Is healthcare a right or a privilege?

Healthcare is probably the single biggest issue in our country right now, as republicans try to dismantle our current system and progressives push for single payer healthcare. Indeed, more Americans than ever are interested in single payer healthcare: 33% say we should adopt such an approach to healthcare (up 14% from 2014), and 60% say that the federal government has a responsibility to ensure its citizens have healthcare coverage (whether that be public or private).

This stands in stark contrast to the current republican government’s approach to healthcare, which, judging by the legislation they’ve written, is that you should only get healthcare if you can pay for it. Naturally, republican politicians have taken to all forms of media to speak out against single payer healthcare.

But really, there isn’t much of a data-driven argument against single payer healthcare. We know that it’s significantly cheaper. We know that the health outcomes for people tend to be the same, if not better. No, people in Canada and Sweden aren’t dying in the streets because of “rationed care.”

The main objection to single payer healthcare, as far as I can tell, is completely philosophical and boils down to one simple question:

Is healthcare a right or a privilege? 

Ask most conservatives and they’ll probably tell you it’s a privilege, not a right. I’ve had numerous conversations about that with people lately, and I’d like to closely examine this argument.

There’s an underlying assumption in this conservative argument that healthcare is a privilege, namely that there is some finite amount of rights in existence, and everything else is just a privilege. The conservative argument that healthcare is a privilege seems predicted on treating rights as if they’re matter or energy–they can be neither created nor destroyed.

To that end, many conservatives use the constitution as the end-all-be-all of rights. If it isn’t in the constitution, it isn’t a right and therefore must be a privilege. This meme perfectly illustrates this line of thinking:

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This is a particularly bizarre argument given that the founding fathers purposely created a constitution that can be changed, amended. And indeed it has been, 27 times. 100 years ago this meme could have said, “Trying to find in the constitution where it says women have the right to vote.” Or you could have run this meme in 1859 to say, “Trying to find in the constitution where it says black people aren’t personal property.” It’s just a foolish argument.

But the point is that rights aren’t some static, finite thing. You’re given new ones all the time. The 26th amendment gave 18 year olds the right to vote. The 17th amendment gave you the right to vote for your own state senators. Prior to those amendments being written, those rights did not exist.

Similarly, rights can be taken away. The 18th amendment took away your right to manufacture or sell alcohol. That one was repealed, thankfully.

The ultimate point here is that rights aren’t written in stone. We give ourselves new rights all the time, as the previous examples showed. So why couldn’t healthcare become a new right?

It almost was. FDR was on the verge of introducing a second bill of rights in the 40’s, shortly before the end of WWII.

Unfortunately, FDR didn’t live long enough to see this enacted, and it became a mere footnote in American history. I’m sure though, that many conservatives would argue that FDR was some kind of communist for this proposal. Ironic, given that in this short speech he seems intent on protecting free markets.

So then, what would be the argument that healthcare is indeed a right? Well, if you’re having a conversation with someone who wants to use to constitution as an argument that it’s a privilege, try giving them this line:

“We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.”

It’s right there in the preamble. “Promote the general welfare.” What’s the argument that single payer doesn’t fulfill this part of the constitution? Or, conversely, how does a “you can have it only if you can pay for it” model promote the general welfare?

But, one might argue, even if healthcare were a right, that doesn’t mean that government run healthcare is. Perhaps it’s simply a matter of the government ensuring that you have access to affordable care. On the surface, this seems like a valid argument.

Well, this is where I would point out that single payer healthcare is vastly cheaper than the alternative. But even ignoring that point we could still make an argument for it. If we were to argue that “promote the general welfare” means that the government is obligated to look after the health of its citizens, that doesn’t necessarily follow that you need to use it. If you want to buy your own private insurance, you should be free to do so. And indeed, in many countries with single payer healthcare, citizens have every right to buy their own supplemental or private coverage. Just because the government offers a single payer option to its citizens doesn’t mean your right to choice vanishes. Indeed, perhaps a little competition between the government and private industry would be a good thing.

If nothing else, we could look at this issue through an ethical lens. If your neighbor was dying and could be saved, but he doesn’t have the means to save himself and you do, are you ethically or morally obligated to help him? What would you want if you were the dying neighbor?

Ultimately, I think I can walk away from this post to leave you with a couple of ideas. First, in reality, there is very little difference between a right and privilege. Indeed, I might argue that a right is simply a legally protected privilege. Which means, as we’ve seen throughout history, we are capable of being granted new rights if we demand them, if there’s a referendum on them. Second, if a government has an obligation to look after the welfare of its citizens, there is no reason why this should stop at healthcare. We’ll subsidize your education, your protection, your infrastructure–the line drawn at healthcare seems completely arbitrary.

 

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