Wednesday, August 5, 2009
A few days ago, Michael P. asked (here), among other things, "is there a human right to (basic) health care?" I am inclined to think that claims about "rights" to health care are not as helpful as arguments about the moral obligations of a political community to its members. We are all familiar with the debates about "negative" and "positive" rights, and there's probably no need to re-work them here. In my view, Yuval Levin, borrowing from Edmund Burke, is helpful, here:
Edmund Burke offered a reflection on this question in 1790:
What is the use of discussing a man's abstract right to food or to medicine? The question is upon the method of procuring and administering them. In that deliberation I shall always advise to call in the aid of the farmer and the physician, rather than the professor of metaphysics.
It seems to me that’s still basically the right response to the question of health care as a right. All sides in the contemporary debate are trying to find a way to provide health insurance to more people more efficiently and cheaply. They are not divided about any fundamental ethical question. People on the left are not saying we should provide unlimited medical care to all without thinking about the cost because health care is a right: They’re arguing their approach would cost less and work better for more people. People on the right are not saying we should forget about the poor because health care is just a privilege: They’re arguing their approach would cost less and work better for more people. Which of them is right is an important question, but it’s not fundamentally an ethical question, and whether health care is a right or not does not seem particularly relevant to finding the answer to that question.
With respect to Michael's "reductio ad non-Brown" argument: That a proposal is called a "health-care reform" proposal does not make it worthy of support. To question "reform" proposals is not to question the responsibilities of a political community or to deny that (basic) health care is a human good and its (efficient) provision an aspect of the common good. To worry about the costs, externalities, and unintended consequences of the Democrats' current proposals is not to call for the abolition of public assistance in the securing of health care. To worry about exploding deficits, or declining standards of care, or loss of patient-choice, or the effects of excessive litigation on health-care costs, or the incentives for doctors, etc., etc., is not to give up on Medicare. And, indeed, to be open to the possibility that programs like Medicaid and Medicare are operating as (to say the least) imperfect means of fulfilling our obligations and promoting the common good is not to deny the existence of those obligations or the importance of that common good.
It seems worth noting again -- I thought of this when, in my home parish, we were urged, in the Prayers of the Faithful, to listen to the "prophets" of today who are pushing the current "reform" proposals -- that there are serious reasons for pro-life citizens (Democrats and Republicans alike) to be wary of these proposals' treatment of abortion-funding. Those who think Catholic health-care facilities are important institutions have additional reasons to worry, the Wall Street Journal reports:
But what if an overhaul expands access to abortion, subsidizes it with tax money -- or, as in Massachusetts, requires Catholic hospitals to offer referrals if they hope to be included in government-run insurance plans?
Catholics want to "extend health care to as many people as possible...but you can't call it health care if it includes a type of killing. It's as simple as that," says Cathleen Kaveny, a professor of law and theology at the University of Notre Dame.