1. Introduction
Fire insurance wouldn’t work if people paid for it only when their house was on fire”, said Mark, a small-business owner whose near-death experience shifted his previously unfavorable view on the Affordable Care Act (Gawande, 2017).
Nominally, healthcare is acknowledged as a basic right worldwide, as affirmed by the World Health Organization: “The right to health and other health-related human rights are legally binding commitments enshrined in international human rights instruments. WHO’s Constitution also recognizes the right to health,” (2023). However, in reality, healthcare is far from universally accessible, with a considerable proportion of the global population having limited or no access to healthcare due to reasons such as unequal distribution of resources and economic underdevelopment.
There has long been a debate over whether healthcare should be regarded as a right or a specialized privilege. The proponents argue that healthcare is a universal right that applies to all individuals regardless of their social status or personal identity because every human life holds equal value. In contrast, opponents view healthcare as a “privilege” and place great emphasis on the idea of “deservingness,” asserting that healthcare constitutes “legitimate aspirations” rather than a universal right.
In this essay, I will argue that healthcare should be taken as a right based the grounds that health is a precondition for other inalienable rights and on the grounds of the Rawlsian theory of distributive justice.
In section two, I will explain the definition of rights and differentiate between the three degrees of perspective for healthcare coverage. In section three, I will expand upon the two aforementioned arguments for healthcare as a right. In section four, I will consider two potential counterarguments, the free rider argument and practicality argument. Lastly, I will make a brief conclusion.
2. Conceptual Framework: What Does It Mean to Say, “Healthcare Is a Right?”
In the public sphere, we hear the expression “healthcare is a right,” from many, and yet the specific meaning of this claim, and its practical policy implications, vary significantly. Before engaging in any discussion on the topic, it is essential to clarify precisely what we are referring to.
We can identify at least three distinct perspectives among those who may consider themselves as supporters of healthcare as a right: the radical, the moderate, and the limited. The radical perspective advocates for free, universal, and unconditional healthcare coverage; the moderate perspective supports uncapped aid for individuals who cannot afford healthcare on their own, while expecting those with the means to contribute at least partially to their own costs; and the limited perspective favors restricted, capped healthcare assistance, are setting very strict limits on the scope or amount of aid provided.
Specifically, the limited perspective ought to be dismissed from our range of discussion, since it directly conflicts with the core tenets of viewing healthcare as a right. Rights, by their inherent nature, must be universal and accessible to all people, regardless of their identity, background, or economic conditions. In the words of Evans, “as a human right, the right to health cannot be bought and sold in the marketplace like other commodities. Nor can the right to health be limited by the ability to pay” (2002). Some societies may operate with a limited healthcare system due to practical constraints such as level of economic development and state capacity, but if they recognize universally accessible healthcare as a goal worth pursuing, healthcare is still conceptually treated as a right in such societies.
In contexts guided by a limited perspective, many people still cannot access necessary healthcare due to financial constraints and other barriers, and this reality directly contradicts the very definition of a “right” itself. For instance, the United States only provides partial to minimal healthcare coverage for its low-income citizens, while there are still 10% of Americans who can’t access healthcare (Julia, 2025). The limited perspective, in its essence, reduces healthcare to an aspirational goal rather than framing it as the fundamental right. By creating conditions for these so called “rights,” one is inherently rendering them to be, what we call, privilege. Consequently, the following arguments will proceed from the radical and moderate perspectives. The distinction between these two is largely a matter of economic and taxation models, both of which are fundamentally predicated on the redistribution of wealth from the more affluent to the less, to ensure universal access.
3. The Precondition Argument and the Distributive Justice Argument for Healthcare as a Right
As Wallis (2008) argues, “Healthcare should be a human right and not a commodity for sale.” In this section, I will focus on two major arguments. One based on health as a precondition for all other rights, meaning healthcare ensures people’s access to any other rights, and the second, being Rawl’s theory of distributive justice, which states that a system can only be just when enforced under a “veil of ignorance.”
