You’ve probably heard something like this before:
Health care must be recognized as a right, not a privilege. Every man, woman and child in our country should be able to access the health care they need regardless of their income. The only long-term solution to America’s health care crisis is a single-payer national health care program. -Senator Bernie Sanders (I-VT)
As we continue to advance the discussion on the health care debate, it is important to analyze the proper role of the state in the provision of health care. We’ll start with a discussion on rights.
A Brief History of “Rights”
The concept of rights is complex and, unfortunately, somewhat subjective. Western philosophy and political theory have struggled with the concept for centuries. Merriam-Webster’s dictionary defines rights as “qualities (as adherence to duty or obedience to a lawful authority) that together constitute the ideal of moral propriety or merit moral approval.” That is a mouthful and doesn’t help much. It is fair to say that the concept of rights is subject to broad interpretation and can be applied to many things. Thus, it is important to explore different types of rights – especially as it pertains to those which should be granted and/or protected by the state.
The English monarchy established one of the first and most influential documents which pertained to the relationship between rights and the state. This document is the famous Magna Carta which established that the King was bound by the law and that free men had certain rights which could not be violated by the monarch. This laid the groundwork for future constitutional law and an expanded discussion of rights during the Age of Enlightenment.
Arguably the most influential of these philosophers was John Locke. His work on the social contract, natural rights and the relationship between society and state were central themes to the Declaration of Independence. While the document holds no legal authority in the United States, the words express the circumstances and principles under which the nation was founded. As it relates to the concept of rights and the state, no sentence summarizes their thoughts better than this:
We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are Life, Liberty and the pursuit of Happiness.
The United States also ratified the Bill of Rights (the first ten amendments to the Constitution) shorty after the ratification of the Constitution. The inclusion of such a “bill of rights” was the subject of much debate amongst early political leaders due, in large part, to the differing viewpoints on whether the federal government needed to explicitly acknowledge rights which were viewed by most as natural.
Positive or Negative / Rights or Liberties
The theory of rights has been explored by philosophers and political scientists; one such method of distinguishing different types of rights is by the definitions of positive and negative rights. Negative rights are defined as those which prohibit the action of one upon another in regard to a particular right. Positive rights are defined as those which obligate or require the action of one upon another in regard to a particular right.
A simple and relevant example which would describe such a distinction can be explained as follows. A negative right to life would imply that you cannot kill someone else. A positive right to life would imply that you are required to preserve the life of someone else. Notice that negative rights generally prohibit action by protecting someone whereas positive rights generally obligate action.
A different way to describe rights is by defining rights as either claim rights or liberty rights. Claim rights are defined as those which obligate others to support the attainment of the right for the individual. Liberty rights are defined as those which give the individual the permission or freedom to the right. This may seem like the same thing as positive and negative rights, but there is a difference.
To illustrate, one can define rights using both methods. A positive liberty right gives you permission to do something. A negative liberty right gives you the permission to refrain from doing something. A positive claim right obligates someone to do something for you. A negative claim right obligates someone to refrain from doing something to you.
Back to Health Care
Let’s turn to health care for a moment. Is health care a right? Well, sure. Anything can be a right. However, it’s important to understand how one would classify the right to health care. This simple “right to health care” would imply that no one can prevent you from receiving health care. On the surface, this appears to be a negative claim right. This is incorrect. If health care must be provided, then this acts as a positive claim right on those who provide health care.
This is not the same thing as our inalienable rights described in the Declaration of Independence or the fundamental rights outlined in the First Amendment. Our rights of free speech and assembly are positive liberties. Perhaps an even more libertarian way to think about this is that the First Amendment is actually a negative claim right levied at the government: “Congress shall make no law.”
Health care is not free. It is a service. The treatment of health care as a right would create a positive claim right on either those who provide the service at no charge or on those who are forced to pay for the service that someone else receives. These are the facts. It is my position that positive claim rights should not be enforced or legislated by the state. If the state is allowed to enforce positive claim rights, then there is no conceivable end to the scope of government… the rights to free education, free transportation, free Netflix, free ponies.
This is not the end of the debate. My intent in this entry is only to explore the nature of rights and the concept of health care as a right. In my next health care installment, we will review the idea of human needs and the role of the state in fulfilling those needs.