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The U.S. Health and Human Rights Initiative
Background
The U.S. has a serious health
crisis. One in every six Americans is without any healthcare insurance and most
are full or part-time employees. Millions more have partial, inadequate
insurance coverage. Insurance matters. A 2004 report from the Institute of
Medicine[1]
said the uninsured do not get the care they need and are more likely to die
prematurely. The report states that lack of health insurance causes roughly
18,000 unnecessary deaths every year in the United States. Poor health in American can cause bankruptcy and poverty. The most common reason for Americans to file for personal bankruptcy is poor health. Americans cannot afford to get sick. The U.S. is the only wealthy country in the world that does not have universal health coverage. Our policies support the concept that healthcare is a commodity that can be bought only by those who can afford it. Unlike education that is guaranteed for every child through grade 12, healthcare is not guaranteed and not accessible to all. The U.S. is ranked 37th on the WHO ranking of overall health system performance. The 2000 report from the World Health Organization[2] is based on 1997 data that measured the quality of healthcare provided, how well the countries prevented illness and how fairly the poor, minorities and other special populations are treated. The ranking put the U.S. just ahead of Slovenia. Americans are ready for a change. A 2006 study by the Commonwealth Fund[3] found that three-quarters of all adults believe the U.S. healthcare system needs either fundamental change or complete rebuilding. This change requires a complete rethinking about health and healthcare access. Americans need to question whether health should be a commodity that is only accessible to those who can buy it or whether health should be a human right that is respected, protected and fulfilled for all. Looking to International Human Rights International human rights law addresses some of the most compelling social, economic and cultural needs of the post-WWII era, including health, housing, work, education, and social security. In addition, international legal norms and standards are practical. They play a role among states, counties, cities and individuals; they provide communities consistent, comprehensive, and globally-endorsed, ethical guidelines. Using a human rights approach to health and healthcare is relatively new in the U.S., but it follows a time-honored tradition of Americans taking positions on international issues and adopting international legal standards. In the area of health, a human rights approach focuses on health before all else, particularly for the most vulnerable populations. Although a seemingly self-evident idea, health is not the current focus of the healthcare system in the United States. Because of its unnecessary complexity, disparities in access to care, and significant non-care costs, the current healthcare system is inequitable, inefficient, and, measured by international human rights law, unethical. Under international law, access to high-quality healthcare is a right, and governments must ensure that appropriate facilities and services are available to all residents. These terms are defined as follows: Health as a Human Right
Health is more than healthcare.
It includes the social determinants of health. Under international law,
health is a right. In terms of health care, governments must ensure that
appropriate facilities and services are available to all residents. These terms
are defined as follows: Accessible: Healthcare must be affordable for all patients. Distribution of services must be done without discrimination based upon race, gender, religion, legal status, ethnicity, sexual orientation, level of education, or insurance status. Services must be accessible in terms of facilities being located conveniently, and the payment system must be simple and straight-forward to use. High quality: Health services must meet all state and federal quality guidelines and other quantifiable measurements of care, but they must also include intangible components of quality such as the doctor-patient relationship and the ability of healthcare providers to relate to and communicate openly with patients. Available: There must be sufficient medical personnel and facilities to treat prevailing health problems. Appropriate: Health services must meet the physical, educational, mental, ethical or cultural standards for the population served. In addition, the beneficiaries of health reform plans must have an opportunity to participate in their design and implementation, have sufficient information about the new services so that they can take advantage of them, and have access to a remedy if the access, quality, appropriateness and availability criteria are not met.[2] The Right to Healthcare in the Pacific Northwest Uplift International’s domestic program promotes the use of international human rights standards in the United States in order to help reach the "highest attainable standard" of health for everyone. we collaborate with national organizations, and we lead and participate in local initiatives. In the Puget Sound region we are actively working with the cities of Seattle and Tacoma (read article in the Tacoma News Tribune) and county policymakers to encourage them to adopt international human rights standards because that would improve local health program planning, implementation and evaluation. We are also working with local policymakers to encourage state and national policymakers to use international human rights standards as part of broader healthcare reform efforts. There are also strategic benefits of adopting international standards at the local level including:
Local implementation of international health norms makes sense. Cities are where the pain of the healthcare crisis is most acute; but they are also where the most creative and effective solutions can take root. Across the U.S., from San Francisco, California to Amherst, Massachusetts, cities have incorporated international norms into local laws. Using these international standards at the local level will allow cities to be the leaders of a national health reform effort that demands a healthcare system that is both ethical and effective.
[1] Insuring America’s Health: Principles and Recommendations, January, 14, 2004, Institute of Medicine of the National Academies, http://www.iom.edu/?id=19175, last visited 8/14/07.
[2]
The World Health Report 2000 – Health systems: Improving performance, [3] 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, last visited 8/14/07.
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