On Fairness: Public goods, or why healthcare is not a right

healthcare is not a right

Healthcare is not a right. It’s a public good, and public goods demand more of a society than a right. In the United States, we’re not doing enough.

Rights and Healthcare

By definition, a right is a claim or privilege that commands duties from others and can be enforced or redressed in court if necessary. For instance, I have the right to own personal property. Other people have the duty to not take my personal property. Should someone take my property unlawfully, I can ask the courts to enforce my rights of ownership.

When I hear the assertion that healthcare is a right, such as in this Boston Globe editorial, I’m confused. According to them, I’m entitled to be treated by medical professionals, others have a duty to provide this treatment or at least not prevent it, and I can seek redress from courts should I not get healthcare? That doesn’t sound right to me.

I think I have a right to not be discriminated against, injured or defrauded when seeking treatment. But that doesn’t mean I have a right to treatment.

Healthcare is not a right.

Neither is it a privilege. This philosophy blog tries to muddle through the dichotomy of rights versus privileges. The post gets caught up in the issue of payment for healthcare and fails to consider any alternate construction other than right or privilege.

However, there is another construction: Healthcare is a public good. And we need to pay more attention to public goods.

Healthcare is a Public Good

Public goods are products and services that benefit all and are available to all. As social beings who live together for the betterment of the group and the individual, we design and produce public goods to fairly distribute those products and services that everyone should have and benefit from. Public goods are how we combat the five villains of social good: illness, ignorance, idleness, want, and squalor.

Somewhat implicit in the definition is that we all pay for public goods in some way, usually some form of taxes or user fees.

Roads are an example of a public good. We all benefit from them. As long as we obey the rules, we have access to them. Even if we don’t personally drive on them, we rely on roads to enable the distribution of goods and the travel of essential services like police and ambulances. We don’t have a right to roads; we have a right to freedom of movement.

So it is with health care (and many other things). We don’t have a right to medical treatment in and of itself. We don’t have a right to be healthy. However, we benefit from health individually and as a group; therefore, it’s in our individual and collective interest to provide health care as a public good.

We have figured this out, so far, in limited ways. We have public health departments and public vaccination programs. For the last 50 years in the U.S., we’ve had Medicaid for those who can’t afford health care on their own. But until the passage of the Affordable Care Act, we had no general framework for providing the public good of accessible healthcare for all, or at least nearly all, people.

Public Goods Benefit All

Education, information, sanitation, habitable environment, food safety–all of these are public goods. We don’t have a right to any of these, but we are certainly better off individually and collectively when we band together to provide them for all of us.

Providing public goods is hard, complex work that requires a marketing mindset. Often public goods are seriously underfunded and under attack. As the Globe editorial states, in the U.S. we now have “an obligation to provide affordable health coverage, and every individual has a responsibility to get coverage.” That’s not a right, but we have made healthcare much more of a public good than a private privilege.

To me this isn’t democratic or republican or socialist or communist. It’s common sense. I don’t want to be surrounded by sickly, ignorant, dirty people, and I’m pretty sure you don’t either. I’d much rather live among health, educated, productive people who are content and don’t feel desperate enough to threaten me or my property. That’s not a right, but it is certainly goodness that I believe the public will fund.

 

(Image courtesy of WikiMedia Commons)

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