Health Care Reform: Back to Human Rights Basics

NESRI has a new post up on Amnesty International’s Human Rights Now blog. Read the first two paragraphs here:

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.

Read the rest of the post here: http://blog.amnestyusa.org/us/health-care-reform-back-to-human-rights-basics/

An affordable commodity? Why health care should be a right and a public good

Read this new NESRI post on Amnesty International USA’s Human Rights Now blog – here are the first few paragraphs:

While protesters have been occupying House Speaker Pelosi’s office, demanding a health care system that serves Patients not Profit, the House of Representatives is preparing to vote on the market-based health care bill introduced last week by Speaker Pelosi. It is not expected that the House leadership will allow a lengthy floor discussion, but the most recent news reports suggest that the promised vote on Rep. Anthony Weiner’s (D-NY) single payer amendment may be allowed. Meanwhile, Speaker Pelosi has presented the leadership’s additions to the bill in a so-called Manager’s Amendment, stating that this would strengthen provisions for “excluding insurers who put profits over patients from an affordable marketplace that will serve tens of millions of Americans.”

Does that mean the protesters demands have been met? Is this health care bill bringing us closer to realizing our human right to health care? Let’s recall that according to international legal standards, the human right to health requires that “health facilities, goods and services must be affordable for all. Payment for health-care services… has to be based on the principle of equity.”

The House bill aims to achieve affordability by subsidizing the purchase of an insurance policy for those earning between 150% and 400% of the federal poverty level, provided they don’t have employer-based insurance. In practice, this means someone with an income at the upper end of this scale would pay $5300 a year in premiums and up to $2000 a year in cost-sharing, amounting to around 17% of their income. At the bottom end of the scale, health care costs would be around 6-7% of a person’s income – which is still higher than a general income tax increase proposed by single payer health insurance bills.  Many immigrants would get no support at all, and anyone unable to afford such an insurance plan would be subject to a penalty payment, since everyone will be mandated to purchase insurance.  

Is this affordable? Maybe for some, but probably not for others. Is it equitable? Giving lower-income people greater subsidies seems like a reasonable starting point, yet even if those subsidies were sufficient, and even if everyone who needed them was eligible, it is not clear that this money would actually buy access to health care, as opposed to access to coverage. Each person’s subsidy would go directly to an insurance company, which would continue to control an individual’s access to care, covering certain treatments but not others, allowing the visit to one doctor but not another, or denying claims altogether. Different groups of people would get different coverage and therefore different access to care, depending on their ability to pay. People would not get health care based solely on their health needs, but based on their income or wealth, age, and immigration status. …Read more here.

Read the full post: http://blog.amnestyusa.org/demand-dignity/dollars-and-cents-of-new-health-care-legislation/

Beyond the Market: Health Care as a Civil or Human Right? From the Amnesty International USA Blog

Check out this new post on Amnesty International USA’s blog, Human Rights Now, cross-posted on The Huffington Post. Here are the first couple of paragraphs:

“A dramatic disconnect between principles and policies has hampered current U.S. health care reform efforts. This became obvious when candidate Obama declared health care to be a right and then proceeded to treat it as a commodity when negotiating with insurance companies a requirement for individuals to buy a commercial health insurance product.

Similarly, early on in the debate the president championed the principle of universality by promising some form of health coverage – if not necessarily health care – for 46 million uninsured people, only to lower the policy goal to 30 million American citizens in his speech before Congress, excluding many immigrants and low-income people. Since then, further policy provisions that restrict access to health coverage for immigrants – documented and undocumented – and reduce affordability for lower-income people have appeared in the health care bill adopted by the Senate Finance Committee.”  Read more here.

The lack of solidarity in health care – reflections on a NY Times op-ed

Here are are a couple of good examples, both in the New York Times, of how the health care debate is finally beginning to inspire more thoughtful reflections and critiques – possibly informed by human rights advocacy – at the same time as dominant policy proposals continue clinging to the status quo. In particular, this opinion piece by Cohen explains some of the ideological obstacles to realizing the right to health care in the United States, yet disregards the growing grassroots movement for rights-based health care principles and their potential implementation through single payer policy proposals.

