A way to argue the United States is obligated to provide health care is by contending it is analogous to its obligation to defend citizens from “enemies foreign and domestic.” While there is disagreement about the obligations of a country, most thinkers believe the state is required to provide a military defense against foreign threats and deploy the police against domestic threats. So, just as the United States is obligated to defend its citizens from foreign terrorists and domestic criminals, it is obligated to defend them against cancer.
Another approach is to forgo the analogy and argue the basis of the obligation to provide military defense and police services also extends to providing health care. The general principle is that the state is obligated to protect its citizens. Since anthrax and heart failure can kill a person just as dead as a bullet or a bomb, then the state is also obligated to provide medical protection. Otherwise, the citizens are left unguarded, and the state would fail in its duty as a protector. While these lines of reasoning are appealing, they can certainly be countered. This could be done by arguing that there are relevant differences between providing health care and providing armed defenses.
One way is to argue that the state is only obligated to protect its citizens from threats presented by humans and not from other threats, such as disease or accidents. So, the state is under no obligation to protect citizens from the ravages of natura disease. But, the state is obligated to protect citizens from foes using disease as a weapon.
This seems odd. From the standpoint of the victim, it does not matter whether their disease is natural or inflicted, since the effect on them is the same. What matters is the harm being inflicted on the citizen. To use an analogy, it would be like the police being willing to stop a human from trying to kill another human but shrugging and walking away if they see a wild animal tearing apart a human. As such, it does not matter whether the harm is caused by a human or, for example, a virus—the state’s obligation to protect citizens would still apply.
Another counter to my view is to argue that while the state is obligated to protect its citizens, it is only obligated to provide a certain type of defense. The psychology behind this approach can be made clear by the rhetoric of those supporting generous state funding of the military and police while being against state funding for medical care. The military is spoken of in terms of its importance in “degrading and destroying” the enemy and the police are spoken of in terms of their role in imposing “law and order.” These are very aggressive roles. One can appear tough while speaking about funding submarines, torpedoes, bullets and missiles.
In contrast, the rhetoric against state funding of health care speaks of “the nanny state” and how providing such support will make people “weak” and “dependent.” This is caring rather than clubbing, curing rather than killing. One does not look manly or tough when speaking about funding preventative care and wellness initiatives.
What lies behind this psychology and rhetoric is the principle that the state’s role in protecting its citizens is one of force and violence, not one of caring and curing. This does provide a potentially relevant difference; but the challenge is showing that this difference warrants providing armed defense while precluding providing medical care.
One way to argue against it is to use an analogy to a family. Family members are generally obligated to protect one another, but if it were claimed that this obligation was limited only to using force and not caring for family members, then this would be rightfully regarded as absurd. Imagine, for example, a parent who was willing to kill to protect their child, but unwilling to take care of their illnesses and injuries. They would be rightfully condemned as a bad parent.
An interesting rhetorical approach is to embrace the military and police metaphors. Just as the state should thrust its force against enemies within and without, it should use its medical might to crush foes that are literally within—within the citizens. So, the state could wage war on viruses, disease and such and thus make it more manly and less nanny. This should have some rhetorical appeal to those who love military and police spending but are loath to fund healthcare.
As far as the argument that health care should not be provided by the state because it will make people dependent and weak, the obvious reply is that providing military and police protection shoulf have the same impact. As such, if the dependency argument works against health care, it would also work against having state military and police. If people should go it on their own regarding health care, then they should do the same when it comes to their armed defense. If private health coverage would suffice, then citizens should just arm themselves and provide their own defense and policing. This, obviously enough, would be a return to the anarchy of the state of nature and that would be bad. If accepting military and police protection from the state does not make citizens weak and dependent, then the same should also hold true for accepting health care from the state.
As a final point, an easy way to counter the obligation argument for state health care is to argue that the state is not obligated to provide military and police protection to the citizens. Rather, the military and the military, it could be argued, exists to protect and advance the interests of the elites. Since the elites have excellent health care thanks to their wealth and power, there is no need for the state to provide it to them. Other than the elites in government, like the Republicans in congress, who get their health care from the state. On this view, support for using public money for the military and police and not health care makes perfect sense.