Question of the Day – Healthcare Edition

Is is possible to make a coherent argument that government-provided healthcare is a moral obligation but that our obligation doesn’t extend to people in Zambia? I don’t think it is but I’m willing to listen to the arguments.” – Dave Schuler

It’s possible to make a practical argument along those lines, as well as to argue that the scope of the moral obligation of the U.S. government only extends to our borders.  But if healthcare is a human right, it’s a universal one.

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James Joyner
About James Joyner
James Joyner is a Security Studies professor at Marine Corps University's Command and Staff College and a nonresident senior fellow at the Scowcroft Center for Strategy and Security at the Atlantic Council. He's a former Army officer and Desert Storm vet. Views expressed here are his own. Follow James on Twitter @DrJJoyner.

Comments

  1. Triumph says:

    But if healthcare is a human right, it’s a universal one.

    We must stop this expansion of “rights” discourse. If we give people health care, the next thing we know they will want gay marriage, then marriage between humans and animals, and all sorts of abominations.

    If anything, the problem in this country has been the expansion of rights. We need to take seriously the “original intent” approach to the Constitution so eloquently promoted by Justice Scalia and go back to our original 1787-era rights. That’s the only way to insure that we’re free.

    This liberal “rightsism” has gotten way out of hand.

  2. yetanotherjohn says:

    So should we string up those great traitors to human rights Jimmy Carter and Bubba Clinton, who violated all our human rights by not providing us with government sponsored health care? And don’t give me any excuses about why they trampled our human rights, you know they are guilty.

  3. The question, if not the answers reflect a breakdown in the connection between responsibility and authority. Are we to be responsible for the health care of the people of Zambia if we have no commensurate authority over them? And by authority I mean the rule of law, taxation, etc. That is all.

    We need a different word for these privileges handed down by men which are necessarily different from the inalienable rights spoken of by Jefferson as being endowed by our creator, whatever you happen to believe vis-a-vis the nature of said creator. It seems too often forgotten that governments cannot bestow rights, but only intrude upon them, just as any right granted by men can be adversely amended or revoked by men just as easily. I suppose I’d mention limited or enumerated powers and the constitution, but that just seems so passe these days.

    Going back to the question of responsibility and authority for a moment, unless you are planning on assuming the responsibility of the creator, I don’t think you should be trying to take on the authority over anyone’s inalienable rights. Now, of course, some people are more than willing to take on the responsibility and the authority of the creator, but these people need to be watched carefully and given control of nothing more important than what beverage will be served with lunch.

  4. odograph says:

    “Is is possible to make a coherent argument that government-provided healthcare is a moral obligation but that our obligation doesn’t extend to people in Zambia? I don’t think it is but I’m willing to listen to the arguments.” – Dave Schuler

    Of course there is a coherent argument: that our moral obligations are commonly partial, and only so rarely (in the case of Saints) absolute.

    We are not all of us Gandhis or Mother Teresas. We don’t expect it of ourselves, nor of each other. We’re very pleased in fact, when we find just one or two.

    I think it’s a simple reality that we do ask ourselves, and each other, to do “enough.”

    … and “enough” is a fuzzy thing. Fixing our healthcare might be enough, for now, with Zambia hopefully someday in our future.

  5. odograph says:

    (Note: my answer depends on there being a “human nature.” Something I think is true.)

  6. Dave Schuler says:

    odograph, I think you’re describing a good deed rather than an obligation. I agree that providing healthcare for the poor is a good deed. The question is whether it’s an obligation.

    I’m no saint but I do honor my obligations to the best of my ability. That’s why I undertake so few of them.

  7. kth says:

    Charles, you actually hit the nail on the head. If health care is a right, it is incumbent upon the government of Zambia to respect that right, and any failure thereof redounds to that government and nowhere else. My commitment to free speech in America isn’t compromised if Zambia fails to uphold that right.

    So if some kind of in-for-a-penny reductio is being argued that support of a public option in America commits one to pay for hip replacements in countries where the per capita GDP is like ten dollars a day–not saying anyone here is actually making that argument, but if anyone is–please, save it.

    Just for the record, I don’t consider health care a right, but I also consider the protection of negative liberties a very small and narrow portion of what government ought to do.

  8. Davebo says:

    Or freedom of speech?

    Or freedom of religion?

    Truly silly question.

  9. Dave Schuler says:

    If it’s a silly question, then I’m in good company in asking it. John Milton wrote in defense of freedom of speech as did Jefferson and Madison.

  10. odograph says:

    I’m not sure Dave, but I think you might be restating what I observe in human nature. You don’t feel an obligation. Right. Why not?

