Quasi-Rights

In response to whether he thinks health care is a right, Michael Novak points out that there is a difference between a right to seek health care and a right to be provided with health care. This positive/negative rights distinction is absolutely true, and worth thinking about whenever the topic of "rights" comes up. But putting that aside there's another important sense in which health care is and is not a right.

Let's say everyone has a right to potable water. I'm all for a government that wants ensure that everyone, no matter how destitute, has enough clean water. Enough to cook, to drink, to bathe regularly, to do some washing of clothes and dishes. We can go ahead and list that as something it is proper for a modern republic to provide. But I do not think there's a similar right to water to wash your car, or water your lawn, or take 30 minute showers. Some of your water consumption we can call a right, but some you must provide for yourself. Water both is and is not a right. Similarly electricity. Enough to light your home, to operate a refrigerator, etc. But not to keep your thermostat set to 68 all summer long. That's a privilege, and like all others, one you make sacrifices for.

Similarly with health care. It's one thing to have wounds stitched up, to have bones set, to get some antibiotics when they'd be useful.* These public provisioning of these services are not objectionable. But at the other end of the spectrum is, well, four dozen things covered by my state employee insurance plan like acupuncture. And there's a multitude of things residing somewhere in the middle. There's a lot blurrier line between necessary and frivolous health care than there is between water to cook your ramen and water to fill your pool, which is why you can't let someone promise that they only mean a right to health care when it comes to the important stuff. You can't just parrot "health care is a right!" without addressing exactly what types of health care you mean.

And not only is this gray area very broad, and very murky, and very ... gray, but where we draw the line between "rights" and "privileges" will keep marching steadily towards everything being a right. We've already seen this with state insurance requirements. Insurance in New Jersey must include fertility treatments, even if you are, for instance, an unmarried 24 year old male or a widowed 70 year old female. You can not purchase low cost, high deductible insurance in Massachusetts.** There are too many people out there with too much to gain by getting the legislature to redefine whatever health-related service they provide (or desire) as part of our "right to health care." If we applied the same process to water service we'd soon end up with the right to free 24x7 slip-and-slides in every yard.


* Let's not get started on over prescription of antibiotics.
** Citations needed. Nolo. But frankly, I'm not in the mood.