The Right to Health Care

See also Project EINO's downloadable pamphlet on the Right to Health Care.

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QUESTION:  What is the historical precedent for even considering making health care a right in the United States?

At the present time it is recognized (and accordingly legislated) that every family in our country (all residents) have the right to have their children attend primary and secondary school.  This right like that of a "right to health care" did not originate with the founding of our republic, nor during the first decades of constitutional development.  A right to education is not in the "Bill of Rights".  Universal education was won state by state with the first attempts at state enactment in the 1770's and the first limited achievement of "common education" in Massachusetts in the late 1830's.  Eventually, there came a time in our history (after most states had already enacted such legislation) when it was federally mandated that every state should provide for universal education.  

Like the right to vote, for laborers to bargain collectively, the 40 hour work week, universal education was slow to be recognized and legislated throughout the states.  Generally, civil rights slowly evolve in the public consciousness and eventually get put into law when the populace overwhelmingly supports them.  At first, they seem like radical ideas to many and are met with vigorous resistance.  However, even some of our nation's founders (Thomas Paine and Thomas Jefferson) argued vigorously in support of the right to health care and the necessity of this right being recognized in a functioning democracy.

QUESTION:  Is there an existing legal precedent for health care  being considered a right ?

Yes.  The U.S. is a signed supporter of the United Nations Declaration of Human Rights.  Article 25 of that document 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."

Also the US signed the International Covenant on Economic, Social and Cultural Rights in October 1977.  This covenant recognizes "the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.  Implementation of this covenat includes the creation of conditions which would assure to all medical service and medical attention in the event of sickness.   

Project EINO gives several examples of the legal recognition as US domestic law in our pamphlet on the Right to Health Care.

QUESTION:  Isn't the idea of a "Right to Health Care" un-American in that it undermines the whole basis of our society, namely individual responsibility and self-reliance? 

First of all, there is not unanimous agreement that tthese are the most essential values of our nation. Many would argue that justice and democracy were primary both at the nation's founding and today. Still, Project EINO grants that these are important American values and core for many Americans. We have, in fact, devoted an entire FAQ section to discussion of individual responsibility. Reading that section our visitors will see that we support this value of individual responsibility very much. PLUS polls have shown that most Americans believe that guaranteeing some sort of national health insurance is an appropriate task for our government.

We do not believe that the "Right to Education" (K-12) has undermined the value of personal responsibility. Indeed, it is difficult to imagine how we could claim in modern America (had we not established the right to education) that we believed in providing basic opportunities so that our citizens would have any chance of prosperity in their lives and the lives of their children. We believe that in exactly this way virtually all Americans will look back on the establishment of the "Right to Health Care" and wonder how opponents could have conceived that their society was open to all individuals having opportunity for a measure of success and security of their families without assuring this basic right.

Low-income Americans simply do not have much chance of attaining any type of "American Dream" ever, no matter how hard they work and how highly they value their children without the foundation that these rights provide. Having sick siblings, parents and grandparents who suffer because they do not have access to care, or because they must bankrupt their entire extended families to afford care is NOT the provision of a decent shot at success to all Americans.

QUESTION:  What is the core of the argument for the "Right to Health Care" being recognized and mandated in the US? 

The core of the argument is the value of life and what it means to live together in a civilized society.  It has always been hard to argue these values or issues of faith to non-believers.  Yet, this has been accomplished dozens of times in our nation's history (abolition of slavery, 40 hour work week, child labor laws etc.).  Indeed it can easily be argued that the value of life has given foundation to all of our nation's laws (example). Eventually (if not indeed, already) it will be possible to convince the citizens of this nation also with regard to health care.  Then, the necessary political decision will be taken, even if a tough one to implement and against wealthy opposition. 

Few opponents of the "Right to Health Care" actually make the argument that citizens should be left to die like "dogs on the street" when sick, debilitated or elderly, solely because they lack the good fortune of having been able to save adequately for health care.  Admittedly, some of our opponents do make this argument (even face to face).  These same (selfish, narrow-minded?)  people however abandon this belief when they or their sick child become the unfortunate one.  We suggest that they are operating under the false belief that no one gets sick who does not bring it on themself and no one is caught between jobs (insurance policies) who has taken the responsibility for a well-directed career.  This is either dumb or ignorant, since it does not correspond to the facts (look at who the uninsured are).

