Access to healthcare as a human right?

[Kyle]

Aside from the argument of a single payer system versus our current system with social safety nets for people that can't afford healthcare- I wonder what people think about the idea of healthcare as a basic human right?

When we think of fundamental human rights-- freedom of thought; expression; self-determination-- where does access to healthcare come in? I think there should be a universal human right to proper healthcare.

[FlameBlade]

Yes.

[Mike]

Yes.

[WillyGilligan]

Kind of depends on what you mean by right. I have the right to free speech. I do not have the right to make you speak for me. Or to force you to listen.

I clearly have the right to medical care. The police can't stop me from staunching a bloody wound, because that would be wrong. Do I have the right to force a doctor to help me for no compensation, or even at a loss? I don't think so. Do I have a "right" to MAKE you pay for my medical bill? Again, I'm against it.

I'm not necessarily opposed to having a single payer system, but I think putting it in the language of RIGHTS is a bad idea.

[mimekiller]

Healthcare is one of those issues that I'm entirely convinced I know nothing about. what system works best for a country like the USA? shit if I know, I hope some smart people figure it out tho.

[Phoebe]

I agree with Willy. The language of Rights could make sense here, only if we are more specific about what that's going to mean. Rights to receive some sort of care or have some conditions set up in which you can accomplish something are obviously different from rights to freedom of expression or religion and that sort of thing. Rights possessed by an individual versus rights possessed by a group... Rights that require you to do something and rights that require something to be done for you by the state or guaranteed by the state so that it will happen... Rights that accrue to people simply by virtue of being born as a human being versus rights that can only be guaranteed if some sort of state or other institution has been established that can preserve them... All of this might require a different approach.

I think it makes the most sense to focus on what we think government should be providing for people, at a minimum level given the resources and capacities available to it, rather than focusing on some individually located right to have a particular service done for you. Just as it doesn't do very much good to tell people that they have the right to equal treatment based on sex if you're not going to enforce that, it does no good to tell people they have a right to health care unless you're going to lay down some conditions that have to be met in order to accomplish that objective. How much care, what kind of care, who's going to provide it, who pays for it... All of that is not just secondary, but integral to saying what the actual "right" is.

A better option seems to go like this:
Government should support people such that they have the basic capacity to live a full human life, that is not artificially shortened or damaged by lack of access to basic health services the government can afford to provide. The details of how that plays out will vary, but the concept behind it makes a lot more sense to me than individual rights.

[Mike]

I understand some reluctance to want to call it a right. It's not a word to throw around lightly.

Regardless of the verbiage, we currently live in a society where people seeking "emergency" medical services for whatever reason cannot be turned away. By law, people can seek and receive medical services that everyone knows they can't pay for and then turn around and make YOU pay for it--where YOU is the taxpayer and/or people who pay insurance premiums. Obamacare was an attempt to make the process more efficient and less costly overall while ensuring that everyone had access to basic medical care (again by subsidizing those who can't afford it by shifting the burden to those who can). With or without Obamacare, the spirit of our law is that people can't be denied necessary medical care due to inability to pay.

I think this basic premise is a good one, and hopefully we get better and ensuring services AND making them more efficient and affordable for all.

Do you feel like basic medical care SHOULDN'T be guaranteed? Because that guarantee means people can demand medical care and force others to pay for it. Essentially.

[Tahlvin]

I’m in the camp where I’m not sure it’s a “right” on par with freedom of speech, religion, etc. However, I do think it is in society’s best interest to have a healthy population, and not have people go bankrupt trying to pay for healthcare. And I’ve covered my thoughts on healthcare reform in other threads, so I won’t rehash it all here. But there does need to be some level of personnel responsibility built into the system as well. Everyone knows the dangers of smoking, so smokers should pay more. Engage in high risk activities and get injured, like skydiving (which I have done and love doing), and you should have to pay a higher portion of your care than if you’re injured in an otherwise “normal” accident. Heck, most life insurance policies won’t cover me when I fly in personal aircraft because of the increased likelihood of a fatal accident; so when I start flying again, I’ll have to buy special insurance that costs much more.

[WillyGilligan]

[Mike]

[Phoebe]

This is one reason why treating it as a right doesn't work so well. If it's a right - whether one that comes to you by being human or one that comes because the government needs to enforce or provide it - then you should have all of those things simply because you need them. People don't deserve more or less right; they don't lose rights at a certain price point.

Just as a side note, someone else is going to know this answer better than I do, but I didn't think emergency rooms were obligated to treat you for whatever reason. I thought they were obligated to stabilize you, perhaps send you on your way, and send you bills later, including going to great lengths to collect from you even if you're in a state of great poverty. I was under the impression that most waste of emergency room service comes from people who are insured.

Anyway, the rights-based view of health care has issues. The human development approach works better imo. What is your goal - what do you want people to be able to do, and what conditions need to be put into place to make that happen? How you determine this depends on the unique circumstances of a given place, time, and type of government.

[bralbovsky]

We spend a lot more money getting ready to kill people (and actually killing them) than we do on healing.
I'd suggest it is a right under the life and pursuit of happiness section.
Every right is understood, or should be, to be fundamental but not absolute. Speech is slightly constrained, etc.

I objected to Mickey Mantle getting a spot on the kidney transplant list, and then getting a kidney. I reasoned that he had spent his poorly, and didn't deserve to use his cash and fame to get ahead of some perhaps wiser, less fortunate person. At any rate, those details about distribution only cloud the idea of it being a right. I didn't begrudge him dialysis, for example. I categorically object to congressmen pretending they are somehow entitled for me to pay for their healthcare, and gym memberships, when they are reluctant to allocate funds to help pay for mine.

