Abstract
The American Dream is a strongly held notion that permeates the American psyche. The subtext of the dream is the assumption of equal opportunity for education and the subsequent career opportunities that presumably follow. Assuming equality of opportunity (a large assumption indeed), potential success is based on individual talent and effort resulting in part in the development of the individualistic societal norms of the ‘self-made man,’ ‘every man for himself,’ and ‘rugged individualism’ ideologies that are predominant in the US today. The archetype of the American Dream is the “self-made man” who, through will and determination gains an education, career success, and material wealth exemplified by home ownership. Human rights language would refer to these as the right to education, work, property, and housing. US constitutional law strongly protects civil and political rights. US federal law has even come to protect some economic, social, and cultural rights such as education as part and parcel of the American Dream. Until the 2010 passage of the Patient Protection and Affordable Care Act (ACA), the right to health has for the most part been excluded from both the notion of the American Dream as well as protection under US federal law. This chapter provides an overview of the historical development of the American Dream, an examination of global health models, and the U.S. model more specifically. It also explores the ACA and the 2012 US Supreme Court ruling as it relates to the international conceptualization of the human right to health, specifically focusing on the human rights principles of accessibility and nondiscrimination and how the ACA may contribute to an expanded notion of the American Dream including the right to health.
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Notes
- 1.
United Nations. International covenant on economic, social and cultural rights (ICESCR). New York, United Nations, 1966. United Nations General Assembly resolution 2200 (XXI), UN GAOR, 21st Session, Supp. No. 16, at 49, UN Doc. A/6316, entered into force 3 January 1976. New York: United Nations, 1976 (hereinafter referred to as ICESCR).
- 2.
Committee on Economic, Social and Cultural Rights. The right to the highest attainable standard of health: 11/08/2000. E/C.12/2000/4, CESCR General Comment 14. Twenty-second session Geneva, 25 April–12 May 2000 Agenda item 3 (hereinafter referred to as GC14).
- 3.
Office of the United Nations High Commission on Human Rights. “Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health” Available: http://www.ohchr.org/EN/Issues/Health/Pages/SRRightHealthIndex.aspx (accessed 25 November 2013).
- 4.
Lovett-Scott and Prather 2014.
- 5.
GC14, at para 12.
- 6.
Idemat, para 12(b).
- 7.
ICESCR, supra n 1 at Articles 2.2 and 3.
- 8.
GC14, at para 18.
- 9.
Idemat, para 19.
- 10.
- 11.
Grover 2012, para 1.
- 12.
Supra n 1. United National Treaty Collection “International Covenant on Economic, Social and Cultural Rights” Available: http://treaties.un.org/Pages/ViewDetails.aspx?src=TREATY&mtdsg_no=IV-3&chapter=4&lang=en (accessed 25 November 2013).
- 13.
The US has only ratified one human rights treaty that includes the right to health, namely the International Convention on the Elimination of all forms of Racial Discrimination emphasizing the importance of the principle of nondiscrimination to this discussion. The US has ratified other treaties, which include health-related rights such as the International Covenant on Civil and Political Rights among others.
- 14.
Meier 2010.
- 15.
Carlin HBO Films 2006.
- 16.
The United States of America, Declaration of Independence 1776.
- 17.
Cullen 2004.
- 18.
Ibid at pp. 214–215.
- 19.
Time Magazine 2012 (hereinafter referred to as Time Magazine).
- 20.
John Locke is widely credited as being the father of rugged individualism. See for example Moulds 1965, pp. 97–109. Locke’s philosophy greatly influenced a number of American Revolutionaries as reflected in the American Declaration of Independence vis-à-vis the concepts of republicanism and liberal theory. See for example Becker and Harcourt 1922, p. 27.
- 21.
Obama’s Remarks to Congress on Health Care (NPR radio broadcast Sept 9, 2009). Available at: http://www.npr.org/templates/story/story.php?storyId=112695048&sc=emaf (accessed 25 November 2013) (hereinafter referred to as Obama’s remarks to Congress).
