As the GOP prepares to continue its long and painful process of self-immolation by voting (or not voting) on a bill whose greatest priorities appear to be cutting taxes for rich people and allowing young, healthy people to pay less into the system if they so desire, there appears to be a great deal of confusion about what health care is. Most Republicans seem to operate from the principle that health care is merely a market commodity like soda or shoes, while the Left is committed to the idea that health care is a human right. (I use “Republicans” and “left” here because both the Right and the Democrats seem to be unable make up their minds either way.) I would argue that health care per se is not a human right, but it is a social good upon which the right to life is contingent.
As the U.S. Conference of Catholic Bishops says:
A right to health care is derived from the dignity of human persons who enjoy a fundamental right to life. The basic good of human life entails access to the means for proper development.
Here’s an analogy: 24-hour access to a police officer is not a human right, but security is a human right. As I argued yesterday, security and justice in society depend on some kind of police force, and a state that doesn’t provide its citizens with 24-hour access to a police officer is almost certainly going to see its citizens suffer for lack of security. There are all sorts of other social goods besides a police force that ensure the right to security of person, and the day-to-day actions of citizens are not particularly dependent on calling the police. Yet if you knock out the pillar of police protection that ensures security, the whole society comes tumbling down. Providing for this social good is a shared responsibility and a duty we have to one another– if someone is getting robbed on the street, they don’t have a right to someone else’s cell phone, but passersby have a moral and social duty to use their precious cell phone minutes to call the police.
Similarly, health care is a social good that buttresses the right to life and we have a moral duty to provide it to one another. Human life is fragile; maintaining it requires attention and discipline to the other goods upon which it is contingent. Anything less is injustice.
Now, we can debate how to ensure that everyone is able to receive enough of this social good in order to protect their life. The state doesn’t have to directly provide it, although I cannot think of any means that would be more efficient for delivering the basic preventive care that everyone needs, such as vaccines, diabetes screening, or colonoscopies. There may be areas where a freer market might help drive down costs, but Americans spend four times as much on healthcare paperwork as Canadians and that problem will almost certainly endure as long as we’re primarily subsidizing insurance companies. I don’t think Medicare For All is ideal, but it would be more efficient than the current system and far more just than what the Republicans have cooked up in the AHCA. I have argued here for a more distributist and less centralized model, but options abound.
Whatever we choose, it has to ensure everyone will have access to preventive care, catastrophic care, and a level of chronic care that keeps them from unnecessarily dying early. There are plenty of options, but as Matthew Tuininga says:
Whatever conclusions we come to with respect to particular policy approaches (and we should be humble here), we should be agreed that health care for the poor is not merely a matter of charity. It is a matter of justice. Our representatives should know that this is where the Christian tradition stands.