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hrjHow's that for deliberately provocative? Yesterday, in the midst of the healthcare meme spreading across Facebook, I posted, Heather Rose Jones considers online memes of the form "post x in your journal in support of y" to be rather unproductive and largely meaningless. Furthermore, my opinions and positions on Issues Of The Day are too complex and nuanced for a facebook post (or a bumper sticker). Therefore, my lack of participation in online memes or opinion surveys should not imply any particular position or lack thereof. In the ensuing comment thread, I noted that if I put forth a more nuanced opinion, it would be in LJ. Having an hour or so to kill....
But before I talk about my opinions on healthcare and rights, I'm going to talk about something else for a while. I'm going to talk about "needs" and "wants".
I've come around to the position that, convenient as the distinction may be for casual conversation, I don't really believe in "needs" as distinct from "wants". Sure, I may use the same verbiage to say, "I need a cup of coffee" as "I need 8 hours of sleep every night" or "I need an oxygenated atmosphere". But when you pick apart the normal understanding of the meaning of "need" as opposed to "want", I believe that all needs are actually simply contingent wants. "I want a cup of coffee because it is a normal part of my morning ritual and I feel unsettled until I have fulfilled my ritual ... to say nothing of the desirable effects of caffeine (or at least my placebo response to caffeine) on my alertness." "I find that I operate at a suboptimal level, physically and mentally, when I consistently get less than 8 hours of sleep a night, and I prefer to operate at an optimal level." "If I desire to continue in an active metabolic state, an oxygenated atmosphere is necessary."
I suppose one could consider "want to continue living" as the baseline contingency for a "need" and that all other uses are simply hyperbolic extensions of the word, applied to "wants". But even that doesn't allow for the nuanced options available at every turn. Let's take one of those extreme situations that's a darling of hypothesists: the gun to the head. Suppose Person X is pointing a gun in an imminently threatening manner at Person Y, who also holds a gun (let us say, for the sake of simplifying the example, in a concealed but usable fashion). And let us say that Person Y, in this situation, shoots Person X and explains afterwards, "I needed to do it." Or even more specifically, "If I wanted to continue living, I needed to do it."
The word "need" conveys an absolute, an inarguable state of affairs. Would it not be more accurate to say, "In my estimation of the likely outcome probabilities, I considered it preferable take this specific action, understanding a certain probability that less drastic action would achieve the same outcome, than to not take this action, given the probability that in doing so I would be seriously -- perhaps fatally -- injured." (This example, by the way, poses its own probability that readers will focus on the specific topic of gun violence, and not on the intended use of gun violence as an example of high-stakes mortal peril. I accept that chance.)
Yeah, long-winded. But it seems to me that the more crucial and high-stakes the "needs" are that we're talking about, the more hazardous it is to think in terms of absolutes, of cut-and-dried categories, which the use of the word "need" tends to predispose us to. That said, I have no interest or intention of eliminating the word "need" from my vocabulary. It's just that if I'm being careful and precise and philosophical, I will try very hard to avoid it in favor of carefully contingent wants.
Now, about "rights".
I similarly think that the ordinary, everyday understanding of the meaning of the word "right" tends to lead us to thinking in terms of external and eternal absolutes. Even those who eschew a prefixed "God-given" will, in my experience, tend to use "right" to mean "an entitlement whose truth-value is external to whatever human-social frame of reference I'm operating in."
Given this underlying understanding of a "right" as having some sort of external verity (if one accepts my framing as valid), how does one understand changes in what is considered to be a "right", or changes in the scope of who enjoys those "rights"? If "rights" are eternal and ideal, then those who fail to accept and apply those "rights" are denying "truth", just as if they failed to accept that 2+2=4 or failed to apply an understanding of gravity when manipulating objects. We see this in a synchronic sense when one culture that considers X to be a right judges another contemporary culture negatively for not considering X to be a right. And we see it diachronically when a culture that considers X to be a right considers itself an improvement over a historic version of that same culture that didn't consider X to be a right. (And similarly for concepts that had formerly been considered "rights" but are now viewed as erroneous.) But how do we judge our own, contemporary culture, with regard to concepts that we don't even have the framework to entertain, that some other or future culture will consider to be a "right"?