- 22.
Time Magazine, supra n 20.
- 23.
King Jr. 1961, p. 7.
- 24.
Henry Clay is credited with coining the phrase self-made man in his 1832 Senate Speech, “The American System.” See Clay 1994.
- 25.
C. Golay and I. Cismas, The Right to Property from a Human Rights Perspective (International Centre for Human Rights and Democratic Development). http://dd-rd.ca/site/_PDF/publications/humanright-en.pdf. Accessed 13 August 2013.
- 26.
Ibid.
- 27.
Reports Submitted by States Parties under Article 9 of the Convention; Third Periodic Reports of States Parties Due in 1999; Addendum United States of America, (10 October 2000).
- 28.
See for example Emergency Insured Student Loan Act of 1969, Sect. 1078(c) (2) (F), Higher Education Act of 1965s. 1011 et seq., The Equal Education Opportunities Act of 1974, Sect. 1703, Elementary and Secondary Education Act of 1965, Sect. 6301 et seq,. General Education Provisions Act, Sect. 1228 (a) and Federal Family Education Loan Program, sect. 1087–1 (e)(3).
- 29.
Rudiger (2008).
- 30.
Ibid.
- 31.
Sunstein 2005, p. 4.
- 32.
The role of the State and its impact on health was not introduced until the nineteenth century. See for example, Virchow 2006, pp. 2102–2105.
- 33.
Hoffman 2009.
- 34.
Muller 2008, available at http://www.foreignaffairs.com/articles/63217/jerry-z-muller/us-and-them. Accessed 25 November 2013.
- 35.
Ibid.
- 36.
Patient Protection and Affordable Care Act pp. 111–148 (hereinafter referred to as ACA).
- 37.
Obama’s Remarks to Congress on Health Care, supra n 22.
- 38.
Remarks by the President at the "Let Freedom Ring" Ceremony Commemorating the 50th Anniversary of the March on Washington. Available at: http://www.whitehouse.gov/the-press-office/2013/08/28/remarks-president-let-freedom-ring-ceremony-commemorating-50th-anniversa (accessed 18 September 2013).
- 39.
Time Magazine, supra n 20.
- 40.
J Biden, Why Middle Class Americans Need Health Care Reform. Available at http://www.whitehouse.gov/assets/documents/071009_FINAL_Middle_Class_Task_Force_report2.pdf (accessed 25 November 2013).
- 41.
O’Connell 2005.
- 42.
Yamin 2005, p. 1159.
- 43.
Farmer 2005, p. 175.
- 44.
Rudiger 2008.
- 45.
Reid 2009.
- 46.
Grover 2012, at para 2.
- 47.
Koivusalo and Mackintosh 2004.
- 48.
Keck 2012.
- 49.
Reid 2009.
- 50.
Keck 2012.
- 51.
Grover 2012, at para 3.
- 52.
GC 14, at para 17.
- 53.
Reid 2009.
- 54.
- 55.
Editorial 2002, p. 1871 (hereinafter referred to as Where health care is not a right).
- 56.
Wilensky 2012, pp. 1479–1481.
- 57.
- 58.
- 59.
Rodin 2012, p. 861.
- 60.
Lovett-Scott and Prather, at Chap. 4.
- 61.
Rodin and De Ferranti 2012.
- 62.
Tiered health systems are defined as those where a State or government health system provides basic health services while a parallel private system provides an additional level of coverage for those who can afford to pay. Such a system exists in a number of European States. In the US Medicare, Medicaid, the State Children’s Health Insurance Program and Veteran’s Health would be considered in the first tier while all employer and private insurance would fall into the latter category. Many of the American uninsured fall between the cracks of the two existing tiers.
- 63.
MacNaughton 2009, p. 47.
- 64.
