Hey Chad, thanks for the article Healthcare is Not a Human Right. Here’s my response: Dead to Rights.
Hope you’re doing swell — looking forward to reading some of your film thoughts very soon. Did you see the Bandersnatch piece by one of our new authors?
As I haven’t left a substantive comment on someone else’s blog in many, many years now, I suppose it’s time to do so since the urge takes me to respond to your article on why healthcare is not a right — I find promptings like this helpful at least for my personal process: sometimes the logical mind needs a romantic, emotional impetus to shoulder the burden of initiation and inception. And since the length of this comment grew to what I am sure is beyond the wordcount limit of your comment field, I’m posting the whole thing on Showbears and dropping this first paragraph in your comment field. Afraid I need to appeal to Pascal again: apologies for the length of the comment, I didn’t have time to write a short one.
I can see from your external data points on this particular post that it has hit some sort of nerve (compared to others you’ve written of late), but since I’ve been off social media for two-going-on-three years now, I remain ignorant as to the substance, span, and slander of the debate it appears to have engendered based on those numbers alone. There’s a benefit to that kind of ignorance, I suppose: I feel neither the need to progress away from previous commenters towards new mistakes nor to conserve their mistakes. I may explore any territory I please, which I find fascinating considering the low-effort voting system that Facebook engenders when compared to my high effort election to slowly and carefully craft this commentary as a letter to a friend within a Word Document.
Coming from one metaphysical jester to another, I’m sure some of the snark and polemics in your post fired someone up. My guess is Jordan. Perhaps a diabetic or two (I doubt my own Tara would have remained silent for this had she read it). Perhaps someone out of left field that suddenly found themself thriving (instead of merely surviving) due to the ban on former corporate and bureaucratic rejections and abstinences of any medical justice and righteousness and grace offered to those with pre-existing conditions. Speaking autobiographically: my bride would literally be dead by now. That’s neither a joke nor hyperbole, just a fact of our lives. Admitted bias and affinity, for sure.
But it’s also a data point, which is instructive. Seems brutal to reduce my bride’s near-death to a statistic, but Tara’s remains an individual’s microcosmic representative sample of our less-broken-than-before system, particularly in New York where, at least in terms of healthcare, we remain landlocked on the island. Well cared for… as long as we still sing Camelot’s anthem.
Be that as it may there’s certainly the personal going on, but of course — as you and I know — the personal is first and foremost a first-person experience of the universal.
You started your article on “rights” by quoting G.K. Chesterton:
What is the good of words if they aren’t important enough to quarrel over?
But to appeal from Chesterton to Chesterton, I’ll quote him twice over:
I hate a quarrel because it always ends a good argument. People generally quarrel because they cannot argue. And it is extraordinary to notice how few people in the modern world can argue. This is why there are so many quarrels, breaking out again and again, and never coming to any natural end.
That in mind:
It’s only worth thinking of something if you think it through.
All GK, all day baby. Fire with fire.
And so I think it helpful to come at this by defining our terms a little tighter that in your post, all due respect, to get into the history and nature of a “right,” and then to come at this again and see if we can get going a step in the right direction.
For even that phrase, a step in the right direction, gets us moving down the concept of trajectory, which I suppose is one way of thinking about rights: aiming towards the “ought.” All law, after all, is predicated on morality. We say you can’t legislate morality and that’s true, but all legislation borrows from warring moralities. That said, I inherently reject the terms “negative” and “positive” rights, unless by “negative” you mean merely “apophatic” and by “positive” you mean merely “affirmative” or “analogical,” in which case your categories are so broad that you might find yourself, in the end, dead to rights.
I much prefer Paul’s definition:
“Everything is permissible (legal), but not everything is beneficial. Everything is permissible (or legal), but not all things build up. Do not seek your own advantage, but that of others.”
