Health Care: Human Right, Civil Right, Privilege, or Market Commodity

by Valerie Elverton Dixon 10-06-2009

What is health care?

Is it a human right, civil right, privilege or market commodity? Is it a public good, moral obligation, government obligation, job benefit, or individual responsibility? Ought it be subject to the profit motive and or to government regulation? Is it all, some, or none of the above?

We have not reached consensus in this country on what health care is. What are our national goals concerning the health of the nation and its people? Can we have a healthy body politic without healthy citizens? Can we have healthy citizens without a healthy body politic? Unless we are clear about our goals, we cannot reach them. Unless we have a clear vision of what we want to create, we cannot craft it.

Some of us argue for universal health care because we understand it as a human right. For us it is a justice due to every human being by virtue of her humanity. It is a question of respect for the human dignity of every individual. For those of us who are believers, it is a matter of respect for the image of God that is created into humankind.

That health care is a human right is the consensus of the world. The Universal Declaration of Human Rights says that medical care is a human right. The International Covenant on Economic, Social and Cultural Rights recognizes “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.”

The Additional Protocol to the American Convention on Human Rights in the Area of Economic, Social, and Cultural Rights, “Protocol of San Salvador” says that states ought to “recognize health as a public good.” (The United States is not a signatory to this protocol.) We ought to decide if health is a public good, and if it is, there is an obligation of government to provide it. This is an obligation of our national government.

During the Great Depression, President Herbert Hoover opposed federal unemployment relief. He thought voluntary agencies, as well as local and state governments, should carry that load. Hoover thought federal unemployment assistance would lead to “socialism and collectivism.”

We hear the same fears today regarding health care. We hear people say that a public option would lead to a government takeover of the health-care system and to socialized medicine. They say this as if health care would automatically be worse if the federal government become involved. However, all the fears of limited choice of doctors, rationing of care, and waits for doctors appointments and of procedures have already come true under the present system. Under the present system, thousands of people declare bankruptcy each year because of medical expenses and some 20,000 die of treatable illnesses.

Further, we think that the government cannot run anything well. Witness public schools, public transportation, and public housing. We fail to consider that our government is OUR government. In a representative democracy, we get the leaders we choose. We get the government we deserve. We get the schools, transportation, housing, banking system, and health-care system that we deserve.

We the people of the United States deserve better than we have now. It is our responsibility to insist that our lawmakers work together to develop a health-care system that will give universal access to the best physical and mental health care available

Dr. Valerie Elverton Dixon is an independent scholar who publishes lectures and essays at JustPeaceTheory.com. She received her Ph.D. in religion and society from Temple University and taught Christian ethics at United Theological Seminary and Andover Newton Theological School.

Categories: Health, Human Rights

xfree9

Yes, we could definitely say that Jesus' teachings apply to the whole world. But is legislating that the best way to spread the gospel and change the world? It didn't work in Israel, when its laws were exactly what God wanted. How much less will it work in a nation where people do not have a covenant with God?

Doing justice work is more than just the Church doing really awesome super-duper charity work. Where are the Christian insurance CEOs who have a conscience? Where are the Christian doctors who live on non-excessive income and provide great treatment at a low cost? Where are the Christian bio-tech companies who are concerned with the justice aspect of their business? Would it not be a more socially just approach to do this within society, rather than legislating it by getting the government to force everyone to do it?

Whether or not sexual indiscretion is the function of "religion" is besides the point I was making. But even so, following biblical ethics, adultery affects more than just the individual, and applies to everyone, not just believers. It just seems to me to invoke this rationale is to invoke my religious ethics upon you involuntarily.

scat

I disagree that Christ was just speaking to his followers. I believe He was teaching the world how He expected us to live, what to do for everyone to have a good productive life. He specifically instructed that His words were to be spread around the world. Otherwise non-followers would be given permission to lie, steal, cheat, kill,etc.

The laws in our country as well as most others have been greatly influenced by religious beliefs There was a time when religious laws were the only laws, when there was no separation of church and state. As a secular govenrment, we pick and choose which laws are of sufficient import to society as a whole and which are primarily the province of religious belief and thought. At this point in our society we have decided that taxes are the business of government while adultery is primarily a religious issue,. although there may still be some states where adultery is still on the books as a felony.

Like you I have pondered the issue of what seems to be so much infairness in this world and wondered why. I don't have answers but some theories that loosely seem to explain some of it. I think we are the authors of both our problems and solutions. I believe God will lead and sometimes give us a hand. We can do what needs to be done if we don't waste our time and resources on foolish irrelevancies (that would include most of the entertainment and fashion worlds where we squandor so much of resources and talent). I think God knows we can do so much better than we have done and that if we exercise our free will to do what is right, we will ultimately succeed.We have the right to expect more of those who have more, whether in materials or ability. Just as we have the responsibility to help those less able. I do not think that a Christian is obligated to keep "hands off" the greedy or lazy among us.

