Equality, Democracy, and the Human Right to Health Care

This chapter considers whether or not there is a right to health care by focusing on equality and democracy. It considers two distinct trends that characterize the human right to health care. First, public health scholars increasingly emphasize that health is a complex good, promoted and protected by circumstances well beyond access to medical care for individuals or even the provision of traditional public health services to populations. Second, work in both public health and in bioethics has increasingly recognized the importance of political empowerment and participatory processes to fair and effective health policies. This chapter articulates an approach to human rights that supports both trends. It criticizes attempts to analyze the precise content of the alleged "right to health" by specifying the levels and kinds of health care to which individuals are entitled. It argues that a "right to health," as distinct from a "right to health care," wouldbe impossibly expensive and ultimately unattainable. It also reviews a number of accounts of rights to health care and suggests that all of them are inadequate. Instead, it favors an approach that considers "rights" to health care not as a foundation of justice, but as established by the political process, especially by the procedures of a democratic state.