Should Healthcare be Considered a Human Right?

A common proclamation I hear among liberal politicians and occasionally in health policy lectures is that “healthcare is a human right.” It sounds righteous and true, but is it really so indisputable? In this essay, I’m going to explain why this view isn't quite as defensible as it may seem and argue why I think healthcare should ultimately not be considered a human right. My position is partly based on what I think of “healthcare,” but primarily based on what I think a human right should represent.

I’ll start by noting that a human right is purely a social concept, not a scientific one. No physicist or biologist is one day going to discover what truly defines a human right. Therefore, it must be defined by us, humans, ideally in such a way that it becomes useful in protecting human beings and resolving international political conflicts. Technically, this has already been attempted by the United Nations’ Universal Declaration of Human Rights (UDHR), which was first established in 1948, following the atrocities of World War II and the Holocaust. 

One could take the UDHR as the definitive definition of human rights and argue that I am clearly wrong since Article 25 states, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care…” However, I’m not denying that this sentiment exists in this document, rather I’m arguing why I think certain goods like healthcare should be excluded from this definition in order to make it a more effective political tool. After all, the UHDR is not legally binding and simply serves as an aspirational document. While the UDHR conceptualizes human rights as the entitlements, both material and immaterial, that we might want all humans to have, I view human rights as the basic requirements for preserving human dignity. 

There are three standards that I believe should apply to all human rights, including: 1) a human right should be consistent and coherent regardless of the time or place in human history; 2) humans rights should be limited to negative rights, which implies that they should be inherently free; and 3) a human right is the type of right that when violated in one nation, justifies people from another nation intervening on behalf of those whose rights have been violated. As I aim to show in the following paragraphs, healthcare does not meet any of these criteria.

Human rights are meant to apply to all humans, not just certain humans in certain times and places. If we were to travel back in time to visit our ancestors living on the plains of Africa and say, “you know, you guys have a human right to healthcare,” they would stare back at us dumbly, not just because we spoke a language that didn’t exist yet, but because healthcare is such a vague concept. Would this imply that humans had a right to care that was common back then, but we now know to be harmful, such as bloodletting? Even today, there is very little agreement within the medical community about what care is absolutely essential and when it should be delivered. Should I have the right to as many CT head scans as I want, even if I have no need for them and they end up giving me cancer? 

Say we could coherently define what healthcare is necessary, we are still left with the problem of inconsistency. Let’s say a new drug is developed today in the US that perfectly cures AIDS with no side effects. It seems odd to me to say that humans now have the right to be cured of AIDS, but anyone who lived before this moment did not have this right. Perhaps we can accept this, but what about people living in different places around the globe? If humans have a right to healthcare, then as soon as this cure is established, all humans must simultaneously have a right to access it. For what I hope are obvious reasons, this would be logistically impossible, which implies that this invention would not only create a cure, but billions of human rights violations at the same time!

Okay, maybe I’m being too literal, and what people really mean by “healthcare as a human right” is that people should be able to access care in a reasonable amount of time. However, this brings in a level of arbitrariness to human rights, which may undermine its effectiveness as a concept. Plus, what if this drug can only be delivered by a handful of physicians who have very specialized training? Most people will then have to wait a very long time to receive what is “rightfully” theirs and may even die in the process. Who would even be responsible for these human rights violations? 

Hopefully this has illustrated why a human right should be coherent and consistent across time. The next point is that human rights should be limited to negative rights, as opposed to positive rights. Negative rights give you the right to not have something actively taken away from you, such as the rights to not be murdered (life taken) and to not be enslaved (liberty taken). Positive rights entitle you to receive something, such as healthcare services, food, and education. To be clear, if the US or any other country wants to provide positive rights to its citizens, I would have no issue with this. In fact, I might even argue that countries should provide basic education and healthcare. However, national rights are a different conversation - at the human species level I think this becomes untenable. 