Most people focus on this so often as a cultural or historical text regarding tact or personal piety, that they miss the broader context when it comes to civic virtue, civic ethics, or morality. As I’m sure you know, the Epicureans withdrew from society in order to eat and drink and be merry. I have some family like that: they’ve wholly grown derelict in their duty to improve upon the culture and its mores that they may eat, drink, be merry and die alone. “Make no trouble and no trouble will come to you,” says the Shire. Of course until the global problems reach the local experience and the Shire burns…
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But the Stoics, as I know you know, advocated for participation in civic life. Diogenes thought the wise man well met for civic life because, overall, he’s more excellent. And Stobaeus thought the rationality of a wise man made him — by default — suitable as a ruler. Now I actually think that a voice like Boethius or even Augustine might take umbrage with the old Stoic definition of wise (and, in my inexpert and unmastered lay opinion, Boethius has the better idea when compared to the house of Hippo), but nevertheless the presence of a virtue list and the absence of a vice list within a given person testified to the Stoic the culmination of the totality of wisdom. The culmination of wisdom in one is, by virtue of the microcosm of society existing within every human, the culmination of wisdom in all, in society at large, in pro bono publico. Some took Stobaeus to such an extreme that they would say that “wise men” ought to, more or less, pass wives around. I find the ending to Life of Pi instructive here, for they also justified cannibalism in extreme cases. As long as it’s pro bono, of course. Even for the twisted-minded Stoic, pro bono cannibalism is infinitely better than for-profit cannibalism. Wouldn’t want to charge someone for the privilege of eating their neighbor, because who in their right mind is that wicked? Who in their right mind would pay poor citizens for the right to consume their plasma, semen, eggs, kidneys, waking hours, arms, organs, bones, DNA, and blood? Yet here we are: anywhere but in our right mind taking something that’s at very least private and at very most part of the global commons — our very bodies and DNA — patenting them and cannibalizing them in bulk for the “greater good” of quarterly earnings reports. Clearly out of our right mind.
And that phrase — in their right mind — gets closer to this meaning of “rights.” We’re talking, in some sense, about sanity. Reason. Right and ordered thinking about a thing. Just adjudication of mores. The basic legal definition of “rights” also helps us, for the idea of a “right” is a just claim or a title, whether legal or prescriptive or moral. Sometimes rights are due to anyone by a just claim or a legal guarantee or a moral principle. Those two orient us to a group of people that would permit anything, legalize anything, for the wise man. Even making an asinine amount of money off the dead and dying. Like my wife Tara.
For that’s what this conversation regarding healthcare as a right is really about: not whether it’s okay to for everyone to receive the beneficence of wellness. But rather whether it’s permissible to make billions every year off of each instance of wellness distributed to the unwell, of health distributed to the sick, of healing distributed to the dying. This applies to all treatment but pick, say, insulin alone, a drug discovered in 1925 that — by all other metrics as an artifact in all other sectors of society and as a logical extension of the morality of nearly all other economic systems both past and present — exists on the public domain and ought to, quite literally, be 3D printed in one’s home at this point, but cannot because Eli Lily — the soul owner of the patent — prioritises quarterly earnings over granting the 30 years that my wife could have tacked on to the end of her life. Is that permissible? Sure. So’s cannibalism. But neither’s really beneficial. And perhaps Lily’s profiteering off of Tara is worse because for Lily and not for the cannibal, it’s more than merely eating my wife — slowly — for the sake of pleasure or in hopes of having longer or perhaps even everlasting life. At least those proximate goods remain rooted in Sehnsucht, longing, nostalgia. And in that way cannibalism can be a kind of faith and, in fact, is when embodied in the Eucharist. But without that — to merely eat people to increase one’s own riches? That’s literally legalized for-profit sadism. Currently permissible while cannibalism is not. And data alone shows it’s not beneficial since my generation will be the first to live shorter lives than our parents in the history of this country.
And that gets us to the negative / positive rights or the contrast between the permissible and the beneficial, permits and benevolence, freedoms and virtuous vows called graces. As our friend Lewis might ask, “Are you free to bind yourself?”
Every right — every right — tethers itself to, binds together, illuminates, grounds, and empowers every other right. That’s how moral law works. The law of unconditional respect is at least twofold: children honor your father and mother and parents do not exasperate your children. That’s a basic conclusion drawn from the moral “oughtness” of human dignity, human respect, human honor. The law of unconditional respect is applied indiscriminately across ages, genders, classes, races, and so forth. And it ends up giving dignity to a ton of people throughout human history. But only because you’re free to bind yourself to that. In your terms, the negative right freeing us to offer unconditional respect frees wives to offer the positive right of dignity even to undignified husbands, frees good children to offer the positive right of honor to dishonourable parents who did honor their grandparents, frees good parents to respectfully rear and inspire and counsel their unruly children rather than exasperate them. You’re free — with your own personal dignity and identity rooted in the unconditional respect the Father lavishes upon you — to interact with anyone you meet. But you’re bound to treat them as if the same is true for them, as if the rich man might at any moment come right in and shake the feces-encrusted hand of the homeless man or that the homeless man might at any moment inherit a fortune and jump four or five castes.
