Why the Health Reform Law Fails to Meet Human Rights Standards

Originally posted to Huffington Post

Amidst the celebrations of a ‘historical moment,’ a healthy dose of realism seems in order as we assess the new Patient Protection and Affordable Care Act and the related reconciliation measures. What is seen as a crucial victory for the Obama Administration has been won on the backs of many grassroots activists struggling for health care as a human right and a public good, including women’s and immigrants’ rights groups. The lengthy health reform process has mobilized many millions of people, some new to political activism and many others veterans of the long struggle for universal health care in the United States. This political moment presented a prime opportunity for finally ending the commercialization of one of our most fundamental needs, health care. The failure to seize this opportunity will haunt us for years to come.

What is now touted as the most far-reaching social legislation in almost half a century in fact bears no resemblance to the landmark Medicare Act of 1965, which instituted a fully public insurance system with contributions shared equitably by everyone, in solidarity with older people. Instead of expanding Medicare to everyone, this new law formally affirms and solidifies the private, market-based system in which health care is the domain of a for-profit industry propped up by substantial public subsidies.

Human rights standards do not tolerate the inequities inevitably linked to a reliance on market competition to meet human needs. Yet this legislation also contains some important improvements to health care access for poor people. The Medicaid expansion and the additional funding for community health centers are very welcome and long overdue, but could have been adopted as stand-alone measures. As such, they are indeed cause for celebration, yet most pundits seem to care precious little about these provisions of the new law, despite the fact that the Medicaid expansion will account for at least half of the newly insured population. Instead, all favorable attention is showered on the subsidized expansion of the private, for-profit health insurance industry.

Yet it is precisely this aspect of the new law — market-based health insurance reform — that entrenches the treatment of health care as a commodity by locking us into a market mechanism that sells access to health care based on a person’s ability to pay rather than their health needs. Public subsidies for pricey (and not price controlled) insurance products are intended to mitigate the inequities inherent in a for-profit system, while leaving no illusion that coverage will continue to be stratified and access to care out of reach for many. This volatile combination of at-will pricing by insurance corporations and the promise of subsidies to match prices also renders the system financially unsustainable for individuals and government alike.

In sum, the new health law fails to meet the key human rights standards of universality, equity, and accountability. Rather than guaranteeing universal health care, the law excludes many millions of people from access to coverage and care. Instead of ensuring that care is available for those who need it, the law makes access contingent on the purchase of private insurance. And rather than holding the private sector accountable for protecting the right to health, the law permits the industry’s focus on their bottom line. Health care is treated as commodity, not as a universal right and a public good shared equitably by all.

Many grassroots activists and their academic and advocacy allies, including the National Economic and Social Rights Initiative, have challenged this prevailing policy paradigm and presented solid evidence that health care financing and management through market relationships is unable to meet everyone’s health needs. In all other high-income countries, health systems are highly redistributive in economic terms, funded collectively through cross-subsidization with a common pool that includes all, not limited to residual public programs for certain groups. Yet Democrats in Congress and the White House did their best to silence these voices and insisted on a market-based approach despite their own better knowledge — the President himself admitted as much when he remarked that a single payer public insurance system would be necessary to achieve universal coverage. But this was not the route pursued by our legislators, and so a workable solution was jettisoned in favor of an ideological approach approved by the health care industry.

We can turn this moment into a historical one if we take it as a new beginning, not an end, for a human right to health care movement in the United States. Grassroots campaigns are well underway for universal health care at the state and even local level, for example in California, Vermont, and Montana. By using the human rights framework to guide us, we can build a broad-based movement that inspires solidarity for sharing the public goods required to meet our fundamental needs.

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23 thoughts on “Why the Health Reform Law Fails to Meet Human Rights Standards

  1. I could not be more in agreement. The so-called reform leaves the profit motive and insurance companies where they have always been to the detriment of the health needs of individuals.

  2. That the health reform bill fails to meet human rights standards is based on the premise that health care access is a human right. In the US, the high level of opposition to the bill strongly suggests that many in the population do not believe this to be the case. Without this belief system, the next best thing a government can do is to provide access to as many people as possible as affordably as possible.

