Rights With No Responsibilities?

Is there such a thing as a right without a responsibility? Our most fundamental rights to "life, liberty and the pursuit of happiness" come - of necessity - with the responsibility not to abridge someone else's rights to life liberty, and the pursuit of happiness.

Consider the Bill of Rights. Each right is accompanied by responsibility.
• Right to free speech (First Amendment) means you cannot stop someone else from speaking things out loud that you bitterly oppose.
• Right to bear arms (Second Amendment) comes with an obligation to bear them responsibly and not use them against each other.
• The Fourth Amendment puts the responsibility squarely on the government not to unreasonably search or seize us or our property.
• The right to a fair and speedy trial (Sixth Amendment) again places responsibility squarely with the legal system not to hold us indefinitely without due process.

Apply this concept to health care and see where it leads. [Healthcare - one word - is the system. Health care - two words - is the service.]

We all have a right to life. No one has the right to make us dead. Many people reason that a right to life includes a right to be healthy. Certainly no one has the right to make us unhealthy. But do we have the right to make ourselves unhealthy? I would answer, Yes! That is part of being free.

Does the right to make ourselves unhealthy come with no consequence? Silly question. Being unhealthy carries the consequence of needing health care. Who should pay, whose responsibility is it to pay for the services we choose to consume? Does that responsibility fall on others? Here I would answer a resounding No!

Wait. Wait. Before people start attacking me again over "Should fat people pay more?" we should only be held responsible for those things over which we have control. The majority of obese individuals; the majority of people with cirrhosis of the liver; all people who smoke cigarettes made a choice. They have control.

Andre the Giant (from the movie Princess Bride) and others who are genetically large did not choose their parents (and their genes). For them, weighing 400 pounds could be normal even healthy, but most important, they had no control.

Same thing is true for people who develop breast or prostate cancer. Not so for lung cancer where over 80% were smokers. Yes, Dana Reeve, deceased wife of also deceased actor Christopher Reeve (Superman), and my good friend Sh. were both non-smokers who died from lung cancer. There are exceptions. We must design a system that covers the vast majority and then build in enough flexibility to handle outliers.

When our bodies are unhealthy because of what we do (overeat) or what we do not do (exercise), we should be held responsible and accountable. When our bodies are unhealthy and we could not prevent it, we should not be held responsible.

We can, should, indeed must have a lively extended discussion about all the important elements such as how much to pay, incentives, productivity effects, and healthcare as infrastructure.

What should NOT require any discussion is the acceptance of personal responsibility, which comes of necessity with the freedoms enshrined in our founding principles.

Freedom to fly includes freedom to fall.

If I have rights, certainly if I have freedom, my actions have consequences for which someone will be held responsible. If not me, then who?

Follow Deane Waldman on Twitter: www.twitter.com/systemmd

Comments

[CDarwin]

You know, I find it quite interesting and telling that in your post you reference the late wife of the late Christopher Reeve as someone who was not responsible for her lung cancer, and yet you fail to mention that Mr. Reeve WAS responsible for his paralysis and his untimely death, not to mention the enormous medical bills he must have accrued.

Posts, such as yours, purporting to support personal responsibility almost always reference obesity, smoking, and alcohol use as if those were the only poor health choices. How come no mention is ever made of those who injure themselves exercising, or engage in potentially dangerous sports (as did Mr. Reeve), or are underweight (anorexics, bulimics), or refuse to have their children vaccinated, or choose high-stress jobs, or choose to live in high-pollution areas? All of these are also lifestyle choices that can result in poor health outcomes. If you believe that the obese, smokers, and drinkers should pay a higher price for health insurance for their poor lifestyle choices, then surely you must believe that ALL people who make poor choices (such as Mr. Reeve) should bear the cost for their poor choices.

Or is it that what you really believe is that only people who make choices YOU deem to be unhealthy should be responsible for them?

[RightWingMarine]

I absolutely agree that people should be held accountable for their personal decisions but I believe your system would be too complex requiring people to prove or disprove their condition is genetic and unavoidable or brought on by their own actions.
I won't go so far as to say that I disagree with your basic premise but I believe you take it a bit too far. My right to free speech and to bear arms does not impose a cost on anyone else. No one is required to provide me with a printing press so that my free speech can be satisfied. But when you describe your right to be healthy you place the burden for the treatment of unavoidable conditions on the govt and this imposes a cost on others. If I don't have a right to have a printing press made available to me at no cost why would I have a right to have a doctor made available to me at no cost?

[MysticalPippin]

RWM - You're comparing apples to oranges. free speech is free. It doesn't cost anyone anything financially. You don't NEED a copier or printer (that's what printing presses are called now) in order to satisfy your free speech. All you need is a voice.

We started this country as people who desired the same thing which put us to the task of caring for each other because we believed we should all have certain rights& the freedom to think what we want. We stood together & formed a new nation as one. If you're sick that could mean life or death. You will no longer have a voice when you die. And with our intrinsic desire to stay alive don't you think it's a categorical imperative for the people of this country to help each other achieve that?

The government's out of pocket cost (because drug & insurance companies will pay for most) will be approximately 9 billion per year for the next 10 years. Isn't that just a drop in the bucket for the government to come up with annually? But, even if it cost more than that it's still the right thing to do.

We're in this together and we need to stick together and act as one. We need to stop fighting amongst ourselves just because we have to spend a little money to get back on track and keep our nation healthy and functioning. In the long run healthcare reform will keep the costs and spending

[dynwit]

"The rest of the world is watching the U.S. debate over health care reform and is flabbergasted at the country's opposition to the obvious answers. They think every one should have access to health care and cannot understand why anyone would oppose Obama's plan... For decades, the largest economy in the world has tolerated the absence of health care for tens of millions of its population (currently 45.7 million), including 20 million children. The U.S. has not only tolerated, but even fundamentally accepted this failure... Most countries around the world, including Japan, China, India and every country in Europe, believe that health care is a basic human right and that no one can be refused access to health care... Even the poorest countries, which cannot afford universal health care, see it as a priority. Furthermore, the U.S. spends three times the percentage of its GDP on health care compared to other developed countries. This means that the U.S. manages to provide health care to 80 percent of its population at the most astronomic cost in the world. The U.S. allows its pharmaceutical industry to sell drugs to Americans at twice the price at which they are available across our border, in Canada. When Americans began crossing the border to save on prescriptions, industry groups fought to close this loophole."

--Georges Ugeux
http://www.huffingtonpost.com/georges-ugeux/heathcare-why-the-world-i_b_275538.html

[dynwit]

"Thousands of Americans are Moving to Mexico for Affordable Healthcare"

http://www.huffingtonpost.com/chris-savage/thousands-of-americans-mo_b_274029.html