In this way, the right to bear arms (negative/permit) and the right to keep your goods and room and board to yourself rather than giving them freely when a soldier asks for them as required per the hospitality social contract (positive/benefit) both root themselves in the moral assumption that someone can protest both violently and nonviolently an executive body or army. It’s just as important for the in cognito Odysseus to reclaim his bow and shoot through the axes as it is for Penelope to publicly rebuke the suitors’s abuse of her hospitality. For one is private violence and the other is civil disobedience and both are the ways of exposing unjust laws (and their tyrannical lawmen) that Dr. King called “no law at all.” That in mind, in a modern context the right to bear arms is less applicable to guns (except verses the cops or soldiers) and more applicable to the right of citizens to bear armoured cars, drones, and bunkers. And the modern context for the right to refuse quarter is more applicable to government sponsored aid to protestors during a civil uprising, tax breaks for churches or cities that give shelter to undocumented migrants during an ICE raid, or free college and single source aquifers to post-colonial natives.
And in this way, the right to assumed innocence when accused of capital crimes or infamy (negative/permit/freedom of accused) and the right to a speedy and public juried trial (positive/tax-subsidised benefit) both root themselves in the moral assumption that false witness leads to false conviction and that justice must be blind, impartial, public, fair, decisive, and efficaciously quick. That in mind, the modern context for assumed innocence applies to the infringement of free press upon the character of the defendant and the modern context for speedy and public trial applies to civil forfeiture, recidivism, bail bonds, affordable and unbiased and just legal counsel, stop and frisk, and so forth.
Free speech and public assembly make the starkest contrast in my mind, for they both deal with accountability of government and business and other institutions, exposing passively and actively injustices and bolstering publicly justices and graces. Free speech, when truly a permit (or what you call a “negative” right), allows the truest and best and most beautiful ideas to rise to the surface. Peaceful assembly, however, allows for nonviolent action such as the Boston Tea Party and boycotts and allows for local assemblies to declare independence or seek statehood and so forth — it’s quite central to taxation without representation. In a Medieval commons system, you may well argue that this is a permitted or negative right, but not since the advent of enclosure, the parcelling of both public and common resources into the corporatised private, and ideas like “intellectual property” abused by entities like Disney. In that sort of economic system, all peaceful assembly is done through rent, paid permits, legal filings, and fiscal lawsuits that end with enclosed “free speech zones,” meaning, of course, that there is no longer a functional right to peacefully assemble. This was precisely Occupy’s critique of Zucotti Park: that this public space is privately owned by large multinational banks and where else can ANY dissenting voice assemble in the financial district? I live here. I can give you the answer: nowhere. Not without the benefit (positive right) of free use of the space for assembly and without common spaces owned by all citizens as in the economics of previous empires, that means that for the right to assemble to be alive and well, it must operate as a temporal property entitlement. Not often or even all of the time, but nevertheless a mandate in order for assembly to happen in the global cities of our country.
I could go on — certainly I’d love to break down the polarity between the right to vote regardless of race or gender verses the granting of the benefits and responsibilities of citizenship and others — but the amendments climax or show their cards in the 9th:
“The enumeration in the Constitution of certain rights shall not be construed to deny or disparage others retained by the people.”
That’s good moral law, as anyone who has read the prime texts or The Abolition of Man well knows. The whole point of any one right is to show both the permits and benefits, both the freedoms and goods, that moral law exercises in a given scenario.
So the tricky thing about healthcare is that we’re using a word that has a parallel meaning to the virtue (civic and spiritual) and moral (civic and ecclesiastical and familial) that undergirds the conversation about permits and benefits. So to avoid confusion, I’ll use the words “wholeness and wellness.” Behind all of the healthcare talk, we’re really after wholeness and wellness. We want our family, our friends, ourselves to be whole persons and to be well persons in every category of our metaphysical being. Generally speaking, the two categories we most focus upon are mental and physical. But the spiritual — that mystic tertium quid bond between the extremely interior or extremely exterior first person perspective and the manifestation of physical reality — must also be whole and well. In any case, that manifests — as all law predicated upon morality manifests — in freedoms and graces, in permits and benefits, or in your “negative” and “positive” forms.
