The Right Question

Wrong Question. Wrong questions get wrong answers.
-- Master Gregory, Seventh Son, 2014

Is healthcare a right?

You know, a right?

With all the many ideas we Americans consider rights, you’d think we would have an answer for this.

Obviously, here in America anyway, healthcare is not an enumerated right like Freedom of Speech or Freedom of the Press. But is it one of those other rights? The ones not specifically mentioned in the US Constitution but implied by the 9th Amendment: The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

In December of 2012, the United States along with dozens of other nations signed United Nations agenda item 123: Global Health and Foreign Policy, which among other things encouraged all nations to adopt “sustainable health financing structures and universal coverage” for all people. The resolution also reaffirmed all member nations’ commitment to the idea of “the right of every human being to the enjoyment of the highest attainable standard of physical and mental health, without distinction as to race, religion, political belief, economic or social condition.”

Do we believe that? 

Is healthcare a right?

Well, is it?

That’s the question I asked this week on Twitter.

Twitter is a weird place, the howling wild frontier of social media. But it’s pretty good for this kind of thing, polling the public mind. I have a large audience there, large enough to get a good sample across the spectrum of opinion, and so I asked: Is healthcare a right?

Not just here in America, but everywhere. Do you believe healthcare is a basic human right?

Now that seems to me a straightforward question.

And it seems to me that it’s the critical question.

Everything in America’s ongoing debate over healthcare depends from the answer to that simple question. Everything. Until you answer that question, until we agree on the answer to that question, the rest of the argument is largely irrelevant – or at least putting the cart before the horse.

Is healthcare a right? Yes or no.

That’s the question we need to settle first.

But that question is the one never put to America. Never asked. Never answered.

In all the debates over healthcare in America, from debates surrounding Medicare in the 60’s and Medicaid in the 70’s and Hillary Clinton’s efforts as First Lady in the 90’s and right on up to the Affordable Healthcare Act and the American Health Care Act, that’s the question we keep avoiding. If you look back, if you wade through all the millions of comments made about healthcare in America, that’s the one question that is never asked. The one question never debated in congress. The one question never discussed by all the talking heads on all the TV shows. That’s the one question never settled.

That’s not a coincidence.

It’s by design.

Why? Because it’s not the question we can’t face, it’s the answer.

We’re all afraid of the answer.

The press is afraid of the answer.

The public is afraid of the answer.

The politicians are terrified of the answer.

The people who don’t believe healthcare to be a right are afraid of their answer.

And the people who do believe are afraid of their answer too – maybe them most of all, because they put the most conditions on it.

The answer to that question, yes or no, has consequences, big ones. If we don’t ask the question, then we don’t have to face the answer. Not as individuals, not as politicians, not as a nation. We can just keep arguing.

Nevertheless, that’s where it all begins, right there. With the answer to that question.

Is healthcare a right?

What if the answer is no?

Look at Scott Walker’s tweet up above.

Obamacare is collapsing. If nothing changes, 28 million Americans will lack insurance by 2026 under Obamacare (according to CBO)

Look at John Cornyn’s comment:

Obamacare has left about 30M uninsured and individual market is in a death spiral.

And it’s not just conservatives:

Those are three examples of literally thousands of similar remarks made by politicians on both sides of the debate.

Essentially: If X happens, y number of Americans will lose healthcare.  Swap in Obamacare or Trumpcare for x and 10, 20, 30, 50 million for y. The sides and the numbers and the plans don’t matter. If x happens, y number of Americans will lose healthcare.

That’s the drum both sides, left and right, Republican and Democrat, keep beating. Millions will lose healthcare.

Millions will lose healthcare.

Millions will lose healthcare.

Millions will lose healthcare.

So?

So, they go without healthcare.

So maybe the quality of their lives is diminished.

So maybe they die as a result.

So?

So? So what? I mean, so long as it isn’t me, why do I care? Why should I care?

As an American, why should I care?

If healthcare isn’t a right?

If healthcare isn’t a right then why should I care how many people don’t have it?

Why would any politician give a damn about how many people lose healthcare, if healthcare isn’t a right?

