Did you know that the Declaration of Independence offers an open-ended list of our basic rights? All of us are created equal, the Declaration proclaims, and endowed with certain unalienable rights. Then the Declaration elaborates: “Among these are life, liberty, and the pursuit of happiness.” Among these? In listing these three rights, the Declaration simply offers a set of examples. Life, liberty and the pursuit of happiness are just three important cases among some larger set.
What, then, are our other unalienable rights? Is health care by chance included?
The Declaration itself predicts an ongoing conversation about basic rights. It anticipates that we, the people, generation after generation, will consider whether our governments are securing these rights. If they are not, it is our right, the Declaration argues, to alter our government. We do this by laying the foundation of our institutions on such principles and organizing the powers of government in such form as seems to us, we the people, living now, “most likely to effect [our] safety and happiness.”
The phrase “safety and happiness” was an 18th-century update of the ancient Roman idea that the supreme guide for all political decision-making was “salus populi,” the health and well-being of the people.
In the 18th century, in other words, the Declaration laid a foundation for securing our safety and happiness on basic rights of life, liberty and the pursuit of happiness, but the words of the Declaration also anticipated that later generations would extend the analysis.
The Bill of Rights picked up the conversation. An addendum to the Constitution, it added as basic rights, among others, a right to assembly, a right to petition for redress of grievances, a right to freedom of religion, a right to bear arms, a right to be free from unreasonable searches and seizures, and so on.
Yet the Bill of Rights also left the conversation open-ended. The Constitution can be amended, of course. It also reserved to the states, and their peoples, such powers as were not explicitly enumerated as belonging to the federal government. That means it is well within the power of the states to continue to define fundamental rights limiting their own powers. This the states have done.
Nearly every state constitution establishes a right to education for its citizens. The express purpose for this is commonly to ensure that citizens be prepared for their civic duties. This means states ought to be constraining their policymaking and directing their resources to ensure that students get meaningful humanities, social sciences and civics offerings in addition to vocational training and science, technology, engineering and math curriculums.
But what about health care?
Health care is now — in the early 21st century, for those of us who live in mass democracies, where diseases can spread quickly and toxins in the environment produce surprising illnesses, where therapies and cures are available but expensive — something that none of us can secure acting alone. The delivery of health care has entered the category of armies, freeways and mass transportation — a public good that necessitates collective effort to provision this fundamental resource to all.
Notably, Republicans in the House appear to agree with President Obama on the grounding principle that access to affordable health care is a basic right. It’s a bit buried in their “A Better Way: Health Care” plan, but House Republicans do describe themselves as seeking to build a system that “ensures access to coverage for all Americans.”
The claim of the Republicans is that, compared with Obamacare, they have a superior mechanism for securing that right.
In other words, it seems that we may possibly be prepared, across party lines, to lay a foundation for health-care policy on a shared principle of access to affordable care for all. Yet we disagree deeply about how to organize the powers of government to achieve this.
Have the Republicans indeed found a superior mechanism? Regrettably, it is not possible to have this conversation, because the Republicans have not yet reached a complete answer to the question of precisely what their mechanism is. The House’s Better Way plan is more shopping list than final policy, and there are many disputes within the Republican caucus.
While we are waiting for the Republicans to clean up their thinking, then, we might as well spend our time discussing the fundamental matter.
Does every American have a right to access to affordable health care?
What do you think?