During a recent radio interview, I outed myself as one who does not believe that healthcare is a “right.”
Like others who have outed themselves, I received no accolades for my courage, though it was an admission I thought twice about before uttering. I felt that being clear about this view in principle was critical if there were to be any useful conversation on the topic at hand. I was then asked about whether Republicans were consistent as Christians in opposing the Affordable Care Act (ACA, or Obamacare). In the end, I said Republicans were consistent because I did not feel that healthcare is a right, and therefore, the violations of conscience ACA demands were a step too far.
Wouldn’t you know, some did not agree with my assessment. It appears that many in our nation, surrounded as we are by Grade A healthcare at relatively reasonable prices, have come to expect that healthcare is as much a right as bearing arms and free speech. (Bearing arms is still a right, no?) It is so often provided by employers as a benefit—or by government when our employer doesn’t provide it—that it just feels natural that we are all entitled to it.
Rights Versus Entitlements
And how you answer that question will end up laying bare your beliefs about healthcare public policy. If you believe healthcare is a fundamental right, then there is really no stopping you from advocating for virtually any law or change in policy to ensure that every American has healthcare. If you do not believe that healthcare is a fundamental right, then you will find before you an endless array of options to consider, none of which involving the imposition of care for you by the medical community.
If you aren’t sure where you stand, consider the meaning of the word “right” and then the word “healthcare.” A right is something so intrinsic, so basic to who you are as a human being, that it can be demanded by the individual over and against his society.
A quick look at the Bill of Rights will serve as a reminder of what things we—as a nation—consider absolutely fundamental to what it means to be a citizen and even a human being. We have an absolute right to self-defense, free association, speedy trials, reasonable bonds, etc. In fact, we have such a right to those things that we can appeal all the way to the Supreme Court to maintain those rights. Again, we can demand those rights because of what we believe about the intrinsic value of human beings. You can’t separate those rights from the reality of being human.
What is “healthcare”? Healthcare is all of the people, places, events, education, technology, and regulations (and many things unnamed here) that lead to a doctor or nurse tending to the sick and dying. In other words, healthcare is an incredibly complicated network of highly (and expensively) educated people, fancy buildings and immense staffs that do not have to exist, but do, to serve you. Healthcare is not an idea, like freedom. Healthcare is not ephemeral, like a hope or a dream. It is a commodity, provided by a vast number of people - seen and unseen - at great expense to them, often at the threat of a lawsuit.
Our healthcare system is, like all major systems, a bit of a mess at times. It has its share of horror stories and a hundred times as many miracles. But healthcare remains a commodity, a service that can’t be provided for free by the provider and therefore cannot be obtained for free by the recipient—unless we want to turn every law of economics on its head.
If you believe that healthcare, in principle, is a “right”, then what you are really saying is that you can demand it at the expense of all of those people, times and places that actually provide that service, medicine, and technology. Since you have a right to it, you should never be refused.
By God’s grace, most patients in emergency situations are not refused in America, though day-to-day practices do refuse patients all the time, particularly if the patient only has Medicare or Medicaid, which pay little and require vast amounts of paperwork. But in the end, if the doctors, nurses and administrators have rights of their own, they should have the ability to refuse treatment for a whole host of reasons. Remember, competing rights and freedoms must be balanced, and that balancing act is never as easy or clean as we might like.
Are All Necessities Rights?
But let’s forget about healthcare. After all, healthcare is only what you need when you are sick. Without food, you’ll die. So, is food a right? What about gas? Without it, you can’t work and get to a job. Should we have a right to access it as well? What about water? Why isn’t my municipal water free? After all, without it, I’ll die!
As much as I wish all of these things could—miraculously—be free, in a world of scarce resources, that is not possible. These things are all commodities, and they all require money to obtain. Just like healthcare. Exempting healthcare from the built-into-the-fabric-of-the-universe reality of economics is foolish, and it ends up ignoring the rights and needs of those actually providing the healthcare in the first place.
But wait, as Christians, aren’t we all about healthcare? What about the Good Samaritan and the Sermon on the Mount and Matthew 25 (“What you did to the least of these…”)—aren’t these all texts that would at least indicate Christians that healthcare is a right? No. These passages teach us that Christians are to love and serve their neighbors. These are ethical commands to Christians, not generally applicable principles for the formation of a society at large. These ethical commands certainly depict a wonderful culture and have, at large, produced a wonderful culture. But these are voluntary acts by Christians; not a recommendation to socialism.
And wouldn’t you know, the track record of Christians doing exactly that in the field of healthcare is so considerable and literally world-changing that we have gotten as spoiled as we are. So spoiled, in fact, that we believe we can demand it of others.
I can’t speak for the world, but I can say this for Christians: we are in a position to demand nothing and ask for nothing. Rather, we are only in a position to serve and love. So rather than demanding “rights”, we serve without asking for reward. And those are very different things.