The precondition argument posits that health is a foundational prerequisite for the meaningful exercise of all other rights. Rights commonly acknowledged–such as voting, free speech, and freedom of movement–are contingent upon a basic level of well-being. The Oxford philosopher Henry Shue (2020) argued that “basic rights,” including healthcare, are “necessary in order for us to enjoy any rights or privileges at all.” If health is not guaranteed, the capacity to exercise other rights is critically undermined. Health is not just a means to an end; it is an essential part of human flourishing. Without good health, people cannot participate fully in economic, social, or political life (Capability Approach, 1985).
Take an example of a seriously ill individual, whose nominal right to freedom of movement is rendered void by their health condition. To guarantee fundamental rights like life and dignity, the right to healthcare must first be secured. As the Lancet Commission (2023) notes, “Health equity [is] not just social value–[it is] pathways to sustainable peace,” thus strengthening societal resilience and the protection of civil liberties.
The second argument arises from John Rawls' theory of distributive justice, which highlights the moral arbitrariness governing the distribution of social goods. Rawls (1971) argues that factors such as birth, natural talent, and social background–which are morally irrelevant–should not dictate one's life chances. His theory seeks to correct these arbitrary distributions by proposing that the rules of a just society must be chosen from behind a “veil of ignorance,” where decision-makers are ignorant of their own future social status, wealth, or talents (Wenar, 2021). From this impartial position, no rational actor would consent to a system where access to healthcare depends on wealth or luck. Unable to know if they would need expensive care, individuals would unanimously reject a system that treats healthcare as a privilege. Instead, they would demand a guarantee of essential care for all to mitigate personal risk. Framing healthcare as a privilege therefore violates Rawlsian justice, as it permits morally arbitrary factors to determine who suffers and who thrives.
4. Rebuttal and discussion
Opponents who view healthcare as a privilege often ground their position in personal responsibility, advocating for minimal state aid. Their primary arguments being the problem of free riders and concerns over practical implementation.
The first counterargument warns of “free riders,” or individuals who benefit from a universal system without contributing proportionally, thereby undermining fairness and common responsibility. However, this counterargument is misplaced. Indeed, the existence of free riders does harm equality as it seems to be truly unfair to those who are hardworking. However, free riders then become an issue of moral hazard when we assume the subject at hand is not a right. Take education for example, the taxpayer's dollar contributes to the education system, which is something everyone pays despite the existence of free riders because it ensures the country’s future development and population quality. Healthcare should then also be treated similarly as a public interest rather than personal responsibility. The spreading of disease and overall healthcare maintenance can and will affect society as a whole, not only mere individuals.
John Rawls’ idea of “justice as fairness” is also reinforced by luck egalitarianism. Rawlsian theory emphasizes that current societal distributions are morally arbitrary and unjust. Healthcare must be a basic right, and not a privilege, because poor health undermines other fundamental liberties. No one “deserves” arbitrary disadvantages like illness, disability, or inability to afford care, and behind the Veil of Ignorance, no one would risk a system where access to healthcare depends on luck. The “free rider” critique, too, collapses under this framework. It implicitly presupposes that “only those who can pay deserve healthcare,” but Rawls’ Difference Principle, which mandates that any societal inequalities must benefit the least advantaged, and luck egalitarianism both reject current distributions as morally arbitrary. Poor people ought to receive far more support than they do now, and many so-called “free riders” are not refusing to contribute, but rather unable to. As Michael Sandel (2025) further argues, healthcare is a common good. When all members of society have access, communities benefit from reduced disease spread and healthier workforces, reinforcing why framing healthcare as a basic right aligns with the goals of a just society. Additionally, framing healthcare as a basic right secures the “background conditions” of justice. Personal responsibility only carries meaningful weight once people have access to the tools and resources needed to make healthy choices, an idea opponent incorrectly invert by demanding responsibility before securing the rights to enable them.
Another main argument against healthcare being a right arises from concerns for practical enforcements and resource scarcity. Many opponents believe it to be overly idealistic as resources will always limited and demand infinite, as per the fundamentals of economics. This line of reasoning is not false in that it can create a financial burden on governments and/or societies, as we can see through universal systems often leading to rationing, long wait times, and reduced quality. (Miller, 2019)
This pragmatic concern, while valid, is not an insurmountable barrier. Wealthier and more developed countries, such as Canada and Sweden, have established government funded healthcare systems to cover the expenditure on health. Notably, the United States’ Medicare f is a federal health insurance program that covers a range of medical services for people over 65 years old. Even though many developing countries cannot currently afford universal healthcare, this does not negate it as a worthy goal, as economic development will eventually make it achievable. Phased reforms, such as Uzbekistan’s mandatory health insurance and targeted UHC designs in the occupied Palestinian territory, prove resource constraints are temporary, not permanent barriers (WHO Office, 2021).
