Catholic Social Thought teaches that all human beings have a right to basic health care. The phrase “basic health care” raises more questions than it answers, however. Just which sorts of health care are to count as basic and which are not. Is aspirin basic health care? Anti-depressants? Open-heart surgery? To hear many people talk, pretty much all health care counts as basic.
Presumably any determination of whether a particular treatment counts as basic care will have to take some account of its cost. We may rail rhetorically against the idea of counting the cost here, but when pressed pretty much every one is forced to acknowledge that no health care system is going to be able to cover everything. Every dollar spent on health care is one less dollar that can be spent on education, or food, or shelter, or research, or even on other health care, and as I’ve noted before, rights within the Catholic social tradition have to be limited and defined by the Common Good.
There are also questions of effectiveness. Suppose that a routine test turns up a worrying result. It may be nothing; on the other hand it may be a sign of something serious. Further testing may tell us more. Is such testing basic care? Does it matter how likely the testing is to turn up something useful? Or suppose that there is an experimental new drug which may or may not be useful in treating a patient’s illness. How much chance does there have to be that the drug will actually work before it becomes basic care?
One typically thinks of denial of care in terms of people not being able to pay for it. But this needn’t be the case. Suppose for example, that the new drug mentioned in the above example is very likely to work, but that it hasn’t yet met it through the laborious FDA approval process. If a patient knows the potential safety risks that taking a non-FDA approved drug may involve, but wishes to do so anyway, does the law preventing him from doing so violate his right to basic health care? Suppose a person needs a kidney transplant, which will save his life, but is unable to find a kidney because federal law prevents him from paying for one. Is that a violation of the right to basic health care?
The huge advances in medical technology in recent years also raise difficulties. It seems strange to say that having an MRI can be a fundamental human right when for most of human history such a thing did not even exist. It is almost like speaking of a fundamental human right to access the Internet, or indoor plumbing.
One might think that a person cannot have his right to basic health care violated by being denied a treatment which doesn’t yet exist. But suppose the only reason a treatment does not exist is because the government has removed the incentives for medical innovation. If the government 30 years ago had instituted a policy providing health care for all, but that system stiffed innovation and advancement, such that many of the new drugs and treatments developed over the past 30 years had never come into existence, would that be a violation of people’s rights (albeit one they wouldn’t know had occurred)? Supposing the government institutes such a system now, with the same result for new treatments that would otherwise have been developed over the next 30 years?
If the right to basic health care is to be more than a mere slogan, serious thinking is going to have to go into answering each of these questions.
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