Health Care in the United States – A Human Rights Violation?
When approaching the study of human rights from a theoretical perspective, especially as a United States-based student, case studies and examples – both from the scholar’s and practitioner’s perspectives – are generally drawn from distant developing nations, regions and events, which may be difficult to visualize. In order for the student to more fully understand global human rights challenges, he must realize that these challenges exist in every country, even in the most rich and well-developed. Examining the state of human rights at home can thus help to inform one’s understanding and appreciation of human rights challenges in other communities.
Indeed, there is one type of human rights in which the United States is missing an opportunity to stand as an example to other nations: because of Americans’ deep-seated ideological preference for a limited federal government role in public life, the U.S. does not provide basic health care to all its residents. The significant resistance to President Barack Obama’s health care reform agenda, which sought to provide a form of universal health care, thus demonstrates an asymmetry between America’s global prominence and its attention to human rights. The domestic shortcoming of avoiding universal health care hinders America’s potential to be a champion of human rights internationally.
Renowned economist and philospher Amartya Sen lists health care as an instrumental freedom, included under social opportunities as “important not only for the conduct of private lives…, but also for more effective participation in economic and political activities.”1 “The right to the highest obtainable standards of health,” according to development practitioner Peter Uvin, is integral among the second generation of economic, social and cultural rights as outlined in the 1976 UN Covenant on Economic, Social and Cultural Rights. While this particular covenant has not been ratified by the United States,2 these theoretical references show that health care has been recognized by the international human rights community as an inalienable right.
Health care, however, remains a fraught topic in American politics. The United States – despite its enormous GDP and geopolitical preeminence – maintains a system of health care which leaves over 30 million number of people unable to access or afford health care for various reasons.3 This is largely because of popular American resistance to any policy perceived as government meddling in private life, a political ideosyncracy which dates to the United States’ founding. Thus, President Barack Obama’s plan to meaningfully reform health care in order to reduce the number of uninsured Americans has met massive popular resistance from those who argue that it is not the state’s responsibility to subsidize health care for those American residents who are not citizens, who are unemployed, or who are otherwise unable to access private health insurance. Yet if one measures the American health care situation in terms of international human rights conventions, it can be interpreted as a violation of uninsured Americans’ human rights to leave them deprived of affordable basic health care.
This deficiency stands out at this juncture of the 21st century, with members of the human rights and development communities struggling to find ways to integrate each other’s work in a meaningful way. In outlining a rights-based to development, which would assist development agencies in making the protection of human rights and freedom more central to their missions, Uvin argues that the United States plays an integral role. Due to the size, strength and skill of NGOs in “the world’s most powerful state,” “third-world governments paradoxically are more influenced by the pressure emanating from rich-country NGOs…than from their own civil societies.” He goes on to point out that “this situation gives the US foreign-policy establishment…a major opportunity to filter worldwide NGO impact.”4 The United States is thus recognized as having major potential in advocating for the protection of human rights.
Unfortunately, the United States often neglects to take decisive stands on global issues, stands which might encourage other states to follow suit and which validate the United States as not only preeminent in economic and military power, but also as inspirationally progressive in the realm of human rights. Examples include the United States’ refusal to ratify the international landmine ban, the Kyoto Protocol on climate change, and the Convention on the Rights of the Child. While enacting domestic health care reform that would universalize access to health care for Americans does not have the same geopolitical ramifications as refusing to ratify an international ban, protocol or convention, it would certainly emphasize to the international community that, as a nation, the United States believes that basic health care is an important human right that all governments should provide for their citizens.
The political controversy surrounding President Obama’s health care reform agenda has made headlines since his election in 2008, and it now seems unlikely that his ideas will ever be enacted in any meaningful way. Given the need for powerful states such as the United States to take a lead on human rights, it is unfortunate that the opportunity has been missed to show support for health care as a basic human right. If the international community’s richest, most developed nations do not lead in the mission of protecting and expanding human freedoms, what motivation do developing nations have to do so?
1Amartya Sen, Development as Freedom (New York: Anchor Books, 1999), 39.
2Peter Uvin, Human Rights and Development (Bloomfield, Connecticut: Kumarian Press, 2004), 10-14.
3Barack Obama, “Remarks by the President to a Joint Session of Congress on Health Care,” U.S. Capitol, Washington, D.C., September 9, 2009.
© 2010, Ilyana Sawka. All rights reserved.