Here’s the crux of the argument: “Europeans don’t get why Americans don’t agree that universal health coverage is a fundamental contract to which the citizens of any developed society have a right. […] Fixing [the US health care system] requires the acknowledgment that, when it comes to health, we’re all in this together. Pooling the risk between everybody is the most efficient way to forge a healthier society. Europeans have no problem with this moral commitment. But Americans hear ‘pooled risk’ and think, ‘Hey, somebody’s freeloading on my hard work.’ […] [Europeans] see greater risk in unfettered individualism than in social solidarity. Americans, born in revolt against Europe and so ever defining themselves against the old Continent’s models, mythologize their rugged (always rugged) individualism as the bulwark against initiative-sapping entitlements. We’re not talking about health here. We’re talking about national narratives and mythologies — as well as money. These are things not much susceptible to logic. But in matters of life and death, mythology must cede to reality, profit to wellbeing.”

This is a welcome analysis of a key barrier faced by those struggling for the right to health care in the U.S. today. It highlights how the national ‘mythology’ of individualism can undermine the fight for vital services that can only be provided collectively. The article goes on to note how some measure of solidarity seems particularly pertinent and plausible when it comes to health – if Americans share nothing else, they surely can agree that unnecessary sickness and death are what everyone wants to avoid and no one deserves.

Yet Cohen is less clear on how mythology and money are intertwined to form a powerful hegemony that is, in fact, not at all representative of the public will, as documented in protests movements, opinion polls, daily letters to the editor, and even, yes, elections. We see more support for rights-based reforms, such as single payer national health insurance, in the public sphere than in the hallowed halls of Congress, where myth and money seem to go hand in hand to keep things the way they are. Our representatives have not yet recognized that, as Cohen says, “health care is a moral obligation rather than a financial opportunity”. Therefore, we should not indulge them by narrowing the discussion to their small-minded policy options. A “clear moral stand” must be based on firm human rights principles that do not allow excluding people from health care based on their ability to pay, their immigration status, or any other factor. This is the principle of solidarity we promote, and it must be the solidarity we practice.

Read the op-ed by Cohen here: http://www.nytimes.com/2009/10/05/opinion/05iht-edcohen.html?scp=1&sq=public%20imperative&st=cse

Read the op-ed by Kristof here: http://www.nytimes.com/2009/10/08/opinion/08kristof.html?_r=1&em

During the Celebrations: World Habitat Day 2009

By Cathy Albisa, Executive Director, NESRI

This October 5th, the United States government has teamed up with UN Habitat to celebrate
World Habitat Day, with the theme of ‘Planning our Urban Future.’ Both the President and the
Secretary of HUD have stated “America has always been strongest when we work in
partnership to build communities that are vibrant, durable and inclusive.” All parties involved
express great concern about the urban poor during this day, and recognize the obvious:
adequate housing is central to human wellbeing.

But during the day of celebration, more than a thousand people are likely to lose their home to
foreclosure in the United States, the majority of poor residents from New Orleans remain
displaced, public housing is threatened by more demolitions despite the growing homelessness
crisis, and most people shut out of the private market face inadequate and humiliating options.
Despite these stark realities, there is no indication that HUD will announce today that it will
stop bulldozing people’s homes in public housing around the country or that the White House
will declare a national housing emergency and ensure that the ongoing foreclosures cease until
a more rational solution can be found. On the contrary, on this day of celebration in
Washington D.C., we will continue to see more and more homes without people and people
without homes.

In July of 2009, UN Habitat sent an advisory group of experts to New Orleans on a fact finding
mission on forced evictions. The international group met people living in abandoned buildings,
saw piles of rubble where homes used to be in public housing complexes bulldozed by HUD,
talked to people with rental assistance who couldn’t find a place to live because no landlord
would take their vouchers, and visited those who literally ended up under the bridges and any
other place they could put down their meager belongings because they no longer had any
home at all.

On October 22‐November 8, the UN Special Rapporteur on Adequate Housing is also
undertaking a mission in the United States indicating that housing rights are so imperiled the
situation requires international monitoring. This is the reality of habitats in the United States,
and one that is more fitting for a day of mourning and reflection than celebration.

Better yet, let’s consider holding off on the celebrations until people in the United State have a
guarantee of a secure and stable home, and instead make World Habitat Day a day of action
and a day of making resolute commitments to change the shameful state of housing in America
today. And when President Obama visits New Orleans later this month, we suggest he meet
with local resident groups, such as Mayday New Orleans, so he can truly work in partnership
and build communities that are vibrant, durable and inclusive.