Health Care in the United States: Individual Right or Government Duty?. (June 2020)

• Record Type: Journal Article
• Authors: Holtzman, Jessica N.; Schwartzstein, Richard M.
• Is Part Of: Academic medicine. Volume 95:Number 6(2020)
• Publication Date: 2020-06
• Subjects: Medical education -- Periodicals; Medical policy -- Periodicals; Medical personnel -- Periodicals; Periodicals; 610.711
• DOI: 10.1097/ACM.0000000000002986
• Languages: English
• ISSNs: 1040-2446

Abstract

Abstract : The authors discuss the notion of health care as a governmental duty rather than a right of individuals. The notion of individual rights was proposed by political philosophers of the 17th and 18th centuries, who posited that people existed in a state of nature before coming together to form communities. Members of communities relinquish certain freedoms in exchange for services provided by government, including protection of the natural rights of "life, liberty, and the pursuit of happiness." In this tradition, there are natural rights that exist before government and must be protected from government infringement. The U.S. Constitution almost exclusively enshrines negative rights, which protect natural rights from government interference. Rights belong to individuals, whereas the government has duties to provide services, such as basic education, that society deems to be important. The discussion of health care as a positive right, one requiring government to provide citizens with services, runs counter to this tradition of natural rights. The authors propose that reframing the discussion to see universal access to health care as an obligation of government, rather than a right of individuals, will center the discussion more accurately within U.S. political tradition. This may drain the emotional charge associated with claims to "rights" from public debate and allow for productive negotiations over the extent of health care appropriate for government to provide, within the context of the other obligations that form the social contract between the citizenry and its government.