Bulldozing Rights: When does Redevelopment become a Violation of Human Rights?

By Cathy Albisa

Every time I talk to my seven year old about possibly moving some day, he says “Mom, you know I am not any good at that!” He probably speaks for most people. But most people do move at some point – new jobs, better or cheaper housing, better schools, etc. We embrace the anxiety and promise of a new home, and hope it will be for the best. In the best case scenario, redevelopment mimics this dynamic. A community makes a decision that change is needed, and works with government and other sectors to create that change. The human right to participation in development is respected for all residents, and though there are challenges and trade-offs, the community embraces the promise of a better life before a plan moves forward.

The demolitions in New Orleans culminating in April of this year did not represent participatory and inclusive redevelopment that respects human rights. They are part of a nationwide trend where public housing residents are not moving – they are “being moved,” or more accurately displaced. Residents generally have neither vote nor voice in what happens to them and their families. And because there is no actual one-for-one replacement for low-income units, residents are all too conscious that far too many of them will not enjoy the fruits of the redevelopment at all as their homes are not necessarily being re-built for them. Rather, what awaits them is an economically inaccessible private market where affordable homes are becoming as rare as hen’s teeth!

In the context of New Orleans, it has been particularly cruel, even for families that aren’t currently living in their houses. Many displaced families still yearn to come home, and the physical displacement by the storm has been compounded by the bitter images of the homes they have always known being torn down. The voices, sounds, music, and cadence of the world they knew were quickly and permanently drowned out by machines that are bulldozing their rights.

The reconstruction and redevelopment policies in New Orleans appear designed to purge the poor from the city. They savagely dismiss any notion that all people have a right to their city and community, that housing is a fundamental right that has been recognized by human rights documents for more than half a century, and that people are not packages that can simply be sent for storage in some other part of the country. But there is a growing chorus of allies in support of human rights and social inclusion for poor Black communities in New Orleans. Dozens of U.S. based advocacy organizations — both national and local – community and volunteer efforts in Minnesota, New York, Miami, Chicago and beyond, and international supporters in Egypt, Indonesia, Italy and Haiti have all expressed their dismay and indignation at the demolitions of poor people’s homes in New Orleans.

Affordable and adequate housing is part of the foundation of human dignity, freedom and equality. No person can truly be free if they are deprived of these essentials and, in a very real sense, cast out of society. How can we bear to see children doing homework in shelters? History will not be kind to us is we don’t cry out against theses abuses today.

Paying More, Getting Less: The Diminishing Value of Health Insurance

Binaries are a central theme in American political culture. From a two party political system (which, at election time, gives rise to another binary – winners and losers) to an economy which increasingly creates haves and have-nots, this diverse country is often broken down into only two, usually unequal categories. One of the most persistent binaries in recent years – those who have health insurance and those who do not – has also served as a fault line on which the haves and have-nots divide. Working people with insurance could well be counted among the haves – they can have check-ups and they can have care in case of catastrophe, or so the theory goes.

Change has been the theme of this election cycle, to some extent on both sides. Obama has long proclaimed that we are beyond the binary, talking about purple states and post-partisanship, and McCain has trumpeted his purportedly valiant forays through the Washington logjam and across the aisle. Little, of course, has yet changed in Washington for mere talk of change, but as a new study released last week shows, our economy is moving us past an old binary, though this change is not for the better.

The Center for Studying Health System Change concluded that from 2003-2007 the number of people not getting or delaying needed medical care in the United States increased by more than half, from 36 million in 2003 to 57 million in 2007. Much of the increase occurred among those who actually do have health insurance. Rising out-of-pocket costs of all kinds – premiums, deductibles and copayments, prescription drug costs – have all contributed to an environment in which people with health insurance cannot actually use their insurance to get the healthcare that they need – and that they assumed they had already paid for when buying coverage.

