Is Health Care a Right and Should It Be?

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"?

Comments

[NWGuy]

I don't like "right" nor "benefit" as terms for providing healthcare for the public at large. A "right" implies an obligation on someone else to provide and has to be legally defined, a "benefit" is too easily taken away or selectively given. I prefer to use the term "service" as in that healthcare is a service provided to all the citizens of the country as decided by the citizens. In the same way that having a fire department available is not a right but is a service that everyone agrees should be available for everyone. Because we all agree that fire departments are a good thing, we are willing to pay to have them, and it doesn't matter if the house fire they fight is a mansion or in a ghetto. I see health care in a similar vein, assuming we all agree that healthcare should be available to all, then we should make sure that it is. Obviously, the devil is in the details and determining how to pay for it will be the fight.

I also believe that it should be a 2-way street, not only does supply need addressing, but so does demand. In any healthcare plan, there should be expectations and provisions to support and encourage better health choices and behaviors to reduce the incidence and prevalence of injuries and illness.

[LewDan]

I happen to be black. No black American wold ever define a "right" as implying "an obligation on someone else to provide." Especially Constitutional rights. Don't kid yourself, this is America, the real world.

The rights you're "entitled to" are statements of principle or, at best, intent. The "rights" you actually get are wholly dependent on what your community and government are willing to provide, or what you can forcefully take. What you call"service" IS what everyone else calls a "right", as long as its also referenced in the Constitution. The Founding Fathers weren't stupid. No piece of paper, even one called a "Constitution" is going to MAKE anyone do anything.

[Miles J. Zaremski - Huffpost Blogger]

Instead of thinking about health care as "an obligation on someone else to provide", think of health care as an entitlement by being an American citizen. How it is provided, and at what cost, comes next in any analysis.

[schatsie]

I believe i have a right to go thru a red light and speed, now does that make any sense at all???

[Miles J. Zaremski - Huffpost Blogger]

In fact, we do not have a right to violate laws, such as speeding, going through a red light. But there is nothing, anywhere, that says it is against the law to be healthy, i.e., to be provided health care as an American citizen.

[Snwbnny9]

I have a friend that can't get Medicaid because she makes too much money in Georgia to qualify. She almost died last year from a ruptured appendix. She was in a coma for 2 weeks and now has health problems.

Somehow the State of GA thinks that the $1000 a month she gets in child support is too much money to qualify for Medicaid. It blows my mind. She has $110,000 in medical bills. This shouldn't happen in America. She didn't do anything wrong. She will never get healthy like this. She wants to get healthy and go back to work.

[Peter007]

Thats the reason many people fear government health care. It can be a life and death issue with them and they would like to live.

[schatsie]

inane comment,,, We have a FREE MARKET healthcare system here and the FREE MARKET was supposed to control costs,,, The fact is that the CUBANS have the same Life Spans as we do and spend 1/10 that is one tenth or 10% of the amount that we spend on healthcare­... We are spending money on this system that could be spent elsewhere two trillion dollars a year....

[SeriousBlack]

Oooooooh, the "government health care" boogeyman.

Oooooooh, the government­-can't-do-­anything right argument.

Try doing more than spewing conservative talking points, i.e., looking at all the actual data like the fact that we spend more than any other western democracy on health care but nevertheless are way down the list in all the objective critical measurements of the quality of our health care, ALONG WITH the fact that almost 50 million Americans don't have any health insurance at all.

Heavy sigh. It is so tiresome arguing with people like you for whom ideology trumps any/all objective facts and reality.

[LeftRight]

And yet it's a Red Herring! The three govt health care plans out there are all SPECIFICALLY limited:

The VA is ONLY supposed to treat Vets and VERY rarely the dependents of Vets.

Medicare is ONLY supposed to provide for those who are too old to work anymore, and therefore cannot get it through their employer, but are not necessarily poor.

Medicaid is ONLY supposed to provide for those who are POOR.

Therefore to claim that a person who is unable to qualify for Medicaid because she is making too much money to be counted by the govt as POOR but makes WAY too little to actually be able to have valid health insurance as an excuse for not having Single Payer Health Insurance.­.....

[LewDan]

The preamble states that the purpose of the government is to "provide for the general welfare." Nothing is more basic to general welfare than health. Unless you construe national defense as protecting real estate, I'd also submit that national defense is about protecting people. More specifically the health of citizenry, as in keeping them alive. Which happens to be the purpose of health care. Keeping people alive.

No, the words "health care" do not appear in the Constitution, neither do the words "nuclear submarine.­" Modern health care wasn't available in the 17th century, neither were nuclear submarines, but no one seems to argue that "providing for the common defense" is somehow limited to 17th century weaponry. We now can defend ourselves against injury and illness using modern health care. National defense is in the Constitution, the fact that the founders new of attacks from ships but not microbes is irrelevant. National defense is such a BASIC function of government it was enumerated BEFORE the bill of rights. Yes health care is a right.

