Is the US health care system a right or a privilege? Which should it be?

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verascity eNotes educator| Certified Educator

In the United States, people have drastically different opinions as to whether health care should be a right or a privilege, particularly around and since the passing of the Affordable Care Act (Obamacare). While no one can make someone agree with them, it is important to know about the two different major beliefs, and why people hold them.

1) Health care is a right: Those who believe health care is a right believe it is morally unjust that a person's ability to live a healthy and full life should be restricted by their income. Those who believe health care is a right argue that, while it is normal for rich people to have more than poor people, this should not be the case when it comes to basic necessities for existence. It is unethical and unjust for poor people to suffer just because they cannot afford health insurance. They argue providing health care for all is a part of the social contract all Americans participate in, just as much as providing roads or schools. We do not prevent the poor from driving on our roads or using fire and police services; it is not right that we have historically kept them from health care using the "free market" as an excuse.

Proponents of this position also point out that the vast majority of developed, first-world nations provide universal health care. The US is one of the very few developed nations that does not. In fact, countries that are otherwise known for having very poor human rights, such as Cuba and Saudi Arabia, still offer universal health care. 

2) Health care is a privilege: Proponents of this position feel that because health care is not included in the Bill of Rights or any part of the Constitution, it cannot be counted as an American right. In the US, health care is typically linked to employment, and this group feels health care is something you should get if you either contribute to society through work or if you are so disabled or young that you absolutely cannot work (even then, some feel children/ the elderly/ people with disabilities should be covered by means other than taxpayer-funded health care). This group argues that we do not fund many things through taxes, and that health care should remain one of them; it is a personal expenditure. In other words, it is part of the individual's contract with the free market, rather than a broader societal contract.

People who hold this position often contend that the American free market has driven us to have better health care than countries with universal insurance. They cite long wait times in countries with socialized medicine and claim that better doctors are available in the US because our approach allows us to pay doctors more. It is, however, important to note that the US can also be very uneven in service delivery, and there are areas or specialties in the US that also offer long wait times or poorer care.