Healthcare is a Negative Right
a fresh perspective with Inherent Care Theory
As I continue to explore and develop the concepts behind Inherent Care Theory (ICT), I find it increasingly clear that a fundamental shift is required in how we approach healthcare. Traditional models, often framed as a positive right, focus on providing services—building hospitals, offering insurance, and increasing the number of healthcare workers. However, these models frequently overlook the systemic barriers that prevent equitable access to care in the first place. Reframing healthcare as a negative right through the lens of ICT—particularly when integrated with the movements for gender-affirming care, reproductive justice, and disability justice—offers a transformative approach that addresses the root causes of inequity.
What Does It Mean to Frame Healthcare as a Negative Right?
In political philosophy, negative rights are freedoms from interference—rights that require the removal of obstacles rather than the provision of something new. In healthcare, this reframing shifts the focus away from merely increasing services and resources, toward dismantling the barriers that prevent people from accessing care.
By emphasizing healthcare as a negative right, ICT places the responsibility on governments, institutions, and society to remove the legal, economic, social, and institutional barriers that block access to healthcare. This reorientation challenges us to think beyond just providing care and asks: What are the systems and structures that actively prevent individuals from receiving the care they need, and how do we dismantle them?
Why Negative Rights Are Key to Healthcare Reform
Framing healthcare as a negative right is useful because it redefines the problem from one of insufficient provision to one of systemic injustice. Here’s why this approach matters:
It Emphasizes Structural Change Over Simple Provision: Viewing healthcare as a negative right focuses on eliminating the barriers—such as discriminatory laws, prohibitive costs, and bureaucratic red tape—that prevent people from accessing care. This approach shifts from expanding the supply of healthcare to addressing the root causes of inequity.
It Broadens the Conversation Beyond Logistics: Traditional approaches often narrow the conversation to how care is provided—insurance, hospitals, and so on—without addressing the deeper systemic barriers that prevent access, even when services are technically available. Focusing on healthcare as a negative right allows for a more profound engagement with issues like economic inequality, geographic disparities, and institutional discrimination.
It Reframes Healthcare as a Justice Issue: Negative rights are about freedom from injustice—in this case, freedom from the systemic and structural forces that deny individuals access to care. Framing healthcare in this way highlights the responsibility of society to dismantle oppressive systems that create inequity, rather than merely producing more services within the existing framework.
It Increases Accountability for Removing Barriers: By reframing healthcare as a negative right, policymakers and institutions are not just tasked with providing care but are held accountable for actively removing the barriers that prevent access. This encourages a systemic approach, where the goal is to liberate people from the structural forces that perpetuate inequity.
It Aligns with Social Justice Movements: This reframing resonates with movements for gender-affirming care, reproductive justice, and disability justice, which focus on dismantling barriers rather than simply expanding services. By removing legal, social, and economic obstacles, these movements seek to make healthcare truly accessible to marginalized groups.
Applying Inherent Care Theory to Gender-Affirming Care, Reproductive Justice, and Disability Justice
This reframing of healthcare as a negative right finds powerful expression in specific areas where barriers to care are most entrenched—particularly in the realms of gender-affirming care, reproductive justice, and disability justice. Each of these areas demonstrates the deep-seated systemic forces that must be dismantled to achieve real healthcare equity.
Gender-Affirming Care
Gender-affirming care is often hindered by a multitude of barriers, including discriminatory laws, social stigma, and institutional roadblocks:
Legal Barriers: Many transgender and non-binary individuals face restrictive laws that limit their access to gender-affirming treatments. ICT calls for the removal of these legal obstacles to ensure that people can receive the care they need without unnecessary interference.
Social and Economic Barriers: Economic hardship and social stigma prevent many from seeking gender-affirming care. By framing healthcare as a negative right, ICT advocates for the dismantling of these barriers, ensuring that everyone has equitable access to gender-affirming treatments.
Institutional Barriers: Bureaucratic processes often create unnecessary delays or deny care altogether. ICT demands the removal of these institutional hurdles to ensure timely and respectful care for all.
Reproductive Justice
Reproductive justice centers on the right to have children, not have children, and raise children in safe environments. This movement aligns with ICT’s focus on dismantling barriers to reproductive health:
Legal Barriers: Restrictions on abortion and contraception disproportionately affect marginalized communities. ICT calls for the removal of these harmful legal restrictions, ensuring that reproductive rights are fully respected.
Economic Barriers: The costs of reproductive healthcare, including prenatal and childbirth services, limit access for many individuals. By focusing on the removal of these financial barriers, ICT aims to ensure equitable access to reproductive care for all.
Social Barriers: Stigma and discrimination surrounding reproductive choices often prevent individuals from accessing necessary services. ICT advocates for a healthcare system that is free from coercion and judgment, allowing people to make reproductive decisions on their terms.
Disability Justice
Disability justice demands a rethinking of how healthcare systems address the needs of people with disabilities. ICT’s negative rights approach focuses on dismantling the barriers that create inequities:
Accessibility Barriers: Many healthcare facilities remain inaccessible, physically and systemically, to people with disabilities. ICT calls for the removal of these barriers to ensure full inclusion in healthcare services.
Economic Barriers: People with disabilities often face higher healthcare costs. ICT advocates for the removal of these financial burdens, ensuring that disability-specific healthcare needs are met without undue hardship.
Discrimination and Bias: Bias in healthcare systems leads to substandard care for individuals with disabilities. ICT emphasizes the need to dismantle discriminatory practices and create a system that provides inclusive, respectful care for all.
Expanding the Healthcare Discourse
By framing healthcare as a negative right, ICT shifts the conversation beyond mere provision of services to addressing the structural and systemic barriers that prevent equitable access. This approach challenges traditional models and broadens the ethical debate, bringing social justice principles to the forefront of healthcare reform. It invites us to think more critically about how power operates in healthcare and how existing structures perpetuate inequity.
Reframing healthcare as a negative right through the lens of Inherent Care Theory offers a radical, transformative approach to achieving equity. Rather than focusing solely on providing more services within an unjust system, this perspective urges us to dismantle the legal, economic, social, and institutional barriers that block access to care. In doing so, we honor our natural human tendency to care for one another, creating a society where healthcare is not just available but accessible, just, and truly liberating for all.