American Public Health Association 2012. “Why do we need the Affordable Care Act? Critical Health Systems Problems facing the United States.” Available at: http://www.apha.org/NR/rdonlyres/19BEA341-A7C3-4920-B2BC-65BDC846B803/0/WhyWeNeedtheACA_Aug2012.pdf (hereinafter referred to as American Public Health Association) (accessed 25 November 2013).
- 65.
Savedoff et al. 2012, p. 924, 932.
- 66.
Mark Tran “UN set to vote in favour of universal health coverage.” 12 December 2012. Available at: http://www.guardian.co.uk/global-development/2012/dec/12/un-vote-universal-health-coverage. (Accessed 25 November 2013).
- 67.
Rodin and De Ferranti 2012.
- 68.
UN General Assembly 6 December 2012. Available at: http://www.un.org/ga/search/view_doc.asp?symbol=A/67/L.36 (Accessed 25 November 2013).
- 69.
Pooling in the field of health care refers to the redistribution of health care risks, costs, and benefits. See for example Savedoff et al. 2012.
- 70.
Rodin and De Ferranti 2012.
- 71.
Rodin and De Ferranti 2012.
- 72.
Savedoff et al. 2012.
- 73.
Ibid.
- 74.
Rodin and De Ferranti 2012.
- 75.
Savedoff et al. 2012.
- 76.
Ibid.
- 77.
Ibid.
- 78.
Ibid.
- 79.
Ibid.
- 80.
Ibid.
- 81.
Ibid.
- 82.
The White House Blog. “On behalf of my mother” Available at: http://www.whitehouse.gov/blog/2010/03/23//behalf-my-mother (accessed 25 November 2013).
- 83.
Savedoff et al. 2012.
- 84.
ACA, supra n 37. See also US Department of Health and Human Services. The Health Care Law and You. Available at: http://www.hhs.gov/iea/acaresources/brochures/health-care-law-and-you.pdf (accessed 25 November 2013).
- 85.
Shaffer 2013, e-1-4.
- 86.
Universal health coverage, supra n 67.
- 87.
American Public Health Association, supra n 65.
- 88.
Ibid.
- 89.
ACA, supra n 37. See also US Department of Health and Human Services. The Health Care Law and You. Available at: http://www.hhs.gov/iea/acaresources/brochures/health-care-law-and-you.pdf (accessed 25 November 2013).
- 90.
Lovett-Scott and Prather 2014.
- 91.
Universal health coverage, supra n 67.
- 92.
American Public Health Association, supra n 65.
- 93.
Ibid.
- 94.
Ibid.
- 95.
Wilensky 2012.
- 96.
Shaffer 2013.
- 97.
ACA, supra n 37. See also US Department of Health and Human Services. The Health Care Law and You. Available at: http://www.hhs.gov/iea/acaresources/brochures/health-care-law-and-you.pdf (accessed 25 November 2013).
- 98.
The White House. “Explore the Timeline of Health Reform in Action.” Available at: http://www.whitehouse.gov/healthreform (accessed 25 November 2013) (hereinafter referred to as Timeline).
- 99.
DeParle 2012.
- 100.
Timeline, supra n 99.
- 101.
Well-woman visits are annual preventive care visits that include preconception and other services prior to prenatal care. See Women’s Preventive Services Guidelines, “Health Resources and Services Administration” (date, year). Available at: http://www.hrsa.gov/womensguidelines/ (accessed 25 November 2013).
- 102.
See www.healthcare.gov for the federal exchange website.
- 103.
Timeline, supra n 99.
- 104.
For select State-specific data regarding implementation see, Corlette et al. 2013.
- 105.
The Tax Anti-Injunction Act is a US federal law (26 U.S.C. para 7421((a)), which limits law suits on the grounds of taxation regardless of payment of the tax in question.
- 106.
Parento and Gostin 2012, (hereinafter referred to as Parento).
- 107.
National Federation of Independent Businesses v. Sebelius, Secretary of Health and Human Services 2012.
- 108.
