ABSTRACT
Faced with significant class, race, sex, and regional inequalities in the distribution of health care services, especially the inaccessibility of certain important services for the un-or underinsured, many are inclined to assert that a violation of basic rights is involved. This chapter argues that people are justified in claiming a right to health care only if it is derivable from an acceptable, general theory of distributive justice. Those who claim a right to health care often gloss over another important distinction. They may intend only a system-relative claim to health care: Whatever health care services are available to any within the given health care system should be equally accessible to all. The chapter shows how far people are from being able to derive rights to health care from even the most sympathetic theoretical frameworks. It explains John Rawls’s theory of justice as fairness to health care.