No, really.  If healthcare isn’t a right, isn’t a right of all citizens, then why does Scott Walker care? Why does Nancy Pelosi care? Why should Donald Trump care? Why should anybody care? If healthcare is just a privilege, something nice to have, but not a right of every American, then why should anybody care? The argument, Oh no! Millions will lose healthcare! just doesn’t hold water – unless you believe that every single person is entitled to healthcare as a right. Not deserves it. Not can afford it. Is entitled to it as a right, as an American, as a citizen, as a human being.

It is a simple black or white answer. Yes or no. Either healthcare is a right, or it’s not.

Everything else in this argument depends from that one fundamental ideal. Everything.

Either you believe people are entitled to healthcare as a right or you don’t. The rest is just details.

Now, before we go any further, let’s get something straight:  I don’t care if your answer is no.

I don’t. Really. I’m not going to condemn you for it. I spent most of my life in the military defending your right to see the world how you want. If you don’t believe that healthcare should be the right of every human being, well, I fully support your right to that viewpoint.

If you’re embarrassed or ashamed to admit your answer is no, that’s on you.

If you don’t believe that healthcare is a right, then at least have the goddamned courtesy to be honest about it.

Own it. Don’t pretend otherwise or try to make it sound like you do when you don’t. Don’t blow smoke up my ass. Don’t move the goalposts. Don’t dismiss the question. Don’t try to rationalize it.

Let me give you an example: a large number of people responded to my question by saying, well, I don’t believe that healthcare is a right per se, but I want you to know that I do believe we should have universal healthcare.

What? How’s that work?

If healthcare isn’t a right, then why do we have a duty to provide it?

If healthcare isn’t a right, then why would society and community have any obligation to provide it?

I mean, what’s the impetus for universal healthcare if it’s not a right?

If providing healthcare is the right thing to do, if it’s some kind of moral imperative, then why isn’t it a right?

Now don’t get me wrong here. Sure, a rational civilization should obligate itself to provide healthcare for all its citizens, because healthy people make for better citizens if for no other reason. Just as a rational civilization would obligate itself to provide quality education, adequate food, clean air, clean water, decent housing, energy, and so on.

We don’t live in that rational society.

And if healthcare isn’t a right, then what’s to keep your universal healthcare system from denying healthcare to certain people? For good reasons and for bad?

That seems an odd definition of universal, doesn’t it?

Yeah, said the responders, but, see, you set up your universal healthcare system so that it can’t deny healthcare to anybody…

Can’t deny healthcare to anybody? Well, haven’t you then made healthcare a de facto right?

Stop playing games. Stop acting like you’ve thought it through when you obviously haven’t.

Look here, if the answer is no, then own it.

Just own it. All the way. And stop pretending that you give a shit about how many people don’t have healthcare. If you don’t believe that healthcare is a right, then don’t use the fact that people don’t have healthcare as an argument. Because you’re insulting not only my intelligence, but yours too. And that kind of cowardice irritates me.

If your is answer is no, that’s fine.

But I want to hear you say it.

Is healthcare a right? Yes or no. Everything else is just details.

If we all agree that healthcare is not a basic right of human existence, then we must acknowledge that healthcare is a privilege.

And not everybody is privileged.

That’s the whole definition of privilege. Some people have it, some don’t.

If the answer is no, it’s not a right, then healthcare is a privilege and we are not obligated to guarantee every person will be able to get healthcare. The privileged get it. Those of lesser fortune don’t.  Simple as that. Oh sure, we might provide some charity, some help for the non-privileged, but we are by no means under any moral obligation to do so.  If we’ve got extra money, if we’re feeling generous, sure. What the hell. But otherwise, no.

If you can afford it, you get it.

If you can’t, you don’t.

And you should at least be honest enough to admit that’s what you’re up to. I want to hear every politician, every candidate for office, go on the record, yes or no. And if it’s no, if you believe healthcare is a privilege of those who can afford it, then have the guts to look into the camera and say so. And if you’re voted out of office as a result, or stripped of your privilege by the mob, well, that’s just too goddamned bad.

If healthcare isn’t a right, then it’s just another line item in the budget, next to bridges and warships and farm subsidies.

And the only argument is where we draw the line between the haves and have-nots – and the best part about capitalism is that we don’t have to draw the line ourselves, the free market will do it for us. Leaving our hands clean.

You just have to hope that you’re privileged enough to be on the right side of the line.

And that the line doesn’t move.

