Still more on health care and rights

Prof. Bryan McGraw (political theory / Wheaton) has this contribution to our conversation:

I've been reading (and skimming) the various posts on whether there is a "right" to health care and a few things suggest themselves to me.  One of the things that comes out very clearly in Wolterstorff's "Justice" was the way in which "rights" are always already embedded in certain contexts and especially in social relationships.   They are norms of social relationships, he says, and that seems quite right to me.  So in thinking about any kinds of rights, we are actually thinking about the proper shape (or the range of proper shapes) of our social and political relationships.  I have a "right" to free speech in the sense that others have an obligation in their relation to me to allow me to express myself.  (Note that such rights extend only insofar as we have relationships with others - some provincial governor in Siberia has no obligation vis-a-vis me unless we come into contact).  The limits to that right - libel, fighting words, physical safety, national security, etc. - are themselves articulated in the context of our relations to one another and what sorts of mutual obligations overlap with speech - an obligation not to libel others, an obligation not to provoke violence, etc. 

The problem with employing "rights" language is not that we do not have any rights when it comes to health care.  Given certain resources, I'm happy to say that such obligations exist.  The problem is that rights rhetoric tends to obliterate the contexts of those rights and the mutual obligations that undergird and limit them.  So in the case of health care, the rhetoric of rights all too often (as is often the case when we talk about welfare rights) erases the distinctions between public and private obligations and public and private resources.  It would make a great deal of sense to me to say that, given the collective wealth of our country, there is a "right" to basic health care (which is today, of course, vindicated in the health care that people receive gratis in ERs and medical clinics) but it gets a great deal more dicey when things go beyond that precisely because to say, as some will suggest (perhaps merely to make a rhetorical point), that we all the right to the same health care as, say, members of Congress suggests that the very substantial resources necessary to make that happen are, in fact, collective resources subject to collective determination.  To say that one has a "right" to health-care just means that one has a right to the resources necessary to exercise that health care.  It seems quite right to say that we have a right, given the resources we have as a country, to basic health care, but beyond that, I think the argument comes to depend on a very strong egalitarianism that is itself underwritten by the sense that the community has at its disposal all the resources in the community.  And that seems to me a mistake, though others, of course, will differ in that judgment.