You may notice that negative rights have the inherent property that they are free. Whether I am the government or just an individual in society, it costs me nothing to not kill you and to not enslave you. In other words, I don’t have to do anything to preserve your (negative) human rights. However, if you have a positive right to something, say a drug, then this implies someone or some entity must give this to you and someone must bear that cost. If you pay the cost for your own drug, that’s like saying “your human right to this drug costs X dollars.” This is obviously inegalitarian - human rights should not have a price tag. But if we are to say that the providers of the care must bear the cost, then this also has unsettling implications. Forcing the physician to administer the drug free of charge would essentially be slavery - violating her human right to not work for free. Forcing the drug company to provide the drug for free would be theft, not to mention a great way to ensure no more life-enhancing drugs are ever produced again.

Wait, but if we don’t have a right to food and healthcare, won’t we just die? Don’t we have a right to do whatever is necessary to extend our lives? I would say yes, you should have the human right to freely pursue the procurement of whatever you need or want, so long as you do not violate anyone else’s rights. If I actively prevent you from obtaining food, that would be a human rights violation, but if I refuse to give you my food for free, that should be permissible. Another way to think about this is that human rights violations can only be acts of commission (actively doing something or intervening in some way), not acts of omission (choosing not to act or intervene). This is not to say acts of omission can’t be bad or frowned upon, just that they should not be folded into the outline of human rights. 

Another point I’ll add is that there are many things that extend and improve life, perhaps even more than healthcare, but we do not take seriously as human rights. For example, having a gym membership and full-time personal trainers and chefs at your disposal would be an incredible boon to your health and longevity, but it would be ridiculous to say that humans have a fundamental right to these things. Additionally, while we have the right to live freely, we do not have the right to live forever. That would be a right against nature, which is nonsense.

This brings me to my final argument: a human right is the type of right that when violated in one nation, justifies people from another nation intervening on behalf of those whose rights have been violated. This standard is admittedly more subjective, but gets at the idea that human rights should be constrained to protecting against more severe offenses. There’s a tradeoff between broadening the scope of what humans have a universal right to and limiting the doctrine to items that will be taken seriously by all peoples. If we say all humans have the right to robotic surgery, endless bread sticks from Olive Garden, and a Harvard education, then no one will care when these rights are violated. On the flip side, if we say your only human right is to not be murdered, then we will unnecessarily restrict the effectiveness of this concept.

For this reason, human rights should be limited to protections that are fundamental to preserving human dignity and recognized by at least a near consensus of all peoples. Examples include the right to not be enslaved or human trafficked. If the Taliban actively prevent women from pursuing healthcare services, then to me this represents a human rights violation worthy of external intervention. However, if the Taliban, like most countries, struggles to facilitate an efficient healthcare system where everyone can easily access the care they need, then this is merely par for the course. 

A full outline of human rights is beyond the scope of this essay, but I think the UDHR is a great starting point, and with some modifications it could become a more effective and enforceable document. There is nothing wrong with having an expansive list of all the things we wish for humans to have, but I think these should be characterized as human aspirations, not rights. Universal access to healthcare is an aspiration that we should work to achieve, but it is not a fundamental human right. I know I won’t win any popularity points for this argument, but I’m more interested in improving the human condition than stating platitudes.

My thoughts on this topic have been shaped by conversations I’ve had with many friends over the past year. One thing I’ve found interesting is how this question has served as a litmus test for where people stand on the ideologic spectrum from liberal / progressive to conservative. My conservative friends seem to accept my arguments almost full-stop, while my liberal friends are more eager to push back against the notion that healthcare is not a human right. Perhaps they are right – I’ve certainly learned a lot from their critiques. I’ve observed that liberals tend to think from the perspective that no one is more deserving of healthcare than anyone else. Meanwhile, conservatives recognize that nothing is free in this world, and especially not healthcare. There is some truth to both of these principles - the question is how we should harmonize them into a coherent and effective definition of human rights.