Tuesday, August 11, 2009

What Is A Right and Does Health Care Belong in That Discussion?

Recent political discussion has brought up the concept of the "right to health care". If you need something, is it the view of some folks that you have a right to it. In order to have a "right" first you need to understand what a right is.

For example, if you are hungry, do you have a right to food? You certainly do need it to survive. However, a right implies that someone cannot take it away from you and that someone is obligated to provide that right to you. In the current political discussion, that someone is the US government. So, getting back to food, if you are able to work and provide for yourself but choose to sit in a lounge chair on your front porch, does the government have an obligation to bring you meals? I am not talking about someone who is affirmed or disabled, but rather about someone who expects assistance because of the "right" to food. Obviously, there is no right to food. If you can provide for yourself, you are expected to do so.

Do you have a right to a residence? We certainly don't want homeless people wandering the streets but if someone is capable of providing for his/herself, does the government have an obligation to house that person? Once again, I am not talking about affirmed/disabled people. The answer is obvious, of course not. Therefore, there is no "right" to a residence.

Alexander Hamilton in 1775, said: ``The sacred rights of mankind are not to be rummaged for, among old parchments, or musty records. They are written, as with a sun beam in the whole volume of human nature, by the hand of the divinity itself;
and can never be erased or obscured by mortal power.''

The beginning of the Declaration of Independence reads "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..."

Seems pretty straightforward, I suppose. The idea, in both quotations is that rights are not granted, they are things which cannot be taken away. However, that is not always true. Some rights are specified in the US Constitution (more about that below). There are times when individual rights are balanced against the community's. You would think the life part would be pretty simple in that no one can kill you. However, it can get complicated. For example, there is the question of what constitutes life? Are fetuses considered a human life? Not to abortion proponents but yes to opponents of abortion. If someone's heart is beating but the upper brain is not functioning, are they alive? Legally, the answer is no even if they can continue physical existence without assistance for a period of time. The protection of your right to life is an obligation of the state. However, in death penalty cases, someone's right to life is taken away by the state. In those cases, it is the considered judgment of the state that the crime committed was so heinous that taking away the individual's life is justified for the protection of society as a whole.

Liberty is a little tougher. The old saying is that your right to swing your fist ends at my face. Allowing individual liberty must be balanced with the good of society. The first amendment protects free speech but not speech inciting violence or endangering the public. Per the second amendment, individuals have the right to bear arms but those arms do not include things like cannons, 500 pound bombs or other mass destruction weapons. You can have consensual sex with pretty much anyone you want but not with children. Believe it or not, in many states, it is legal to have sex with animals. In Oregon, it is not a law violation to be in public nude, even in the presence of children. Liberty as a specified right cannot be taken away unless your exercise of that liberty is deemed sufficiently harmful to society as a whole. Those specific limits to individual liberties have been litigated for as long as the United States has existed, and continue today. Some liberties have even been stretched a bit. Nude dancing in strip clubs has been interpreted as free speech. I think if people want to strip nude and dance in an indoor club out of the view of anyone except those who went there to specifically see the dancers, more power to them. But calling that free speech is a stretch.

I have always found, the phrase "pursuit of happiness" pretty vague. To take away someone's pursuit of happiness is then also a vague proposition. We clearly don't want to do it but don't know exactly what it is.

Other specified rights are included in the Constitution; protection against unreasonable search and seizure, the ability to practice the religion of choice; petitioning the government for grievances; freedom of the press; no quartering of soldiers in private homes in peace time; no self-incrimination, a speedy trial, etc. However, what is important to realize is that the Bill of Rights really specifies what the government can't do to citizens rather than what it can.

With that as a preamble, is there a right to health care? Just like food, people can certainly need it, at times. As opposed to food, a majority of the time, most people don't need it. While no one wants people to die from non-treatment of curable conditions, I revert to the previous example. If someone is perfectly capable of providing care for him/herself and chooses not to, does the rest of society have an obligation to give them a free ride? Once again, I am not talking about people who cannot fend for themselves. If health care is a "right" then the government has an obligation to care for those who can afford to take care of themselves and choose not to. I have a tough time swallowing that argument. If you are ninety seven years old with peripheral artery disease, poor cardiac function, obstructive pulmonary disease, etc., and you fall and break your hip, does the government have to provide you a hip replacement? I am not talking about whether it is risky but rather is it a right? If you choose not to wear a motor cycle helmet or seat belt despite a law requiring it, do you have a right to taxpayer-funded health care if you choose not to buy insurance for yourself? If you gorge yourself up to 600 pounds and cannot leave your bed, does the government have to pay for your care or gastric bypass? If you choose to become a heroin addict and contract hepatitis via an infected needle, do you have a right to free health care from the government?

I think is a rightful role of government to help the those who cannot help themselves due to disability or impairment but that if you have the ability to provide for yourself and do not choose to do so, you are on your own. Therefore, there is no "right" to health care and those who argue for it are doing so out of a desire to have everything provided to them without effort. Of course, if enough people go that route, no one produces anything and there is no care for anyone.