I don't think you can legislate a sense of justice, but you can teach it and make it more attratice than injustice.

As far as the church stepping and doing the "charity" work. Some churches have done a good job, most haven't. The problem has gone way beyond being one of charity. It involves systems that are not functioning the way we want them to --the insurance industry, pharmaceutical and bio-tech industry, the health care delivery system. Even if the Church could miraculously help everyone who needs help today, the problems would still be there. It would be just treating the symptoms, not the disease.

scat

First, all of us pay taxes for things we do not otherwise agree with or reap any direct benefit from. There are a number of solutions to that problem. You could give up earning an income and go live off the land. You could petition or lobby your representatives to change the law. You could live somewhere else that does not collect taxes.

In a democratic republic like ours, what the government chooses to spend our taxes at least theoretically depends on what the majority decides is appropriate. So yes you do have a say in it if you choose to exercise it.Of course, taxes are not the same as charitable giving, but taxes are still representative of our will. It is a clumsy inefficient system, but I think we are seeing what can happen when people become involved and seek to express their will.

xfree9

From the perspective of the Scriptures and of a Christian, you and I agree about "sharing the wealth" and our "collective job." From a social standpoint, however, those phrases are used (not necessarily by you) to exert power in the argument. The Bible may instruct us to share our wealth, take care of the needy, but that instruction is for followers of Christ, which a voluntary involvement. But the Bible also teaches that we are to not commit adultery. Does that mean we must also pursue "collectively" legalization against adultery?

Using our biblical mandates or kingdom ethics to shape society is one thing. Using the government to do that work is quite another. You are absolutely correct that we are to do whatever is in our power to accomplish social justice and good deeds. But inherent in that pursuit is the understanding that whatever a Christian does, he/she does it peacefully and without forceful coercion. When society isn't already cooperating enough to provide for those who are needy, it is indicative of a poorly functioning society. This is the task of the Church to bring about true social change. When others aren't voluntarily joining in that movement, the task doesn't change to, "force them to."

I suppose that some minimal form of taxation can cover "human rights," but I do not see the services necessary to provide health care as "human rights" because it is the product of somebody else's labor, property, capital, and wealth. What we call "health care" today has not always existed; it was created and produced.

For the past week I've really pondered a lot about this. Believe me, I'd love to legislate justice the way you and I see the world. I wish I could just print up money and hand it out to folks who are needy. I wish I had millions to do part of the task myself with charity. And I wish I could make people give up all their money for what my world view says is "common good." But alas, we are disciplined into doing the work of justice within the boundaries of justice itself. Moral boundaries and ethical limits are there to keep the Church from dangerous domination of society.

xfree9

That you said you want Congress to do whatever it fancies as defined as "general welfare" is an acknowledgement that what you are advocating is not provisioned in the Constitution, else you'd point to something more specific in the Constitution. "Love your neighbor" is a very broad command by Jesus, but we are not at our own whims to go beyond what Jesus also taught that "love your neighbor" meant. Many use it as a reason for war (ironically), justifying violence to "love" another neighboring country.

The Madison quote does apply. If you read the context, Madison was specifically writing about your belief that "general welfare" could not be used to justify whatever "common good" was perceived to be "good." And by whose definition? Whose standards? The health care proposals currently on the table do not provide for general welfare, in my opinion, and in the opinion of nearly half the American people, if not more than half.

mstree

-- "The people who say "health care is a human right" in regards to this specific policy discussion mean it to mean "everyone in the United States has the right to all the health care services they need regardless of their ability to pay for it". And because the federal government is the protector of human rights it is therefore incumbent upon the federal government to ensure everyone has health care services."--

This is the same mentality that caused the housing crisis. If health care is a human right, isn't housing also a human right? It seems to me that denying shelter to someone is just an immoral as denying health care.

And so, those who could not afford homes were given mortgages. And then, it all came tumbling down. I fear what the end result will be of the government's plan to mandate health insurance coverage and how they will go about doing this. I wonder how the walls will come tumbling down in this case.
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mstree

"Otherwise we become lazy couch potatoes expecting God to solve all of our problems."

Or, on the other hand, we become lazy couch potatoes expecting government to solve all our problems.

A comment about taxes - Sharing our wealth certaintly is not equitable to paying taxes. We are forced to pay taxes, and we do not choose how our taxes are spent or to what causes they go to. We also have no say in how much taxes we pay. My taxes go to many causes that I am very much against.

Sharing and giving freely, on the other hand, is quite different. We choose where our money goes, to which charity or which person, and we choose how much of it we give. We are under no compulsion or law when we give freely, other than the law of love.

