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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.
