In what sense do Americans have a right to medical care? In what sense is access to medical care not a right?

In what sense do Americans have a right to medical care? In what sense is access to medical care not a right?

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January 2, 2021
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In what sense do Americans have a right to medical care? In what sense is access to medical care not a right? How have the reforms at the state level helped define the nature of the right to medical care in this country?

 

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Answer

Access to healthcare in the US is mediated by insurance coverage, either in the form of private or employer based cover, which may be government based for public sector employees or private for private sector employees. The majority of spending on healthcare however, comes from government expenditure on health programs such as Medicare, Medicaid, Tricare, and the State Children's Health Insurance Program (SCHIP). Medicare is a federal government funded social insurance program that provides health insurance to people aged 65 and older, younger people with disabilities, and those with end stage renal failure requiring dialysis. Medicaid is a means tested insurance coverage program for individuals with low incomes and their families, and is jointly funded by state and federal governments. Tricare is a healthcare program that provides healthcare insurance for military personnel, retirees, and their dependents. The SCHIP provides states with federal government funding to provide health insurance to children from families with modest incomes that do not qualify for Medicaid. As such, although the majority of the US population is insured by federal, state, employer, or private health insurance, the remainders go uninsured.
Article 12 goes on to require that "states must protect this right by ensuring that everyone within their jurisdiction has access to the underlying determinants of health, such as clean water, sanitation, food, nutrition, and housing, and through a comprehensive system of health care, which is available to everyone without discrimination, and economically accessible to all." This treaty was signed by all UN countries. It was ratified by all countries except three—Palau, Comoros, and the United States of America. All signatory nations to CESCR are subject to periodic review of progress on the human rights so protected. The UN High Commissioner of Human Rights also reviews progress on rights protected by the UDHR. In preparation for these reviews, the U.S. government submits a report, touting its successes in the area of human rights.
There are limitations to this: it applies to individual actions rather than governmental change. Further, it assumes that health care can be improved without significant personal loss when in actual fact the introduction of, for example, the PPACA has been estimated by some to be of significant cost to the US, let alone the implementation of universal care Cost is not the only way in which our system renders the right to health null and void. Health access is also tied to employers' control of employees' health care under the ACA. Employees remain in jobs where they are underpaid or suffer abusive working conditions so that they can retain health insurance; insurance that may or may not get them health care, but which is better than nothing.
The real meaning of this right to health care requires that all of us, acting together as a community and society, take responsibility to ensure that each person can exercise this right. As individuals, we have a responsibility to contribute to making health care available to each of us. We have a right to the actual health care envisioned by FDR, Martin Luther King Jr., and the United Nations. We recall that Health and Human Services Secretary Kathleen Sibelius (speech on Martin Luther King Jr. Day 2013) assured us: "We at the Department of Health and Human Services honor Martin Luther King Jr.'s call for justice, and recall how 47 years ago he framed health care as a basic human right. We are committed to reducing health disparities, and that means making sure all Americans have access to affordable, quality health care. There is nothing more fundamental to pursuing the American dream than good health."

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