The details about addiction or obesity are tangled in other social and economic constructs that make them difficult, but on a basic level, because we as a society DO have a certain level of knowledge and a certain level of resources, health care deserves to be a right. Anything less indicates that we are immoral and uncivilized.

The questions of profit only reinforce that immorality, and should be framed that way. It would make our present debate much clearer.

[Tahlvin]

[FlameBlade]

Therein a slippery slope. It could get to the point where someone kneecapping you is a result of your poor choices of being in the wrong place.

Healthcare is only one thing out of many things necessary to treat the society at large. Smoking? Can be discouraged through multiple means. Gun violence? Only if we have better research, by which Congress has prevented CDC from doing. Obesity? Not just people's choices there. Poverty makes it extremely difficult to acquire proper food, and look up grocery store deserts.

My point is that if we take off some of basic worries, we get freed up to actually look at real problems. Lots of stuff are interconnected, and also consider that if people do not lose insane amount of life savings because of a bastard shot up the place or some unexpected events, they will have money to contribute to society writ large, and keep economic engine humming.

Granted, might be idealistic on my part, but USA is pretty much only developed country where people get bankrupted by medical bills.

[Mike]

See... I'm with Flame on this one. I'm not much for the idea of picking and choosing who to reward and punish through the cost of their medical care. I understand the desire for "fairness" and "justice" that drives such an idea... it does make sense... I just don't feel it is productive.

There's lots of evidence that big powers have shaped our laws and our society to encourage people to become addicted to harmful activities in order to drive profits. Often they target younger demographics to get people hooked on something before they have the ability to weigh all the factors correctly. Often they obfuscate the facts and/or outright lie so that even intelligent adults have a tough time sorting out the relevant issues. Big food interests literally paid to sway the science on sugar to get the government, for decades, to publish food guidelines that encouraged 8-11 servings of breads and starches per day. Tobacco interests famously lied about the dangers of tobacco and paid for bunk science.

I just feel like raising medical costs for people who make "bad choices" focuses on blaming individuals when, as everyone has pointed out, there's sooooo many factors that contribute, and there's a crap-ton of blame to go around. As Flame says, don't sweat all that nitpicky stuff... let's just find a way to make sure everyone gets appropriate health care, and then we can work on more of the root causes of those other issues.

[Tahlvin]

I understand where you're coming from. With the possible exception of smoking, which has been established via large punitive damage settlements against tobacco companies as being bad for you and increasing costs of healthcare, I'm fine with keeping most lifestyle-type choices out of the equation when computing the cost of premium. I'd love to be equitable when it comes to allocating the cost of those sort of voluntary factors, but you're right, the more of those you add, the more complex things get: the more questions you need to answer to get a rate quote, the more administrative costs increase for the insurance companies to compute the rating factors of different activities, etc. So limit it to smoking and MAYBE a couple other voluntary activities that have documented impacts on the cost of healthcare.

[Mike]

I don't want to derail this discussion into nitpicking over tobacco, but I'm going to. (Which I guess means I DO want to.)

An alternate suggestion is that we take the average $2.50 per pack that governments collect in taxes which are supposed to be earmarked for healthcare costs and programs to reduce smoking rates, and actually commit all of that money to those purposes. Estimates say that something like 30 billion packs are sold in the U.S. each year, so... $75 billion? The average smoker in this country consumes 19 cigarettes a day, so... that means each one pays an extra $900 yearly (on average) that's supposed to be devoted to health care costs. Not high enough? Have everyone follow New York's example and charge $4.35 a pack in taxes (plus the $1 to the feds). It only slightly reduces cigarette consumption, and now each smoker is paying an extra $1850 yearly for healthcare. That's $150 per month is smoking taxes. Increasing their healthcare costs directly as well seems like we're really heaping it on.

Of course, there's all sorts of issues about this as well. Like lottery money going "to education", a lot of this money doesn't go to its originally promised purpose. It doesn't do much to reduce smoking. People who are poorer and less educated are more likely to smoke, so it looks like a regressive tax that rests largely on people who can least afford it.

And despite the fact that "everyone" is aware of the dangers of smoking, remember that 90% of all smokers begin before the age of 18. The average age at which smokers first start smoking is at 13 or 14. Hard to claim that these people made an informed decision to dive into a lifetime of addiction. It's complicated.

[Stan]

Why is it that so many people who against universal healthcare are baby boomers on Medicare?

[Mike]

"Nobody knew healthcare could be so complicated."

[Phoebe]

Agreed that it's counterproductive to focus on people's choices as a determination concerning whether they deserve health care. But again, that is why it's better to focus not on individuals and what they do or don't deserve or have a right or entitlement to, and instead focus on what outcomes, goals, and values you want for your society. If you want it to be a place where people's lives aren't curtailed or harmed by lack of health care, or where preventative medicine could have saved lives and expenses, then offer those things. Whether people choose correctly or incorrectly, or take advantage of the options or not, is irrelevant. That's freedom. But the government can still be organized around supplying what makes sense, given its resources, to best achieve certain functions. The language of rights and being deserving works at total cross-purposes to this. For every person who eats poorly, there's that smug know it all who wants to tell you how cheap bananas are. Great, how smart! Meanwhile, the outcome for the nation keeps happening no matter how smart all the banana buyers are, and how undeserving the stupid seem to him/her.