Sickness Unto Death Part VII: Health Care — Right or Responsibility? ~ By John MacWillie, Ph.D.

Murphys, CA…The United States Declaration of Independence declares “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” Without good health, where is the possibility for the pursuit of happiness? As the Declaration’s primary author, Thomas Jefferson, would later write, “The care of human life and happiness, and not their destruction, is the first and only legitimate object of good government.” (Jefferson 1809).

This is a series of eight articles on a single theme to be released once a week.  Copyright license granted under  

For the past six weeks, we have examined the issue of health care in terms of its delivery, effectiveness, and cost. This week we turn to a much more contentious question — the political status of health care. Is health care a fundamental right, or is it simply a privilege granted to some in society? Under what basis could health care be considered a right?

There are two categories of rights: legal rights and natural rights.

We are all familiar with legal rights. They are rights established by law. Laws passed by Congress and business contracts set forth certain kinds of rights. These kinds of rights are presumed to be valid as long as the statutory provisions remain valid or until a contract expires. For example, under the Affordable Care Act (Obamacare), the right to health care is assured by statute that simultaneously enables these rights through the provision of insurance contracts between insurance companies and their customers. A customer with a pre-existing condition is guaranteed by legal rights that he or she will not be treated differently than any other customer of that insurance provider. It does not establish a rightful guarantee that insurance rates among customers in California and Alabama will be the same.

By contrast, there are natural rights. Originally, natural rights were assumed to be those rights guaranteed by a divine power, as it was assumed that everything in nature is derived from God. For example, the U.S. Declaration of Independence refers to self-evident truths that human beings are “endowed by their Creator with certain unalienable Rights”. In this secular age, natural rights are more likely to be referred to as “universal rights” and are asserted by consensus in a common compact and in an appeal to common interest. The right of free speech is an example of a claim to a universal right. Universal rights, by their very name, are asserted to apply to all that are a member of a common compact and, without exception, unlimited in scope or time. Thus, the claim that there exists a right to universal health care is much stronger assertion than a contractual or statutory right and one that all persons have a right to exercise.

Is there any basis for saying that American citizens have a universal right to health care?

Consider the following interpretation.

Thomas Jefferson stated in the United States Declaration of Independence that “all men….[have natural rights including] the pursuit of happiness.” Curious word, “happiness”. Whatever did he mean? Surely not that everyone has the right to “feel” happy or “giddy”? Hardly.

Jefferson was a child of the Enlightenment — the age of Reason — when philosophers such as Locke, Rousseau, Diderot, and Montesquieu took their inspiration from the ancient world and relied on Reason as the best guide to a better, freer life. In their turn to the ancients, Jefferson, like Madison, Adams, and Hamilton observed that happiness was interpreted as the highest satisfaction one could derive from the highest goal — virtue. For the ancients, happiness referred to the Greek word “eudaimonia” (u-dy-moh-nee-ah) which means “living well” or “flourishing”.

Any examination of this nation’s founding documents, including the Federalist Papers, as well as Jefferson’s phrasing of the Declaration of Independence, will highlight the degree to which the founding fathers saw the kind of happiness the ancients called “flourishing” as the ultimate goal of a new nation. As George Mason, the author of Virginia’s Declaration of Rights wrote, stated “All men are created equally free and independent and have certain inherent and natural rights . . . among which are the enjoyment of life and liberty, with the means of acquiring and possessing property, and pursuing and obtaining happiness and safety.”

But if happiness was so important to the early leaders of this country, why is there no mention of health, doctors, or medicine? First of all, health care in the eighteenth century was not much more than superstition and experimentation. To be treated by a “doctor”

The first vaccine was not discovered until 1796 by Edward Jenner; a general anesthetic (ether) was not developed until 1837; Joseph Lister didn’t demonstrate antiseptics to reduce infections until the 1860’s; while it wasn’t until the 1870’s that Louis Pasteur and Robert Koch identified bacteria as a major source of pathogens; a decade later a number of biologists isolated and grew viruses. It was not until 1928 that Alexander Fleming developed the antibiotic, penicillin. Only in the second half of the twentieth century, did biologists, pathologists, geneticists, and molecular scientists begin to unravel the enigma we call biological life. In other words, for most of this nation’s history there wasn’t a health care practice about which anyone would care to claim a right. It is only in this century that we have the knowledge, the capacity, and the will to offer health care for all.

So the question has to be asked: if something didn’t even exist as a conceptual possibility in the eighteenth century are we limited to those concepts as the basis for asserting political rights or do we re-evaluate what the founders meant when they said the foundations of our social compact included social flourishing? Given the capacities of modern medicine to give everyone a more flourishing life, can we not begin to consider the possibilities of what happiness means in the twenty-first century?

There is a very strong argument that equal access to flourishing (which does not mean everyone will flourish) justifies the claim that healthcare is a universal right. And if it is a universal right, it is something far more exhaustive and extensive than the legal right to health care which is the standard of Obamacare.

What such an assertion that implies is taken up in next week’s final article.

[To be continued]

AUTHOR: John MacWillie is a native of Calaveras County, California. He graduated from UC Berkeley where he studied European history and bio-engineering. His graduate studies include economics and urban planning at New York University and philosophy at San Francisco State. He received his Ph.D. from the University of Leeds in the U.K. He worked for ten years in law enforcement policy and administration in New York City, spent nearly thirty years as a senior executive in the software industry, primarily in information security, and for the past twelve years has been teaching in undergraduate and graduate programs at California State University — East Bay in multimedia, art history, and criminal justice. He resides with his wife, an attorney, in Murphys CA