Or how to convince conservatives to favor guaranteed healthcare for all

Many progressives believe the state ought to provide health care to all citizens.  They often support health care for all by appealing to a universal right to health care.  This argument is misguided, since this right may not exist.  However, I want to show that even if we don’t have a right to health care, the government should still guarantee it for reasons conservatives should endorse.

Maintaining that there ought to be guaranteed health care for all by appealing to a universal right to health care isn’t a particularly effective argument.  Many rejecters seem to think that the only universal rights are natural rights – like freedom of speech and freedom of religion – that we associate with the Bill of Rights.  Asked to say why this is so, rejecters usually rely on mere intuition or gut feeling.  The problem is that disagreements become intractable when they bottom out in mere intuition, and the debate comes to a stalemate.     

But I don’t think it needs to come to this, since there ought to be universal health care regardless of whether we all have a right to it.  Universal rights don’t matter for this debate. 

In his 1984 article “The Right to a Decent Minimum of Health Care,” Allen Buchanan suggests that a decent minimum of guaranteed health care can be established by combining the force of three arguments that don’t appeal to universal rights.  Before addressing these arguments, let’s look at the advantages of advancing a decent minimum of universal health care.

First, a decent minimum would be determined by the resources available to society.  The more affluent the society, the higher the decent minimum could be.  Second, a decent minimum is open to which aspects of guaranteed health care should take priority.  This is politically advantageous, because it lends itself to bipartisan support.  Finally, advancing a decent minimum avoids problems with claiming that everyone ought to have the best health care available.  The most obvious problem is that it would be too expensive.

So, what are the three arguments whose combined force supports a guaranteed decent minimum of health care for all?

First, a strong case can be made that many groups have a special right to health care.  This right is special in the sense that it only applies to specific groups.  Many groups are entitled to certain rights to rectify institutional injustices that have been committed against them.  Native Americans, for example, may be owed health care due to the history of unjust treatment by the government.  Similarly, many groups are entitled health care if they have suffered unjust harm.  Employees exposed to toxic chemicals at work may be owed health care to redress the harm suffered.  Finally, many agree that people who have made great sacrifices for our society have a special right to health care, such as military personnel, police officers, and firefighters.  Appealing to a special right to health care would cover many citizens.

The second argument for universal health care appeals to the principle of non-maleficence: The government ought to prevent social harm.  For example, public sanitation measures are justified based on preventing harm to citizens that would result from living together in large groups.  This also justifies the government providing a police force and military.  These measures lower mortality and morbidity rates and help ensure the health and safety of all citizens.  By the same line of reasoning, the government ought to provide a measure of health care to all citizens.

The third argument appeals to socio-economic prudence.  It’s in the best interest of society and the economy to offer a decent minimum of health care to all citizens.  First, a healthier society would create a more productive workforce.  Second, a healthy and fit citizenry is beneficial for national defense.  Finally, universal health care would lower the cost of health care for individuals thereby bolstering the spending power of citizens.  There are at least two reasons for this.  First, when individuals who don’t have health care get treatment, the cost is picked up by those who have health care.  This increases premiums. If everyone had health care, less cost would be left over for others to bear.  Second, universal health care would make it easier for folks who would not otherwise have health care to seek treatment early before their health problems become more severe and costly.  This saves the consumer money, which is good for the economy.

We don’t need to appeal to a universal right to health care to show that the government ought to provide a decent minimum of health care for all.  The combined force of three considerations is enough to establish this: many groups are owed health care, universal health care prevents social harm, and universal health care is in the best interest of society and the economy.