Is There a Such Thing as a Right to Health Care? If Not, Should We Still Treat It As Such?

Health care is one of those important facets of life. It is a vital determinant for physical and mental wellbeing. It is important enough where it is a debate in the United States as to whether it is a right. In other developed countries, the government de jure provides some form of universal health, whether in the form of single-payer, two-tier, or a health insurance mandate. For those who advocate for greater government involvement, the argument is that it is a right, and that the United States should catch up with the rest of the developed world. That sentiment is growing within the United States. According to Pew Research, a majority of Americans believe that the government should be involved in providing health care for all. The question I hope to answer today is whether or not health care is a right.

This is a question that gets us into the realm of political theory and political philosophy, which means that data or studies cannot inform us in a more empirical fashion per se. One way to distinguish rights is to look at the difference between natural and legal rights. Natural rights state that rights do not come from the law, but rather are derived from human nature or a deity. Under the framework of natural rights, they are universal and innate. Under natural-rights libertarianism, for example, the idea is that the individual possesses certain natural rights, mainly that of individual sovereignty. That means that fraud or coercion are a violation of said rights. Natural-rights libertarianism comes with two major flaws. One, these rights are guaranteed according to whom? To G-d? Not everyone believes in G-d. There is no objective authority or arbitrator to determine that rights are natural. There are enough political philosophies out there that could not care less about individual sovereignty, which leads to my second point: throughout history, government has been involved in the individual's decision-making process, for better or worse (usually worse). It is for those reasons I consider myself a consequentialist libertarian, as opposed to a deontological libertarian.

That would lead us to the idea of legal rights, which means that it is the societal, economic, and political contexts that determine whether or not an individual or group of individuals has access to a certain good or service. If rights only exist in a certain socio-political context, then that means that the government can take away rights just as quickly as it granted them. Under the idea of legal rights, it would mean that the right to health care is neither an absolute nor a guarantee. That being the case, this brings up a follow-up question: should the government treat health care as if it were a natural right? Another way to ask it: should the right to health care be a legal right?

Let's start with the assumption that under the law, we should treat health care as a right. To answer the question about treating health care as a right, let's start with a practical series of questions:

1. How do we define the scope of a right to health care? Does it only entail treatment or does it include preventative health care? If it is the latter, then a lot more will have to be covered than if that right solely entails curing people of already-existing ailments. Do we include experimental or unproven tests and procedures? Should this include such procedures as cosmetic surgery or infertility treatment? The ambiguity presented in this bullet point alone brings up a point: a minimum requirement of a right should be the ability to unequivocally define it. The fact that these questions cannot be answered with certainty tells us a lot about whether health care is really a right. This is also the reason why a positive right cannot be exercised in absolute or can be scalable like a negative right can, but let's continue a bit longer with the assumption that health care is a right....
2. Who is going to pay for the right to health care? Freedom of speech does not require that someone else pays for that right, nor does it infringe upon someone else's freedom of speech. With freedom of press, journalists don't force someone else to pay for producing their publications and media. Freedom of religion can be exercised in a pluralistic way and others practice their religions without infringing upon others' right to religion. With health care, someone would have to be forced to pay for that right. When looking at it through the lens of individual rights, a right should not be conditioned on an ability to pay. The extent of how distributive the tax system would be to pay for this would be contingent upon the scope of goods services rendered [per Point #1 above]. 
3. Who is responsible for providing this right? A right to possess something implies that someone has the corollary duty to provide health care to all individuals. With the right to a fair trial, that right is provided by the judicial system and a jury of twelve peers. Who delivers under a framework of health care being a right? Do we force private-sector doctors to perform all procedures? Do we socialize government and have every medical professional be an employee of the government? This also gets messy because if health care were a positive right, then it is an imperative that resources are channeled for that purpose. Those resources include doctors, nurses, physicians, and other health care professionals being conscripted to providing those services. It is unclear as to who holds the right to provide these services, which thereby creates more doubt as to whether health care is actually a right. 
4. What sort of incentives would a right to health care create? First, let's think of this in terms of consumption. For one, how much incentive would a consumer have to take care of their own health if health care were treated as a right? They could simply get treated if/when things got bad enough instead of taking personal responsibility for their own health. Also, if a consumer has full access to all treatments at little to no cost, what incentive is there for restraint in consumption? Single-payer systems in practice show that overconsumption is a concern. If overconsumption is a concern, then that also means that medical care professionals are overextended. This is not simply a matter of doctors not being where they are most needed. What sort of disincentive would this create for people to enter the medical profession? 

The truth is that health care is not a privilege or a de facto right: it is a commodity. Not only that, health care is a finite commodity, which makes it all the more impractical to define it as a right. Food, clothing, and shelter are vital as health care is, but you don't see universal "food care." As the Cato Institute points out, there are only so many hospitals, doctors, and health care-related goods that exist. Whether it is by bureaucratic fiat (e.g., United Kingdom), waiting lines (e.g., Canada), or by higher prices (e.g., the United States), there is going to be some sort of rationing mechanism, much like there is in other markets. We have the right to use our hard-earned money to seek medical treatment. We should use our rights to help our less fortunate neighbors seek treatment. However, whether we look at it through the lens of natural or legal rights, there is no guaranteed right to health care.

Even if there were a guaranteed right, do we really want government to guarantee that right? We see what happens when health care is treated as a right under a single-payer system: overconsumption of health care, fewer choices, a limit in supply, and most importantly, an inability to contain health care costs. As a side note, these countries with single-payer have as much innovation as they have in the first place because of the spillover effects from the United States' health care innovation.

It might be a more heavily regulated market, but health care is a market with goods, services, supply, and demand.  Having a mature and rational discussion about how to ration and allocate health care is a must, but advocating for health care as a right is nothing more than political grandstanding at a time when we need to find actual ways to make health care more accessible and affordable.