National Federation of Independent Businesses v. Sebelius, at 567, Slip opinion C.J. Roberts, at 39.
- 109.
Congressional Budget Office. Estimates for the Insurance Coverage Provisions of the Affordable Care Act Updated for the Recent Supreme Court Decision. July 2012. Available at: http://www.cbo.gov/sites/default/files/cbofiles/attachments/43472-07-24-2012-CoverageEstimates.pdf (accessed 25 November 2013).
- 110.
U.S. Const. Article I, § 8.
- 111.
DeParle 2012.
- 112.
Ibid.
- 113.
The penalty in 2014 is $95 per adult and $47.50 per child or 1 % of family income, whichever is greater. By 2016, these numbers will increase up to $695 per adult and $347.50 per child or 2.5 % of family income, whichever is greater. See The Henry J Kaiser Family Foundation. “The Requirement to Buy Coverage Under the Affordable Care Act.” Available at: http://healthreform.kff.org/the-basics/requirement-to-buy-coverage-flowchart.aspx (last accessed 25 November 2013).
- 114.
Parento and Gostin 2012.
- 115.
Ibid.
- 116.
Kaiser Family Foundation. “Key Findings of the July Kaiser Family Foundation Health Tracking Poll.” 31 July 2012. Available at http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8339-f.pdf (accessed 25 November 2013).
- 117.
National Federation of Independent Businesses v. Sebelius, supra n 108.
- 118.
The US Poverty Guidelines (also referred to as the federal poverty level) are a federal poverty measure issued annually by the US Department of Health and Human Service used to determine eligibility for federal programs. For 2013, the poverty guideline for a family of four is $23,550. See Annual Update of the HHS Poverty Guidelines, Federal Register. (date, year) Available at: https://www.federalregister.gov/articles/2013/01/24/2013-01422/annual-update-of-the-hhs-poverty-guidelines (accessed 25 November 2013).
- 119.
National Federation of Independent Businesses v. Sebelius, Slip opinion, J. Ginsburg.
- 120.
Ibid. Slip opinion C.J. Roberts.
- 121.
Cruze 2012.
- 122.
Ibid.
- 123.
Congressional Budget Office, supra n 110.
- 124.
Ibid.
- 125.
Ibid.
- 126.
GC 14, at para 33.
- 127.
Ibid.
- 128.
Ibid.
- 129.
Committee on Economic, Social and Cultural Rights. ‘The right to adequate food’ 1999, agenda item 7.
- 130.
Lovett-Scott and Prather, Chap. 1.
- 131.
Idem, Chap. 3.
- 132.
GC 14, at para 12b.
- 133.
ACA supra n 37.
- 134.
Ibid.
- 135.
Ibid.
- 136.
Ibid.
- 137.
Ibid.
- 138.
Ibid.
- 139.
Ibid.
- 140.
Time Magazine, supra n 20.
- 141.
Lovett-Scott and Prather 2014, Chap. 17.
- 142.
Wilensky 2012.
- 143.
Savedoff et al. 2012.
- 144.
Ibid.
- 145.
Editorial 2002.
- 146.
See for example, Hunt in “Reclaiming Social Rights: International and Comparative Perspectives” (1996) discussing the relationship between civil and political rights to social rights.
- 147.
Freeman 2012.
- 148.
Ibid.
- 149.
Hunt 2003, para 82.
- 150.
Parento and Gostin 2012.
- 151.
GC 14, at para 35.
- 152.
Lovett-Scott and Prather 2014.
- 153.
Time Magazine, supra n 20.