At least in a just system properly ordered around what is right and good. Our system has become untimely, ill-fated, and tyrannically unprovidential: it’s seldom in the right place at the right time.
We ought prioritise the wellness of people over the wealth of profits. On the permission side, that means that we ought have the freedom — the right — to care for the health of one another which ought to stop at profiteering off of the sick, ought to stop at monetizing and therefore incentivising the maintenance of illness rather than cures, ought to include provisions for when inventions and discoveries become public domain and therefore limit the freedom so that as a permission it’s quite clear that you are permitted to make your neighbor well and have a duty to do no harm, especially no harm by prioritizing profits over people. So we have a right to healthcare in that sense: we have a right to make our neighbors and ourselves well, a freedom to do so, a negative right as long as it does not infringe on someone else’s freedom to do so. And withholding insulin’s patent from the public domain SIGNIFICANTLY limits medical breakthrough, for instance. In Canada, Tara’s vial of insulin is $30. Here, it’s $300. And the United States has far more wealth per person than Canada, so obviously it’s not a problem with availability of resources. And on the benefit side, your “positive rights,” we have a right to healthcare because it’s just and good and beautiful to give whatever we can to one another to make each other well and whole, civic law after all still being predicated upon moral law. That’s what insurance is: a lot of healthy people paying for a few sick people. That’s what Ozark’s health insurance did while Tara worked there, though far less efficiently than the New York state of health. It is just and good and beautiful for the healthy and well and whole to share that health and wellness and wholeness for it’s not the healthy who need a doctor, but the sick. It’s not the well who need a doctor, but the unwell. It’s not the whole who need an orthopaedic surgeon, but the broken.
Therefore, it’s not the well-cared-for that need healthcare, but the uncared for — those for whom society simply does not care. People whose physical condition engenders apathy and ambivalence in the most ambitious and greedy: for these we must first care. Even the old Boy Scouts manual teaches this. Only a radically social Darwinian mind would think otherwise, one who favors eugenics and euthanasia and I’m assuming that’s not you, is it?
We might make one more simple comparison. The freedom, permission, or (your word) “negative” rights to education and the grace, benefit, or (your word) “positive” rights to education draw the cleanest parallel. We have permissions and freedoms and negative rights like speech, press, religion in order to make us explorative and free to let our minds figure things out for themselves. But we also have benefits and graces and positive rights like integration of schools and public school (that is to say “socialized school”) and the Pell Grants that fund a large chunk of the college you teach at and administer. We need both because it requires both for us all to fulfill our deep desire to not live in a society dreamt up, crafted, and run by dumb people. Rather we want our citizens to have their minds as liberated and full of truth and moral goodness and beauty as possible.
And a similar thing should be said in the current debate: we ought not want to live in a society dreamt up, crafted, and run by sick and injured people. Rather we want our citizens to have their bodies as whole and healthy and well as possible. Who wants their burgers cooked by someone with a contagious virus? Who wants to cook while full of pneumonia? The list goes on.
To strive the other way is to prioritize short-term profits over long-term economic compounding progress, short-term arguments won at the expense of long-term sanity, legal battles won at the expense of moral decay, the current generation over the seven generations to follow this one.
That’s why ministers who opt out of social security have not widows and orphans in mind, but merely themselves. We Christians once so deeply believed in the beneficent right and good of free healthcare that we invented free hospitals. And we can get there again, but only if we take the moral high ground and do what’s right by rights.
Ought the federal government do this? No, the church should, but the church does not and will not so long as it remains as divided as it is. This sort of special beneficence requires (1) unity to the degree that (2) hierarchy can work humbly so that (3) institutions and infrastructure can undergird (4) the sort of radical hospitality that predicated the Christian invention of free health care we call “hospitals.” You know, those gracious houses of healing that now charge $50,000 per visit for a few stitches?
So we must step it back and ask how else we might change the culture for the better. Which leaves us with reforming the world through wills and not laws. For moral law predicates civil law, so asking about legislation before asking “what good shall we then do?” is the wrong order. Good preemptive oughts prevent garrotte afterthoughts. Meaning I’d rather hang my hat on healthcare as a right then get hung for stinginess and be dead to rights.
Or, I suppose, in this case rotting of gangrene without access to antibiotics.
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