Health Care: Rights And Obligations

Dean Kagan was not my Harvard Law School professor of constitutional law, but Professor Arthur Sutherland, a gentle scholar with a penetrating mind (and wit) was. He taught us that rights are closely tied to obligations. Although health care issues may seem too mundane to be linked to Harvard legal principles, Sutherland's message remains relevant: health care rights and obligations are inextricably linked.

In 2008, when I started this blog, I discussed the franchise that health care professionals obtain when they receive their licenses, granting them their rights to practice, and noted that their rights were accompanied by serious professional obligations to provide services in the public interest which those licenses were granted to serve. For physicians, it means the obligation to provide care for desperately ill patients who may not be able to afford the health care provider's "usual and customary fee." For licensed (franchised) hospitals, whether for-profit or not-for-profit, it means taking care of the needs of those who would become seriously impaired, suffer unnecessary pain, or die without the hospital services the institution is licensed to provide. For licensed (franchised) insurance companies, it means considering issues above and beyond profit when underwriting and providing insurance benefits. For patients who proclaim their rights to health care, it means taking those personal measures which promote health rather than (i.e., alcohol, tobacco and dangerous drugs as well-as high-risk behaviors) demand that society take the responsibility to correct the damage they have done to themselves. It may mean understanding that the demands which an individual makes on the health care system may be unrealistic, unnecessary and economically impossible and, if met, may result in the system being unable to provide basic care to others.

Each of us will require health care. When we (or our surrogates) make demands upon the our health system, we should understand the system's capacity, it's obligations and our own. Health care does not represent a bottomless trough at which we can all line up to get our fill. Nor is it an ever-growing source of revenue to its franchisees.

What are your health care rights? And what are your obligations?