References
Achenbaum A (1986) Social security visions and revisions. Cambridge University Press, New York
American Public Health Association (2012) Why do we need the Affordable Care Act? Critical Health Systems problems facing the United States. www.apha.org/NR/rdonlyres/19BEA341-A7C3-4920-B2BC-65BDC846B803/0/WhyWeNeedtheACA_Aug2012.pdf. Accessed 25 Nov 2013
Becker CL (1922) The declaration of independence: a study of the history of political ideas. Harcourt, Brace and Company, New York
Brown v. Board of Education (1954) 347 US 483
Clay H (1994) The American System. In: Byrd RC, The Senate, 1789-1989: Classic Speeches, 1830–1993. Government Printing Office, Washington, D.C, 1994. http://www.senate.gov/artandhistory/history/resources/pdf/AmericanSystem.pdf
Cullen J (2004) The American dream: a short history of an idea that shaped a nation. Oxford University Press
Committee on Economic, Social and Cultural Rights. The right to the highest attainable standard of health: 11/08/2000. E/C.12/2000/4, CESCR General Comment 14. Twenty-second session Geneva, 25 April–12 May 2000 Agenda item 3
Committee on Economic, Social and Cultural Rights. The right to adequate food: 05/12/1999. E/C.12/1999/5, CESCR General Comment 12. Twentieth session Geneva, 26 April–14 May 1999 Agenda item 7
Corlette S, Monahan C, Lucia K (2013) Moving to high quality, Adequate coverage: state implementation of new essential health benefit requirements. Georgetown University’s Health Policy Institute. http://www.rwjf.org/content/dam/farm/reports/reports/2013/rwjf407484
Cruze D (2012) Justice in health care reform. Emory Health Magazine. Woodruff Health Sciences Center. http://emoryhealthmagazine.emory.edu/issues/2012/fall/features/justice-in-health-care-reform/index.html
DeParle N (2012) A Supreme Court upholds President Obama’s health care. The White House Blog 11 July 2012
Editorial (2002) Editorial: where health care is not a right. Lancet 359:1871
Evans DP (2012) The synergistic approach: racial discrimination and the right to health. LAP Lambert Academic Publishing
Farmer P (2005) Pathologies of power: health, human rights and the new war on the poor. University of California Press, California
Freeman J (2012) Health reform, ACA and primary care: Is there still a conundrum? Medicine and Social Justice. http://medicinesocialjustice.blogspot.com/2012_11_01_archive.html. Accessed 19 June 2014
Grover A (2012) Interim report of the special rapporteur on the right of everyone to the highest attainable standard of physical and mental health UN doc.A/67/302
(The) Henry J Kaiser Family Foundation. The requirement to buy coverage under the Affordable Care Act. http://healthreform.kff.org/the-basics/requirement-to-buy-coverage-flowchart.aspx. Accessed 25 Nov 2013
Hoffman C (2009) National Health Insurance, A brief history of reform efforts in the U.S. http://www.kff.org/healthreform/upload/7871.pdf. Accessed 13 Aug 2013
Hunt P (2003) Report of the Special Rapporteur on the Right to the Highest Attainable Standard of Physical and Mental Health” UN doc.E/CN.4/2003/58, 13 Feb 2003
Hunt P (2005) Report of the Special Rapporteur on the Right to the Highest Attainable Standard of Physical and Mental Health UN doc.E/CN.4/2005/51, 11 Feb 2005
International Convention on the Elimination of all forms of Racial Discrimination, G.A. Res. 2106 (XX), U.N. Doc. A/RES/2106 (XX) 21 Dec 1965
Keck C (2012) Personal communication. San Francisco, California, 2 Oct 1012
King ML Jr (1961) Speech to the AFL-CIO, 11 Dec 1961. http://www.thekingcenter.org/archive/document/mlk-speech-4th-constitutional-convention-afl-cio
Kinney ED (2008) Recognition of the International Human Right to Health and Health Care in the United States. Rutgers Law Review 60:337. http://www.pegasus.rutgers.edu/~review/vol60n2/Kinney_Macro_web.pdf
