In the second presidential debate in October in Nashville, President-Elect Obama was asked whether health care was a right, a privilege or a responsibility. Without hesitation, he said it was a right. He never said why he felt that way, but he has been clear that his administration is making health care reform a top priority -- that is, if there is any money left over in the government after filling the tin cups of Wall Street, the big three automakers, schools, municipalities, etc. But, regardless, should health care be a right? And shouldn't it (health care being a right) be clearly articulated by the electorate and those on both sides of the aisle before our elected officials cogitate over all the bills to reform the health care system once the inauguration is over? The answer to both these questions is clearly, yes.
First, why should health care be a right? After all, it is not written in our Constitution that it is an inalienable right; it is not contained in the Bill of Rights either. Parenthetically, neither is procreation, how many kids to have, being forced to stop smoking after being diagnosed with lung cancer, the right to be free from second hand smoke in public, or crime, or terrorism; and rejecting the imposition of curfews to protect our safety and welfare. The list here goes on and on. Yes, we do have a recognized right to life, liberty and the pursuit of happiness, so maybe receiving affordable and accessible health care falls under this umbrella?
Is health care a right founded in American history? Sources are few and far between on this one, though in an article I wrote last August ("Universal Coverage: How to Get There", in Clininal Endrocrinology News,Vol. 3, No.8 (Elsevier, Inc.-publ. (August 2008)), I suggested that reviewing the background and development for Medicare that was signed into law in July,1965, would be useful for the current debate on how to achieve real reform in our health care system. A writer on the history of Medicare at the time, Peter Corning, described Medicare as the product of considerable effort -- in many ways the product of plain-old political "wheeling and dealing". But Medicare represented the first social legislation to provide medical care to a segment of our population at the time. This perspective was recently amplified in a piece by Blumenthal and Morone, "The Lessons of Success -- Revisiting the Medicare Story", (359 NEJM 2384-2389 (November 27, 2008). In audio tapes and archival materials recently released by the Johnson library, President Johnson told Hubert Humphrey, "Don't ever argue with me. I'll go a hundred million or a billion on health or education...You got to have health...I'll spend the goddamn money. I may cut back some tanks. But not on health." (recording of tel. conv. between Johnson and Humphrey, March 6, 1965, 11:25 a.m., Citation no. C.7024-7025).
The following year, the preamble to a federal health planning act bill stated, "The fulfillment of our natural purpose depends on promoting and assuring the highest level of health attainable for every person."
But, still nothing about health care being a right.
In 1993-94, then President Clinton tried to champion the Health Security Act; it died a million deaths. Now comes along various proposals and commentary to revise our present system: Sen. Ron Wyden's "Healthy Americans Act"; Sen. Baucus' white paper on the subject; Sen. Kennedy is working on his draft; and even HHS Secretary-Elect Daschle has spoken during a recent conference call. Of course, we can't forget what Obama has proposed; what McCain offered and even what Sen. Clinton put forth on health care during the campaign. And, we have yet to hear what Members of the House will offer. True, among these efforts is defining who should be provided with health care protections, but still a whole lot of chest-beating without knowing why are we doing this?
But where has it been officially said that health care is, or should be, a right?
Webster's dictionary defines a "right" in general terms as what is sound and in accord with justice, fact or reason -- what is suitable and appropriate. There is even a definition inclusive of having sound health! So, is health care what is suitable and appropriate?; is it reasonable that all Americans must be healthy by being provided with a doctor and a place to be treated every time we are sick, injured or require surgery? Or, is health care a right because, as we have read and heard, 45+ million Americans have no health care coverage, or have been forced into bankruptcy because they could not pay their doctor and hospital bills? Not exactly, though this (latter) data and events are reasons enough to certainly suggest a system in crisis and in need of immediate repair.
We have seen other countries provide their citizens with health care. Did the leaders there consider health care to be a right. Maybe; maybe not.
How about trying on for size this reason: without being healthy, we cannot be productive, i.e., we cannot work, earn income, spend on goods and services and promote the economy and welfare of the nation. Likewise, if we are sick, dollars have to be spent to make us better; this places a drain on the economy. Of course, if we are healthy, we can do more things for our family, relatives, our churches and synagogues, and our communities. Putting all this slightly differently, without our health, we have nothing, and we then have nothing to offer! Do these premises just stated make health care a right for all Americans? Absolutely!
We see our President-Elect tout change in health care accessibility and affordability, and we see pundits and elected officials debate the pros and cons for reforming health care; yet, without a clearly articulated statement from the electorate through our elected officials on both sides of the aisle that health care is a right of all Americans, aren't we all just really "dancing on the head of a pin"?
Follow Miles J. Zaremski on Twitter: www.twitter.com/mzaremski