In a turbulent week in U.S. politics that saw the president abandoning his promise of universal health insurance and the Supreme Court elevating corporate spending in elections to a human right – protected as free speech in the same way as human speech – human rights activists should take solace in the fact that giving up pretensions can be the first step to real change.
This is particularly important for human right to health care activists who have long been dismayed with market-based health care proposals that blatantly fail to satisfy basic human rights standards. There was perhaps only one policy measure the U.S. needed even less than the opening of floodgates for vast new corporate political spending, and that was a health “reform” bill funneling millions of new customers to the for-profit insurance industry and billions in subsidies into the coffers of the…wait for it…very same industry. If this bill, in its Senate and House versions, now appears threatened by the Democrats’ loss of one Massachusetts Senate seat, a new opportunity has emerged to call for simple but meaningful health reform measures based on human rights.
Many activists and advocacy organizations, including Amnesty, have consistently pointed to the fundamental flaw underlying the approach adopted by health reformers in DC, and urged them to treat health care as a human right, not a commodity. Yet the reform bills failed to meet the human rights principles of universality, equity, and accountability. Rather than guaranteeing universal health care, they excluded many millions of people from access to coverage and care. Instead of ensuring that care would be available for those who need it, the bills made access for most people contingent on their ability to purchase a private insurance plan. And rather than holding the private sector accountable for protecting the right to health, the bills perpetuated the industry’s focus on their bottom line.
The rapidly faltering popularity of this market-based approach creates a new opening for demanding simple but systemic policy changes that move the U.S. system toward treating health care as a public good shared equitably by all. A Medicare-like public health insurance program for everyone in the U.S. could guarantee progressively financed, publicly accountable, and fiscally sustainable universal coverage. Therefore, building on the success of Medicare and expanding it to more and more people below the age of 65 can be a key component of a rights-based reform strategy. It is equally important to secure and expand the health rights of poor and low-income people through guaranteed public coverage provided by Medicaid and the Children’s Health Insurance Program (CHIP). Without a progressive expansion of publicly financed and administered health care, it will remain virtually impossible to ensure that people’s health needs are prioritized over market incentives to deny access to care.