Koivusalo M, Mackintosh M (2004) Health systems and commercialisation: in search of good sense. Social Policy and Development Programme. http://www.unrisd.org/80256B3C005BCCF9/32A160C292F57BBEC1256ED10049F965?OpenDocument. Accessed 25 Nov 2013
Lovett-Scott M, Prather F (2014) Global health systems comparing strategies for delivering health systems. Jones & Bartlett Learning, Burlingham
MacNaughton G (2009) Untangling equality and non-discrimination to promote the right to health care for all. Health Hum Rights 11(47):47–63
Meier BM (2010) Global health governance and the contentious politics of human rights: mainstreaming the right to health for public health advancement (December 1, 2010). Stanford J Int Law 46(1) 2010. Available at SSRN: http://ssrn.com/abstract=1816625
Moulds H (1965) John Locke and rugged individualism. American J Econ Sociol 24(1):97–109
Muller JZ (2008) Us and them: the enduring power of ethnic nationalism, March/April Foreign Affairs. http://www.foreignaffairs.com/articles/63217/jerry-z-muller/us-and-them. Accessed 25 Nov 2013
Naderi PS, Meier BD (2010) Privatization within in the Dutch context: a comparison of the health insurance systems of the Netherlands and the United States, Sage Publications, pp 603–618. http://hea.sagepub.com/content/14/6/603.refs.html. Accessed 25 Nov 2013
National Federation of Independent Businesses v. Sebelius, Secretary of Health and Human Services, 567 US 05 (2012)
O'Connell P (2005) The right to health and the privatisation of Irish Health Care. Medico–Legal Journal of Ireland 11(2):76 et seq
Parento EW, Gostin LO (2012) The Supreme Court’s Landmark Decision on the Affordable Care Act, Healthcare Reform’s Ultimate Fate Remains Uncertain. O’Neill Institute for National and Global Health Law. Briefing Paper No. 7. July 9, 2012
Patient Protection and Affordable Care Act (ACA) [P.L. 111-148]
Reid TR (2009) The healing of America. Penguin Press, New York
Report by the Independent Expert on Human Rights and Extreme Poverty (2006) U.N. Doc. E/CN.4/2006/43/Add.1 (Mar. 27, 2006)
Reports Submitted by States Parties under Article 9 of the Convention (10 October 2000) Third Periodic Reports of States Parties Due in 1999; Addendum United States of America, U.N. Doc CERD/C/351Add.1
Rodin J, De Ferranti D (2012) Universal health coverage: the third global health transition. Lancet 380:861–862
Rudiger A (2008) From market competition to solidarity? Assessing the prospects of U.S. health care reform plans from a human rights perspective. Health Hum Rights Int J 10(1). http://ssrn.com/abstract=1984251. Accessed 25 Nov 2013
Savedoff WD, de Ferranti D, Smith AL, Fan V (2012) Political and economic aspects of the transition to universal health coverage. Lancet 380:924–932
Shaffer ER (2013) The affordable care act: the value of systemic disruption. Am J Public Health 103(6):969–972
Sunstein CR (2005) Why does the American constitution lack social and economic guarantees? 56 Syracuse L Rev 56:1
Rodin J (2012) Universal health coverage: the third global health transition. Lancet 380:861–862
Vicini J, Stempel J (2012). US top court upholds healthcare law in Obama triumph”. http://www.reuters.com/article/2012/06/28/us-usa-healthcare-court-idUSBRE85R06420120628, 28 June 2012. Accessed 25 Nov 2013
Virchow RC (2006) Report on the typhus epidemic in Upper Silesia. Am J Public Health 96(12):2102–2105
Wilensky GR (2012) The Shortfalls of ‘Obamacare’. N Engl J Med 367:1479–1481
Yamin A (2005) The Right to Health Under International Law and its Relevance to the United States. Am J Public Health 95:1156 et seq
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Evans, D.P. (2014). The Right to Health: The Next American Dream. In: Toebes, B., Ferguson, R., Markovic, M., Nnamuchi, O. (eds) The Right to Health. T.M.C. Asser Press, The Hague. https://doi.org/10.1007/978-94-6265-014-5_8
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