Right to Health: A new kid on the block for the US?

Should the US create a human right to health care?


US President Elect Joe Bidden and former Vice-President under the Obama tenure is a supporter of access to universal health care for all american citizens. Dr Travis Carpenter, a Canadian citizens, takes the opportunity of the new presidential election to reflect on the “right to health” debate that seems to gain traction and offer a few lessons learned from the Canadian experience.


In the Regulatory Review, Dr Carpenter underscores from the outset of his analysis that the very fact that there is a single-payer system in Canada led all health stakeholders to consider that access to care is a fundamental right. It is perhaps the curse of the era that all public service activities are considered carved in stone and any limitations thereof an infringement of human rights, while such constitutional or legislative level provision may actually not sanction this belief. The issue raised by Dr Carpenter is the consequence of the intangibility of this belief:


Despite the lack of a formal legal foundation, a majority of Canadians believe that access to health care services is a constitutional right. (...) 


Undue public pressure and political influence often result in counterproductive decisions such as provincial governments approving funding for a patient’s “right” to astonishingly expensive cancer treatments, which an independent regulator may deem to be not cost-effective, while simultaneously failing to deploy scarce resources to provide arguably more vital universal basic prescription drug coverage.


The risk is there: the untainable promise of a free-for-all access which no public authoriy can guarantee, and the lack of scientific, economic, societal or moral criteria to entail decision making in health. Or the other way round: the duty to provide regardless of limitations, enforced by the Judiciary. These cases are detailed in a section of the forthcoming “How to HTA” Guide that WHO will soon launch (more on this topic soon on your Decide platform): the contextualisation of the right to health.


Amongst the recommendations drawn by Dr Carpenter are the need to first think about filling the gap in the access to essential care such as dental care, as well as ensuring the care pathways are optimised (i.e. PHC development may mitigate the over use of ER services for people who only have access to healthcare through these costly and overstretched resources).


In sum, there seems to be a case to extend access to care, ensure it is operational and responds to needs, while understanding that health is one social sector competing and often outshadowing other important social sectors which may have a coniderable influence over populations’ health: from water and sanitation, education, economic access to a balanced diet or decent housing, or else a clean environment... should these sectors also be enshrined in the right to health?


This would certainly be consistent with the excellent legal analysis published by WHO on the topic and which remains the flagship legal expertise insight on the topic (click here to read the Decide article relating to this document)


Dr Carpenter therefore concludes that building a robust universal health insurance would resolve the issues that affect American citizens without the need for additional constitutional rules: to read the full article click here!


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