Health Care: Neither Right, Privilege nor Commodity

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

See "Predatory Health Care: Putting Lipstick on a Pig" in Pediatr Neurol, volume 128 on page 65. See "Reply to Letter From Klunk." in Pediatr Neurol, volume 128 on page 66.

In a March editorial, Pavlakis and Roach wrote, “As long as health care is considered a commodity instead of a basic right, it will be susceptible to market forces and to efforts to maximize profits.” 1 While appealing, labeling health care as a right without acknowledgement of what that right entails, how it generates reciprocal obligations, and how that label frames advocates for other approaches to improving healthcare as unsupportive of human rights is fraught. This approach precludes discussion of the desirability of a universal health care system (UHS); instead, declaring it must be so. What of the philosophical principle “ought implies can?” Health care for all is desirable, but can it be acceptably done and why should we think a more regulated health care system would provide more equitable care? Government bureaucracies are hardly known for their efficiency, the criminal justice system is near-completely a governmental entity, and concerns of unequal treatment/systemic racism have racked our country.

Furthermore, whether one views the assertion that UHSs stifle innovation as canon or canard, readers should refer to The Global Burden of Medical Innovation, a Brookings Institute report, and the work of Dr. Daniel Callahan, cofounder of The Hastings Center, before drawing conclusions. 2 , 3 Whether good or bad, a dramatic shift toward a UHS in the United States is likely to have lasting effects, both locally and abroad, on our health and that of our children for years to come.

Lastly, rejecting the framing of health care as a right should not be equated with less of a desire to see the greatest number of people receive the best possible health care. We all want that, but getting there requires us being able to talk about the pros and cons of different approaches and viewpoints. Surely there is common ground between commodities, privileges, and rights where fruitful conversation can exist.

References

1. Pavlakis S., Roach E.S. Follow the money: childhood health care disparities magnified by COVID-19. Pediatr Neurol. 2021; 118 :32–34. [PMC free article] [PubMed] [Google Scholar]

2. Goldman D.L. The Schaeffer Center for Health Policy & Economics at the University of Southern California; Santa Monica, CA: 2018. The Global Burden of Medical Innovation. [Google Scholar]

3. Callahan D. Rationing, equity, and affordable care. Health Prog. 2000; 81 :38–41. [PubMed] [Google Scholar]