Even aside from the problem of the imperfectability of the instant, my primary problem with conceptualizing things as "rights" is that it makes it difficult to discuss them rationally with those who are operating within a different framework. A right is or it isn't. An individual is or isn't within the scope of a right. Well, sure we acknowledge that "rights have limits" (e.g., the "shouting fire in a crowded theater" exception), but the very difficulty we have in defining exceptions points out our underlying acceptance of the absoluteness of the concept. If a person doesn't believe that a right to X exists, operating within the framework of rights-as-external-truths doesn't give you a pathway to convincing them otherwise; all you can do is insist to them that they're wrong. Similarly, if you believe that right X has scope Y, but the other person believes it has scope Z, where is the basis in this framework for negotiating a common understanding?
As with the need/want distinction, I think of "rights" as being contingent social agreements. "I belong to a socio-political entity that organizes itself by principles X, Y, and Z; the acceptance of principles X, Y, and Z creates a framework that is also consistent with principle W and one that is in significant logical conflict with principle Q. To the extent that my socio-political entity prefers to avoid logical inconsistency and values the underlying concepts that create the parallels between X, Y, Z, and W, it should be seriously considered to agree to add W to our organizing principles and to avoid or eliminate including Q."
For example, I don't believe that there is any existential right to a "free" education. But I believe that the mutual benefit that comes from being part of a generally educated society is so significant as to make it an excellent candidate for a social consensus that basic education should not be contingent on parental wealth. I do not believe that there is any existential right to gender equality. But I believe that the logical inconsistency of legal gender inequity in a society that takes as an organizing principle the equality of all persons is ethically insupportable. A society may choose to do (or refrain from correcting) ethically insupportable things, but at a cost to its internal coherence.
And this is the context in which I do not believe that healthcare is a right. Because I don't believe in rights. But I do believe that the benefit-to-cost ratio of organizing our society to ensure access to basic healthcare regardless of financial circumstances -- just like the benefit-to-cost ratio of organizing society to ensure access to basic education regardless of finances -- is sufficiently high to make it an excellent candidate for a social consensus, and one that is in alignment with other organizing principles of our society, such as access to justice regardless of finances. Not because it's a right, but because it's simply a damned good idea.
But before I talk about my opinions on healthcare and rights, I'm going to talk about something else for a while. I'm going to talk about "needs" and "wants".
I've come around to the position that, convenient as the distinction may be for casual conversation, I don't really believe in "needs" as distinct from "wants". Sure, I may use the same verbiage to say, "I need a cup of coffee" as "I need 8 hours of sleep every night" or "I need an oxygenated atmosphere". But when you pick apart the normal understanding of the meaning of "need" as opposed to "want", I believe that all needs are actually simply contingent wants. "I want a cup of coffee because it is a normal part of my morning ritual and I feel unsettled until I have fulfilled my ritual ... to say nothing of the desirable effects of caffeine (or at least my placebo response to caffeine) on my alertness." "I find that I operate at a suboptimal level, physically and mentally, when I consistently get less than 8 hours of sleep a night, and I prefer to operate at an optimal level." "If I desire to continue in an active metabolic state, an oxygenated atmosphere is necessary."
I suppose one could consider "want to continue living" as the baseline contingency for a "need" and that all other uses are simply hyperbolic extensions of the word, applied to "wants". But even that doesn't allow for the nuanced options available at every turn. Let's take one of those extreme situations that's a darling of hypothesists: the gun to the head. Suppose Person X is pointing a gun in an imminently threatening manner at Person Y, who also holds a gun (let us say, for the sake of simplifying the example, in a concealed but usable fashion). And let us say that Person Y, in this situation, shoots Person X and explains afterwards, "I needed to do it." Or even more specifically, "If I wanted to continue living, I needed to do it."