More affordable accessible healthcare and economic development are synergistic as they do not require waiting for full economic maturity. Cross-country studies link public healthcare to lower mortality, higher per capita income, and boosted labor productivity. Practically, Thailand’s UHC cut healthcare-driven poverty by two-thirds, while Armenia’s inadequate care caused annual losses from out-of-pocket spending and lost productivity (Theelders, 2016). The WHO and World Bank further confirm that health investments drive development by maximizing human capital, making healthcare a growth driver, not a luxury for wealthy nations.
5. Conclusion
In conclusion, this essay has argued that healthcare should be unequivocally recognized as a fundamental human right. This position is supported through the argument that health is a precondition for the exercise of all other rights and by the principles of Rawlsian distributive justice, condemning systems that allow morally arbitrary factors to determine life outcomes.
For future prospects, we should focus on analyzing the trade-offs between equity and efficiency in public healthcare financing, especially how to optimize resource allocation to avoid overburdening governments while upholding universal access. More efforts should also be devoted to investigating the alignment between public perceptions of “healthcare as a right” and policy implementation, to identify barriers that hinder the translation of contemporary normative claims into practice. As written in the constitution of WHO, “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition” (WHO, 2025).
References
About Us | Medicare. (n.d.). Medicare.gov. U.S. Centers for Medicare & Medicaid Services. https://www.medicare.gov/about-us
Bonavitacola, J. (2025, April 3). 11% of Americans cannot access quality health care, survey finds. American Journal of Managed Care. https://www.ajmc.com/view/11-of-americans-cannot-access-quality-health-care-survey-finds
Evans, T. (2002). A human right to health? Third World Quarterly, 23(2), 197–215. https://doi.org/10.2307/3993496
Gawande, A. (2017, September 25). Is health care a right? The New Yorker. https://www.newyorker.com/magazine/2017/10/02/is-health-care-a-right
Harvard University. (2025). Justice: What’s the right thing to do? | Michael J. Sandel. https://sandel.scholars.harvard.edu/publications/justice-whats-right-thing-do
The Wilson Center. (2023, September 7). Launch | The Lancet Commission on peaceful societies through health equity and gender equality. https://www.wilsoncenter.org/event/launch-lancet-commission-peaceful-societies-through-health-equity-and-gender-equality
Miller, T. (2019, August 15). It’s wrong to treat health care as a right. American Enterprise Institute. https://www.aei.org/articles/its-wrong-to-treat-healthcare-as-a-right
World Health Organization. (2021, April 7). Feasibility study for the introduction of mandatory health insurance in Uzbekistan. https://www.who.int/europe/publications/i/item/WHO-EURO-2021-2317-42072-57915
Rawls, J. (1971). A theory of justice. Harvard University Press.
Shue, H. (2020). Basic rights: Subsistence, affluence, and U.S. foreign policy (40th anniversary ed.). Princeton University Press. https://academic.oup.com/princeton-scholarship-online/book/37832
The Elders. (2016, May 17). UHC explained: Universal health coverage delivers substantial health, economic and political benefits. https://theelders.org/news/uhc-explained-universal-health-coverage-delivers-substantial-health-economic-and-political
World Health Organization. (2023, December 1). Human rights. https://www.who.int/news-room/fact-sheets/detail/human-rights-and-health
Wenar, L. (2021, April 12). John Rawls. In E. N. Zalta (Ed.), The Stanford encyclopedia of philosophy (Fall 2021 ed.). Stanford University. https://plato.stanford.edu/entries/rawls
Wallis, J. (2008, August). A visit to the ER. Sojourners. https://sojo.net/magazine/august-2008/visit-er
World Health Organization. (2025). Constitution of the World Health Organization. https://www.who.int/about/governance/constitution