Healthcare and human rights cont.
A response to the replies…to my response to Jonah Goldberg
I posted yesterday on healthcare and human rights in response to Jonah Goldberg at the National Review. The comments were interesting and I thought I might raise some issues and questions in response. I’ve written before that our collective understanding and agreement on what constitutes a human right is surprisingly limited, given how much moral weight people associate with the term.
1. Negative Rights vs. Positive Rights.
I was trying to argue that the distinction between negative rights (i.e. the right not to have one’s speech abridged) and positive rights (i.e. the provision of something, for example healthcare) isn’t as stark as it seems at first glance. They both require the government to do and not do certain things.
With private property rights–a seemingly negative right–this requires the government to both (a) to refrain from taking peoples’ private property (ignoring eminent domain and taxes) and (b) to actively prevent other people from stealing. With freedom of speech, the government has to (a) refrain, for instance, from telling people what to say to the public and (b) actively provide protection to those who do speak in public and, more abstractly, provide and protect the public spaces where public speech happens. Freedom of speech is a harder case admittedly. Positive rights mean the government has to actively deliver something (i.e. the right to counsel, in criminal cases), while not taking away from those who already have it (i.e. taking away someone’s lawyer).
2. Justifications for Human Rights
One rationale for rights–and negative rights in particular–is that by limiting the government’s power and giving the people a say in its activity, they prevent tyranny. Another (related) rationale concerns people’s individual lives and their ability to live freely and autonomously or, possibly, to live with a certain amount of decency and dignity. The latter rights are usually deemed “human rights,” though there is overlap with the rights that prevent tyranny (i.e. freedom of speech).
We as a community might believe that negative human rights don’t guarantee sufficient autonomy or dignity and that a conception of positive rights might be introduced to fill in the gap. If human rights are to protect people’s freedom, autonomy, dignity, etc., it’s possible that negative rights alone won’t protect these capacities enough. I’m not sure. Negative rights are easier theoretically: they’re limitations on state power rather than positive grants of state authority. And they’re certainly cheaper (and therefore don’t involve other’s private property as much).
But the justification for negative rights, insofar as they relate to guaranteeing self-determination for individuals and not tyranny prevention alone, can relate to the justification for positive rights. People are more autonomous when they are not attacked (invoking a negative right) and they are more autonomous when they are healthy (invoking a positive right). Or something like that.
3. Taxes and Human Rights
Even negative rights require taxes to enforce (i.e. paying for the police to prevent others from infringing upon your negative right to private property). We need, in a way, to infring upon the right to property (i.e. taxes) to ensure the right to property. Just because a right requires others to sacrifice doesn’t mean it isn’t a right or even a fundamental human right.
I think the deeper issue here might be that of representative democracy and majority rule. There is a concern that people shouldn’t be forced to pay taxes so other people can receive services they don’t believe constitute a right or anything the government should be involved with. Nobody really disagrees we should pay for the police, so that doesn’t come up here. But what about people who disagree with healthcare as a legitimate government concern; is it right to redistribute their private property to pay for others healthcare? Well, it’s justifiable if a majority wants it and it works its way through the law-making process. That’s the way our system works; it’s justifiable coercion if it’s the law (meaning it’s constitutional). That doesn’t mean people have to like it or accept it without a policy fight.
One major concern is that when the federal government declares something a right (either explicitly or implicitly), it almost never goes away (i.e. Social Security, etc.). So even if people decide they don’t want it down the line, there are surprisingly strong head-winds working against them. Bureaucracies, like John McClain, die hard. A somewhat unrelated, but charming Milton Friedman quote: Hell hath no fury like a bureaucrat scorned. Is there any way to prevent this, to allow us to reassess in the future, if we decide now to declare healthcare some sort of (human) right?
4. Education, Healthcare, and Food
Food for thought: To what extent and why is education a right or human right and how does that relate to the healthcare debate?
5. The Constitution and Morality
If something isn’t in the constitution, it can still be considered a moral or human right. The constitution is not meant to house our entire moral universe–it is primarily meant to guide and limit the federal government.
One way to phrase the healthcare discussion, I think, is: (a) Is healthcare a right and (b) Is it constitutional for the government to involve itself in that? I haven’t seen people really debate the latter. The point is that we can have policy and moral discussions that are divorced from the founding moral discussions, so long as they are within constitutional bounds. Of course, the founders have something genius to say on almost any issue.
Also, we can declare something a human right, but since it’s not in the constitution, that doesn’t mean anything more (to me) than saying: This is very important and the government should be very concerned with this, while balancing that concern with other moral demands (see #6).
6. Moral smoothness
Rights invade each other. We invade private property (i.e. taxes) to deliver rights like education and freedom from bodily harm. That’s the nature of the moral world, as far as I can tell. It’s not smooth, harmonious, or clear. There are trade-offs. So the fact that healthcare as some sort of right might invade other rights or require sacrifice is nothing new or strange and not an independent reason for declaring healthcare not a governmental concern. There may be other reasons, though, and we are debating it out now in Congress (sort of).
Related posts:
- Healthcare, Rights, and Human Rights
- Healthcare rights, healthcare programs
- Human rights organization unites with human rights antagonist
- Human rights and gay marriage
- Is poverty a human rights violation?
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[...] an already contentious debate over whether we have a right to healthcare, one point in Jake’s reply to the replies to his reply to Goldberg (phew!) that struck me was this: One major concern is that [...]
I think the key here is the question you asked in your previous blog entry – are there different kinds of rights?
The timeline as I see it:
Merely by existing, we have certain natural or human rights – the right to speak freely, the right to have families and children, etc.
We band together in countries and communities to form a group to PROTECT the rights we had before the community existed. We also use something like the Constitution to define new ‘constitutional’ rights we have within the framework of this community. In this case, the right to a lawyer when the community accuses you of breaking its rules. The Constitutional right describes how the government will try not to violate your human right to freedom unless you’ve been proven to have done something against other people’s rights.
So now we have human rights, a government to protect those rights, and the rights we need to protect ourselves from the government overreaching its bounds.
Now we might decide to add new rules, as the community advances, time changes, we become more wealth, etc. So we create laws that, due to their existence, create legal rights. Legal rights exist only so long as the laws creating them.
The reason this is important is as follows: If we agreed that health care was a human, or natural right, then the government would be bound to create a legal framework to protect it – legal rights codifying the natural rights. I suppose this entire argument springs from people trying to use this argument to REQUIRE universal health care. But currently the only clearly accepted health care rights are the legal rights that have been enacted through law, such as Medicaid, Medicare, SCHIP, etc.
In terms of your government argument:
You HAVE the right to private property. Without the existence of the government, it is pretty easy for someone to violate your right to private property. We create a government to protect that right and also do what we can to make sure the government doesn’t violate that right (barring stuff like eminent domain) but that right existed before the government.
How does the right to health care pre-exist government? My favorite test is, “If you’re the only person in the world, do you have this right”?
If you’re the only person in the world, you clearly have the right to private property and free speech. You even have the right to treat yourself for medical issues – but you don’t have the right for anyone else to do it.
[...] See a continuation of this discussion, and a reply to the commenters, here. [...]
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