The word "need" conveys an absolute, an inarguable state of affairs. Would it not be more accurate to say, "In my estimation of the likely outcome probabilities, I considered it preferable take this specific action, understanding a certain probability that less drastic action would achieve the same outcome, than to not take this action, given the probability that in doing so I would be seriously -- perhaps fatally -- injured." (This example, by the way, poses its own probability that readers will focus on the specific topic of gun violence, and not on the intended use of gun violence as an example of high-stakes mortal peril. I accept that chance.)
Yeah, long-winded. But it seems to me that the more crucial and high-stakes the "needs" are that we're talking about, the more hazardous it is to think in terms of absolutes, of cut-and-dried categories, which the use of the word "need" tends to predispose us to. That said, I have no interest or intention of eliminating the word "need" from my vocabulary. It's just that if I'm being careful and precise and philosophical, I will try very hard to avoid it in favor of carefully contingent wants.
Now, about "rights".
I similarly think that the ordinary, everyday understanding of the meaning of the word "right" tends to lead us to thinking in terms of external and eternal absolutes. Even those who eschew a prefixed "God-given" will, in my experience, tend to use "right" to mean "an entitlement whose truth-value is external to whatever human-social frame of reference I'm operating in."
Given this underlying understanding of a "right" as having some sort of external verity (if one accepts my framing as valid), how does one understand changes in what is considered to be a "right", or changes in the scope of who enjoys those "rights"? If "rights" are eternal and ideal, then those who fail to accept and apply those "rights" are denying "truth", just as if they failed to accept that 2+2=4 or failed to apply an understanding of gravity when manipulating objects. We see this in a synchronic sense when one culture that considers X to be a right judges another contemporary culture negatively for not considering X to be a right. And we see it diachronically when a culture that considers X to be a right considers itself an improvement over a historic version of that same culture that didn't consider X to be a right. (And similarly for concepts that had formerly been considered "rights" but are now viewed as erroneous.) But how do we judge our own, contemporary culture, with regard to concepts that we don't even have the framework to entertain, that some other or future culture will consider to be a "right"?
Even aside from the problem of the imperfectability of the instant, my primary problem with conceptualizing things as "rights" is that it makes it difficult to discuss them rationally with those who are operating within a different framework. A right is or it isn't. An individual is or isn't within the scope of a right. Well, sure we acknowledge that "rights have limits" (e.g., the "shouting fire in a crowded theater" exception), but the very difficulty we have in defining exceptions points out our underlying acceptance of the absoluteness of the concept. If a person doesn't believe that a right to X exists, operating within the framework of rights-as-external-truths doesn't give you a pathway to convincing them otherwise; all you can do is insist to them that they're wrong. Similarly, if you believe that right X has scope Y, but the other person believes it has scope Z, where is the basis in this framework for negotiating a common understanding?
As with the need/want distinction, I think of "rights" as being contingent social agreements. "I belong to a socio-political entity that organizes itself by principles X, Y, and Z; the acceptance of principles X, Y, and Z creates a framework that is also consistent with principle W and one that is in significant logical conflict with principle Q. To the extent that my socio-political entity prefers to avoid logical inconsistency and values the underlying concepts that create the parallels between X, Y, Z, and W, it should be seriously considered to agree to add W to our organizing principles and to avoid or eliminate including Q."
For example, I don't believe that there is any existential right to a "free" education. But I believe that the mutual benefit that comes from being part of a generally educated society is so significant as to make it an excellent candidate for a social consensus that basic education should not be contingent on parental wealth. I do not believe that there is any existential right to gender equality. But I believe that the logical inconsistency of legal gender inequity in a society that takes as an organizing principle the equality of all persons is ethically insupportable. A society may choose to do (or refrain from correcting) ethically insupportable things, but at a cost to its internal coherence.
