OpenForum – a blog by the Health and Human Rights community

Now that the President has officially designated the ongoing health care reform efforts as “health insurance reform,” we can stop the charade that this debate was ever about “care.” Or about health, for that matter. Oddly enough, the obsession with “coverage” – a potential mechanism to facilitate access to care – has not led to a serious consideration of the private insurance industry’s raison d’être, at least not beyond the community of single payer advocates whose voices are drowned in the constant drumbeat about a supposedly American – read: “market” – solution.

How are the current proposals for health insurance reform treating an industry that siphons off roughly $10 billion in annual profits? We now have two health reform bills reported out of congressional committees (”America’s Affordable Health Choices Act” in the House and the “Affordable Health Choices Act” in the Senate – using terminology pushed by Democratic pollsters, no doubt). Neither of them meets key human rights standards, and both cast private insurance corporations in the role of gatekeepers that control people’s access to care. At the same time, opposition is mounting against all and any reform measures.

Yet there continues to be great hope among many long-time health policy advocates that will we see meaningful health reform later this year. Advocates count on this reform to solve or at least alleviate the current health care crisis, which results in an estimated 22,000 preventable deaths due to lack of insurance each year, as well as skyrocketing costs that bankrupt families and public budgets alike. Pundits optimistically point to the many new measures the reform bills introduce: reining in the “free” insurance market through tougher regulation, including through a so-called Exchange mechanism; setting up a public insurance plan; expanding Medicaid; requiring employers to contribute to costs; and mandating everyone to buy insurance. All Americans (though not all immigrants – documented or not) will get health insurance – or so the hopeful want to believe.

Their hope is born out of desperation. Most advocates are painfully aware that health care is treated as a market commodity in the United States, and that market rules are stacked against those with little purchasing power. And these are usually the very people who need health care the most: poor people and people with serious health issues. In a blatant affront to the basic human rights principle of equity, minority groups and poorer communities in rural and inner city areas suffer disproportionally from market barriers to health care. Read more

Recent changes in U.K. health policy affecting asylum seekers who have been denied refugee status reflect a larger trend of decreased willingness by governments to provide healthcare to migrants. Is this vulnerable group being denied the right to health?

It depends on who you ask. UK’s National Health Service (NHS) states that its mission is “to make good healthcare available to all, regardless of wealth, as long as you are a resident of the UK.” Overturning last year’s decision, appeals judges ruled that rejected asylum seekers are no longer legally entitled to free secondary NHS care, although hospitals can treat them at their discretion if they are penniless. Lord Justice Ward argues in his decision that “failed asylum seekers ought not to be here. They should never have come here in the first place and after their claims have finally been dismissed they are only here until arrangements can be made to secure their return.” Last year, Matthew Elliot of the TaxPayers’ Alliance argued that rejected asylum seekers should not be paid for at the expense of law-abiding taxpayers, and that providing them with free care will only create a burden on the already overstretched system, especially with the flood of health migrants he believes will follow. These concerns are by no means unique to the UK, and are echoed in other countries trying to decide how and whether to provide care to migrants using public funding. Read more

Health care is a universal right, declare health care reform activists in Montana. If we recognize universal care as a right rather than as a private product, the activists contend, Americans across the country could gain fair and equitable care.

Anja Rudiger of the Human Right to Health Program, said that a set of principles should be used to determine whether a system supports health care as a right or if the “profit motive” overshadows the affordability and accessibility of care.  Rudiger has previously written an article for Health and Human Rights demonstrating the use of a “human rights framework, [in which] ethical principles — or “values” — are the premise for action.” This framework, Rudiger asserts, allows activists and policy-makers to re-frame the debate on health care by leveraging,  “theoretical and empirical findings to make a case for re-envisioning health care as both a right and a public good.” Read more