Health Care & Human Right protesters at the June 19, 2008 protest against the health insurance industry in San Francisco.
Credit: Heather McLaughlin

* Every person has freedom to make decisions about his or her own health.
(For example, nobody can force you to undergo treatments that you don’t agree to.)

* Governments must put into place to a system to prevent people from getting sick or injured and to treat them if they do.
(We don’t have a health protection system like this in the US. We have a patchwork of agencies like the Occupational Safety and Health Administration and the Food and Drug Administration. Our public health system has been under funded for many years. It is doubtful that it will be able to prevent or minimize serious epidemics such as the “bird flu”. There is also no system in place to ensure that people can access medical care when they need it.)

* All health related facilities, goods and services must be available, accessible, acceptable, appropriate and of good quality (AAAQ).
(This means that everything that is done to improve health, from medical care to water treatment, must be available to all. All people must be able to access the facility or service. It shouldn’t depend on things like being able to pay or to fit your wheelchair in the door.  Services must be acceptable to people of different cultural backgrounds and who speak different languages. “Appropriate” means that services that are unnecessary or extravagant shouldn’t be given. For example, total body CT scans used as screening tests are popular now, but they are not appropriate. Finally, all the facilities and services must meet the same minimum “good quality” standard.)
 
* These rights apply to EVERYONE without discrimination.
(Everyone means everyone, regardless of citizenship status, disability, ethnicity, incarceration, etc.)
 
* Governments must respect, protect and fulfill the right to health.
(We all should ensure that our actions as neighbors, workers, and citizens are consistent with human rights standards, but it is ultimately the government’s duty to make progress towards the complete realization of human rights.)
 
* People affected by health related policies must be able to participate in the creation and monitoring of those policies.

* There also must be in place a system to monitor compliance with human rights obligations; accountability mechanisms; and remedies when there are violations of the right to health.

This framework doesn’t mean anything unless we use it. Around the world there is a movement to put human rights into practice at all levels. Any organization can apply human rights to its own work. These groups are developing new ways to hold governments and other institutions accountable for their impact on people’s health.

The right to health is made real through both the government’s compliance with its obligations, and by rights-holders claiming their rights. We can’t claim our rights unless we know what they are, so the first step is to learn about our right to health and then teach others.

Most people, even doctors and nurses, don’t know about the right to health. The next time you see a health care provider, suggest they take a look at The Right to Health: a toolkit for health professionals written by the British Medical Association. It shows the practical meaning of the right to health in the day-to-day work of health professionals.  It can be downloaded here.

Think about whether the health care reform plans you hear about are consistent with the right to health. Do they guarantee availability, accessibility, acceptability and quality (AAAQ) for ALL? Is there a way that people can participate in the decisions made under the reform plan? The presidential candidates’ health care plans are evaluated from a right to health perspective in Pursuing A New Vision For Health Care: A Human Rights Assessment of the Presidential Candidates’ Proposals, by the National Economic and Social Rights Initiative.  Read an excerpt about individual and employer mandates here.

Organize with people in your community to:
-monitor your local hospital or health center’s compliance with human rights standards.
-fight for a health care financing system in California and the USA that covers health care services for everyone. The existing plans that actually would do that are H. R. 676, "The United States National Health Insurance Act,” or "Expanded & Improved Medicare For All" in the US House of Representatives, and in California, SB 840, the California Universal Healthcare Act.
-use the standards of the right to health when commenting about policy decisions at city council, school board, or other local government body public sessions.

The right to health was first recognized in 1948 in the Universal Declaration of Human Rights (UDHR). You can read it the whole declaration here.

The UDHR mentions medical care specifically in Article 25:
(1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
(2) Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.

This article means that not only is medical care a right, but so are all the things that contribute to good health. You can see if you read the whole UDHR that most of the articles deal with things that relate to being able to achieve good health, like education, non-discrimination, participation in decision-making and other aspects of community life, as well as civil rights.

Since then, many international conventions have had some impact on further defining the right to health. The most important is the International Convention on Economic, Social and Cultural Rights.

1. The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.
2. The steps to be taken by the States Parties to the present Covenant to achieve the full realization of this right shall include those necessary for:
(a) The provision for the reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child;
(b) The improvement of all aspects of environmental and industrial hygiene;
(c) The prevention, treatment and control of epidemic, endemic, occupational and other diseases;
(d) The creation of conditions which would assure to all medical service and medical attention in the event of sickness.

FOR MORE INFORMATION ON THE RIGHT TO HEALTH AND HEALTH CARE, CHECK OUT THE LINKS BELOW:

“25 Questions and Answers on Health and Human Rights”, "The Right to Health" Cartoon and other publications on health and human rights.

“Accountability and the Right to the Highest Attainable Standard of Health”.

The web pages of the United Nations Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health (that is really its title!):
http://www2.essex.ac.uk/human_rights_centre/rth/
http://www2.ohchr.org/english/issues/health/right/

A coalition of grassroots groups evaluated the City of New York using the Convention on the Elimination of Racial Discrimination, to which the USA is a signatory. Their report includes a section on health. They presented their report to the Convention committee in Geneva and were able to counter the US government’s claims that the US is making great progress on eliminating racial discrimination.

“The Right to Health in the United States: What does it mean?”