Blog by Joe Babaian
Health care is a right, not a privilege. ~ Edward Kennedy
I think it’s probably more of a privilege. ~ Sen. Ron Johnson (when asked by a high school student whether he considered health care a right.)
I am dedicating this week’s #HCLDR to the survivors of the Las Vegas attack as they begin to navigate their “rights” to peace, happiness, and healthcare services. This can’t be the new normal.
A recent chat with Megan Janas reminded me of Atul Gawande’s piece in the New Yorker, “Is Health Care A Right?” Things coming together as they do, with so many interesting topics, I was certain this was the week to look at the elephant in the room. We all work toward both disruptive and sustaining innovation, changing and creating healthcare in ways we’re passionate about, and connecting with others who feel the same. We are #healthIT pros, marketing ninjas, clinical magicians, nursing wonders, patient voices, and everything in between. With all of this in mind, we sometimes pause to consider the basics, even when we don’t have an easy answer.
That’s the mark of leadership – tackling subjects that are not easy but can be discussed and worked on together without animus or anger. That’s what you all do best at #HCLDR – you jump in and bring unbelievable access, knowledge, and skill to bear every day.
Healthcare as a right. The very statement causes the flight or fight response for many. How can something so essential to everyone be so controversial? Well, let’s not look at this from the point of view of the controversy, let’s flip the topic and come at things from a different lens. As it happens, Atul’s piece in the The New Yorker looks for, and arguably finds, middle ground on the question of “Is Health Care A Right?”
Atul references Oxford’s Henry Shue to allow us the opportunity to consider that we may be looking at rights in an incomplete way:
The Oxford political philosopher Henry Shue observed that our typical way of looking at rights is incomplete. People are used to thinking of rights as moral trump cards, near-absolute requirements that all of us can demand. But, Shue argued, rights are as much about our duties as about our freedoms. Even the basic right to physical security—to be free of threats or harm—has no meaning without a vast system of police departments, courts, and prisons, a system that requires extracting large amounts of money and effort from others. Once costs and mechanisms of implementation enter the picture, things get complicated. Trade-offs now have to be considered. And saying that something is a basic right starts to seem the equivalent of saying only, “It is very, very important.”
Should we all be looking at rights in a more nuanced way? An understanding of the balance inherent in most of the rights we hold dear? Atul’s friend Arnold Jonas shares a line of thought that really provides the basis for a middle ground if we allow it. When asked if he felt that he has a right to health care, Arnold’s view is unique:
So did he [Arnold] feel that he had a right to health care? No. “I never thought about it as a matter of rights,” he said. “A lot of these things we think are rights, we actually end up paying for.” He thinks that the left typically plays down the reality of the costs, which drives him crazy. But the right typically plays down the reality of the needs, which drives him crazy, too.
“I think the goal should be security,” he said of health care. “Not just financial security but mental security—knowing that, no matter how bad things get, this shouldn’t be what you worry about. We don’t worry about the Fire Department, or the police. We don’t worry about the roads we travel on. And it’s not, like, ‘Here’s the traffic lane for the ones who did well and saved money, and you poor people, you have to drive over here.’ ” He went on, “Somebody I know said to me, ‘If we give everybody health care, it’ll be abused.’ I told her that’s a risk we take. The roads are abused. A lot of things are abused. It’s part of the deal.”
I won’t summarize the entire article, instead, I’m going to leave you to read Atul’s article on your own – it’s worth your time. That in mind, these snippets go a long way towards providing the framework for something other than an “us vs them” answer to the question, “Is Health Care A Right?” Some questions are not simply answered yes or no but require the nuance that provides for so much of what we hold dear.
Let’s jump in! I have provided some background recourses to look at, but this discussion is about you and what YOU bring to the topic. Each step we make together advances our mutual mission and vision for healthcare.
#HCLDR operational note: be on the lookout for our special topic and guests next week – the good people from OpenNotes, including #HCLDR peer Liz Salmi, will be hosting as we discuss “Transparency in Healthcare” – Tuesday, October 10th, 8:30pm Eastern. Do join us! Blog out soon.
Please join the #hcldr community of friends and peers as we work to make a difference, one idea and one action at a time. Join us on Tuesday, October 3, 2017, at 8:30pm Eastern (for your local time click here) as we discuss the following topics:
- T1: What are the limits of “basic rights” and does healthcare reside firmly in this realm? Why or why not?
- T2: What is your definition of healthcare for everyone? What limits do you see as necessary to preserve the system?
- T3: Given resources that are always limited, how would you like to see these allocated to healthcare for everyone vs. other societal needs?
- T4: How can we as empathic and wise leaders create a system that creates security when it comes to health and healthcare?
Resources for Further Study
Farmer, Paul. “Health Is A Human Right.” NPR.org, December 21, 2008. http://www.npr.org/2008/12/21/98460202/health-is-a-human-right.
Fink, Sheri. “Atul Gawande’s ‘Being Mortal.’” The New York Times, November 6, 2014, sec. Sunday Book Review. https://www.nytimes.com/2014/11/09/books/review/atul-gawande-being-mortal-review.html.
Gawande, Atul. “Is Health Care a Right?” The New Yorker, September 25, 2017. https://www.newyorker.com/magazine/2017/10/02/is-health-care-a-right.
Geiling, Natasha. “Republican Senator Calls Health Care, Food, and Shelter a ‘privilege’ – ThinkProgress,” October 1, 2017. https://thinkprogress.org/ron-johnson-health-care-a-privilege-1d9fe371b55a/.
Goozner, Merrill. “Our Latest Editorial Asks the Question: Is Healthcare a Right?,” December 31, 2016. http://www.modernhealthcare.com/article/20161231/MAGAZINE/312319985.
Kliff, Sarah. “Is Health Care a Right? What Ohio and Kentucky Teach Us. – Vox,” September 29, 2017. https://www.vox.com/policy-and-politics/2017/9/29/16387380/health-care-right-ohio-kentucky-atul-gawande.
Napolitano, Andrew P. “Is Health Care a Right or a Good? | Fox News,” March 30, 2017. http://www.foxnews.com/opinion/2017/03/30/is-health-care-right-or-good.html.
“Should All Americans Have the Right (Be Entitled) to Health Care? – Right to Health Care – ProCon.org,” February 23, 2017. https://healthcare.procon.org/view.answers.php?questionID=001602.
Stern, Mark Joseph, and Perry Grossman. “Americans Now View Health Care as a Right. Republicans Can’t Change That.,” May 5, 2017. http://www.slate.com/blogs/outward/2017/05/05/americans_now_view_health_care_as_a_right_republicans_can_t_change_that.html.
Photo Credit: https://imgur.com/a/RKV5g