Medical care: Is it a right?

Alice A. Chenault, M.D.

When I was handed the microphone at a recent town hall meeting, I asked Sen. Jeff Sessions if medical treatment should be the right of every U.S. citizen. The crowd roared “No!” The senator agreed.

This got me thinking about what we mean by “rights.”

One lady called out, “We only have the three rights guaranteed in the Constitution: life, liberty and the pursuit of happiness. The Constitution doesn’t say anything about health care!”

Never mind the fact that life, liberty, etc., are mentioned in the Declaration of Independence, not the Constitution. She had launched me on a quest.

A cascade of “rights” flooded my mind. The right to vote, speak freely, choose your own religion, express grievances against the government, decline to testify against yourself, or the right to due process before giving up your property or liberty — all these are granted by the Constitution and its amendments.

But many of our rights are not declared in the Constitution. Supreme Court decisions, like the 1954 ruling that banned racial segregation in schools, bind the entire country with the same force as constitutional provisions. Laws enacted by Congress and signed by the president similarly confer rights with nationwide effect. Other rights are granted by actions of state, county or city governments and affect smaller groups of people.

American children’s right to a free public education is an interesting example. The Constitution makes no mention of any such right. Congress has passed no law mandating it. The Supreme Court has never ruled that our government has to pay for all American kids to attend grades K-12 tuition-free.

This vital matter is left entirely up to the individual states. Laws on schooling differ from state to state. Rules about teacher qualifications, classroom hours and curriculum can change whenever you cross a state line. Shockingly, for example, Alabama’s constitution still mandates separate schools “for white and colored children,” though the law is not enforced and would certainly be unconstitutional if tested.

We usually think of a right as something we can choose to do or not, as we please. “You have the right to remain silent” when arrested, yet you’re free to discuss your case with police if you choose. But consider the difference between the right to education and, say, the right to vote. Voting is considered a sacred right, with elections paid for by government, not the voter. Still the choice is yours: nobody is forced to vote or punished for staying home on Election Day. Sending your children to school, on the other hand, is not only your right but your legal obligation. If your kids don’t go to school, you the parent can go to jail.

This loops me back into whether medical care is, or should be, a right. How weird would it be if parents had to see to it that their children were in school, but no such thing as free, public, universal education existed? Parents unable to afford private school tuition could face criminal charges. I argue that the lack of universal, affordable medical care puts American citizens in a similar bind.

Medical neglect — failure to provide necessary medical treatment for one’s injured or ill child — is legally defined as a form of child abuse, with penalties ranging from loss of custody of the child to imprisonment of the parent. This puts families without health insurance or money to buy medications at greater risk of these punishments than the wealthy. Doesn’t that violate our Fourteenth Amendment guarantee of “equal protection of the law”?

If you can’t go that far with me, consider at least this from veteran journalist Christopher Dickey: “[G]overnments spend money to acquire assets. That includes bridges and nuclear reactors, but also hard-to-price, intangible assets like a well-educated and healthy population.” (My emphasis.)

I hold that to be a self-evident truth.

Alice A. Chenault, M.D., is a psychiatrist in Huntsville, Ala., and a member of Physicians for a National Health Program (www.pnhp.org).