Rousseau and the Right to Property: Healthcare Edition
In book 1, chapter 9 of On the Social Contract, Rousseau claims that “Every man by nature has a right to everything he needs”, but when he owns something, he excludes himself from that which he does not own (p.435). One aspect of the debate over the healthcare reform bill of 2010 was: Is healthcare a right? Rousseau seems to believe that it would be- by the establishment of property as a right by society the provider has a right to be paid for services rendered. The patient also has the right to property, and should therefore use this property for payment. Once property is removed from public ownership and becomes privately held it becomes a means of exchange, and property is an institution that cannot exist outside of society. Upon forming society out of the state of nature one does not give up the right to maintain themselves. People enter into society to improve their condition, and since society by nature includes everyone, everyone has the same right to an improved condition. Therefore the basis of a society is the common good, which never includes a right to profit at the expense of others. To do so would be a violation of the foundation of the society and also an undoing of its legitimacy and ability to hold the victimized party to the society’s laws. Once society does not provide to someone what it was founded to provide them, they are no longer obligated to it, and if not universal it is a society no longer. Therefore the very right one claims to acquire property is undone because it is a right created by society. In short: For a healthcare provider to deny the right of the citizenry to their expertise and treatment is to undermine the very society that is the foundation of their right to require payment for their services.
When speaking of land, Rousseau says that to deprive others of the “shelter and sustenance that nature gives them in common” is a “punishable usurpation” (p. 435). I cannot imagine very many things more critical to one’s continued survival than access to healthcare. The expertise of the provider becomes their land, their storefront, to which Rousseau says that “each private individual’s right to his very own store is always subordinate to the community’s right to all”, because the foundations on which it is built is held in common (p. 435). I argue that healthcare is therefore a right and it is not currently treated as if it were. While it is true that providers are not able to deny someone care that is needed to save their life, it is also required that the patient pay for their care with no attention paid to how much of their personal property they must part with in order to do so. When this amounts to trading healthcare for everything else one owns, it is essentially the trading of one right for another; an obvious affront to the public good.
In sum, there is no argument about whether healthcare is a right that we enjoy as citizens, and that the providers of that care are not required to give up their right to their “store” in order to provide their services to the people. If the public good is the goal of a society then healthcare for the people, being fundamental to the public good ought to be a goal of an effectively administered society. One could argue whether the healthcare bill passed in 2010 accomplishes this or not, there are compelling arguments on both sides, but the debate must be framed as to how to best accomplish this goal, not whether someone “deserves” or has a right to healthcare. Clearly, according to Rousseau they do.