Why Universal Access to Healthcare Isn’t a Constitutional Right, It’s Just Plain Fair

So, I acknowledge my biases at the outset. However, my comments are not meant to be a polemic so much as a contemplation of why one would, or would not, favor universal access to healthcare. This is not an argument for Obamacare, Medicare for All, single-payer insurance, or any specific proposal. I support the Affordable Care Act, with its many flaws, but for this discussion, that is beside the point. I am also not trying to address the issue of spending large sums of money on healthcare as we address the federal deficit; that is a very complicated issue and I don’t pretend to have the solution.

A Suggested Goal for Our Healthcare System

Fly fisherman Kevin Shelley sets the hook on a trout on a chilly morning on the North Fork of the White River in Missouri.

I do not believe that healthcare is a “right,” as so many argue. To my mind, a “right” is something articulated by rigorous philosophical argument, or something contained in the Constitution or Bill or Rights. I think that arguing over whether access to healthcare is a “right” distracts us from the more important question of whether we believe that everyone should have adequate access to healthcare or not. In what kind of society do we want to live? Virtually all citizens of modern societies embrace ideas of justice and fairness and equality as “these truths we find self-evident,” as the Founding Fathers said. Should that include universal access to healthcare?

I had the good fortune in college to study under Robert Nozick and John Rawls, two philosophy professors who have had important impacts on contemporary philosophy, although with opposing views. Nozick articulated the libertarian philosophy and made a cogent argument for fierce individualism, in which one’s property, money, or possessions could not be expropriated by society or government for any reason.

“A minimal state, limited to the narrow functions of protecting against force, theft, fraud, enforcement of contracts, and so forth, is justified …the state may not use its coercive apparatus for the purpose of getting some citizens to aid others.”—Robert Nozick, Anarchy, State, and Utopia

In fact, Nozick’s treatise, Anarchy, State, and Utopia, was in large part written to counter the views of Rawls (discussed below). I was not sympathetic to Nozick’s view, but because I found him so engaging and clever, I did take his course on “The Meaning of Life”: my grade was B+.