    It would be good, but it is beyond our expectation, for ourselves and for others. That’s human nature.

    In western cultures, at least, we expect individuals to keep the majority of their bounty, and count as generous people to give a “significant minority.”

  11. odograph says:

    Oh, and of course we expect in-tribe welfare to be more of an “obligation” than out-group welfare.

  12. rodney dill says:

    If it’s a silly question, then I’m in good company in asking it. John Milton wrote in defense of freedom of speech as did Jefferson and Madison.

    Hmmm… I didn’t read in that DaveBo was against freedom of speech, rather how do we enforceprovide it to the rest of the world (e.g. Iran). Same with women’s rights. We can’t even feed the rest of the world without thugs in other countries trying to divert food and money.
    Of course, just because its difficult is not necessarily a good argument against an obligation. I think the recipients have an obligation to fairly accept any help offered. I don’t see that happening for anything other than the offer of a blank checkbook.

  13. Drew says:

    LOL

    Thanks for your usual amorphous point, odo.

    Look, you have no right to my property. However, you may properly request that I contribute a portion of it for the better community good, and in turn for the benefit of myself to the degree that the community good is my own as well.

    Private charity has recognized this for centuries.

    Amazing that our current President wants to make new tax policy such that incentives to contribute privately are diminished. But he’s not showing himself to be the sharpest knife now that he’s under the bright lights of the office……..now is he?

  14. Steve Verdon says:

    Freedom of speech and religion require nothing of others other than that they don’t try to stop you from practicing those freedoms.

    Health care as a right requires more for everyone than mere non-interference. I have to provide it for those who cannot provide it for themselves. To do this means that they take some of my time–i.e. my life. In short, I become a sort of slave to them. And of course, if I decide not to do anything to provide my own health care then I am demanding that others provide me with part of their life, that they work for my benefit for at least part of the time.

    And why stop there? Why not food, shelter, and clothing?

    Funny how we don’t usually declare private goods to be rights.

  15. sam says:

    Is is possible to make a coherent argument that government-provided healthcare is a moral obligation but that our obligation doesn’t extend to people in Zambia?

    I think you could. It would go something like this. If I am under an obligation to do X (a duty to do X), then I am under an obligation to do the optimum amount of X that I can (‘ought’ implies ‘can’). I’m further under an obligation to not engage in a course of action that would prevent me doing the optimum amount of X that I can. If government-provided health care is a moral obligation, then the government is obligated to provide the optimum amount it can. However, if attempting to extend that health care to Zambians would result in the government not being able to provide the optimum it can, the government is not obligated to extend health care to the Zambians.

    This strikes me as a conservative argument, BTW.

  16. odograph says:

    Thank you for your narrow and non-reflective response, Drew.

    The answer you just gave is politically correct for a certain segment of a certain population in a certain country at a certain point in time.

    That is, you gave me a American Conservative position circa 2009.

    (Your point that private charities have existed for centuries is a small step. Now put it context of “sharing rules” for hunter-gatherer societies a million years older. Or even for non-western societies in the same recent timeframe.)

  17. Steve Verdon says:

    Nice try sam, but there are (at least) two optima in your attempt. The first optimum is when you are constrained to just the U.S., the second optimum is when there is no such constraint. Your argument fails because you assume there is a unique optimal point, when there is no reason to believe the uniqueness of the solution.

  18. odograph says:

    And yet you do all those same things Steve, for the good of Public Education.

    (Man, it’s funny how persistent this blind eye to the education-health parallel can be.

    Certainly it is not proven to the majority of Americans that basic health care is a “right” in the same way that basic education is …

    but if society evolved to accept one, to the extent of even forgetting that it’s there, then it seems possible that health care could take the same path.)

  19. rodney dill says:

    Freedom of speech and religion require nothing of others other than that they don’t try to stop you from practicing those freedoms.

    Really? I’ve never heard of such a thing. I’m sure those protesting in Iran will be happy do know they’ve been doing it wrong. They can just be free without having someone help them with a regime change. I wonder what the people at Tiananmen Square did wrong. Once you’re ‘obligated’ to help people where do you stop. Why isn’t setting them free and obligation?

  20. Steve Verdon says:

    Actually no Odograph, Drew’s position is actually hundreds of years old and can be traced back to the origination of Natural Rights. His view was, initially known as the (classical) liberal view point.

    Your hunter-gather aside is too obtuse for me to figure out.

    Oh, and he is merely responding to your attempt to turn the question around and ask why we shouldn’t provide health care to others outside the U.S. If you didn’t want him to venture an answer, then don’t ask the questions.