QUESTION:  If there is such a strong basis for a "Right to Health Care" why haven't we even been able to convince the professionals directly involved in providing care of its necessity? 

Many if not most health care professionals agree that everyone in the United States should have access to regular and appropriate health care.  This is borne out by the lists of endorsing professional organizations listed at each of the state websites linked from our homepage.  Note that by numbers nursing associations typically have the largest memberships and represent the health care workers most directly and constantly involved with patients.

Furthermore, even the most conservative of health professional organizations - namely the AMA has recently passed the resolution recognizing that " A physician shall support access to medical care for all"  This was adopted by the AMA House of Delegates June 17, 2001.  Admittedly, the AMA have continually backtracked on their commitment.

The main objection of the more conservative health professional organizations has been to the word "right".   These organizations like to claim that they are "the advocates for patients" and for the idea that "all people should have access".  At the same time the AMA and many of the state Medical Societies adamantly resist the idea that health care is a "right".  How is this to be understood?  

The Neither the AMA or such state medical societies have thus far given any explanation, except to state that they don't want health care access to be a "right" something any patient can demand when they show up at a clinic.  However, any right of refusal physicians may may have at present is extremely limited by individual state law.  Furthermore, acknowledging the "right" to primary and secondary education did not result in private schools having to accept every applicant, regardless of ability to pay or preparation.  Apparently the question boils down to fear of loss of privelege on the part of many physicians.  At EINO we believe that the "Right to Health Care" must be recognized so that patients can make the demand of their state governments that an avenue of access to high quality health care be allotted to them.  Patients need the right so they can defend it when it is denied or abridged.

QUESTION:  But isn't this a radically new idea?   Making health care a "right" of each individual in the U.S. who could expect or even demand treatment at a clinic.

Neither new nor radical, even in this country.  In fact it is illegal to refuse medical treatment, or to make treatment dependent on proving medical coverage, to any individual who presents themselves for emergency medical care at any Emergency Room, public or private, in the US.  This is part of the reason why so often uninsured and underinsured show up at ERs after they are in critical condition, rather than getting timely treatment for the same ailments (at a fraction of the cost to society as a whole).   Furthermore, the same charge of a "radical new idea" was leveled against primary education during the struggle for acceptance of that right.  See next question.

QUESTION:  I don't believe that there was ever all that much opposition to primary education.  The "right to education" was always apparent as a good for the nation.

You couldn't be more wrong, read the first 60 page section of "School".  "The debate was long and hard fought in each state.  The Democratic opposition mustered 43% of the votes in the Massachusetts legislature to oust Horace Mann and abolish his position.  Two years later a similar challenge in Connecticut succeeded, costing Henry Barnard his job.  The lynchpin of the movement was the laws requiring property tax support for free schools. 

QUESTION:  Isn't a "Right to Health Care" completely different though than a right to vote or to education.  Those latter are essential to the idea of an effective democracy with nearly equal opportunities for all citizens.

Historically, it's correct that universal education and voting rights were argued largely on the basis of being necessary to effective democracy.  Its hard to see though how access to appropriate medical attention, mental and other health services are any less necessary to having a responsible citizenry that pays attention to and understands the crucial arguments of the day.  And how else could one hope that the people will be able to cast responsible meaningful votes.  If certain sectors of the U.S. population are allowed to suffer with an illness that is treatable or curable (for lack of appropriate insurance), how could they be considered to have the same opportunities to participate actively in the society (voting, attending public meetings, speaking to their neighbors, handing out leaflets)?  Indeed they will have a difficult time thinking about anything other than how to get their needed medical treatments and provide the basic essentials to their families.

DAVID TYACK  (Concluding his introduction to "School")  and we quote:

Is education primarily a consumer good or common good?  This book provides a context for answering that question. If Thomas Jefferson, Horace Mann and John Dewey were now to enter policy discussions on public education, they might well ask if Americans have lost their way.  Democracy is about making wise collective choices, not individual consumer choices.  They have never been more essential to wise self-rule than they are today.  [Likewise, at Project EINO we believe that the opportunity to enjoy good health by having access to necessary services is intertwined with the practice of democracy.]