 pm
    Meera Sury
    I'd like to focus a little more on what the function of healthcare is in a person's life. The intention of seeking out a clinician is usually to heal/treat an ailment or to eliminate pain. Healthcare functions as a mechanism to improve a person's current standard of life. As such, another consideration of healthcare as a human right is the standard of life that people have the right to. Does everyone have the right to be free from extreme pain? Does everyone have the right to vaccines that protect them from diseases? Does everyone have the right to undergo extensive testing to diagnose a moderate/severe condition? Does everyone have the right to undergo expensive voluntary procedures (cosmetic surgery, gastric bypass)? The determination of the lowest acceptable standard of life provides us with a starting place to understand where healthcare should be a right.
  • May 25 2012 at 11:38 pm
    Peter Joy
    It is easy to make the case that negative rights qualify as human rights. It is difficult to make the case that healthcare is a human right because it is a positive right, which like many positive rights, involves reallocation of resources from one person to another. However, even if healthcare is not a human right, it arguably has some qualities (discussed in previous comments) that makes it the case that US citizens should have universal access to it at some level. We are comfortable having tax-payer dollars go towards law enforcement, schools and roads. Conceptually, healthcare is no different, and the ensuing debate goes along the classic taxation vs freedom debate. Practically, healthcare is different from these because unlike law enforcement etc., it involves variable services with high variability in costs depending on individual health requirements. If we can agree that some level of healthcare must be provided, but also that not all treatments can be guaranteed, we have to draw the line somewhere. Granted, its a very twisty line. I would begin with preventative medicine, have the majority decide on medical treatments related to contentious issues (with ethicists battling it out in newspapers columns and cable news appearances, of course), keep moving, and stop somewhere before cosmetic treatments etc. Fiscal constraints will kick in early in this process and give us a good stopping point. I apologize for the resigned tone regarding the important discussion of proper "rationing". The list of not-so-squeaky-clean cases outlined by Nick Ickovic suggests that blanket prescriptions may not work and that these may need be legislated on a case by case basis. While it would be ideal to have a sound ethical inquiry into each of them, the pressing practical concern of having a generally acceptable healthcare bill (one that doesn't allow twelve year olds to die from abscessed teeth) passed and enforced means that we may have to leave these discussions to our lobbyists… I mean lawmakers.
  • May 26 2012 at 4:03 pm
    Yongming

    Peter Joy points out that since "we are comfortable having tax-payer dollars go towards law enforcement, schools and roads," we should be just as comfortable subsidising healthcare for the poor and needy.

     The analogy, though, isn't that straightforward in the case of healthcare. Unlike law enforcement, schools, and roads, all of which are clear 'public goods' (in the economist's sense of being non-rivalrous and non-exclusive), and which have clear positive externalities, healthcare is slightly more complicated. That the poor minority in a country does not have access to healthcare might not bother the rich as much as, say, a deficient police force or decrepit infrastructure.  

  • May 28 2012 at 3:30 pm
    Dana Mackey
    Like Peter, I do believe that some fundamental aspects of health care should be required. While every human has the right to relief from immense pain in most circumstances, it may be impossible to guarantee the provision of every extensive health care treatment for each patient. I also agree that as citizens of the United States we should "subsidize healthcare for the poor and needy." For me, the most pressing question is what treatments (if not all) should the public feel obliged to subsidize? I disagree with Yongming that the rich "might not be bothered" by poor people without healthcare. Without healthcare, underprivileged citizens are often driven to self-destructive (or societal-destructive) behavior that often has adverse affects on the entire society. America's upper and middle classes should absolutely be concerned with whether the working class can effectively access sufficient healthcare.
  • May 29 2012 at 4:21 pm
    Spencer Pratt

    When speculating about human rights, it is imperative to draw a distinction between the alternatives to rights. If healthcare is not a right, is it a privilege or is it a responsibility? Taking the privilege stance, how exactly does one secure the privilege of healthcare? Must one be employed, drug-free, or have a clean criminal history? Contrarily, does the responsibility stance impose responsibility on the government, on medical institutions, or on taxpayers providing the financial support?

    It seems to me that most human rights are considered a protection of one’s individuality and freedom within our society. To consider healthcare a right is not only protecting one within our society, but it is taking an extra leap by imposing a financial burden on others in society, a health burden on other patients waiting for care, and a labor-intensive burden on healthcare providers. Healthcare cannot be a right if the right requires a duty or obligation by another. I do agree that everybody has a right to the access of healthcare – but not a basic, fundamental right to the care itself. There are too many anomalies in specific cases, with specific individuals, and a right to care could drive our health care system, as we know it, to even greater inefficiency.