    And yet you do all those same things Steve, for the good of Public Education.

    Yes, it does, doesn’t make it right. People do lots of things that many might have moral objecitons too. This should be obvious.

    Man, it’s funny how persistent this blind eye to the education-health parallel can be.

    Let me see…one is private good, the other is a private good with positive externalities…geez lets turn a blind eye to that yeah that’s brilliant.

    Certainly it is not proven to the majority of Americans that basic health care is a “right” in the same way that basic education is …

    I wouldn’t say public education is a right, I wouldn’t even say most people would think this way.

  21. DavidL says:

    Healthcare is not a right, but rather a commodity. That is a product of human endeavor. For the state to give healthcare to one person, it must first must take it from another.

    Food, water,shelter, bodily warmth and medical care are all essential commodies of life. So by what devine guidance can the one determine which of these commodities magically become rights? Film at Eleven.

  22. G.A.Phillips says:

    (Your point that private charities have existed for centuries is a small step. Now put it context of “sharing rules” for hunter-gatherer societies a million years older. Or even for non-western societies in the same recent timeframe.)

    lol…….

  23. Steve Verdon says:

    Really? I’ve never heard of such a thing. I’m sure those protesting in Iran will be happy do know they’ve been doing it wrong.

    You are misreading what I wrote. Let me try again.

    For there to be freedom of speech all that is necessary is that others do not interfere with people exercising that right. This is not the case in Iran, therefore they don’t have freedom of speech. Pretty simple.

    They can just be free without having someone help them with a regime change. I wonder what the people at Tiananmen Square did wrong. Once you’re ‘obligated’ to help people where do you stop. Why isn’t setting them free and obligation?

    Uhhhmmmm…hrrrmmm. Are you saying we should invade Iran and should have invaded China back during Tiananmen…heck that we should invade now?

    I’m thinking one of us missed something.

    Please, tell me what I need from you to have freedom of speech. What must you do so that I am free to say what I want? I contend that all you have to do is nothing–i.e. you don’t try to shut me up. If there is something else that is required from you, please elaborate.

  24. odograph says:

    I guess you guys want to miss my point.

    I observe that it is universal in cultures that the successful are allowed and expected to keep the majority of their winnings.

    That actually argues in favor of low taxation, or at least minority taxation.

    Where you got this, I don’t know:

    “Oh, and he is merely responding to your attempt to turn the question around and ask why we shouldn’t provide health care to others outside the U.S. If you didn’t want him to venture an answer, then don’t ask the questions.”

    Huh? Don’t we send aid to Africa now? We just do it, as we would expect from human nature, in smaller proportion to (a) what we do for our own nation, and (b) what we keep for ourselves.

    On this:

    Man, it’s funny how persistent this blind eye to the education-health parallel can be

    .

    Let me see…one is private good, the other is a private good with positive externalities…geez lets turn a blind eye to that yeah that’s brilliant.

    I know enough to know when you lie to me. Public good arguments can certainly be made for both health and education.

    It’s why we’ve had health departments, going on centuries.

  25. Steve Verdon says:

    Huh? Don’t we send aid to Africa now? We just do it, as we would expect from human nature, in smaller proportion to (a) what we do for our own nation, and (b) what we keep for ourselves.

    Again, the fact that we do it doesn’t make it right. Or more accurately, it doesn’t make the way it is done right. If a people got together and wanted to give to people in Africa that is hardly objectionable. If you use coercion to have people give to people in Africa it becomes less morally clear, IMO.

    I know enough to know when you lie to me. Public good arguments can certainly be made for both health and education.

    Really, I’m lying? Pray tell where in any of my comments here I’ve used the word public good? Especially in relation to health care of education?

    And just out of curiousity, please explain to the viewing audience exactly how my make a public good argument for health care. I’d love to see it. Pleae note I said public good as you claimed, so don’t provide the positive externality argument.

    It’s why we’ve had health departments, going on centuries.

    FFS. No, we have health departments because there are aspects of health care that are positive externalities. If you inoculate 50% of the population, you reduce the risk of the un-inoculated portion of catching the disease because now there are going to be fewer carriers. The higher the percentage of inoculation, the lower the risk.

  26. odograph says:

    Let me get this straight, your fall-back positions are:

    1) a sloppy argument that since Bush’s AIDS plan was based on taxes (coercion) it was a greater evil than no AIDS treatment. “Morally unclear, LOL”

    2) if we provided health care for the poor, it would only yield “positive externalities” and not “public goods”

    I do think that “health” passes the bar as a “good that is non-rivaled and non-excludable.” Not only that, to the extent that bad health is contagious, so the spread of “health” not only does “not reduce availability of the good for consumption by others” it assists the spread of health … in that positive externality.