We mustn't confuse and equate taxes to freely giving.

butchragland

·“That is not a constitutional argument. Using the phrase "general welfare" in such a broad sense of the term is inaccurate and disingenuous.”
· Utter misuse of those 2 words! You have no ruler to measure the accuracy or judge my sincerity.
·
·“Why not just write a very simple Constitution that says, "Congress shall write any law that promotes the general welfare"?”
· Why would congress not write any law that promotes the general welfare?

In Federalist #41, James Madison wrote, "For what purpose could the enumeration of particular powers be inserted, if these and all others were meant to be included in the preceding general power? Nothingis more natural nor common than first to use a general phrase, and then to explain and qualify it by a recital of particulars. But the idea of an enumeration of particulars which neither explain nor qualify the general meaning, and can have no other effect than to confound and mislead, is an absurdity."
· Precisely cited it doesn’t apply to my point, I confess it almost sounds like it applies.

”In other words, "general welfare" was prescribed specifically in the Constitution. If that were not the case, our nation wouldn't be a nation of laws, but a nation led by politicians who write laws that suit whatever they believe "general welfare" meant for the day.”
· That is exactly what I want them to do.

You may argue for universal health care for other reasons, and you may well be 100% correct. But you cannot use the "general welfare" clause as a reason for it.
· I hope I am right and I most certainly can and did use the term “general welfare”. I want and expect congress to see to the “general welfare” in every law.

scat

In response to your question about why didn't Jesus heal some and not others, I believe God expects us to do the things we have the capability of doing. In that way we are encouraged to learn from our mistakes and our experiences. In other words, it is our collective job to take as good care of ourselves and others as is humanly possible. Otherwise we become lazy couch potatoes expecting God to solve all of our problems.
Human rights always cost other people's wealth. Today we call it taxes. In the Bible, we are instructed to share our wealth with those less fortunate.

xfree9

That is not a constitutional argument. Using the phrase "general welfare" in such a broad sense of the term is inaccurate and disingenuous. Why would there be so much in the Constitution that spells out enumerated powers that the states granted the federal government if the purpose of Congress was to promote "general welfare"? Why not just write a very simple Constitution that says, "Congress shall write any law that promotes the general welfare"?

In Federalist #41, James Madison wrote, "For what purpose could the enumeration of particular powers be inserted, if these and all others were meant to be included in the preceding general power? Nothingis more natural nor common than first to use a general phrase, and then to explain and qualify it by a recital of particulars. But the idea of an enumeration of particulars which neither explain nor qualify the general meaning, and can have no other effect than to confound and mislead, is an absurdity."

In other words, "general welfare" was prescribed specifically in the Constitution. If that were not the case, our nation wouldn't be a nation of laws, but a nation led by politicians who write laws that suit whatever they believe "general welfare" meant for the day.

You may argue for universal health care for other reasons, and you may well be 100% correct. But you cannot use the "general welfare" clause as a reason for it.

xfree9

If we are God's image-bearers, and by that reasoning you believe we have a human right to health care, why isn't this spelled out in the Scriptures to the extent that whomever was writing at the time endorsed such "rights"? Why did Jesus choose not to heal everyone? He didn't even have to get government involved... he had the power in and from himself to do it for anyone he wanted!

And if it is indeed a human right, by what means, and by whose choices, are we to ensure everyone has a right to the property and services of others? If it is a human right based on our bearing God's image, then it is also a "natural" right. Yet what natural health service can you point to that causes no expense to somebody else in order to achieve it? Human rights do not cost other people's wealth.

Hippocrates

Interesting discussion going on here. If a person believes that health care is not a right, then he/she should be pressing for the repeal of EMTALA (Emergency Medical Treatment and Active Labor Act). Then sick people who can't pay could be told to just go die in the parking lot outside the Emergency Room. Or deliver their babies there. Sure would save a lot of money! Sure would keep us taxpayers from paying one thin dime on medical care for an illegal immigrant!

Does that scenario curdle your blood? As a physician who has sworn the Hippocratic Oath, it curdles mine. My calling is to provide what health care I'm capable of providing to any human being who needs it. Heck, I'd even try to save the life of a dog or cat or wild animal (that's not trying to attack me, that is).

Health care is a mixture of a human right and a social good. Not only do we feel better as caring human beings if everyone in our nation gets the best quality care we can make available to anyone, but also, as other rich nations have discovered, the system works better and cheaper (by far!). Worrying about this is a non-issue in ALL the other rich nations on Earth. (Even the conservative political parties wouldn't dream of dismantling their national health care systems.)

