Monday, November 18, 2013

Healthcare Rights: A Conflict of Visions

In some of the most well-known words every written, Thomas Jefferson asserted that:

"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty, and the pursuit of happiness."

Jefferson never claimed originality for these words. He only claimed that they expressed the sentiments of British North Americans at the time they began their War for Independence. And he never explained exactly what they meant.

While most Americans today still share the sentiments expressed in Jefferson's timeless words, we often find ourselves divided over exactly what they mean for us today. This is especially evident in the ongoing controversy over the Affordable Care Act. This division at root a disagreement over the concept of rights.

Conservatives, when we speak about rights at all, usually establish our philosophical foundation for rights on human nature, whether this nature derives from God or simply natural processes. We see humans as possessors of life as a gift from God or nature that others may not take away. We see humans as possessors of natural liberty, or free will, that we enjoy the right to exercise without obstruction by others. And we see humans as possessors of the right to pursue happiness without interference by others. This last contention, of course, is a source of controversy in itself. Usually today we think of happiness as the psychological or emotional state that comes from acquiring whatever we happen to desire. Jefferson, however,  probably used it in its older,  traditional sense established by Aristotle over twenty centuries ago. When Aristotle wrote of happiness as the ultimate goal of human life (it is the only thing sought for itself and not for the sake of something else), he used the Greek word eudaimonia, which means thriving or flourishing. The pursuit of happiness, then, means the right of humans to seek those things which allow them to thrive or flourish, i.e., live the good life.

Notice two things. First, it is a pursuit. We possess the right to seek the good life and secure the basic natural rights of food, clothing, shelter, and even health care. But there are no guarantees. That is why  both obscure philosophers and popular self help gurus fill library and bookstore shelves with books on how to succeed or live the good life. Second, these basic rights (as well as many others that could be listed) exist as "claims" against others. We claim these rights and impose a negative duty on others to respect them. Our rights claims negate any efforts by others to take away those rights.That is why rights so conceived are sometimes called "negative claim rights."

Finally, conservatives see the Constitution as providing the legal framework for the exercise and protection of those rights. And when conflicts arise over rights claims, the laws seek to resolve those conflicting claims so that each party receive what is his due: justice.

Modern progressives begin with the same premises. They, too, see human beings as possessors of the rights to life, liberty, and the pursuit of happiness. They tend, however, to conceive of happiness in its modern sense of the psychological or emotional satisfaction of desires. (Each of us manifests the "progressive" inside of us each time we say with a shrug of the shoulders, "Whatever makes you happy.")

More important, they see rights as "positive claim rights." In other words, they see rights claims as imposing a positive duty on others to provide for those rights. In essence, according to progressives, rights claims by individuals exist as claims against society as a whole to act through public institutions to satisfy those claims.

This is why the debate about health care goes way beyond any utilitarian notion of  "what works best." Even if one could prove on paper or demonstrate in actual practice which approach to health care works best, the divide will remain.

It is a conflict of visions about the rights to life, liberty, and the pursuit of happiness.

1 comment:

CW said...

Absolutely superb post, V.L.!

You are spot on when it comes to defining the nature of this fight.