Beyond the substance of whether Obamacare has been successful or not, we need to ask ourselves whether healthcare is a basic human right or not. If healthcare is a right, then it would seem to follow that government should provide it for its citizens. If it isn’t a right, then it would be each person’s individual responsibility to ensure for themselves.
So which is it? To answer this, we need to think about some fundamental principles about what rights are and where they come from.
What are rights and where do they come from?
Rights are those things which govern our moral and legal interactions with other people. When we say, “You don’t have a right to do that,” what we mean is you don’t have moral standing or legal authority to do something.
This video explains these concepts in more detail.
People innately possess rights. Thomas Jefferson wrote in the Declaration of Independence that, “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.” This reflects the Judeo-Christian worldview that rights are endowed on humanity by God. This is because God created mankind in his image with intrinsic worth and value (Genesis 1:26-27, Psalm 8:5).
These kinds of rights do not come from the government or society. Because rights inherently deal with moral questions, where your rights come from also determine where your morality comes from. So if rights come from the government, then the government deems what is moral or immoral. If rights come from society, then society determines morality. The problem with this way of thinking is that you lose any objective standard of morality from which to say that your rights are being denied if the government or society think the opposite.
For example, let’s take the issue of slavery. Up until the nineteenth century, the vast majority of societies and governments deemed slavery to be a morally acceptable practice. If rights and morality come from government or society, then can we really say that they were doing something wrong or that they were denying someone their rights? We can’t, because in such a system, government or society are the highest authority of morality and the originator of rights. It’s only when rights come from God and are intrinsic to a person’s nature can slavery be considered objectively wrong because God has higher authority than government or society.
When rights come from God, then humanity possesses something intrinsically valuable that governments, communities, or other individuals cannot take away. It’s true that such groups can suppress or deny the rights of people. But it is not something that they can take away.
Positive vs. Negative Rights
Ted Cruz, during the healthcare debate, talked about how people have the right to access healthcare, whereas Bernie Sanders argued that people have a right for actual healthcare services to be provided to them. This is the difference between negative rights and positive rights, although these formal philosophical terms were not used.
Positive rights refer to rights that impose a “positive” duty on someone else to fulfill. For example, if you are arrested, you have a right to be provided an attorney by the government if you can’t afford one. These positive rights are sometimes called entitlements.
Negative rights, on the other hand, refer to rights that impose a “negative” duty on someone else to not interfere. For example, the freedom of religion imposes a duty on the government to not interfere with my ability to practice my religion or worship the god of my choice. Negative rights can also be called liberties.
This video explains in more detail.
Is healthcare a right?
Is healthcare a basic human right? In one sense, it is because it is either a positive or negative right. The better question, then, is to ask whether healthcare is a positive or negative right. If it is a positive right, then the government or other people are obligated to provide it for me. If it is a negative right, then other people are obligated not to hinder my ability to obtain it.
I’ve been thinking for the past several days on how to answer this question, but so far have not been able to find a satisfying criteria for justifying my answer one way or another. So instead, this is the argument I’m going to make: whether healthcare is a positive or negative right, government is not the answer.
If healthcare is a negative right (as I am personally inclined to believe), then the government is under no moral compulsion to provide healthcare for everyone.
If healthcare is a positive right, then someone is under moral compulsion to provide healthcare. But the next question that needs to be asked in this scenario is: Who will provide it? Just because there exists a moral compulsion to provide a service, that does not mean that government has be the agent through which that service is provided. The question then turns into: What is the most effective way to provide good quality healthcare to the greatest number of people? In other words, what system of healthcare will accomplish the greatest good?
That will be what I discuss in Part 3. Would a single payer system or a free market system work best to provide healthcare?
Why am I inclined to think healthcare is a negative right?
1. It is impractical in many cases to have a positive right on a finite resource.
Healthcare is a finite resource. There are a certain number of healthcare professionals and facilities in this country that are incapable of fulfilling everyone’s healthcare needs at once. This is why you often see rationing in countries with socialized medicine. If healthcare is a positive right, then what level of healthcare is someone entitled to? The best and most expensive available, or is a lesser form acceptable? Are you entitled to healthcare that is extremely expensive but would only lengthen your life by a few months? In order to accommodate everyone’s positive rights, certain practical limitations would have to be arbitrarily imposed. This means that people’s positive rights will not always be fulfilled equally. Wouldn’t this be unjust?
2. Nature of Charity and Generosity
While the Bible isn’t an exhaustive political treatise, there are a couple of fundamental reasons why I believe healthcare and other services like it are best handled through the free market and charity. In Scripture, the nature of charitable giving is outlined in 2 Corinthians 9:6-7, which says, “The point is this: whoever sows sparingly will also reap sparingly, and whoever sows bountifully will also reap bountifully. Each one must give as he has decided in his heart, not reluctantly or under compulsion, for God loves a cheerful giver.” This makes two important points regarding charity: 1) The sow and reap principle – generosity will bring blessing, and 2) Giving must be done cheerfully and not under compulsion.
Government welfare, by nature, is compulsory for the reason that it has to rely on taxation in order to pay for its programs. It would therefore seem that it is incompatible with the principle of giving cheerfully and not under compulsion.
I want to make another point along with this: this passage was not written to say that if you don’t want to give, then you’re off the hook. It is rather a challenge for you to examine your own heart and see why you do not want to give with generosity. We all ought to want to help those in need, especially if we have the means to. Once you have resolved that issue, then you will give cheerfully and not under compulsion.
3. Role of Government
The role of a secular government, as outlined in Scripture in Romans 13:1-7 and 1 Peter 2:13-17 is to “praise good” and “punish evil.” While there are numerous commandments given to help and care for the poor, those commandments are always given to the church or to Israel, not to a secular government like the Romans. (When understood properly as God’s people, Israel is analogous to the church (God’s people) and not to a secular government.)
I believe the reason for this is simple: God’s people are far more capable of taking care of the poor in not only meeting their physical needs like food or healthcare, but also can meet their emotional and spiritual needs. Government, while it can to some extent meet a person’s physical needs, by its very nature, is incapable of meeting a person’s emotional or spiritual needs.
The unfortunate side of this story is that churches, to some extent, have neglected the poor and needy over the past several decades. Some people argue this is because the government stepped in and churches no longer felt compelled to serve in this capacity. Another possible reason is that many people who go to church simply don’t want to be inconvenienced by those in need. They come to be fill up their gas tank, so to speak, and then leave. There are several other reasons I could list, but the point I’m trying to make is that government is not the only thing that needs reform. The Church just as readily would need to reform itself if it were to assume this monumental task again.
Here are links to my other articles on healthcare: