Thursday, August 6, 2009
This from an MOJ reader, in response to the "health care as a right" question:
My first thought is a criticism of those who claim that health care is a right. It seems that the argument for health-care (which would be significantly subsidized, somehow, by the state) is based upon the contingencies of history rather than on a universalizing principle of human-ness. In this regard, I think I bypass the argument as to whether it is a positive or negative right (and possibly a legal or moral right) because certain historical and economic characteristics have to be in place for this discussion to even make sense. For example, two hundred years ago, I have not heard of any person argue for a right to health care, precisely because the materialistic conditions for it to be a possibility were not in evidence.
However, there were discussions about rights in religion, speech, conscience etc. I believe that these rights discussions were about how we define ourselves as human, while health care, while an undeniable good, is not fundamental to our ontology. Health care, or the lack thereof, does not detract from us as humans. Furthermore, these fundamental rights appear to be able to be universal, appealing across time and space to our consciences. Yet, discussing the right of (say) Nigerians to healthcare seems somewhat backwards when their basic, fundamental rights of religion and conscience is not defended by the state. Additionally, they do not have the economic nor technological skill to have the same level of health care as we enjoy in North America. Essentially, the material conditions have to be met before universal health care can be even concieved of, while the more foundational liberties do not.
Relatedly, as a Canadian, I wonder at the distortion of the meaning of health care when we celebrate our wealth by the wholesale slaughter of our children through embryonic stem cell research and abortion. Is the entrenchment of these practices and state support for them something that we, as Catholics, can support? Is the greater evil having universal coverage if these profound injustices persist under our medical plans and in our names?
The reader's observations about historical contingencies and material conditions confirm, in my view, my sense that it is better to think about the health-care debate in terms of the moral obligations of (and practical challenges that confront) a political community than in terms of "rights." I take it (and I am confident that Michael P. agrees) that, given all the current givens, political communities (in the developed West) ought to take the steps necessary (and prudent) to secure access to cost-effective, reasonably high-quality, basic health care. This is the smart, and right, thing to do, but the *reason* it is the right thing to do might not be because there is a human right, possessed by individuals, invokable against governments, to such health care. The moral case for policies that secure the kind of access just described, and the moral responsibility of a decent political community to pursue them, does not depend, it seems to me, on their being a "right" to that access.