Do We Have a Right to Healthcare?

Healthcare is recognised in the UK as a basic right with a corresponding societal duty to ensure its provision. This right and related principles are articulated in various pieces of legislation, from the NHS Constitution in England to the European Declaration of Human Rights. In the UK the governmental obligation to provide healthcare and to realise a person's right to access it, is currently achieved primarily through the National Health Service (NHS). In a difficult economic climate traditional attitudes have been challenged, requiring us to re-examine the question: is it reasonable to expect universal provision of healthcare and must this come exclusively from the government?

Rights, Beliefs and Governmental Provision of Universal Healthcare

Rights are based on commonly accepted values that society believes should shape interactions between individuals and society as a whole. For example, in a democracy people share the belief that unrestricted dialogue leads to a more productive society; consequently freedom of speech is enshrined as a right. 

When rights are undisputed and universal, then any legal action to protect that right aims to ensure that all individuals are able to exercise it, regardless of their personal circumstances or characteristics.

For example, in the interest of allowing a healthy debate on gay marriage, all individuals and groups are allowed to express their opinion in a constructive manner under the protection of the law.

A belief, on the other hand, is a proposition that an individual holds to be true that shapes their interactions with other. What distinguishes it from a right is that it is not necessarily shared by the rest of society and there are no guarantees regarding its provision. Rights are meant to be the indicator for the basic level of dignity a government accords a citizen. Frequently an individual’s belief will either seek to extend or minimise that basic level.

For many, the most important right is the one to life. The mechanisms by which society provides for this right can be complex. The right to life can be conceptualised in to the creation of new life on the one hand and the maintenance of existing lives on the other. Healthcare is one mechanism by which governments can help to ensure the maintenance of life, however how far should this responsibility extend and how should it be enacted?

Societies, acting through democratically elected governments, are pre-disposed to protecting the right to healthcare, not simply out of compassion for the individual, but also for the wider benefit of society at large. Healthcare provision on an individual scale helps improve the wellbeing of that person, but also has a cumulative societal benefit, as more people can actively contribute to society for longer. Society therefore has a vested interest in maintaining a basic level of health in the population, and improving this benchmark over time. Investment in healthcare is a balance, designed to produce a net benefit to society. The question is, at what point does this cease to be mutually beneficial?

The pivotal point concerns provision. Traditionally it is accepted in contemporary society that where a right exists, it is the government that must secure its provision; however there is no logical reason why this provision must come from government or indeed that they are even best placed to do so. We must open ourselves up to the possibility that the most efficient and morally appropriate paradigm may be for the market to provide healthcare to all those who can pay, with the government’s duty to provide healthcare limited only to those who cannot afford to pay themselves.        

Conclusion

The modern conception of rights should no longer be about aspirational, but unacheiveable concepts. Instead this idea should be replaced by an arrangement between the state and the individual as how to best achieve sustainability without foregoing equity.  The government should act in the most efficient way possible. This may mean a move to the market providing the bulk of healthcare, with, government only stepping in to provide for those who the market fails. The societal benefit would still be present, but the government would no longer shoulder the entire burden of provision.

This artilce is taken from the Autumn/Winter edition of TSnews and was written by Bilal Akhter Mateen and Hygin Prasad Fernandez.