Healthcare: not a “right” but. . . (part one)

Last updated on: July 22, 2013 at 9:59 pm by Jane the Actuary

Healthcare: not a “right” but. . . (part one) 2013-07-22T21:59:00-06:00 Jane the Actuary

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So what I really wanted to do with this blog is, in part at least, to work out my pet solutions and explanations on various political issues — but it’s difficult to pair that with the customary advice of “to get people to read your blog, comment on other blogs and link to a blog post of yours on the same topic.”

Anyway, I’m neither a lawyer or a philosopher, but I wanted to write a bit on rights. This is mostly for myself and as a means of thinking through the topic

In general, human rights have historically been defined as one’s right to pursue certain activities without the State interfering: freedom to practice one’s religion (so long as it doesn’t directly harm another person), freedom to publish, freedom of assembly, and the like, as well as the more fundamental freedom from servitude.

More and more often, politicians and activists of various sorts have been redefining rights and freedoms as positive obligations of the State.

In that context, I pulled up Roosevelt’s Four Freedoms. Freedom of speech and freedom of worship and pretty mainstream. Freedom from fear (according to Wikipedia) was defined by Roosevelt as “a world-wide reduction of armaments to such a point and in such a thorough fashion that no nation will be in a position to commit an act of physical aggression against any neighbor — anywhere in the world” which is an odd statement for January of 1941, with the Nazis dominating Europe and the Japanese, Southeast Asia. And freedom from want is broad and prescriptive and oddly phrased in the passive tense: everyone has the “right to an adequate standard of living.”

At least in the Soviet Union it was clear that, in prescribing its variant on a “freedom from want” they certainly meant by it that the State undertakes to provide the requisite benefits to its people. And due to the wonders of the internet, I’m perusing the 1977 constitution of the Soviet Union. What were the rights of the citizens of the Soviet Union? — read on!

The right to work (which means the right to guaranteed employment) — the specific right to choose one’s trade or profession being subject to the “needs of society”.
The right to rest and leisure, to be provided by a workweek limited to 41 hours, and the provision of recreational and cultural opportunities.
The right to healthcare.
The right to maintenance in old age, sickness, and disability/death of the family breadwinner.
The right to housing.
The right to education.
The right to enjoy cultural benefits (that is, the right to have the state provide cultural programs fairly distributed across the country).

Of course, they were also guaranteed the right to worship, the right to vote, freedom of assembly, etc., and we know how dilligently the Soviet Union honored those freedoms. But I still remember (do you?) defenders of the Soviets who said “sure, they may not have the types of freedoms we’re used to in the West, but they have other very important freedoms, like the right to healthcare.”

Anyway, this is a very long tangent — but I do believe that the concept of human rights is only useful in defining what the State (or others in power) may not do, and things they may not prevent a person from doing, and that a human right can never be something that obliges another person or entity to act — by providing health treatments, providing housing, etc.

Of course, there is a “right to work,” in that the State may not actively impede a person from earning one’s livelihood (I mean cases where the State prevents a disfavored group from pursuing a certain profession, not cases where the profession itself, for other reasons, is declared illegal, like prostitution). And there is a “right to housing” insofar as the State may not actively impede a person’s attempt to acquire housing (e.g., by permitting segregation).

But it really disturbs me when a politician proclaims that “healthcare is a human right.” Maybe it reminds me too much of the Soviet apologists — but I find the acceptance of “positive rights” (as I believe the term to be) to be very unsettling.

Having said all the above, I will say this, too: the State has the ultimate responsibility to ensure that its citizens’ basic needs are met, and has the responsibility to do so in the most prudent way. In a society in which systems of private charity are functioning well, the State does not need to intervene, but when this is not the case, the State should act (though prudently, not just giving away food willy-nilly). I’m not going to get into all kinds of political theory about what the State is (maybe I’ve still got a textbook on the topic in one of the back bookshelves in the basement, but it probably went to the used book store years ago), but I do think you can identify this as a responsibility of the State, as part of what makes it a legitimate sovereign entity with governing powers over the people in its territory, without at the same time deeming there to be any particular right held by the people. And maybe it’s a distinction without a difference, but it feels like there is a difference — if for no other reason than because, once you establish this, you can work out some basic principles around what the government should and should not do.

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