The Problem With Calling Heathcare a Human Right

Human rights are certainly good things, and certainly humanity has an ethical duty to urge their adoption in every corner of the world. However, economic necessities are not human rights, and the most effective way to see them adopted throughout the world is not through their designation as such. Similarly, governments do not have an absolute duty to provide for the unlimited welfare of every citizen, but rather to provide a basic level of health and security which every society should be allowed to approach as they see best fit, through the will of their own residents.

Many who support the argument that everyone deserves the right to be taken care of, and that therefore governments have an ethical responsibility to provide for citizens (and, for many who argue this, for all people) if they became ill and need medical attention. This view is based on different justifications; commonly a form of social contract theory for those who argue that government’s first responsibility is to those within a state, or natural law or humanist arguments for those who argued that it is humanity’s duty as a whole to provide for everyone.

I am skeptical of this. Certainly access to health care is a necessity for an individual to live a long and fulfilling life; equally certain, for a society to advance and develop as a whole its people should be healthy. My argument against it being designated a right, however, is twofold and based on the belief that there is a fundamental distinction between what are known as civil or political rights (such as the right to choose one’s government, the right to freedom of expression, and the right to live under the rule of law, with an institutionalized and impartial legal system, which grants all who are brought before it a fair trial and presumption of innocence) and those rights which are called social or economic rights (such as the right to work, the right to housing, to an education, or to receive health care).

This first group of rights is straightforward, with fairly clear definitions and with generally clear oppressors and oppressed. If someone is being denied their right to say what they wish, or to have a fair trial for a supposed crime, the solutions are generally clear, the oppressor easily identified. Economic rights are much more muddled, however. If someone has no access to health care, then who is to blame exactly? What is the solution? There has never been a government system where everyone has been guaranteed a real job. Indeed, those systems which have tried the hardest have generally proven unsustainable and ill-equipped for a world which is ever changing. By guaranteeing a society the right to vote and live with political and civil rights, we give the society the ability to determine for itself what system they wish to use, to take care of their people as they think is best.

The counter-argument with the most merit is that which argues that the fastest way to ensure that the many poor and impoverished people across the world who lack these basic necessities, to help those who are uneducated, jobless, or sick become educated, healthy, and productive, is to designate them as universal rights, thereby making it an ethical duty for governments to provide aid to make it happen. While there is some merit to this argument, (I would probably accept it as legitimate if I was convinced it was true, and would help these people the fastest) it opens up a new source of problems. First, I believe strongly in the social contract, and while I certainly support increasing global governance, and support the proliferation of international organizations, while states remain sovereign they have a duty to first provide for their own residents. On an international level, if one ensures that political and civil rights are kept, then the citizens of a state will have an active role in determining the government’s priorities, and if they are generally or vocally supportive of foreign aid, it will be forthcoming. For example, in the case of AIDS, successful activism movements throughout the world have resulted in massive transfers of cash and medicine, as can be seen in the case of PEPFAR, the Global AIDS Fund, and other examples. On a domestic level, the most effective way for a government to function properly, legitimately, and with long term success, is for the residents to enjoy those civil and political rights I have mentioned. It should be up to the citizens within a state to determine what kind of health care system they think will best provide for their society, what kind of economic system will provide the most or best jobs, and what kind of education system will best educate their children.

On a fundamental level, health care, jobs, education, and other economic necessities are services provided by the government or private companies, and the taxpayer should determine how they are best allotted. The most effective way for a society to efficiently allocate these goods is through an informed and empowered citizenry, determining what to do at the ballot box. There have been many cases of governments which ignore political and civil rights, and focus instead on giving their people a low level of economic necessities, following a particular ideology. Almost invariably this leads to an overstretched, corrupt, and unsustainable form of government, which becomes increasingly authoritarian until it falls or, if lucky, transitions away from such a system.

The condition of humanity is such that if a large group of people gather and make decisions, some people will always be better off than others. However, most free societies will also decide that governments should have a safety net in place, that the poor should have access to certain economic necessities, and where this isn’t the case, dedicated groups and individuals can work successfully to swing the opinion of society around, provided they have access to political and civil rights. I am not arguing that a system in which the bottom third of society has no health care, a poor education, and will likely lack many of the social benefits which lead to good jobs and living conditions is a good one, or is morally acceptable, I am simply saying the solution is not through a continual expansion of things designated as rights. I have only respect for an individual who feels as though he or she should spend their lives helping others, advocating for the material well-being of the poor, but I do not think they will accomplish their goal faster, or with any more lasting success, by designating economic necessities as rights.

The designation of economic necessities as human rights muddles what a right is without helping solve the many concrete problems faced by humanity. A government’s first responsibility is to the wishes of its people, and when these people are granted political and civil rights they are best able to determine what kinds of social programs will best help the poor in their area, and what gaps need to be filled in to raise the safety net to a higher level. Foreign aid can help raise this net to a level unreachable for many developing countries, and many citizens of the developed world have pushed for their governments to give aid; hopefully this trend will continue and increase in the future. The ability to engage in political debate and decision-making, whether through activism or the ballot box, is the best way to ensure better health and opportunities for the many people in the world whose voices aren’t heard; to focus instead on proclamations of unenforceable rights is more of a distraction than it is a solution.