I think when people say healthcare is a right, or ought to be a right, they don’t always have the same thing in mind. I think everyone would agree that you shouldn’t be denied healthcare on account of race or religion or ethnic origin, or sexual orientation. Well, maybeeveryonewouldn’t agree, but it’s not what people usually dispute about. The question is whether you can get healthcare if you don’t have money to pay for it.

你知道这个问题还不太清楚。这是否意味着你有权获得医疗保健，即使你无法支付，但你仍然会收到账单，最终不得不以某种方式处理它?这就是目前的情况;如果你破产了，你可以去公立医院的急诊室，得到照顾，然后可能一个月后会收到2万美元的账单。

Or这是否意味着医疗基本上是免费的，就像在其他一些国家一样，由税收覆盖，没有债务或由接受者自掏腰包?

As I understand Obamacare, which hadn’t yet passed when we recorded this program, the basic answer the U.S. is going to provide aboutrightsis that things stay unchanged. You have a right to get healthcare, in that you don’t have to pay for it up front, but you still have to pay for it, or at least be in debt for what you get.

The big new change is that it's not going to be a right but aduty; everyonehasto have health insurance. So it seems to be that we have a right to healthcare without paying cash out of hand, but we have a duty to be able to pay for it, and this means having insurance.

But that is an important change, that affects our rights, namely our right to have health insurance. You can’t have a duty to buy insurance, unless youcanbuy insurance. And right now, we don’t all have that right. Some people can’t buy insurance at all, and others can’t buy decent insurance at a reasonable price. So if the plan is to make sense, the duty to have insurance will have to be paired with affordable, available insurance for everyone.

So our new right won’t be to healthcare, but to affordable insurance. At least, that’s the outcome some people are hoping for.

在西欧，人们的医疗保险一般由税收支付。我们将会有一些完全不同的东西——医疗保险;购买保险的义务;以及购买负担得起的保险的权利。

还有很多不清楚的地方。考虑到我有权利享受医疗保健，有义务购买保险来支付我所获得的医疗保健，有权利获得可负担的保险——但仍然存在我有权享受何种水平的医疗保健的问题。我们在医疗保健中包括了很多东西。从设置断臂到阴唇复位手术;from stitching up a child’s wounds to ten years of psychotherapy for a philosopher with writer’s block…

Consider the analogy with education. Everyone is entitled to a high school education that covers basic subjects. But some people, who live in richer school districts, or go to private schools, have smaller classes, and a wider variety of subjects. Do we have a right to basic healthcare, like we have a right to a more or less basically adequate education? Or does everyone have a right to healthcare that’s equal to everyone else’s?

It sounded so simple: right or privilege? But it’s a mess. We need help.

And we’ll have it. Laurence Baker, a Professor of Health Research and Policy joins us in our conversation about right and healthcare.