    With this bill, the government will promote activities that better the health of more people than what existed previously. As more people see the benefits of such legislation to their security and wellbeing, they may come to see health care as a human right in the way thay many in other countries already do. However, this change will not come over night and it is important to recognize the bill as a small step in the right direction.

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  5. I could not be more in agreement. The so-called reform leaves the profit motive and insurance companies where they have always been to the detriment of the health needs of individuals.

  6. That the health reform bill fails to meet human rights standards is based on the premise that health care access is a human right. In the US, the high level of opposition to the bill strongly suggests that many in the population do not believe this to be the case. Without this belief system, the next best thing a government can do is to provide access to as many people as possible as affordably as possible.

    With this bill, the government will promote activities that better the health of more people than what existed previously. As more people see the benefits of such legislation to their security and wellbeing, they may come to see health care as a human right in the way thay many in other countries already do. However, this change will not come over night and it is important to recognize the bill as a small step in the right direction.

  7. If we finally have it in the door don't let them slam it. Yes much needs changed in health care. No doubt. But it has to start somewhere. Tell me why here in the US we have to pay over 125.00 for a 20 day course of Quinidine when you can go to Africa, India or Pakistan and get Quinine for 5.00? Tell me how they are going to come out in Africa injecting them with the new Malaria vaccine and the new HIV vaccine without any clinical trial in those populations that also have Lyme because they will not give us a test that is at least 50% accurate but studies show incidence of at least 11% of the African population infected with Lyme done in one small study? Tell me how they get away with giving babies a vaccine that has been recalled citing death caused by immunocompromised and then declared infected with a pig virus to preserve the rest of the sales. Tell me how they get away with an experimental new MS brain treatment that can kill, when MS is most likely caused by the infection of Lyme. And serves no use except prolonging the arterial vasculitis caused by Borreliosis. Yet thousands have signed up because they will not tell them the truth….Leave my foot in the door with hope for change at least.

  8. If we finally have it in the door don’t let them slam it. Yes much needs changed in health care. No doubt. But it has to start somewhere. Tell me why here in the US we have to pay over 125.00 for a 20 day course of Quinidine when you can go to Africa, India or Pakistan and get Quinine for 5.00? Tell me how they are going to come out in Africa injecting them with the new Malaria vaccine and the new HIV vaccine without any clinical trial in those populations that also have Lyme because they will not give us a test that is at least 50% accurate but studies show incidence of at least 11% of the African population infected with Lyme done in one small study? Tell me how they get away with giving babies a vaccine that has been recalled citing death caused by immunocompromised and then declared infected with a pig virus to preserve the rest of the sales. Tell me how they get away with an experimental new MS brain treatment that can kill, when MS is most likely caused by the infection of Lyme. And serves no use except prolonging the arterial vasculitis caused by Borreliosis. Yet thousands have signed up because they will not tell them the truth….Leave my foot in the door with hope for change at least.

  9. Yes, there are many flaws in the HCR law. It is often the nature of new legislation of this magnitude that improvements are needed. But it is a beginning and that is more than we have ever had before. Criticize if you will but be aware that flaws often exist in laws and can be set straight at a later date. Give us props for passing a flawed bill rather than nothing at all. It will be improved upon, no doubt.

  10. Yes, there are many flaws in the HCR law. It is often the nature of new legislation of this magnitude that improvements are needed. But it is a beginning and that is more than we have ever had before. Criticize if you will but be aware that flaws often exist in laws and can be set straight at a later date. Give us props for passing a flawed bill rather than nothing at all. It will be improved upon, no doubt.

  11. I am part of the public that does not view the every-thing-under-the-sun medical care as being a right. Our country actually does provide very good medical care for people who are poor. If people have the money (or resources to pay), they should pay for their medical care. These professionals devote their lives to training in medicine. They expect to be monetarily rewarded for the services they provide. Obamacare and its expansions will eventually bankrupt our country as government dependence grows. We will become like the bankrupted African countries that depend on "leftover" pharmaceuticals as described in one of the e-mails above.

  12. quote janetsued" These professionals devote their lives to training in medicine. They expect to be monetarily rewarded for the services they provide.

