Right or Privilege?

I have been talking with people regarding whether they think medical care is a right or a privilege. I have talked with MDs I work with as well as fellow RNs, friends and family.

The general consensus of medical staff is health care is a privilege. Some friends say privilege and some say right. I found this conversation necessitates defining these terms:

Right - something a civilized, developed nation should guarantee at a basal level to its citizens. Basically the same thing as you should be able to be safe in your home, pursue whatever career choice you want and the choice of worshiping, or not, whatever deity you chose.

Privilege - something earned, bestowed upon or above and beyond those basal "Rights" spoke of earlier. Like a driver's license. You have to behave within parameters to obtain and keep you privilege to drive.

Once those definitions were hashed over, I came to think the following: I think every person should have a right of some basal level of medical care. Vaccinations, annual physicals, screenings, nutritional education; all basal levels of care that should be available to all. To me, these equate to the betterment of society and thus provide for a more productive society. An investment that benefits society as a whole, much like our public school system does now. I pay taxes and don't have kids, but I see the need for public schools.

However, there are levels to health care that are most certainly a privilege. Keeping people alive when the most honest, humane thing to do is to "let nature take its course," is not a right. As harsh as it sounds, I think if you want that for a family member, or even if you yourself wrote this out in a living will, your estate or your family needs to cough up the cash to pay for it.

There are many other instances where a much higher level of care or intervention is a privilege and should often times be denied to an individual so that greater resources are available for the society at large.

As a health care professional, the real question is this: Will these interventions (treatment) improve or return the person back to his or her previous level of function and comprehension? Will we really make something better? Or are we just prolonging death?

Once those questions are posed, one still has to ask, who is going to pay for it? The reality is someone is going to.
Our society has become removed from the fact health care is not a product, it is not something one purchases that will have perfect function and is completely full-proof in its application. If it does not do what the person receiving it expects, you cannot return it for a refund! This attitude of "It did not work the way I wanted, so now give me my money back plus pain and suffering..." well, that is the attitude of privilege.

Another recent attitude of privilege is people expect hospitals to be 5-star hotels. Hospitals used to be wards...with curtains. But our "I'm so entitled" society now thinks they need to be at the Westin while having surgery, or even just food poisoning....

So what do you think?
Privilege or Right?