Tom Brokaw asked a really interesting question last night that required some political theory to make an answer work. Neither candidate explained what a right is versus a responsibility and how the two are related.
Brokaw: Quick discussion. Is health care in America a privilege, a right, or a responsibility?
McCain: I think it's a responsibility, in this respect, in that we should have available and affordable health care to every American citizen, to every family member. And with the plan that — that I have, that will do that.
Obama: Well, I think it should be a right for every American. In a country as wealthy as ours, for us to have people who are going bankrupt because they can't pay their medical bills — for my mother to die of cancer at the age of 53 and have to spend the last months of her life in the hospital room arguing with insurance companies because they're saying that this may be a pre-existing condition and they don't have to pay her treatment, there's something fundamentally wrong about that.
Bill O'Reilly made a couple of good points today with which I basically agree.
1) McCain's answer lacked detail and it is hard to know what he actually meant by it other than a belief that has no substance. Obama, on the other hand, gave a wrong answer but gave a good exaple that is absolutely correct.
2) Health care is the responsibility of government so that stories like the one to which Obama referred do not happen, but still did not get at the fundamental difference between the rights of the individual citizens and the responsibilities of government and how the two are fundamentally related.
A right is an an essential quality of being human. Fundamentally, this is the right to pursue life, liberty, and individual happiness. The essential property that all human beings have in the Constitution in order for this to happen is the ability to have and act upon a freedom of conscience. It is the government's responsibility to protect that freedom. But it is not a freedom without constraint. In order to protect these fundamental rights, the government must impose a structure that protects the minority in the midst of a majority opinion that rules. The rich should not push out the poor and the majority opinion should not extinguish the minority opinion. This is the principle of equal regard which we see in the First Amendment.
So how is this related to health care? Free health care is not constitutive of happiness or freedom to be happy, it is regulative of it. To pay for health care for absolutely everyone enables some people who abuse their own well being to continue to do so, and essentially causes those who do take responsibility for their own well being to pay for such abuses (similar to the government bailout of greedy people who could not afford loans and the banks that risked it). If this is true, health care is not an essential right of every human being since there are those whose abuses of health by fiat have theoretically diminished that right.
The state of being healthy is however, a responsibility that every human being should take and the government should sponsor a structure in which this is an outcome of higher probability. Given that over 40,000 citizens do not have health care and are thus in the minority, it is the obligation of the government to create a structure in which people have incentive to be more healthy. This means that regardless of one's income or the kind of job one has, that a minimal level of health care should be available for anyone to receive.
The difference is subtle, but important. On the one hand, if health care is an essential right, then it should be granted to every individual. On the other hand, if it is the responsibility of government to make proper health care available to every individual, it does not follow that every individual would receive it if they are not practicing any due diligence to be healthier people. Responsibility of the government here should meet the responsibility of the individual. This latter excludes conditions that would persist regardless of the measures one would take without proper treatment at health care facilities. But it would not be a right for drug addicts, gluttons, smokers, alcoholics, etc. who are engaging in behaviors that are not essential to happiness, but are rather destructive to happiness.
In other words, health care as the obligation of government to provide to its citizens can offer more incentives for people to be more healthy and for companies, production practices, etc. to engage in practices that promote rather than diminish health. This would include better programs to reduce obesity, smoking, addiction, sexual promiscuity, pollution, etc. that all lead to increased risk and disease. The goal is to get at the root causes of poor health rather than apply bandages to problems that will continue to become infected. We want to live in a society that rewards those who are doing the best they can with what they have rather than what we currently have – rewards and incentives for people to be selfish and ignore the obligation every citizen has to support the life, liberty, and happiness of every one equally.
Thus, both candidates grabbed an aspect of the question that was fundamentally correct, but missed the important point of the role of government in conjunction with the role of the citizen.
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