The Bush administration and its allies may be the most obvious abusers of the words “freedom,” “liberty,” and “rights,” but talk of “rights” is also pervasive on the left. Their use of the term is not restricted to the civil and political rights identified in the French Declaration of Rights of 1789 or the American Bill of Rights of 1791. Those great charters shaped the views of those who think of rights as limits on the state. The French declaration proclaimed the presumption of innocence, while the first ten amendments to the American Constitution set forth the protections to which all are entitled before they may be subjected to a criminal penalty; and both charters guaranteed that each of us may speak, write, publish, or worship without the interference of the state. (The French declaration also asserted that all are equal in rights, whereas in the American case, it was only in a further series of amendments, adopted after the Civil War, that the concept of equal rights was incorporated into the Constitution.)
Today, however, it is customary on the left to add a great many rights to those enumerated in the French Declaration of Rights or the American Bill of Rights (supplemented by the Thirteenth, Fourteenth, and Fifteenth Amendments that abolished slavery and recognized equal rights). These additional rights include economic rights, such as a “right to health care,” a “right to housing,” and a “right to food,” and what are sometimes called “third-generation rights” such as the “right to a healthy environment.”
Yet calling such matters “rights” raises profound questions about what is meant by “rights.” The effort by the left to equate economic rights with traditional civil and political rights is the mirror image of the effort by the Bush administration to equate free trade and economic freedom with political freedom. Although economic freedom and economic rights sound similar, they actually signify opposite approaches. The champions of economic freedom contend that there may be no restraints on the uses of capital. On the other side, the proponents of economic rights not only want to restrain the way that capital is used but also to require its redistribution as a matter of rights.
Use of the term “rights” to deal with economic issues is a worldwide phenomenon; the obvious inability of poor countries to provide all the benefits that the left has designated as rights has not acted as a restraint. Instead, it has given birth to other concepts. One is that rights should be realized progressively as countries acquire the necessary resources for economic development. The other is that there is yet another right: a so-called right to development. Implementation of this right requires the transfer of resources from countries that are wealthy to those that are poor.
As an example of the way economic rights would work, consider the question of the right to health care. One person may require kidney dialysis, another may need a heart bypass operation, another may have to have long-term cancer care, and yet another may need lifelong antiretroviral therapy. In each case, failure to provide this care would probably mean that the person who needs it will die. Surely, therefore, if health care is a right, the state has an obligation to provide such treatment to each of these persons and all others who have similar needs. Moreover, the manner in which such care is provided should meet a high standard. That heart bypass operation, for example, should be conducted by a well-qualified surgeon operating in state-of-the-art facilities.
As should be evident, substantial resources that lie well beyond the reach of most countries are required to provide such care. In my view, a wealthy country such as the United States should, as a matter of good public policy, provide such care to all citizens who need it. Yet to achieve this even in the United States, unless public spending on health care were greatly increased, deep cuts would have to be made in spending on primary health care. If total spending on health care were increased to the degree required for both lifesaving care for the chronically ill as well as primary care for all, there would seem to be two alternative ways to cover the extra costs. One would be to decrease spending on other aspects of government—education, transportation, criminal justice, or national security, for example; the other would be to increase taxes. As a citizen, I espouse the shifts in spending priorities and in tax policy needed to provide comprehensive health care for all.