The Hastings Center, a nonpartisan bioethics research institute, recently asked me to write an essay to help launch their new group blog, The Values and Health Reform Connection. The website focuses on American values, and why they matter to health care reform. Here is the link to the blog.
Below, an excerpt from the piece that I wrote:
“While many speak of health care as an individual ‘right,’ I prefer to think of universal coverage as something that we, as a civilized nation, desire for all members of our society because we recognize each other as equally human, vulnerable, and in need of care.
“As a society, we have a moral obligation to provide access to medical care for all of our citizens. When we frame health care as a “right,” we shift responsibility from society to the individual. It is up to him to demand his due. At that point, the word “entitlement” comes to mind, along with the conservative image (so artfully drawn by President Reagan), of an aggrieved, resentful mob of freeloaders dunning the rest of us for having the simple good luck of being relatively healthy and relatively wealthy.
“‘We didn’t make them poor or sick,’ some libertarians say. ‘Why should they have the “right” to demand so much from us? And just how much care are they entitled to? Should they get the same care that wealthier Americans expect? Wouldn’t it be sufficient to give them care that is “good enough’?
“Put simply, the language of individual ‘rights’ doesn’t seem, to me, the best way to build solidarity. And I am convinced that social solidarity is key to improving public health.
“A friend who lived in France for many years once explained to me: ‘Healthcare is so good in France because the French believe that nothing is too good for a fellow Frenchmen.’ Unfortunately, in this country, many of us do not feel that way about each other. . .
“If health care is, in any sense, a ‘right,’ I would argue that it is what the Declaration of Independence named an ‘inalienable right’ conferred on us, not by government, but by someone the authors of the Declaration referred to as ‘Our Creator.’ The point is that inalienable rights are natural rights: something we deserve simply by virtue of being human, so that we can be free to pursue life, liberty and happiness. These are affirmative rights which empower us to become part of society. Without our health, we cannot participate as members of a political community.
“An ‘inalienable right’ is very different from a constitutional right (to free speech, for example ) which gives the individual the right to be free from interference by government or their neighbors—to be protected against unreasonable searches, cruel and unusual punishment, or invasion of privacy. Those rights are designed to protect us, as individuals, from society. By contrast, universal health care acknowledges each of us as equal members of society.”
Go to the website to read the rest of my post, and other provocative essays focusing on what terms such as these mean when applied to health care reform: “ justice,” “fairness,” “solidarity,” “liberty,” “stewardship,” and “responsibility.”
Health Affairs is the media sponsor for this website and will publish a selection of posts from the site.