And you never lose your privilege.

What if the answer is yes?

Well, hang on. We can’t just say yes, can we?

Not without caveat. Not without conditions.

We need to know some things first. Before we say yes.

Because as it turns out, it’s really difficult for a lot of people to say yes.

What was it Anatole France said? The law, in its majestic equality, forbids the rich as well as the poor to sleep under bridges, to beg in the streets, and to steal bread.

They want to.

They want to say yes, that healthcare is a right.

But they need to know things first. What kind of right? Like fundamental? Inalienable? Enumerated? Civil? Human? What kind of right, man?

What kind of right?

What are we talking about here? The kind of high ideal we give lip service to but don’t have to follow up on? Well, sure, Jim, I believe healthcare is an inalienable right, like life, liberty, and the pursuit of happiness.  Just like that. Nobody can keep you from pursing healthcare if you want it. Go ahead. Sure. No problem. No action required on my part, on society’s part. You have at it. Pursue away. The government can’t stop you. Pursue that healthcare. It’s a “right.” Wink. Wink. 

Like that?

As soon as you define the kind of right, you can start finding ways to weasel out of it, to find ways to deny that right to others.

Some people seem to think rights only exist if they’re specifically enumerated in the Constitution. I don’t know if they think other countries don’t have rights, or if they even bothered to think it thought that far. And I wasn’t inclined to ask. They are also apparently unfamiliar with the 9th Amendment.

For them, the paperwork comes first, rights second.

I’m not sure how they think the Constitution was written in the first place, i.e. your basic chicken and egg problem, and more on that in just a minute.

A lot of folks were reluctant to answer the question without the exact parameters of the right defined.

Define “Freedom of speech.”

Define “Freedom of religion.”

Define “Right to peacefully assemble.”

Define “Right to keep and bear arms.”

Those rights were enumerated without definitions by the Framers and put into the Bill of Rights.

In other words, the rights came first. And we’ve spent two hundred and forty years since figuring out the details.

And we’re going to have to keep figuring out the details and how they apply to our time.

Why? Because the details are dynamic. How we define those rights changes over time.

The limits of the rights change depending on evolving context. Society, civilization, community, are a living things and so are rights. For example: The Framers never envisioned how Freedom of Speech would apply to social media, because social media didn’t exist when they enumerated the right and they couldn’t peer across time into the future. It’s up to us, in the moment, to figure that part out.

This is the mistake gun rights advocates keep making. Rights are not absolutes.

Of course, this being America, rights always seem to come down to … money.

Predictably, I got hundreds of responses like this one.

If healthcare is a right, how do you pay for it – OR – essentially, we can’t afford it.

It amuses me when people explain how rights are “God given” or “natural” or some other lofty idea – then they want to hang a price tag on it.

Funny thing, these same people never say, whoa, hang on. This right to keep and bear arms, how much is that going to cost us?

When it comes to healthcare, they always bring up money. How much is it going to cost? Then they bring up the freeloaders and start quoting Heinlein, TANSTAAFL.

They want everybody to pay for their own healthcare, which is fair enough I suppose, but like the woman in this example, they don’t want to pay people enough to afford to buy their own healthcare. Again, making healthcare a privilege of the affluent.

It is a matter of priorities. And if you don’t believe healthcare is a right, then there’s no reason to make it a very high priority, is there?

But at least she was honest. 

Horrifyingly so.

For her, rights are about money.  For her, healthcare isn’t a right. It’s a privilege for those who can pay for it. And if you can’t pay, then you’re a cockroach.

She’s not the only one. This is by far and away the most common response I got, how are we going to pay for it? How?

As if rights were some commodity, like gold or corn or nuclear aircraft carriers.

This is the kind of thing that once led ultimately to civil war in America. Because when you believe rights are dependent on money, those that have no money have no rights. Q.E.D

And from there, it’s a damned short hop to the idea that people are property.

We went to war here in America once upon a time because the South didn’t believe it could afford to free the slaves. Because the South’s entire economy was based on the idea that rights belonged to those who could afford them, otherwise, you were property. If black people gained rights same as everybody else, the Antebellum South would be out of business. And they spent millions upon millions of dollars, and thousands upon thousands of lives, trying to maintain that economic model.