I think a better analogy is education (which is also without tuition in most rich nations). Our nation and all the people in it would do better if each individual were able to obtain (without accumulating crushing debt) the highest level of education of which he/she is capable. When education is a combination of individual responsibility (to demonstrate qualifications for the curriculum chosen, to attend classes and do assignments, etc.) and a social right (we taxpayers pay the tuition), our nation would reap the benefits of a much better educated populace.

By the way, nations with both tax-supported health care systems and tuition-free medical education have physicians who are much happier in their jobs even though they earn less money than American physicians. They view their work as a calling to serve the public with their special skills as physicians, and find their compensation as middle class professionals acceptable. Physicians corrupted by huge "consultant" fees from drug companies and device makers are an American phenomenon for the most part.

While we're at it, the American Bill of Rights may declare that running around armed to the teeth with firearms is a "right", but I can't imagine that God would agree that it's a "human right". Physicians get to try to clean up after the human carnage that results.

xfree9

In an ideal world, government is unnecessary. But we do not live in an ideal world. Yet if the ideal world where everybody was "good" and acted neighborly and lovingly, government would be less necessary.

I would advocate a government that protects the rule of law as set by the people, or the best possible mimicking of that scenario. Our constitution is a very good one, and neither the "black hole" wars we are in today, nor the health care debate we have, is supported by the Constitution. The Constitution is very specific about enumerated rights and responsibilities of the federal government.

But if I had to choose, I'd choose health care over foreign wars. I'm with Ron Paul on this one. He's said he'd be willing to vote for some of the things going thru Congress if the way we "paid for it" was by withdrawing our occupying forces in over 130 countries around the world that only make our foreign policies more dangerous.

WaveTossed

"No one, illegal or otherwise, is denied essential, life-saving care. That is already a current federal law."

Really? So if I get cancer and have no insurance and can't afford to pay for treatment: can I go to a hospital ER and get chemotherapy or radiation? If I am diabetic, can I go to an ER and get a good supply of insulin? Can I expect that a hospital won't bill me or place liens upon my house or property under these conditions?

WaveTossed

Amen!

WaveTossed

"I agree about the conservative inconsistency. However, natural rights should not require the use of other people's resources without just compensation and without their consent."

I've read all of the health care proposals. Including some by radical left-leaning folks who openly would wish a socialist single-payer system. NO BODY have ever said in any of these proposals that doctors, nurses, other health care providers should be forced to work without fair wages for their work.

As for taxes: taxes are taken from people for legislative and administrative functions to preserve our rights and defend our land. Which is fine (I'm not an anarchist). My taxes are taken from me to fund all sorts of foreign military ventures overseas without my consent, which is NOT fine with me.

The provisions of taxation are provided for in the Constitution. Are you opposed to all taxes? Would you be opposed to all government?

Myself, I'm not opposed to all government. So I don't mind limited taxation to assure people of the Right to Life. I'd much rather have my tax dollars used for health care access than for the Black Holes in Bagdad and in Kabul.

WaveTossed

Bush's proposals for health care savings accounts were a joke because the amounts allowed in these accounts would have been ridiculously low. McCain proposed something similar. However, he would have allowed a tax deduction only for the first $2000 (for individuals). The rest would come out of peoples' pockets from taxed income. Worse than that, McCain wanted to raise taxes for those who have employer-based insurance plans by taxing these plans as "income."

I cannot think of any insurance company that only charges $2000 per year for any plan. The situation is that both Bush and McCain were afraid of the revenue that would be lost by any sort of tax-free health savings accounts that actually would allow for reasonable amounts. That is because they desperately wanted revenues to fund the Black Holes in Bagdad and Kabul.

A true tax-free health savings account would have no limits as to how much can be saved. Also there shouldn't have requirements for a high-deductible insurance plan. Some employers (including my own) provide benefits that allow for tax-free health savings accounts. However, if the Repubs (and some of the Dems) were to be able to go through with their plans, these tax-free health savings accounts would be taxed as income -- ergo, they would no longer be tax-free.

WaveTossed

"And because the federal government is the protector of human rights it is therefore incumbent upon the federal government to ensure everyone has health care services."

Exactly. However, this does NOT necessarily mean that the government is required to create a federal health plan where everyone is mandated to carry insurance. What it means is that the government must regulate in such ways that all people have the opportunities to access health care. This means limitations and prohibitions on the sorts of monopoly-like actions of insurance companies so that a true free market can exist.

WaveTossed

"Think of the money, and lives, saved if we viewed 'health care' as something that begins with our own responsible choices in how we take care of ourselves."

True, very true. However, when the Bill of Rights specifically defines rights to free speech, freedom of the press, freedom to bear arms, and other rights, it doesn't say that these rights are granted only if a person "makes responsible choices." They are granted regardless. The only instances where actions might be disallowed is when they directly infringe on someone else's rights.

The Right to Life is a natural, God-given right. This is the baseline, whether a person "makes responsible choices" or not.