The Real Reason Americans Have a Right to Healthcare

Posted on October 30, 2008
Filed Under A right to healthcare |

In recent posts (here, here and here), DrRich has considered the legitimacy and the implications of our recently-announced right to healthcare.

In one of those “meditations” DrRich decided that declaring healthcare to be a right is indeed legitimate, but not because it is the only humane thing to do, or because there is some sort of a natural right to healthcare, but rather, due to the BOSS rule (that is, Because Obama Says So), which is simply another manifestation of the longstanding principle that the sovereign authority gets to declare anything he/she/it wishes to be a right.

At this time, DrRich wishes to drop his usual sarcasm, to the furthest extent possible, and explain why Americans in truth have a legitimate claim to a right to healthcare - even if the electorate (through some unaccountable fluke) should fail to consummate their promised elevation of Mr. Obama, thus, incredibly, negating the BOSS rule.

In short, Americans have a right to healthcare because they’re paying for it.

Under our present system, every person living in the United States is sharing in the cost of healthcare for every person who receives healthcare. Let us list some of the ways in which this is true:

1)    Anyone receiving a paycheck is subject to payroll deductions to pay for Medicare for the elderly and Medicaid for the poor.
2)    Anyone paying income tax is paying higher tax rates to offset tax-deductible health insurance premiums purchased by businesses for their employees. (That is, employer-provided health insurance is subsidized by the taxpayer.)
3)    Anyone buying products in the U.S. is paying higher prices to cover the healthcare costs of American businesses.
4)    Anyone living in America is sharing in the massive societal burden we are creating by allowing healthcare spending to be passed off to future generations, by way of the national debt.

These costs, and more, are borne by everybody living in the U.S.  Since everyone in one or more ways is paying for healthcare, everyone has a just claim - a right - to some of that healthcare.

It is important to notice that this argument for a right to healthcare is fundamentally different from the arguments typically given.  Typically, a right to healthcare takes on the characteristics of an entitlement, a grant bestowed on individuals by society just because of who they are (such as, citizens, people over 65 years of age, etc.)  A right like this - an entitlement - is rarely taken away, or even limited, once granted.  Entitlements are soon seen by their recipients (and by the bureaucracy that administers and regulates them) as something that is owed forever, as a natural, God-given right, which can always be expanded, but never ever restricted.

In contrast, the right to healthcare which DrRich is describing is not “granted” to an individual by a beneficent society because of some inherent characteristic of the recipient, but rather, comes into being solely as a result of their being party to a social contract, under which healthcare is a consideration given in return for certain obligations the individual makes to society.  Those obligations would include paying for the publicly-funded healthcare through taxes, and subjecting oneself to whatever limits to publicly-funded healthcare such a system requires in order to maintain societal integrity.

This kind of contractual right to healthcare would enable us to set necessary limits on what we mean by healthcare. There would no longer be an obligation to provide individuals with every manner of available healthcare under all circumstances, but only to provide individuals with that level of healthcare provided as a public benefit to all other individuals, under the terms of the social contract. (An entitlement, in contrast, generally is an open-ended promise in which “healthcare” comprises anything and everything one might think has any possibility of restoring every bit of health.)

To summarize, as DrRich sees it we have already created an obligation to provide publicly-funded healthcare to all individuals, by virtue of the fact that we have already burdened every individual with the cost of healthcare for anyone who is now receiving it.  We might as well own up to our responsibilities with a formal contract that recognizes the widely-shared cost of American healthcare, that recognizes the right of all Americans to the considerations that arise from this widely-shared burden, and that establishes clear limits to the obligations borne by the parties, limits that are part of any legitimate contract.

Such a social contract will finally give us the framework we need for a public discussion on setting necessary limits on publicly-subsidized healthcare spending.

Comments

3 Responses to “The Real Reason Americans Have a Right to Healthcare”

  1. Jim Sabin on November 1st, 2008 8:04 am

    Hello DrRich -

    I’ve just come upon your blog and website, and am happy to find a kindred spirit with regard to straight talk about rationing. Your argument that all Americans have a right to health care because we’re already paying for it (though often covertly) will be news to a lot of the public.

    “Setting Limits Fairly: Learning to Share Resources for Health,” written with Norman Daniels (second edition published this year) may be of interest to wonky readers who want to delve further into the question of how societies can set limits in a clinically informed, ethically justifiable and potentially politically acceptable way. Also in healthcareorganizationalethics.blogspot.com

    I’m glad to “meet” you and look forward to following your very lucid and well written blog!

    Best

    Jim Sabin

  2. Red Baron on November 2nd, 2008 11:47 am

    I am sure it is no accident of Irony that Yves Smith’s posting on Naked Capitalism today http://www.nakedcapitalism.com/ opens with a link noting how the Australian Immigration Service denied permanent residency to a German physician whose son has Down’s syndrome
    http://www.physorg.com/news144769516.html

    and the launches into the tectonic shift occurring in the world’s debt markets as Credit Default Swaps designed to protect bond investors in the event of US Government default are reaching all time highs.

    We live in a fractal world, only most of us do not see it.

  3. Red Baron on November 2nd, 2008 11:49 am

    Sorry:
    http://www.nakedcapitalism.com/2008/11/links-11208.html

    and

    http://www.nakedcapitalism.com/2008/11/cds-pricing-in-increasing-treasury.html

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