In The Wealth of Nations, published in 1776, Adam Smith wrote that a nation cannot truly flourish if a sizable number of its people are “poor and miserable.” In discussing the virtues of the increasing division of labor and the inequities it produced, he argued, “It is but equity, besides, that they who feed, clothe, and lodge the whole body of the people, should have such a share of the produce of their own labour as to be themselves tolerably well fed, clothed, and lodged.”
Since it is the division of labor that has givenb those trained in medicine the opportunity to advance our knowledge and technology for treating illnesses and extending life, would Smith’s vision include access to healthcare as a matter of equity for all?
The United Nations Universal Declaration of Human Rights, which the US helped draft, seems to think so. It states, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care ….”
Not everyone agrees. One physician, Philip Barlow, has argued that it is unproductive to consider healthcare a right. After all, healthcare is difficult to define. While we might agree that it should include life-saving heart surgery and organ transplantation, might there be less agreement around cosmetic surgery or erectile dysfunction? Barlow raises similar questions in an editorial in the British Medical Journal.