The current U.S. health care system, with both rising costs and demands, is unsustainable. The combination of a sense of individual entitlement to health care and limited acceptance of individual responsibility with respect to personal health has contributed to a system which overspends and underperforms. This sense of entitlement has its roots in a perceived right to health care. Beginning with the so-called moral right to health care, the issue of who provides health care has evolved as individual rights have (...) trumped societal rights. The concept of government providing some level of health care ranges from limited government intervention, a ‘negative right to health care’, to various forms of a ‘positive right to health care’. The latter ranges from a decent minimum level of care to the best possible health care with access for all. We clarify the concept of legal rights as an entitlement to health care and present distributive and social justice counter arguments to present health care as a privilege that can be provided/earned/altered/revoked by governments. We propose that unlike a ‘right’, which is unconditional, a ‘privilege’ has limitations. Going forward, expectations about what will be made available should be lowered while taking personal responsibility for one’s health must for elevated. To have access to health care in the future will mean some loss of personal rights and an increase in personal responsibility for gaining or maintaining one’s health. (shrink)

Erratum to: Health Care Anal DOI 10.1007/s10728-013-0244-5In the original version of this paper, unfortunately, there happened to be a mistake in the paragraph “Several studies have compared health…better results or lower costs [7].” under the section “Health Care is NOT a Right?”The incorrect sentence is: For example, hip and knee replacements are not performed on Canadian and UK citizens after 77 .The correct sentence is: For example, hip and knee replacements in Canada and the UK are prioritized by age such (...) that older citizens are on a long waiting list. (shrink)