Though he’s reportedly “a staunch defender of Canada’s nonprofit, government-insured health care,” the premier of Newfoundland, a province in northeast Canada, recently chose to travel to Miami for heart surgery. Predictably, the choice of this wealthy Canadian public figure has not been wasted on opponents of the Obama faction’s effort to promote an eventual U.S. government takeover of health care. Canada’s system pretty much leaves people of modest means without access to insurance coverage adequate to purchase the best available care, but it preserves a preferential option for the rich. Americans prey to the temptation to adopt the Canadian model should take a deep breath and find a place to lie down until it goes away. That said I found myself mulling over a more fundamental question as I read Sandro Contenta’s GlobalPost report of this story. In it he notes that “in the U.S., health care is a commodity to be bought and sold for profit; in Canada, it’s considered a human right.” Though the phrase smacks of high-minded idealism, it begs a question. In what sense can health care be considered a “human right”?
The phrase implies that health care involves an intrinsic (unalienable) responsibility of the human condition such that when individuals act to fulfill that responsibility they are in the right. Others cannot interfere with or hinder them without acting against what is right. In light of this understanding of the term, Newfoundland Premier Danny Williams simply and properly asserted his human right to health care when he answered Canadian critics of his medical visit to Florida: “This was my heart, my choice and my health. … I did not sign away my right to get the best possible health care for myself when I entered politics.”
Because in the first instance every human right arises from an individual responsibility, it is primarily the individual who must answer for the choice involved in fulfilling the responsibility. The exercise of right thus necessarily includes the freedom to decide the course of action consistent with what is right. It is of course not reasonable to hold individuals responsible for taking actions that lie beyond their means. But when they have the means and rightly seek to make the best possible use of them as they fulfill an intrinsic human obligation, those who interfere with or hinder such use violate the basic human (unalienable) right it serves.
As I have elsewhere observed, the idea of health insurance originally appears as a way to allow people with limited financial resources to maximize their access to health-care services they could not otherwise afford. Under the Canadian system of public insurance, private individuals of modest means are deprived of the choice to purchase a health-insurance option that offers what they judge to be access to better health care than the insurance their government offers. Far from respecting health care as a “human right,” this forcible imposition of a government monopoly a) interferes with the individual liberty inherently connected to each and every human right; b) establishes an invidious distinction between people of independent financial means and those whose more limited resources force them to rely on the government monopoly. This violates the essential premise that all human beings are equal in the possession of human rights, and of the liberty arising in connection with them; and c) imposes involuntary servitude on health workers forced to offer their services on terms dictated by the government.
The last point draws our attention to the essential contradiction of right involved in the notion that, outside the context of the natural family, one human being can have a human (unalienable, intrinsic to humanity) right to enjoy goods or services that require the labor of another. The purpose of government is to secure unalienable rights. When one person hinders or otherwise violates the right of another, the use of force to defend the right is a just exercise of government power. So if one person’s right entitles them to another person’s labor, the forceful imposition of slavery must be counted among the just powers of government. Slavery, however, involves the extinction of liberty. Liberty is an unalienable right, which directly gives rise to the basic premise of governmental legitimacy that government derives its just powers from the consent (i.e., exercise of liberty) of the governed. A use of government power that extinguishes liberty necessarily departs from this premise of legitimacy, and is therefore unjust. A human right that involves the compulsory provision of goods or services (whether by health workers or anyone else) would therefore require wrongdoing. But a human right so defined as to involve doing wrong cuts away the ground of its own existence. It is no right at all.
Of course, this reasoning makes sense only when human rights are defined in connection with the intrinsic individual responsibilities of human nature. Thus defined, they are not collective rights because human beings naturally exist as distinct individual persons. Most of the positive sentiments associated with the concept of human rights arise in connection with the reassurance of individual identity and dignity connected with provisions that guard against government abuse of individuals. When the phrase is used in connection with government programs that supposedly guarantee material outcomes, however, these positive feelings are being invoked for rhetorical purposes to cloak the use of government’s forceful power without regard for individual claims of right. This use is part of a trans-valuation of values (as Nietzsche termed it) that literally stands the concept on its head, in order to define human dignity in a way that justifies the abuse of individuals so long as it plausibly claims to serve the collective welfare. This is the change the Obama faction really stands for, and it’s what the health-care fight is really all about.