    … but geez, your fall-back is actually semantic?

    LOL, you yielded the positive externality to me, and still think you have an argument that health is so unlike education?

  27. Drew says:

    Odo –

    Your cover has been blown for months. Every time you are challenged to articulate an argument you revert to “the commentator is a narrow political partisan, therefore his position is incorrect.”

    Please, try for once a direct and analytical response.

    You truly bore these days, odo.

  28. rodney dill says:

    Uhhhmmmm…hrrrmmm. Are you saying we should invade Iran and should have invaded China back during Tiananmen…heck that we should invade now?

    I’m saying that the “obligation” to help everyone in all situations (healthcare is just one aspect)
    could lead to that line of thinking. I don’t particularly think that it would be a good idea, or even feasible.

    For there to be freedom of speech all that is necessary is that others do not interfere with people exercising that right. This is not the case in Iran, therefore they don’t have freedom of speech. Pretty simple.

    Pretty simple when only two parties are involved. In Iran their’s the gov’t, Presumably anti-free speech. The people, at least some of which are pro-free speech. When you add us, or other countries that feel ‘freedom of speech’ is a univeral human right, you have someone that may feel obligated to overthrow the Iran gov’t.

    In reading the post I responded to, I find myself pretty much agreeing with the rest of what you said concerning healthcare, etc.. I just think it also applies to freedom of speech and freedom of religion.

  29. Tlaloc says:

    “Is is possible to make a coherent argument that government-provided healthcare is a moral obligation but that our obligation doesn’t extend to people in Zambia? I don’t think it is but I’m willing to listen to the arguments.” – Dave Schuler

    Um, WTH? Was that a serious argument, Dave, cause it makes no sense. Our government is obligated to maintain the rule of law in the US but not in Zambia, why? Because its our government and not the Zambian government. I think that should be ridiculously obvious.

    We have the UN to try and attend to those issues where a state is failing to attend to the basic human rights of its own people (or threatening those of a neighbor). It’s not the place of a country, even a “superpower” to impose on another by fiat.

    I’m having trouble believing your initial statement was serious because you aren’t a dumb guy but if taken literally it was a very dumb thing to say.

  30. Davebo says:

    I’m having trouble believing your initial statement was serious because you aren’t a dumb guy but if taken literally it was a very dumb thing to say.

    Let me help you out here.

    I’ve reached a conclusion and now I’m looking for arguments to support it.

    And honestly, in this area Dave is a piker compared to Verdon.

  31. Steve Verdon says:

    1) a sloppy argument that since Bush’s AIDS plan was based on taxes (coercion) it was a greater evil than no AIDS treatment. “Morally unclear, LOL”

    First, if you are going to quote me please do so accurately, or to put it more succintly, don’t be a tw@t.

    Second, yes, it is not so morally clear. Its easy when you have a gun to donate somebody else’s money to a cause. That the cause is good, doesn’t make the initially morally questionable act less questionable.

    2) if we provided health care for the poor, it would only yield “positive externalities” and not “public goods”

    So you can’t provide the public goods argument. Figures.

    Actually, no there is no public good aspect to providing health care to the poor. In fact, if you provide a heart transplant to poor Mr. Smith you can’t do a transplant for rich Mr. Johnson because its a private good.

    Now providing some health care for the poor could have positive external benefits.

    I do think that “health” passes the bar as a “good that is non-rivaled and non-excludable.”

    That you think it is not enough. The problem is that if you take that heart in the example above…once it’s in Smith it provides no benefit to Johnson. Hence it fails the definition. Really, I think you need to learn what the words “non-rival” and “non-excludable” mean. Once the heart is in Smith, Johnson is by definition excluded from using it.

    Jesus, can’t believe I had to write that.

    LOL, you yielded the positive externality to me, and still think you have an argument that health is so unlike education?

    Some health care has positive external benefits. Some.

  32. Steve Verdon says:

    Let me help you out here.

    I’ve reached a conclusion and now I’m looking for arguments to support it.

    And honestly, in this area Dave is a piker compared to Verdon.

    U mad Davebo?

  33. Zelsdorf Ragshaft III says:

    Rights apply to things you get yourself. Either you already have them, as in “endowed by a creator” or you have earned them as in becoming legally age which carries with it certain rights. The right to vote for instance. However there is no right to a service which must be supplied by another.