More people than ever before have to make the impossible choice between paying their bills and getting medical care. From a cost-efficiency perspective, fewer people seeking care will only make existing problems worse. Prevention is the cheapest solution to improving health outcomes, an early fix is next best, but a late fix is most costly of all. In the long run, people forced to delay treatment will cost more to treat, exacerbating the health-cost mess.

A human rights approach tells us that the health of every human being must be protected, that health care should be denied to none, regardless of ability to pay. Yet the U.S. is unique amongst industrialized countries in its poor health outcomes, high degree of privatization, and its astronomical health care costs. The US spends far more per capita on healthcare than any other nation, yet fails to provide basic care for a fifth of its population – a number which is rising even among the supposedly insured. Even those who do receive care pay more for it than anyone else in the world.

Some insurers place the blame on doctors and hospitals while at the same time defending the value added by private insurance companies. But considering how much people in the US pay for health care coverage, only to be denied access to care when they need it, the sole efficiency claim insurers can make is efficient profit generation.

If we as a society insist on the current approach in which a healthcare binary is allowed – a binary that signals power differentials and exclusionary dynamics – in which some are made to go without care because they cannot pay, we will only see more unnecessary illnesses and deaths. Traditionally, the fact that the majority receives care has deflected attention from the fact that so many do not. In the midst of the current election campaign, healthcare reform advocacy has been influenced by research indicating that nearly ninety-five percent of voters are insured and so has sidelined the plight of the uninsured in favor of seeming political expediency. For the longest time, insured people were lured into thinking the system, while expensive, “worked,” because they felt they had a de facto guarantee of health care, even if not a de jure one. As new barriers to care cause this spurious guarantee to vanish, we must demand of our government a system that protects health and serves people, rather than protecting profit margins and serving insurers. Providing universal care, especially preventive care, and enabling people to see doctors before illnesses worsen is not only an efficient idea; it is also the only humane one – and it is our human right.

Happy 5th of July!

 

 

A human rights vision for health care is not modest.  But it doesn’t need many words.  Let’s try it:

 

We need a health care system that

·      meets the needs of everyone,

·      is free at the point of delivery,

·      is based on clinical need, not ability to pay

 

That sounds too ambitious?  Too expensive?  Too disruptive of the status quo?

 

Except it already exists.  Just not in this country.

 

These are the principles on which the National Health Service of England was founded exactly 60 years ago. Happy Birthday, NHS!

 

While we’re celebrating our independence from Britain, they are celebrating their health care system, conceived on July 5, 1948. So what did we miss out on?

 

For example, a strong commitment to protecting our health, as set out in the proposed preamble to the new NHS constitution:

 

“The NHS belongs to the people. It is there to improve our health, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can. It works at the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health. It touches our lives at times of basic human need, when care and compassion are what matter most.”

 

The new draft constitution is currently open for comments from the people – everyone can participate in designing their health care system’s guiding principles and values, rights and responsibilities.

 

But what about translating commitments and principles into practice – how has the NHS fared in reality?  Let’s hear it from some who should know, NHS staff and patients:

• ‘I’m proud to work in the NHS because we treat everyone regardless of insurance, age, race, religion, social class, etc. I chose to be a nurse in the NHS to help people become healthier, help them through their illness and to just work with a wide variety of people.’ 
• ‘Where else do you have people with different skill mix, cultures, beliefs come together for one common goal of improving someone’s wellbeing?’
• ‘Such a wonderful dream 60 years ago – free health care is a great thing and has huge numbers of dedicated staff.’
• ‘The NHS is a beacon and the greatest example of how a society should care for the disadvantaged.’
• ‘No matter who you are you’re equal in the NHS. Long may it endure.’
• ‘It is free at the point of need. I have had many operations over the years (I am 77) and hope that the NHS is Never privatized either overtly or by the back door!’   

Despite this praise, the threat of privatization, afflicting public services throughout the world, is always all too present.  U.S. hospital corporations have their eyes set on new overseas markets to rake in further profits.  Let’s hope people in Britain have heard about poor health outcomes in the U.S., and will keep their doors shut to these modern day invaders from the New World.  May they look forward to another 60 years of universal health care.