Discovery Draft

            The areas of health care and human rights are present in every country. However it is not often that these two subjects coincide and pose the question of whether health care should be considered a human right. The sources being looked at aim to give answers to this question by each examining different moral, political and economic perspectives of the issue. Mentioning the sources in such an obvious manner was something that was appropriate for the discovery draft but I knew would have to be changed for the final draft. This comes in the form of historical background information, international examples, and the analysis of legislation regarding the two issues. While the US currently is going through a transition into a form of universal health care, there has yet to be a mention of human rights in any domestic documents showing that there still is a need to address the underlying principles that the switch to universal health care should be based on. 

            First looking at the history of human rights and health care as separate issues is necessary to see how they relate. The three authors who wrote the “Foundation for a Natural Right to Health Care” give an overview of natural rights and laws. Their definition of natural law comes from the philosophical foundation of Thomas Aguina’s concept that has had considerable influence on international documents. Johnathan Wolff also references philosopher John Locke’s parallel beliefs concerning human rights in his novel. A natural law, by definition, “includes a set of principles which, if followed, will satisfy a human being’s natural inclinations and thus lead to their perfection according to their nature as a human being.” The human law that follows this, “is the determination of general natural law principles made by human legislators using practical judgment” (Eberl 538). Using concrete definitions from revered philosophers is a good approach to introducing what is a widely accepted view of what a natural right can be characterized by. It also introduces the connection between these rights and laws, which is to be discussed later. More importantly, these two sources go into great detail with the United Nation’s Universal Declaration of Human Rights and the International Covenant on Economic, Social and Cultural Rights. These are the international documents that the United Nation’s has drafted and every country that is a part of the treaty is expected to uphold. Besides the general outline and historical agreements of what a natural right is to be, the “Foundation for a Natural Right to Health Care” and Gable’s piece on the Patient Protection and Affordable Care Act, specifies the three duties that a State has. These are the obligations to respect, protect and fulfill people’s natural human rights (Eberl 540).

              The general definition of natural rights may be useful, but Wolff asks the question of whether these “fine words” have substance. He suggests that a human rights doctrine is a broadly liberal and somewhat ideological framework, because it assumes that everyone acknowledges the same basic morals (Wolff 230). This is valid because of how unspecific rights can be, but these pieces include the excerpts from these international documents that do give more specific duties to the governing bodies. Wolff also voices a common criticism that because the rights spelled out by the United Nations only apply to the countries that have signed the treaty, they are only values that are appropriate in some parts of the world. This would mean they are natural rights stemming from Western values. This generality can also be looked at in a different light; that it actually can apply to humans of all backgrounds and cultures because it is so broad (Eberl 542).

            There was a need of a better transition sentence for the beginning of this paragraph. Kingson and Cornman look at the economic side of health care reform. Written in 2009, their article is a look into the United State’s health care system before the Patient Protection and Affordable Care Act. Their statistics show the level of dissatisfaction of the American people with the system. What were these specific statistics? This dissatisfaction they say is due to the lack of accessibility, affordability, acceptability and quality of health care in the US at the time. Senator Edward M. Kennedy similarly wrote in 2009 about the current state of the US health care system. His statistics also show that the cost of health care was over two trillion dollars in 2008, and yet the US was ranked 37th in health outcomes by the World Health Organization (Kennedy). These statistics are effective in the demonstration of how the US clearly was in need of a huge change in its health care system. Kingson and Cornman also answer the question of why the American people and government have not already agreed upon a form of universal health care. America, historically, has distrust in large government programs and a fear of changing from the status quo. However Kingson and Cornman believe that by looking at other democratic and industrialized nations, it is apparent that universal health care is “feasible and necessary” (Kingson 40). This article does not go into many details of the health care systems of other nations, but the book Health of Nations helps fill in the gaps.