  34. steve says:

    Not to go all meta, but those things we view as rights have changed over time. I am not really sure you can even claim people had rights under the older pure monarchies. That which is not a right now, may well be in the future. Also, we occasionally subjugate some rights to others or temporarily suspend rights. You are not allowed to yell fire for no reason in a crowded theater.

    If you believe that life is one of our basic rights, it is not a stretch to conclude that at least life saving medical care is a right. Indeed throughout history caring for the ill, the deathly ill has generally been seen as a societal obligation. Can this interfere with the right to liberty? Yes, but we already know that we need to balance rights. So the debate could be about how to balance those rights, not necessarily denying that one is not a right.

    As for Zambia, what Americans see as a right may not be sen as such in other countries. Do we have the right to impose our views on others? I would think that as long as that other country is not limiting our rights, no. One could make the case that we have an obligation to reach out to others in dialogue to try to convince them of the rightness of our views.

    Drew-Might you be one of the very few to have ever finished reading Leviathan?

    Steve

  35. Franklin says:

    It’s an interesting question, and I hardly think it’s as silly as some posters make it out to be.

    Many people feel that our government should promote democracy, freedom, and capitalism around the world. Are each of these inalienable and/or human rights?

    Civilization is an evolution of individualism. At some point in my lifetime, I predict that decent basic healthcare will be provided to every American (and I also expect pay for it some form or another). It’s just more civilized. I just hope it is done right.

  36. yetanotherjohn says:

    I was obviously to subtle in my argument above.

    If you say it is a human right (of whatever geographic scope), then when did this occur or has it occurred? Has this been a human right since the dawn of time (e.g. life, liberty and the pursuit of happiness) or has the right come into being some time later? Can there be a right to something that has never existed? I don’t think so.

    If the right comes in to being later, please fix the point that government funded health care became a human right in the US. I don’t think you will be able to do so. If you can fix the point and given that it doesn’t exist, then don’t we citizens have a case against our leaders for violating our human rights (aka not providing us with government funded health care)?

    If it hasn’t become a human right in the US yet, then how could it possibly devolve on the US to provide world wide government funded health care?

  37. Joe R. says:

    I think it’s a simple reality that we do ask ourselves, and each other, to do “enough.”

    I have no problems if you ask. The problem is that you’re never asking, you’re telling. The distinction between the two seems to be lost on you.

  38. odograph says:

    Talk about pot, kettle, black:

    Odo –

    Your cover has been blown for months. Every time you are challenged to articulate an argument you revert to “the commentator is a narrow political partisan, therefore his position is incorrect.”

    Please, try for once a direct and analytical response.

    You truly bore these days, odo.

    Not only was your response “zero content”, it it doesn’t even show you grasping the concept, that human cultures (human nature) divide between what Dave calls an “obligation” and what he does not.

  39. odograph says:

    1) a sloppy argument that since Bush’s AIDS plan was based on taxes (coercion) it was a greater evil than no AIDS treatment. “Morally unclear, LOL”

    First, if you are going to quote me please do so accurately, or to put it more succintly, don’t be a tw@t.

    Second, yes, it is not so morally clear. Its easy when you have a gun to donate somebody else’s money to a cause. That the cause is good, doesn’t make the initially morally questionable act less questionable.

    If you sign onto it, it must be accurate enough … talk about high school libertarianism.

    Here’s the reality of that: Programs like this are chump change. The story here is about our human nature and our small allocation to the Africans.

    The story is that not only do we think it’s appropriate … most Africans think it’s appropriate.

    They are grateful that we spend a very small minority of our taxes (more than adequately democratically determined taxes, high school “coercion” arguments aside).

    Talk about dishonesty … on the rest you first claim I didn’t make the Public Goods argument, and then you respond to it? In a highly chopped hack job?

    Sober and or grow up.

  40. odograph says:

    I think it’s a simple reality that we do ask ourselves, and each other, to do “enough.”

    I have no problems if you ask. The problem is that you’re never asking, you’re telling. The distinction between the two seems to be lost on you.

    The problem with you imbeciles is that I don’t make that argument, and yet you still see it hiding behind every bush.

  41. Fog says:

    “Healthcare is not a right, but rather a commodity. That is a product of human endeavor. For the state to give healthcare to one person, it must first must take it from another.”
    Healthcare is a zero-sum game? Really?
    I would love to see some fundamentalist libertarians go live in countries that have practices more in line with their beliefs. Like Somalia.
    “Taxes are a fee we pay to live in a civilized country.” -Somebody smarter than I

  42. Hangtown Bob says:

    No “human right” can exist that REQUIRES the labor of others. If you believe otherwise, then you are a proponent of SLAVERY.