[Rule Of Law]

Perhaps not a right, but in a country that prides itself on being of, by and for the People, it is a moral necessity.

Let's call it a balancing of the scales. Insurance, pharmaceutical and health care corporations have lobbyists that extract tax breaks, tariff protections, favorable supports for research and development, and any number of other financial gifts that the people never receive. We have NO Lobbyists. We have, really, no representation in Washington that hasn't been gotten to by the money men first. Their interests are well protected: ours are a political football.

So, let's not call it a right, but just a leveling of the playing field, and evening of the teams, so to speak. If the Corporations can continue to receive special benefits, at the expense of the taxpayer, then surely the taxpayer--the workers and consumers of America who drive the economic engine upon which all those CEO's depend for their perks--deserve to be taken care of at least as well.

A right. Maybe not. But good business for America and its workers--Yes.

[SeriousBlack]

I think it's a right - but, I would accept your take on it (not the least because the points you make, are, in fact, good/true ones), if the ideologues who can't see past conservative talking points would be able to see those truths as well.

[sociocanuck]

I am currently studying within the health care field, in health informatics. This might bias my answer since the more people are cared for the more stable my career prospects. Plus, I'm personally affected by a chronic congenital medical condition, so my bias is amplified by being a patient who - with just one surgical intervention of the kind that I have occasionally needed - could have cost me or my parents before that an entire year's salary in a few days under any healthcare system other than the one I currently enjoy. Which brings me to my final bias: I already live in a system with Universal Healthcare. In fact, not just Universal: the Canada Health Act guarantees Comprehensiveness (all defined insured services are covered), Universality (all insured persons are guaranteed coverage for medically necessary services), Portability (a patient can be treated in another Province than their place of residence, etc.), and Accessibility (both with respect to treatment and cost of treatment); all within a Publicly Administered system.

Most of the opposition to "universal health care" seems to confuse the fact that everyone gets covered with the only coincidental reality that in most countries with some form of universal health care coverage requirement there has been parallel movement toward public administration. It is not quite necessary that these go hand in hand, so they're really two different issues that opponents nonetheless try to argue as one and the same.

[lletaa]

i agree, health care is good for business. Im not a constitional scholar just a retail businessman. keeping things simple is a must for my business. it should be the same in medical care. sickness is the prerequisite for care. single-payer is the simple and cheaper method. it would take alot of work off my business if we didnt have to mess health insurance companys. no one I know is secure with the health coverage they buy, to complicated. we have the best military protecting us from bombs and guns. if we are attacked with germs there useless. It is a "common defense" issue. anyway, I agree, healthy people are more better, simple.

[schatsie]

The best military in the world has also been condemned to suffer from Agent Orange and Gulf Syndrome and what about that health care... They have had to pay for surgeries out of pocket when they are uninsured because the VA ignored and buried the informatio­n...

We need a univeral health care system to identify and address issues like this on a fair basis,,, think Love Canal, where will it hit next....an­d who will pay or be held responsibl­e...

[SunDriedTomato]

We have 220,000 homeless veterans living on the streets in the US. Most of them are in dire need of health care, and cannot work. We had a vet sleeping nights in the doorway of our clinic for months as he waited to get into a VA shelter. I've had to turn people away because they didn't have insurance, didn't have the right kind of insurance, couldn't afford their copay, or lost insurance because their employer was downsizing. I had an elderly lady crying in front of me because we couldn't treat her due to finances. (she had insurance, but not one the clinic accepted)

Health care may never be a Right in this country, but what this country has certainly isn't right...

[giita]

USA signed on to the The Universal Declaration of Human Rights, therefore it is as legally binding as a treaty between nations.

From Article 25:

(1) 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 ....

As it happens, December 10, 2008 is 60th anniversary of the Declaration, so look for a few commemorations (or at least a few xenophobe anti-rants).

www.un.org/Overview/rights.html

[ReasonIsMyReligion]

Awesome.

[realityczech4u]

From Article 25:

(1) 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 ....

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So the essence of Article 25, Sec. (1) is that, yes, the world does owe you a living.

[Bjarni]

In theory I agree with that agreement, but at what cost do they guarantee those rights ?

Many nations in Africa have complained about foreign aid the US has sent the the country, the US hands the money/food/clothes that's meant to assist the public to the local government, but those countries have corrupt governments who hoard most of the items and hand out at most 20-30%.

We've spent trillions on the war on Poverty in this country, and we're seeing more and more people slipping into that group now than before. The people getting the money out of that war are the people who work for the agency's who provider that funding to the poor.

