I think it might be nice if once, just once, politicians of any ideological stripe would discuss honestly whether health care is a right, a responsibility, or a privilege. I think each of the three can be argued persuasively, but apparently no politician agrees, since for over a year the nation has been discussing the issue, and nobody tried to make the case for what they believe.

Obama claims that health care is a right. Well then, the current bill is really flawed since it isn’t set up as if we have a right to it; instead, the way the bill appears to be written, it is a responsibility. That is, each person will have to purchase their own health insurance. Well, we have a responsibility to have car insurance, so we have to buy it. We don’t have a right to car insurance (or I can’t imagine how that argument would be framed). The way Medicare is set up is more like a right, I think. If you live to be 65 (or whatever the age of benefits is), you fill out an application and get it. But, other than the 15-20 Representatives who argued for this, nobody else can claim that they believe it is a right.

I always thought Republicans, or more generally conservatives thought that health care was a matter of personal responsibility. But nobody on that side of the aisle has made that case very vociferously. Their arguments have focused on ancillary discussions like (just take your pick, there have been a hundred of them). Well, what that says to me is that they’re not comfortable arguing that position, so it must poll badly, or it really isn’t a conservative position any more. I can’t figure out why either politically or philosophically that position is a loser, but I’m sort of dense.

I think the politicians who, I think, believe that health care is a privilege approach the issue less obliquely, but since nobody in the media ever follows up, it’s hard to tell. I would put any political actor in this camp if they say we have the best health care in the world, you just have to be able to afford it. Well, my friend’s home costs over $1 million. Mine is about a quarter of that. Well, I can’t afford his house so I can’t buy it.

The answer to the question determines what the correct policy outcome is. If it’s a right, everyone gets it. If it’s a responsibility, this is more normative. Everyone should get health care, but pay for it yourself (or perhaps with government subsidies to deal with market inequalities). If it’s a privilege, just keep the system the way it is. I’m not sure what I believe; I am sure that we need to know what politicians think and why when we elect them.