When rights depend on money, those who can’t afford rights, well, they’re just cattle. Or cockroaches – the same term the Nazis used to describe Polish Jews.

But then there’s this:

No one says food is a right.

Well, actually, a lot of people do think food should be a right. But even if it was, shoplifting would still be a crime.

Americans have the right to keep and bear arms. That doesn’t mean you can just take any gun you happen to come across. Stealing a gun is still a crime. You still must pay for a gun and for the bullets. There’s still freedom of choice, you can choose not to have a gun, you can choose what kind of gun you want.

This argument is stupid.

But (and there’s always a but, isn’t there?), for a truly ridiculous argument you have to go full Ayn Rand:

I got hundreds of responses like this one.

Most from self-proclaimed libertarians.

The logic goes that if healthcare is a right, then healthcare providers become slaves.

If healthcare is a right, they say, then I (for example) am entitled to the labor of doctors and nurses and they cannot refuse me. If healthcare is a right, according to these Randian libertarians, then any doctor, any nurse, any healthcare provider must provide me with their services free of charge at any time. Because it’s my right, you see?

Which is a damned good example of why Atlas Shrugged should be regarded as a tediously mediocre science fiction novel and not a blueprint for civilization.

In America, guns are a right. The right, in a lot of ways. But you can’t just walk into a gun store and demand a gun as your due free of charge – not without getting shot, probably. The government isn’t obligated to provide you with a gun. Hell, we don’t even have subsidies for poor people who want a gun and can’t  afford one. And instead of turning gun manufacturers into slaves, it made them fabulously wealthy.

Look here: in America, you have the right to legal representation. If you’re accused of a crime and you cannot afford a lawyer, then one will be appointed to you by the court. Does that make you entitled to another’s labor? Yes. Yes it does. That’s what Public Defenders do. They’re not slaves, they chose to do that job and they’re paid for it. And just because you’re entitled to legal representation doesn’t rob lawyers of their rights.

This argument is idiotic to a degree that boggles the rational mind.

I received thousands of responses to my question. The responses are still coming in a week later.

And despite all of the above, the resounding, overwhelming answer was YES.

Yes. Healthcare is a right.

Now, I don’t pretend that my survey was scientific. And I don’t pretend that my twitter feed is a non-biased representative sample of America or the world, but I’m looking at thousands of people who believe that healthcare is a basic human right. A basic human right. Without caveat, without condition, without question. Yes.

And I agree, without reservation.

How will we pay for it? I don’t know. How do we pay for every other right? For guns. For the free press? For freedom of Religion? We’ll find a way. How do we keep this right from becoming oppression? I don’t know. How do we keep guns and freedom of speech and freedom of religion from becoming oppression?

Those are just details. Big ones, sure. But just details nonetheless. Just like every other right.

If we agree that healthcare is a right, a basic human right of not just all Americans but of all people, then we’ll find a way. We’ll figure it out. We’ll keep figuring it out, just like every other right.

And it matters.

It does.

Because right now, right this very minute, as I write this, as you read it, as the world wonders at Donald Trump’s next Tweet, and Congress chases after threats to the Republic, and the crises of the day fills the headlines, right now, a handful of powerful men are secreted away from the public eye, working in confidence, working in collusion with those who profit from misery, deciding the fate of healthcare in America. 

I don’t know for certain what their priorities are, because healthcare is not a right and as such their motivations are secret and I as a citizen am not entitled to know. You are not entitled to know. They’ve locked the doors and they are deciding our fate. And from their track records I am forced to guess that the focus of this law is not my rights, not your rights, not the rights of humanity.

No, I am forced to suspect this committee’s priorities are money and privilege.

And I suspect that this law they are currently penning will reflect that when it finally emerges into the light of day.

And that is the point of this entire essay.

That, that right there, is the point of the question.

Because when healthcare is not a right, then it becomes a privilege doled out by a handful of powerful men hidden away from accountability and the consequences of their actions. You don’t even have the right to question them.

And you had better damned well hope that when it comes, you and those you love are privileged enough to be on the right side of the line.

And that those men don’t one day move the line.

And that you never lose your privilege.

Is healthcare a right? Yes or no. Everything is just details.

But some of those details will kill you.

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Correction: Originally the article said Hillary Clinton was First Lady in the 1980s. That has been corrected to the 1990s.