The Human Right to Health and Health Care Systems

Yahaira Plata

PM 565

Blog

3/25/09

There are various documents in history that state the right to health and well-being.  The Universal Declaration of Human Rights (1948) states in Article 25,

“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 and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control” (http://www.unhchr.ch/udhr/lang/eng.htm). 

 

The first line clearly dictates the right to medical care and a standard of living adequate enough to be healthy.  Similarly, the International Covenant on Economic, Social, and Cultural Rights (1966) states,

“The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

2. The steps to be taken by the States Parties to the present Covenant to achieve the full realization of this right shall include those necessary for:

(a) The provision for the reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child;

(b) The improvement of all aspects of environmental and industrial hygiene;

(c) The prevention, treatment and control of epidemic, endemic, occupational and other diseases;

(d) The creation of conditions which would assure to all medical service and medical attention in the event of sickness” (http://www.unhchr.ch/html/menu3/b/a_cescr.htm)

 

Furthermore, the Convention of Elimination of All Forms of Discrimination against Women, the Convention on the Elimination of All Forms of Racial Discrimination, and the Convention on the Rights of the Child each also contain articles that explicitly state the right of humans to health and medical care.  However, very few current health systems worldwide can say they truly offer their people this right.  This paper will examine the successes and failures of systems to provide this right. 

    Some of the most prominent universal health care systems talked about in the world today are those of Britain and Cuba. The British National Health Service dates back to 1948 and “was the product of one of the most successful transitions from a private to a national public system” (Susser, 1993).  In principle, the population had access to medical services, the inequities in the distribution of hospitals were addressed, and patients and doctors were still allowed freedom in choice.  Susser points out, “We see the results in lower rates of surgery in the UK as compared with rates in the United States” (1993).  However, early data showed that, despite a truly national health service, the UK was still not successful in diminishing the disadvantage in health.  “A 10-year follow-up of a total population found an accelerating gradient in the risk of death, with the least risk in the highest grades and the most risk in the lowest grades” (Susser, 1993). There has been a widening differential in mortality between the most and least deprived of the UK and show a clear socioeconomic gradient (Whitehead, 1997).  Therefore in the case of Britain, a universal system still did not guarantee equality in health across the board.

     Cuba, on the other hand, has been able to implement a system that has truly improved the health of an entire country.  “In the words of Dr. Paul Farmer, Cuba is showing that ‘you can introduce the notion of a right to health care and wipe out the diseases of poverty’” (Van Gelder, 2007).  Each neighborhood in Cuba has their doctor and nurse team, and if a patient is not satisfied, they can choose to visit a different neighborhood team. 

“House calls are routine, in part because it's the responsibility of the doctor and nurse team to understand you and your health issues in the context of your family, home, and neighborhood. This is key to the system. By catching diseases and health hazards before they get big, the Cuban medical system can spend a little on prevention rather than a lot later on to cure diseases, stop outbreaks, or cope with long-term disabilities” (Van Gelder, 2007)

 

When a health issue is beyond the neighborhood doctor, polyclinics provide specialists and outpatient surgeries; hospitals provide inpatient treatment and neighborhood doctors take over care when patients return home.  Cuba is able to maintain the health status of their population because “ its economic system prioritizes the needs of the population instead of the profits of the corporations. It is only because Cuba has chosen to build its society according to different principles, based on equality and social justice, that it has been able to make the right to health a reality for its citizens” (Da Fonseca, 2007).  This prioritization is one that many nations need to follow.   

      While these two nations show success in providing their population access to health, the United States is far behind in providing the right to health. In 2007, President Bush praised the US efforts to fight hunger, AIDS, and malaria in Africa and emphasized Article 25 of the Universal Declaration of Human Rights.  However, when later asked about the child’s health bill, he said he vetoed it because it was too expensive.  As Alan Jenkins points out,

“that fundamentally misunderstands what a human right is. Recognizing a human right to health care, as the Universal Declaration of Human Rights does, means prioritizing fulfillment of that right over other objectives. And paying for it. To be sure, a country's financial resources are relevant to the calculus; poor countries are expected to move incrementally towards satisfaction of the right when they cannot fulfill it immediately”

Today the US has nearly 46 million uninsured Americans and about 18,000 Americans die every year of preventable or treatable diseases. The Institute of Medicine points out, 69 % of children come from families with one or two full-time workers. These families depict the lack of Article 25 in the US.

     Though the United States has the most expensive health care system in the world, it does not take care of its population nearly as well as Cuba or Britain.  The US is ranked 37^th on the WHO ranking of overall health system performance. And while, as a country, its policies point to health as a commodity, a 2006 study by the Commonwealth Fund found that three-quarters of all adults believe the U.S. healthcare system needs either fundamental change or complete rebuilding.  The number one reason Americans today declare bankruptcy is due to medical bills and financing their health care.  One of the richest nations in the world does not provide their citizens the ability to even afford health care and denies them the right to health. 

            Cuba and Britain was able to transition their nations to provide their citizens the right to health. The US, however, has allowed their citizens to suffer this inequity.  Alan Jenking points out,

“Acknowledging the human right to health care does not resolve whether the government should be the chief provider of health insurance for Americans. But it does make government responsible for ensuring that all Americans have access to health care."

 The United States needs to stand behind their claim to equality and human rights by providing access to care.  A need for reform has arisen and the US needs to act and provide its citizens what it promises. 

References

Da Fonseca, Joaquim. “Our International Experience in the Struggle for the Right to

Health” International Conference on the Right to Health. Dec 11, 2007. 

 

Insuring America’s Health:  Principles and Recommendations, January, 14, 2004, Institute of Medicine of the National Academies, http://www.iom.edu/?id=19175,

Jenkins, Alan. “ A Human Right to Health” Retrieved from      http://www.tompaine.com/articles/2007/10/09/a_human_right_to_health.php

Shoen, Cathy, et al. Public Views on Shaping the Future of the U.S. Health System, August 2006, The Commonwealth Fund, http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=394606

 

Susser, Mervyn. “ Health as a Human Right: An Epidemiologist Perspective on the

Public Health” American Journal of Public Health. Vol 83:3. March 1993.

 

The People’s Movement to Human Rights Education: The Human Right to

Health.http://www.pdhre.org/rights/health.html. 

 

Van Gelder, Sarah. “Health Care For All: Love, Cuba” Yes! Magazine. Issue 42, Summer

2007.

Whitehead, M., Evandrou, M., Haglund, B., and F. Diderichson. “As the Health

Dividends Widen in Sweden and Britain, what’s Happening to Access to Care?” British Medical Journal. 315: 1006- 1009. 1997.