            Specifically, this book looks at the health care systems of six industrialized nations- the United States, Canada, Germany, the Netherlands, Japan and the United Kingdom. The author, Laurene A. Graig, compares and contrasts the systems but also realizes that none of them are completely applicable to the United States. She recognizes the fact that each country has many differences in structure, so for the US to use any of their methods they must be modified to fit this country’s conditions. The structures of these countries may be quite different, but the challenges in health care they face are very similar, and mostly include the balancing of costs, quality and access to care (Graig 7). Her claim is that all of the countries she has studied all have developed a more cost-conscious model of care and base their systems on the rule that individuals must contribute corresponding to their ability to pay (Graig 126). According to Kingson and Cornman, this is the opposite of what America has; health care is available only to those who can pay and there is a large issue of costly and unnecessary care specifically in the last year of life (Kingson 41). These countries have also retained their status of universal health care even while using American style cost control measures. This is her main point that parallels Kingson and Cornman’s, that access for all and affordable care are in fact possible together and America can learn from these experiences of other countries.

            When looking at health care and human rights as one issue, the United Nations human rights documents are the pieces that dictate what is expected from the countries a part of the treaty, including the US. The authors of a “Foundation for a Natural Right to Health Care” and Johnathan Wolff find every excerpt from the Universal Declaration of Human Rights and the International Covenant on Economic, Social and Cultural Rights that combines both subjects. Both of these texts include Article 25 from the UDHR, which states that “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.” In my final draft, I decided there was a need to explain how relevant this document was to the present day, because it was written so long ago. They also include Article 12 of the ICESCR that 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” (Eberl 542). These documents specifically spell out that health is considered a human right and the authors of “The Foundation…” believe that the US should be a follower of this, although the country has not ratified this specific part. An ethicist Noman Daniels of Harvard University proposes that this standard of good health is imperative in the fulfillment of the human condition and being someone who can contribute to the workings of society (Eberl 546). Similarly, Lance Gable expresses that “a strong health system is an essential element of a healthy and equitable society” (Gable 254). There needed to be more explanation and evidence of this quote, before I added the following statement. Therefore it is in the country’s best interests to protect, respect and lastly fulfill its citizens right to health. Kingson and Cornman writers do recognize the economical and political challenges when implementing these rights into a country’s structure. The content of the right to health is hard to specify given a country’s resource limitations and health needs. But going back to the morals of the issue, Gable states “issues of cost and complexity should not render human rights any less fundamental” (Gable 260). After this paragraph in the final draft I added the perspective of a health care provider. This perspective was not very needed in the discovery draft, but for the final paper it strengthened my arguement. This draft was also missing a paragraph dedicated to the opposing arguement.

            As Lance Gable claims, President Obama’s Patient Protection and Affordable Care Act is a huge step in the process of the US providing universal healthcare to its citizens. His detailed synopsis of this new act shows us all the ways the country is attempting to greatly increase the accessibility, acceptability and quality that Kingson and Cornman claim were the central problems in America’s health care system. Low and moderate-income families without access to employer sponsored insurance will now receive tax credits to help pay for their insurance. Services such as cancer screenings, vaccinations, birth control, and depression screening will now be with free with insurance plans. Each state will now have a health insurance exchange to find and compare insurance plans. Insurance companies will now have to justify any raise of premiums and states have the power to block them. Insurance companies will also not be able to charge higher premiums because of a woman’s gender, which was very common before.  All of these provisions, according to Gable, have very promising effects on public health (Gable 256). However while this act makes health care coverage “universal” and available to all, there is no mention of rights. Gable suggests that this is due to how controversial human rights can be in the US because of its history of domestic political and philosophical disagreement (Gable 260).  Paul T. Menzel does assert that the US has accepted the moral values of a just sharing of the costs of illness and a prevention of free riding. The new insurance mandate will prevent this free riding, and the subsidies will lessen the burden of cost (Menzel 594). But this hole in the legislation is why the United State’s health care system remains fundamentally unjust and should be improved by adapting health care as a human right into the new health care reform before its complete implementation in 2014. Adapting health care how?