Human right to health care in the United States: Toward a normative and analytical framework for policy change

The United States does not recognize the human right to health care, and it stands alone among industrialized countries in failing to implement a universal health care system. While reform efforts have followed in close succession, access to care remains restricted, based on factors such as ability to pay, health status, geographical location, race/ethnicity, or, for public programs, financial situation, citizenship status and “worthiness”. As long as health care is seen as a product, privilege or charity, reforms may expand access to broader categories of people, but not altogether remove classicifcations that regulate access. Universal, equitable access to health care, enjoyed by virtue of being human, remains elusive.

Human rights provide a conceptual and practical tool to overcome the classification and differential positioning of individuals in relation to health care. Understood as a universal right to an equitable system of health protection, the recognition of a right to health care could drive fundamental change in policy and practice. However, current health care reformers only recognize the flipside of a right -- an individual duty, in the form of punitive mandates on individuals to purchase insurance.

Building recognition for the right to health care in the United States entails, in the first instance, a normative challenge to the prevailing policy paradigm. Furthermore, a rights-based framework can serve as an analytical tool to assess policy failures, practical gaps, and reform efforts, with principles and criteria based on internationally recognized standards and adapted to specific conditions in the United States.