health care as a human right

NYU economist Bill Easterly has a column in today’s Financial Times that seems to reject the idea of universal health care, even for a country as wealthy as the US. I was not convinced.

The agonising US healthcare debate has taken on a new moral tone. President Barack Obama recently held a conference call with religious leaders in which he called healthcare “a core ethical and moral obligation”. Even Sarah Palin felt obliged to concede: “Each of us knows that we have an obligation to care for the old, the young and the sick.” ….

The pragmatic approach – directing public resources to where they have the most health benefits for a given cost – historically achieved far more than the moral approach.

In the US and other rich countries, a “right to health” is a claim on funds that has no natural limit, since any of us could get healthier with more care. We should learn from the international experience that this “right” skews public resources towards the most politically effective advocates, who will seldom be the neediest.

William Easterly, “Human rights are the wrong basis for healthcare”, Financial Times, 13 October 2009.

Easterly’s argument makes sense only if we interpret “right to health” as a right to any and all health care, regardless of cost. No universal programme – not even US Medicare for the elderly – provides unlimited care at any cost. If we interpret “right to health” as a “right to basic health care”, it is entirely consistent with Easterly’s preferred “pragmatic approach – directing public resources to where they have the most health benefits for a given cost”.

The definition of ‘basic health care’ will, of course, vary from country to country. Similarly, the right to “basic education” is typically restricted to primary school in poor countries, but may include high school or even post-secondary education in more affluent countries.

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