    They expect to not be lied to also by the guidelines makers and drug companies.

    Do you know just how much compensation goes to other countries for vaccine trials?

    Do you know how many and how long they are followed?

    Countries like Guyana? Citing it didn't work…..
    And what happened in Australia when WHO and Unicef went in to vaccinate the Aboriginals? Thats a good one. They killed one out of every 4.

    Until they get all the Filthy Lucre out of medicine will it be Just.

  13. I am part of the public that does not view the every-thing-under-the-sun medical care as being a right. Our country actually does provide very good medical care for people who are poor. If people have the money (or resources to pay), they should pay for their medical care. These professionals devote their lives to training in medicine. They expect to be monetarily rewarded for the services they provide. Obamacare and its expansions will eventually bankrupt our country as government dependence grows. We will become like the bankrupted African countries that depend on “leftover” pharmaceuticals as described in one of the e-mails above.

  14. quote janetsued” These professionals devote their lives to training in medicine. They expect to be monetarily rewarded for the services they provide.

    They expect to not be lied to also by the guidelines makers and drug companies.

    Do you know just how much compensation goes to other countries for vaccine trials?

    Do you know how many and how long they are followed?

    Countries like Guyana? Citing it didn’t work…..
    And what happened in Australia when WHO and Unicef went in to vaccinate the Aboriginals? Thats a good one. They killed one out of every 4.

    Until they get all the Filthy Lucre out of medicine will it be Just.

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  17. How does the U.S. Health reform law fail to meet human rights standards?
    The article debunks the law without providing specific details of exactly which paragraphs are offensive.
    Amnesty International should have been more responsible about attacking a law which will provide health care to uninsured people.

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  19. How does the U.S. Health reform law fail to meet human rights standards?
    The article debunks the law without providing specific details of exactly which paragraphs are offensive.
    Amnesty International should have been more responsible about attacking a law which will provide health care to uninsured people.

  20. Thanks for your comment, Debra, but I'm afraid the new law will only provide some type of COVERAGE, not CARE, and only to SOME, not all uninsured people. That coverage will be costly, with co-pays and deductibles, and it may not lead to people actually getting the care they need. From a human rights perspective, it's the overall principle and outcome that matters – whether people have a right to get the care they need, regardless of their ability to pay or any other factor. The new law does not make that happen, and I'm focusing on this here (rather than on the details of the law – some of which are positive, many others not; see http://www.nesri.org for that analysis), because it's important to keep on fighting for our rights.

  21. Thanks for your comment, Debra, but I'm afraid the new law will only provide some type of COVERAGE, not CARE, and only to SOME, not all uninsured people. That coverage will be costly, with co-pays and deductibles, and it may not lead to people actually getting the care they need. From a human rights perspective, it's the overall principle and outcome that matters – whether people have a right to get the care they need, regardless of their ability to pay or any other factor. The new law does not make that happen, and I'm focusing on this here (rather than on the details of the law – some of which are positive, many others not; see http://www.nesri.org for that analysis), because it's important to keep on fighting for our rights.

  22. Thanks for your comment, Debra, but I'm afraid the new law will only provide some type of COVERAGE, not CARE, and only to SOME, not all uninsured people. That coverage will be costly, with co-pays and deductibles, and it may not lead to people actually getting the care they need. From a human rights perspective, it's the overall principle and outcome that matters – whether people have a right to get the care they need, regardless of their ability to pay or any other factor. The new law does not make that happen, and I'm focusing on this here (rather than on the details of the law – some of which are positive, many others not; see http://www.nesri.org for that analysis), because it's important to keep on fighting for our rights.

  23. Thanks for your comment, Debra, but I’m afraid the new law will only provide some type of COVERAGE, not CARE, and only to SOME, not all uninsured people. That coverage will be costly, with co-pays and deductibles, and it may not lead to people actually getting the care they need. From a human rights perspective, it’s the overall principle and outcome that matters – whether people have a right to get the care they need, regardless of their ability to pay or any other factor. The new law does not make that happen, and I’m focusing on this here (rather than on the details of the law – some of which are positive, many others not; see http://www.nesri.org for that analysis), because it’s important to keep on fighting for our rights.

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