Sorry for the long post, but this is an informative discussion on "rights"
Liberty vs. Welfare Rights
Let's begin by defining our terms. A right is a principle that specifies something which an individual should be free to have or do. A right is an entitlement, something you possess free and clear, something you can exercise without asking anyone else's permission. Because it is an entitlement, not a privilege or favor, we do not owe anyone else any gratitude for their recognition of our rights.
When we speak of rights, we invoke a concept that is fundamental to our political system. Our country was founded on the principle that individuals possess the "inalienable rights to life, liberty, and the pursuit of happiness." Along with the right to property, which the Founding Fathers also regarded as fundamental, these rights are known as liberty rights, because they protect the right to act freely. The wording of the Declaration of Independence is quite precise in this regard. It attributes to us the right to the pursuit of happiness, not to happiness per se. Society can't guarantee us happiness; that's our own responsibility. All it can guarantee is the freedom to pursue it. In the same way, the right to life is the right to act freely for one's self-preservation. It is not a right to be immune from death by natural causes, even an untimely death. And the right to property is the right to act freely in the effort to acquire wealth, the right to buy and sell and keep the fruits of one's labor. It is not a right to expect to be given wealth.
The purpose of liberty rights is to protect individual autonomy. They leave individuals responsible for their own lives, for meeting their own needs. But they provide us with the social conditions we need to carry out that responsibility: the freedom to act on the basis of our own judgment, in pursuit of our own ends; and the right to use and dispose of the material resources we have acquired by our efforts. These rights reflect the assumption that individuals are ends in themselves, who may not be used against their will for social purposes.
Let us consider what liberty rights mean in regard to medical care. If we implemented them fully, patients would be free to choose the type of care they want, and the particular health care providers they want to see, in accordance with their needs and resources. They would be free to choose whether they want health insurance, and if so, in what amounts. Doctors and other providers would be free to offer their services on whatever terms they choose. Prices would be governed not by government fiat, but by competition in a market. Since this is an imaginary state of affairs, no one can predict what mix of private practitioners, HMOs, and other sorts of health plans would emerge. But market forces would tend to ensure that patients have more choices than they do now, that they would act more responsibly than many do at present, and that they would pay actuarially fair prices for health insurance—prices that reflect the actual risks associated with their age, physical condition, and lifestyle. No one would be able to shift his costs onto someone else. In a truly free market, I might add, there would be no tax preference for obtaining health insurance through employers, so most people would probably buy health insurance the way they buy life insurance, auto insurance, or homeowners insurance—directly from insurance companies. They would not have to fear that losing their job, or changing the job, would mean losing their coverage.
So that is what liberty rights—the classical rights to life, liberty, and property—would mean in practice. The so-called "right" to medical care is quite different. It is not merely the right to act—i.e., to seek medical care, and engage in exchanges with providers, free from third party interference. It is a right to a good: actual care, regardless of whether one can pay for it. The alleged right to medical care is one instance of a broader category known as welfare rights. Welfare rights in general are rights to goods: for example, a right to food, shelter, education, a job, etc. This is one basic way in which they are quite different from liberty rights, which are rights to freedom of action, but don't guarantee that one will succeed in obtaining any particular good one may be seeking.
Another difference has to do with the obligations imposed on other people. Every right imposes some obligation on others. Liberty rights impose negative obligations: the obligation not to interfere with one's liberty. Such rights are secured by laws that prohibit murder, theft, rape, fraud, and other crimes. But welfare rights impose on others the positive obligation to provide the goods in question.
Health care does not grow on trees or fall from the sky. The assertion of a right to medical care does not guarantee that there is going to be any health care to distribute. The partisans of these rights demand, with air of moral righteousness, that everyone have access to this good. But a demand does not create anything. Health care has to be produced by someone, and paid for by someone. One of the major arguments offered by supporters of a right to health care is that health care is an essential need. What good are our other liberties, they ask, if we cannot get medical treatment for illness? But we must ask, in return: why does need give someone a right? Fifty years ago, people whose kidneys were failing needed dialysis every bit as much as they do today, but there were no dialysis machines. Did they have a right to protection against kidney failure? Was Mother Nature violating their rights by making their kidneys fail without a remedy? It makes no sense to say that need itself confers a right unless someone else has the ability to meet that need. So any "right" to medical care imposes on someone the obligation to provide care to those who cannot provide it for themselves.
If I have such a right, some other person or group has the involuntary, unchosen obligation to provide it. I stress the word "involuntary." A right is an entitlement. If I have a right to medical care, then I am entitled to the time, the effort, the ability, the wealth, of whoever is going to be forced to provide that care. In other words, I own a piece of the taxpayers who subsidize me. I own a piece of the doctors who tend to me. The notion of a right to medical care goes far beyond any notion of charity. A doctor who waives his bill because I am indigent is offering a free gift; he retains his autonomy, and I owe him gratitude. But if I have a right to care, then he is merely giving me my due, and I owe him nothing. If others are forced to serve me in the name of my right to care, then they are being used regardless of their will as a means to my welfare. I am stressing this point because many people do not appreciate that the very concept of welfare rights, including the right to health care, is incompatible with the view of individuals as ends in themselves.
I might add that the difference between charity and rights is very well understood by the advocates of a right to health care. One of their main arguments for using the language of rights is that it removes the stigma associated with charity. A right is something for which you don't owe anyone any gratitude. But notice the contradiction. The reason for proposing such a right in the first place is the claim that certain people cannot provide for themselves, and are thus dependent on other people for their medical care. The advocates of a right to health care then turn around and insist on using the concept of rights to disguise the fact of dependence, to allow the recipients of government subsidies to pretend that they are getting something they earned.
It is also worth noting that the Supreme Court has never recognized a constitutional basis for any welfare right, including the right to medical care. The Court recognizes that the concept of rights embodied in our legal system is the concept of liberty rights. Welfare rights are a product of later movements to expand the role of government beyond the original conception of its role. In our constitutional system, there is no requirement that the federal government provide health care. Health care entitlements, unlike fundamental rights like freedom of speech, have to be invented by legislators