Most of us in the US pay for our food, our clothes and our housing directly and pay taxes on it. I don't see what the problem is with paying for our health care.

Why don't people demand HMO's and PPO's to be dismantled and rather pay into Health Savings accounts where you have your own money in? With HMO in the picture the price of healthcare has skyrocketed and doctors who get paid salary, now spend more of their time working on federal and HMO paperwork rather than assisting clients (more efficient use of doctors time would reduce cost on each visit). Whether a doctor sees 5 or 10 clients in 1 day he gets paid the same, the cost per client would go down.

[AntsyAmerican]

How many Americans do you think are in a position to bargain for their healthcare?

[kimleehan]

This is my secound blog for the day on health care but you did ask the question "is health care a right or a priviledge" ? and the answer is, its a priviledge given to those that can afford it. Federal law says that a potential recipient for a organ transplant must show the ability to pay for the transplant before they can be placed onto the united network of organ sharing's national wait list. Not being placed on the list means almost certain death to those who might have survived with a transplant.
If you are uninsured or even underinsured you are no longer a good candidate for transplant surgery but you are eligable to be a organ donor in the event of your death. Why would you want to donate to a cause that if you were ever in need of its services would deny you their services. If you want universal health care than do not sign the donor part of your licence and tell your family that in the event of your death they will not donate your organs until there is universal health care.

[schatsie]

wow that is really an interesting comment...­I never signed the card because I don't want the health system profitting from my organs... I read Bartlett and Steele about the blood processing with Red Cross and boy was that a mess... I don't want some overpaid nephrologist making bundles off of my organs....

[ReasonIsMyReligion]

Does the phrase "promote the general Welfare" ring a bell?

(#5 on the list below after Union, Justice, Tranquility, and defence.)

"We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, 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."

http://www.archives.gov/exhibits/charters/constitution_transcript.html

[Peter007]

I guess it means that " promote the general welfare " was one of the reasons they wrote the Constitution. I guess. Its not clear to me what it really means. But if you think it entitles you to free health care, go to a doctor for a checkup and not pay the bill. Take it to a court. I don't think the judges will agree with you but you can try. Let me know if you win..

[TheFriendlyAtheist]

Single payer healthcare is not free, but it's a hell of a lot cheaper than what we have now. Our present system is a drag on all other economic activity.

[SeriousBlack]

""But if you think it entitles you to free health care, go to a doctor for a checkup and not pay the bill."

What part of logic don't you understand? Just askin'.

[ReasonIsMyReligion]

Who said anything about "free?"

[research]

It's not that complicated: Health Care is not an "inalienable Right",

but it should be a right of the contract between citizen and government.

We pay twice per person for inferior care that doesn't even cover everyone.

You have no choices once you a deathly ill.

Free market does not apply:

Health care is "inelastic"

[ReasonIsMyReligion]

Inelastic. Hmm. On the demand side or the supply side?

[research]

demand: you need it now. at any price.

[Peter007]

The health care system we have now sucks. I know, I'm sitting here with a broken leg so I just went through the ringer.
But, just because you feel very, very, very, strongly that we need a new government program, doesn't allow for the calling of health care program a right. It's a benefit. It has a cost. Its a fine line but using the proper word means something.
We already have national health care in this country. It just doesn't cover everyone. How do you like it?

[SeriousBlack]

You declaring that it is a benefit because of YOUR IDEOLOGY doesn't make it so. Me declaring that it is a right because of MY IDEOLOGY doesn't make it so. What WOULD determine whether it is a benefit or a right should be based on the facts. On the facts as to whether a government­-administe­red, single-payer, every-sing­le-America­n-gets-hea­lth-care program would cost more and deliver better quality to all Americans. You want to have a discussion about whether THAT statement is true or not BASED ON ALL THE FACTS AVAILABLE then let's go. Don't just spew ideology.

Secondly, yes "it has a cost". But making THAT statement wins the argument for you? Laughable. The. cost. is. part. of. the. discussion. outlined. above.

Thirdly, "We already have national health care in this country. It just doesn't cover everyone." You're kidding, right? (Besides the fact that it's nonsensica­l.)

And lastly - "How do you like it?" What the H are you talking about?

[Bjarni]

It's not a right. Defenately not an Unalienable right, defined as "Not to be separated, given away, or taken away"
If they are going to insure everyone (word that means measure risk and use in emergency's) we should see a system where major procedures and life saving operations are covered by taxpayers money but checkups and other things that are totally predictable should be paid for by the individual that needs it.
I oppose to have my tax money spent on behalf of people who go against what I think a person who wants to stay healthy should be doing. Like smoking, binge drinking, extreme sports, over eating, poor nutrition, wreckless driving to name a few. Unless you want to push massive legislation on those activities it's not fair for people who are and go out of their way to stay healthy to have to pay the way for the people who will injure themselves and will benefit the most from government paid healthcare. Taking from Peter to give to Paul takes away from Peters Unalienable right to liberty.

