Mobilizing for the Right to Health and Health Care

Abstract

This chapter addresses efforts to secure the right to health care through community practice. It depicts the importance of different forms of community practice to the realization of the human right to health and health care. The authors link the conceptual framework of community practice, focusing on political and social action, with human rights-based mobilization for health and health services. Emphasis is placed on the importance of fostering broad-based participation in social and political campaigns to affect policy change. Community practitioners can help assure the participation of local groups in mobilizing for rights-based approaches to health care. Grassroots participation is also seen as integral to developing programs and policies responsive to local communities, and in promoting accountability and transparency in health care provision through broad public engagement. The chapter outlines what the human right to health and health care means and describes the US government position on the human right to health and health care. We also highlight prominent examples of efforts to challenge the dominant framework of health care-as-commodity to illustrate how local, community-based mobilization can further the realization of human rights.

We really need to stop thinking of health care as a for-profit venture and start treating it as a right and a public good.

—Franzen, as cited in NESRI (2010, p. 9)

Appendices

Class Exercises and Additional Resources

For Discussion: The Core Minimum Obligations to the Right to Health in the US Context

According to the UN Committee on Economic, Social, and Cultural Rights, the core minimum obligations to the right to health include:

• (a) “[A]ccess to health facilities, goods and services on a non-discriminatory basis, especially for vulnerable or marginalized groups”;

• (b) “Access to the minimal essential food which is nutritiously adequate and safe”;

• (c) “Access to shelter, housing and sanitation and an adequate supply of safe drinking water”;

• (d) “The provision of essential drugs”; and

• (e) “Equitable distribution of all health facilities, goods and services”

(WHO, 2008, pp. 24–25).

Questions for Discussion

• Which of the core minimum obligations to the right to health exist in your community?

• Which of these core minimum obligations to the right to health would you prioritize in your community and why?

• What are the benefits and/or limitations of using a rights-based approach to health and health care in advocacy efforts?

For Discussion: Illustrating the Interdependence of Human Rights Through the Child’s Right to Health and Health Care

Read the excerpt from a recent general comment of the Committee on the Rights of the Child (2013) concerning the child’s right to the highest attainable standard of health. In small groups discuss the questions below.

28. Article 24, paragraph 1, imposes a strong duty of action by States parties to ensure that health and other relevant services are available and accessible to all children, with special attention to under-served areas and populations. It requires a comprehensive primary health-care system, an adequate legal framework and sustained attention to the underlying determinants of children’s health.

29. Barriers to children’s access to health services, including financial, institutional and cultural barriers, should be identified and eliminated. Universal free birth registration is a prerequisite and social protection interventions, including social security such as child grants or subsidies, cash transfers and paid parental leave, should be implemented and seen as complementary investments.

Questions for Discussion

• Have the barriers to children’s access to health services (identified above) been eliminated in your community?

• How would you frame the issue of children’s access to health care to generate public support to realize children’s right to health and health care?

• What groups in your community and professional organizations (state, local) should be involved in efforts to address this human rights concern?

For Discussion: Does the United States Need a Constitutional Amendment on the Right to Health?

Over the past decade a number of Congressional representatives have introduced a proposed amendment to the US Constitution that would provide an entitlement to health care. Read the text of the proposed amendment introduced by Rep. Jesse Jackson, Jr. to the 108th Congress. Then discuss the questions that follow.

 

Questions for Discussion

• How would a federal Constitutional Amendment help advance a right to health care?

• What actions could lead to the adoption of such an amendment?

• What short-term and mid-term goals would be necessary to develop a campaign to amend the Constitution for a right to health care?

• What other approaches to ensure the human right to health care would likely generate public support?

Human Rights-Based Guidelines for Analyzing Vermont’s Legislation

The following questions were used to analyze the state of Vermont’s proposed legislation on health care in the late 2000s. They were directly tied to human rights principles for health care. Consider how these questions could be used in advocacy for health care in your community.

• Does the system provide health care for all?

• Does the system provide equal access to comprehensive health care services?

• Does the system treat health care as a public good?

• Does the system eliminate barriers to use needed health care services?

• Is the system financed equitably?

• Do people pay for their health care on their ability to pay without regard to unrelated factors such as age, gender, employment, or health status?

• Does the system use money effectively and efficiently?

• Does the system allocate resources equitably, according to health needs?

• Does the system improve the quality of health care by rewarding providers who utilize best practices and provide excellent outcomes?

• Does the system enable meaningful community participation?

• Is the system accountable to the people it serves?

Sources Adapted from McGill (2012, p. 111); see also more detailed guidelines with links to specific aspects of the right to health care on the Vermont Workers’ Center website at: http://www.workerscenter.org/sites/default/files/hchr_hsiao_assessment.pdf.

Organizations in the United States Using a Health and Human Rights Perspective

Listed Below are Organizations that Advocate for Access to Health Care from a Human Rights Framework

• Healthcare is a Human Right: Accessible healing for all: http://healthcareisahumanright.com/

• Healthcare NOW! Organizing for a National Single-Payer Healthcare System: http://www.healthcare-now.org/

• Montana Human Rights Network: http://www.mhrn.org

• National Economic and Social Rights Initiative: http://www.nesri.org/

• National Health Law Program: http://www.healthlaw.org/

• South L.A. Coalition for Health and Human Rights: http://www.southlahealthandhumanrights.org/about.html

• Vermont Workers Center-Healthcare is a Human Right Campaign: http://www.workerscenter.org/healthcare