Courtesy of U.S. Senator Bernie Sanders, with over 116,000 likes and 28,000 shares. This meme quotes Pope Francis from a meeting he had with Doctors With Africa in 2016. The quote is correct, but is the sentiment? Is health, or healthcare a universal right?
Many Say Yes
Pope Francis and Bernie Sanders are far from the only people to consider healthcare a right. Similar language is found in the UN Declaration of Human Rights and the EU Charter, as well as the constitution of more than half the world’s countries. It was even proclaimed a right in FDR’s “Second Bill of Rights“. However, declaring something true doesn’t necessarily make it so. What, then, do the proponents of this claim use as their reasoning?
Surprisingly, very little. In looking at essays defending this position, like here, here and here there is a noticeable omission. There is no mention of what a right is! This appears to be the case in every article the MP could find on the subject. There are plenty of arguments given about the history of healthcare, other country’s systems, comparative costs and pragmatic justifications, but never a mention of what a right is and why healthcare is a right. Even the website Healthcare is a Human Right doesn’t define it. The closest they come is this:
Our movement is built on the vision of human rights and guided by human rights principles that affirm and prioritize the inherent worth and dignity of all human beings.
What does this mean? Which principles are they referring to? How can they declare healthcare a right without explaining what a right it? In any proper debate, the terms must be defined, so we need to start with a proper definition of a right.
What is a Right?
For most of human history there were no theories or acknowledgments of individual rights. Generally, people were thought to belong to the state, king or tribe, and could be ordered or disposed as such. Rights were theorized by philosophers, like John Locke, and became more popularly accepted during the Enlightenment. The political culmination of the Enlightenment was the Declaration of Independence (and later the US Constitution) which laid out what rights were, and aimed to protect them.
For a more in-depth analysis of rights, read this. For a more concise definition of rights:
A “right” is a moral principle defining and sanctioning a man’s freedom of action in a social context.
Rights, in their proper philosophic context, pertain to freedom of action, not to material goods or services. They exist because of our rational nature as human beings, which requires certain freedoms to live properly.
- The right to life means one has the moral right to their own life (as opposed to the king or state having a moral claim on someone’s life).
- The right to liberty means one has the moral right to act by their own judgement and make their own choices in life.
- The right to property means one has the moral right to go out in the world, earn and acquire property, and have a moral claim on the use and control of that property. It doesn’t mean a right to be given property from others.
- The right to the “pursuit of happiness” means one has the moral right to pursue their chosen purpose and fulfillment in life. Not the right to be happy or demand items to make them happy.
Other freedoms, like speech and religion, all derive from right to life. While there are many different rights, they all have one thing in common; they impose no obligation or burden on anyone, except in the negative sense. The right to free speech simply means no one may use force to prevent that action. Not that they provide anyone with a microphone. The right to practice religious beliefs means no one may forcibly prevent others from worshiping. Not that they must provide a church.
Rule of Thumb on Rights
A good rule of thumb to determine if something is a right is the following: would it be immoral for me to use force to stop them engaging in that action? If the answer is yes, it’s a right. For example, it would be immoral to use force to stop someone from practicing their religion (assuming they were on their own property or church). On the other hand, it would be moral to use force to stop a burglar, or to apprehend a murderer.
This was the intellectual understanding of natural rights during the Enlightenment and the founding of America. It wasn’t until the Progressive Era when this was challenged and material goods like food, housing and healthcare were declared “rights”. Were they just improving on the concept, or invalidating it?
The Contradiction of Material Goods as “Rights”
At its core, rights are a concept of morality and ethics. Yet, some would point out that it’s moral to ensure people’s needs are met. How is one supposed to live without food? Have freedom of speech without water? Religion without shelter? Aren’t these goods essential to life? Of course, but that doesn’t make them rights. Refusing to label needs rights is not discounting their importance. It’s simply defining them properly. Calling needs rights would inevitably lead to a contradiction in the concept of rights and destroy the concept. Why?
First, there’s a practical problem. What is meant by healthcare? Does that include preventative care? Dental care? Brain surgery? The latest cancer treatment, gender reassignment or procedures not yet invented yet? The rights identified above, like speech or property, are timeless. Yet, if we have a right to healthcare, when did we gain the right to antibiotics? The moment they were discovered? The moment they were mass-produced and became affordable? The same problem applies to aspirin, statins, cancer drugs and the latest surgical techniques. In fact, it applies to every aspect of healthcare. It’s nonsensical to claim a right when you can’t define what you have a right to, or how that right came about.
Next is the philosophical problem. If rights are moral claims to something, how can one morally claim to be provided healthcare? Healthcare is a service that must be provided by someone. Someone must invent and produce the equipment and medication. Others must go to school to learn medical science. How can one claim a right to this? Claiming the right to receive healthcare is declaring a moral claim for others to serve you, or pay for your care. What about their rights?! Don’t they also have a right to life, liberty and property? What if they don’t want to provide you the service? What if it’s too expensive, or they can’t procure the equipment? Or there’s not enough doctors to treat patients? What if they want to go on vacation, or retire? The implication of claiming this right is an attempt to enslave others. It invalidates the concept of rights, because it infringes on rights. It’s a contradiction, and can’t coexist with the concept of rights laid out in the Declaration.
Arguing that it’s moral to provide healthcare to those who need it or can’t afford it misses the point. Providing services to the poor is charity or welfare, not a justification of rights. It comes with the understanding that the service flows from the productiveness and property of others, not some moral claim. Charity must be given by others, and welfare must be taken from others. The absurdity of declaring healthcare a right is apparent in Venezuela, as horror stories pour in about patients dying from lack of basic medical care, facilities and life-saving drugs. The government has proclaimed healthcare as a right, yet its citizens aren’t receiving it.
If healthcare isn’t a right, then what is it?
Is Healthcare a Privilege?
No, Pope Francis is correct that health services shouldn’t be a privilege. A privilege is a special advantage granted to certain people. In a free society, everyone should have the freedom to purchase or ask for health services, it’s not something requiring special permission.
Healthcare is a Need and a Consumer Good
As with other items essential to human survival and flourishing (food, water, shelter, clothing) healthcare is a need. We need food to live, and we need healthcare when we’re sick or injured. Calling it a need instead of a right doesn’t discount its importance. Needs are often a matter of life and death, but there’s a difference in how to secure needs vs rights. All one needs to secure their right to free speech is for no one else to violate it.
Needs, like healthcare, are obtained differently. Either by producing goods and services ourselves, or getting them from someone else. This, by definition, makes healthcare a consumer good, contrary to Pope Francis’s assertion. After all, would anyone deny food is a consumer good? Or clothing? What’s different about antibiotics or pain medication?
Far from being compassionate or kind, declaring healthcare a right becomes dangerous in a political context. Venezuela is finding this out, just as the Soviets discovered declaring food a right didn’t stop millions from starving. While no one needs to produce actual rights, like your freedom to practice religion, the same can’t be said for modern medical equipment and staff. How to provide this service for those who can’t afford it is a separate question (private charity vs welfare), but calling it a right leads down a dangerous road. By confusing the terms, it ends up instituting a political system that elevates needs over rights.
Pope Francis’s claim (and Senator Sanders’s endorsement) that health services are not a consumer good is false. While it’s true access to health services shouldn’t be a privilege, it’s incorrect to label it a “universal right”. Attempting to make healthcare, or any consumer good, a right destroys the very concept, and renders the term meaningless. To be accurate, healthcare should be identified as a need and a consumer good, even by those who advocate socialized medicine. How to best provide this good (i.e. through free markets and charity, or through state welfare programs) is a separate political question.