[realityczech4u]

I oppose to have my tax money spent on behalf of people who go against what I think a person who wants to stay healthy should be doing. Like smoking, binge drinking, extreme sports, over eating, poor nutrition, wreckless driving to name a few. Unless you want to push massive legislation on those activities it's not fair for people who are and go out of their way to stay healthy to have to pay the way for the people who will injure themselves and will benefit the most from government paid healthcare. Taking from Peter to give to Paul takes away from Peters Unalienable right to liberty.

----------­----------­--------
Therein, you unwittingly sound the alert to the primary danger to individual liberty posed by goverment funded healthcare. People will be forced to conduct their lives according to what you and others like you consider "what a person who wants to stay healthy should be doing". And those standards will be determined by who has the most powerful lobby and bangs their drum the most loudly, be it smoke nazis, veggies, or any of the other fringe of self-proclaimed experts on living a "health-friendly" lifestyle.

[Bjarni]

"Therein, you unwittingly sound the alert to the primary danger to individual liberty posed by goverment funded healthcare­."

My statements were intentionally put forth in the way I wrote it. I don't think I have any right to dictate how anyone spends their life, they are free to do whatever they wish, as long as it's not taking money from the public's pool of money to fund their bad habits. It is for this reason I don't think Universal Health Care should be implamented. If you take risks in life you shouldn't have a safety net to bail you out of your own recklessness. This goes for personal behaviour the same as NY Banks. The risk of us having what you call "Smoke Nazies" and such lobby groups to save taxpayer money and thus push forth more legislation to restrict you as a human to go about your life is a slippery slope to go to and I'd prefer not to go there.

[PATina]

In another article re: President Obama's Senate replacemen­t... I remarked upon Jesse Jackson, Jr.'s book, " A More Perfect Union". I have to dig this book back out and re-read... but I do believe he mentions in it establishing a Constitutional Amendment for Health Care (along w/ education and affordable housing).

[ReasonIsMyReligion]

With all due respect, and plenty of enthusiasm for better and cheaper health care, we don't need to amend the Constitution: government is already empowered to make more sweeping changes than we can stomach politically. So what's forcing 2/3 of the states to ratify going to getcha?

[Peter007]

Health care is not a Right in the traditional sense of the word. In the Declaration of Independence they used the words "unalienable rights." These are more akin to Human rights. They aren't granted but are part of our human existence. The constitution illuminates the rights of the citizens with respect to their government. The idea is to differentiate the rights of people and individual states with respect to the rights of a Federal Government.
The lefts use the word "Right" is an attempt to justify the passage of a piece of legislation which is a large entitlement program. Without the police powers of the state, there exists no Health Care Rights. They want to the government to create a right which they can bestow on selective citizens. Calling it a right doesn't make it so. Call it a benefit. Thats a more appropriate word.

[Pleneras]

It doesn't not have to be a constitutional right to be implemented. There are laws protecting ideology that were not in the constitution. Healthcare should be a human moral right simply because there is no rule that says it cannot be, and even if it were, rules are to be judged by their capacity to effectively help govern. If they are outdated then they need to be revised or dissolved. The fact that government is empowered by the taxpayer's dollars is enough reason to provide such services to the very people who hold the foundation of a governing society. Government cannot continue to operate in a feudal framework when it comes to servicing the public. We are no longer a few million citizens grabbing a couple of acres of land picking ourselves up from the bootstraps. The pre industrial era is long gone. A Government's success is not determined by how many people can make it up the pyramid, but by how well everyone at the bottom can survive in a "functioning" society free of disease. The cost of healthcare has become big business and expensive simply because they are allowed put a high price on something so cheap as an intravenous. This is the government's fault. B. Braum medical's cost to make one IV is 10 cents yet they sell it to the hospitals for 200 dollars. Something is completely wrong with these practices. It's called greed.

[Miles J. Zaremski - Huffpost Blogger]

Thank you for your thoughtful observations. Again, the simplest reason why health care is a right (as I put forth in my post) is because, without our health, we can't do a damn thing - - - for ourselves, our families, our communities, and certainly not for the economy or nation in general.

[Pleneras]

If hesistant people would take the time to review why the poor laws were implemented in England they would be reminded what happens to a society when people get sick and have no access to healthcare. Healthcare should not be a business. It should be a human service funded by the government which is funded by the people.

[Peter007]

We have two words. Right and benefit. Which is more appropriate? I believe a right is embedded in the identity of the person. A benefit has to be bestowed.