More on health care ... and "rights"

A friend of MOJ writes:

A quick thought or two, if that, on health care as a right and obligation, in connection with your MOJ exchange with Rick Garnett:

First, the positive versus negative right distinction is admittedly ambiguous at this point, but I think all agree that anything like an affirmative, directly costly provision, at least partly by a government, of something like a physical examination, an x-ray, a kidney, or a surgery would count, if a right at all, as a positive right.  I.e., the asserted right is clearly not just a matter of a government’s refraining from interfering with the health care-related choices and actions of the public.

Second, and more importantly, the right versus obligation (or duty—sometimes, people use ‘obligation’ to emphasize a “taken-on” character) distinction seems to me a bit tricky here.  There’s not always what we might call a “super-symmetry” between right and obligation, in the sense that, as noted early on by Hart, we can each have a moral and legal right to pick up a lost dollar bill we simultaneously notice on the sidewalk, but neither of us has a legal right that the other defer to us and allow us to pick it up—and for that matter probably no moral right that the other so defer.  Neither of us has a legal or moral duty or obligation to so defer.

But as you’ve both noticed, in the case of a standard welfare state-type health care system, rights and obligations do seem to entail one another.

The point I would want to emphasize, though, if only for my own clarity of thought, is that both you and Rick could be correct in what you say about the relationships between rights and obligations in this context.  Your point could be restated in terms of health care rights and obligations (on someone’s part) being two sides of the same coin.  Or the same relationship, between obligor and obligee, viewed from different perspectives.  But Rick’s point could be valid as well, in the sense (by very loose analogy, really) that two sides of the same coin can be significantly different for some practical purposes (such as a coin toss on the middle of the football field).  A head differs in some respects from a tail.

The latter idea takes on less trivial import when we appreciate that it could matter very much, psychologically, or culturally, or whatever, whether we choose to emphasize health care as a right or as an obligation.  It might at least be possible, as some might argue, that emphasizing rights rather than obligations could tend more to perhaps unintentionally foster an unfortunate “entitlement mentality.”  But then, another person might argue that emphasizing rights as distinct from obligations would tend to emphasize, valuably, the infinite and incommensurable worth or dignity of each individual person.  Perhaps focusing on the obligation more than the right distinctively promotes—or not; this seems a cultural/empirical question—a sense of responsibility (collectively, if not individually).  My point here is of course not to explore which of these takes is more nearly correct on the merits.  It’s instead that emphasizing the one rather than the other—as we clearly might do—takes us down one cultural path rather than another.

I’m trying to think of a clearer example.  I guess we could say that the fact that The Morning Star and The Evening Star both refer unequivocally to the same object, Venus, does not mean that we can accomplish the same purposes exactly as well by using either term.

As you may by now have realized, I’m not good with examples.