LARRY R. CHURCHILL
Is there a moral right to health care? Most Americans think so. They rank health above wealth and achievement as "the greatest single source of happiness." 2 And ninety one percent say they believe that "everybody should have the right to get the best possible health care— as good as the treatment a millionaire gets." 3 This is not surprising. Every industrialized democracy except the United States and the Republic of South Africa recognizes a right to health care. In all other countries, universal access to basic health services is assured as a matter of public policy, even though in practice many countries fail to achieve that objective.
Though not always called a right, health care is seen in these other countries as a basic good no one should be without. In the United States there is no general, legal right to health services. Still, most U.S. citizens see health care as central to their concept of a good, or even a minimally tolerable, life. 4 Being denied health care services is hazardous to a person's well-being. But of equal importance, denial of health services is an assault on one's self-respect. In short, while most Americans believe health care should be a right, this moral conviction is not reflected in the law, or in any organized government program to provide general health services to the population.
If health care is to become a tangible right in the United States, a way must be found to define the scope of that right. A system of health care which entitled all citizens to all possible services would be financially infeasible. We currently spend fourteen percent of our Gross Domestic Product (GDP) on health care, yet twenty five percent of the population is unserved or underserved. If we were to provide health coverage to everyone and leave other aspects of the system unchanged, health expenditures would immediately rise to twenty percent of the GDP. No one believes this is economically possible, let alone practical. There is growing consensus that financial and administrative reforms are needed, such as reducing the paperwork,