And this is the context in which I do not believe that healthcare is a right. Because I don't believe in rights. But I do believe that the benefit-to-cost ratio of organizing our society to ensure access to basic healthcare regardless of financial circumstances -- just like the benefit-to-cost ratio of organizing society to ensure access to basic education regardless of finances -- is sufficiently high to make it an excellent candidate for a social consensus, and one that is in alignment with other organizing principles of our society, such as access to justice regardless of finances. Not because it's a right, but because it's simply a damned good idea.
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no subject
Date: 2009-09-05 06:07 am (UTC)no subject
Date: 2009-09-05 01:07 pm (UTC)And if one takes what passes poorly for public "debate", it is difficult to escape the conclusion that some people disagree with your assessment of the benefit-to-cost ratio in your conclusion, giving the appearance of a disagreement over axioms.
no subject
Date: 2009-09-05 01:28 pm (UTC)no subject
Date: 2009-09-05 06:30 pm (UTC)no subject
Date: 2009-09-05 07:07 pm (UTC)This issue is going to be decided by people who not only don't understand the math involved, but have never been taught that there's any value in such understanding. Given that, catchy slogans are going to beat scientific explanations every time.
Yes, I'm a cynic and an intellectual elitist. You knew that already.
As for the idea of 'rights' existing independent of a social contract (whether of church, state, or simply interpersonal dynamics), I think that's a straw man - no such thing exists. Rights are always backed by some asserted authority, even if it doesn't rise above the 2-year-old "I want it so it's mine" level. (And yes, 'God-given' is social - it equates to 'My church says so.') Note that in our current brouhaha over 'universal' health care, no one is suggesting that it apply to people who neither reside in nor are citizens of the United States. That makes it 'my right as an American', not 'my right as a sentient being' (which latter is itself a form of authority, occasionally raised with regard to environmental issues.)
As for 'needs', I agree that these imply absolutes - and those are damned hard to find outside of contingencies. 'In order for X to occur in context Y, Z needs to happen.' The constraints of Y and the desirability of X are often unstated, but if you look closely enough, they're usually there. Even '2+2=4' is not an absolute; there are underlying definitions and axioms involved. Arguments about 'needs' often mean that the unstated portions of the contingency - taken for granted by each side - significantly disagree with regard to specifics.
no subject
Date: 2009-09-05 01:58 pm (UTC)There are other ways to look at rights and still come to the same conclusion. A simplistic view is that the word "right" is often used in place of either "authority" or "permission." The divine right of kings (granted to them by a higher authority). A simple and easy way to look at rights is the legalistic sense: there is no right to own a car because it is not specified in the constitution. This is the big stumbling block of Roe v. Wade, whether or not there is an implied right to privacy, and whether or not there can be any implied right in the constitution at all. My own take on rights is a bit awkward. I believe that rights as a concept speak to limits on its own authority that the state puts upon itself. That is certainly the purpose of the "Bill of Rights." Now, the 10th amendment states that there are rights not listed in the bill of rights, so obviously there is a problem here. Regardless, rights do not describe something the government has to provide to the people. Rights describe only those things that the government cannot stop the people from doing and those things the government cannot do to the people.
Regardless which if these interpretations you adopt, health care is not a right. It is, as you say, a damn good idea. And, btw, calling health care a "right" provides significant ammunition to those opposing health care, since it allows them to argue, as some have started to do this week, that if health care is a right then under the 10th amendment the federal government has no authority to regulate it. (The Feds will counter with the Interstate Commerce Clause, as they always do).
no subject
Date: 2009-09-05 07:18 pm (UTC)no subject
Date: 2009-09-06 01:39 am (UTC)no subject
Date: 2009-09-05 03:14 pm (UTC)no subject
Date: 2009-09-05 03:24 pm (UTC)no subject
Date: 2009-09-05 08:05 pm (UTC)no subject
Date: 2009-09-05 07:25 pm (UTC)no subject
Date: 2009-09-06 01:34 am (UTC)