Access to Healthcare as a Fundamental Right or Privilege?
DOI:
https://doi.org/10.33192/Smj.2021.92Keywords:
healthcare, human rights, healthcare rights, universal healthcareAbstract
Right to health is a government obligation to provide its citizens with necessary medical services regardless of their ability to pay. The right to health requires the state to develop policies and action plans to achieve accessible health care. Ensuring access to healthcare services is an important social responsibility; because of its socio-economic nature, demand for it often carries not only individual but also social aspects that need to be considered and requires the consolidation of consumer funds. Peculiarities of the medical market such as health risk and uncertainty, incomplete information, limited competition, external effects, production of public goods, lead to special forms of economic relations in the medical market, which requires the development of appropriate regulatory mechanisms. In countries, where an individual’s financial contribution to health care does not depend on his or her health risk, there is a principle of universal health care, which covers the entire population. Human is a higher social capital for whom health care is considered a right and not a privilege not only for humanistic and moral reasons, but also for rational, utilitarian approaches, as universal access benefits both the individual and society as it increases labor productivity.
References
Human Rights. A Basic Handbook for UN Staff. Office of the High Commissioner for Human Rights, United Nations Staff College Project, 1999. [Link]
Vienna Declaration and Programme of Action. Adopted by the World Conference on Human Rights in Vienna on 25 June 1993. The World Conference on Human Rights. Office of the High Commissioner for Human Rights, United Nations. [Link]
Winstone H. Human rights in the new millennium. Med Leg J 1999; 67(1): 35-39. [Google Scholar]
Bodenheimer T. The Political Divide in Health Care: A Liberal Perspective. Health Aff 2005; 24(6):1426-1435. [Google Scholar]
Braveman P, Gottlieb L. The social determinants of health: it's time to consider the causes of the causes. Public Health Rep 2014; 129(2): 19-31. [Google Scholar]
Constitution of the World Health Organization. Geneva: World Health Organization. 1948. [Link]
World Health Organization. Primary Health Care. International Conference on Primary Health Care. Alma-Ata, USSR, 6-12 September, 1978. [Link]
Kinney D. The International Human Right to Health: What does This Mean for Our Nation And World? Indiana Law Rev 2001; 34:1465. [Google Scholar]
Curran WJ. The Constitutional Right to Health Care: Denial in the Court. N. Engl. J. Med 1989;320(12):788–789. [Google Scholar]
Pacem in Terris. Encyclical of Pope John XXIII on Establishing Universal Peace in Truth, Justice, Charity, and Liberty. April 11, 1963. Libreria Editrice Vaticana. [Google Scholar]
UN General Assembly, International Covenant on Economic, Social and Cultural Rights (December 16, 1966, entered into force on January 3, 1976. [Link]
Verulava T, Jorbenadze R, Dagadze B, Eliava E. Access to Ambulatory Medicines for the Elderly in Georgia. Home Health Care Manag Pract 2019; 39(2). [Google Scholar]
Verulava T, Gabuldani M. Accessibility of Urgent Neurosurgery Diseases by the State Universal Healthcare Program in Georgia (country). Gazi Medical J 2015; 26 (2): 42-45. [Google Scholar]
Laur A. Patients' responsibilities for their health. Med Leg J 2013; 81(3):119-123. [Google Scholar]
World Health Organization. Gender, equity and human rights: Availability, accessibility, acceptability, quality—Infographic. 2016. https://www.who.int/gender-equity-rights/knowledge/aaaq-infographic/en/
Mwachofi A, Al-Assaf AF. Health care market deviations from the ideal market. Sultan Qaboos Univ Med J 2011;11(3):328-337. [Google Scholar]
Vladeck BC. Paradigm lost: provider concentration and the failure of market theory. Health Aff 2014;33:1083–1087. [Google Scholar]
Reinhardt U. Hard choices in health care: a matter of ethics. In: Health Care: How to Improve It and Pay for It. Washington, DC: Center for National Policy 1985:19–31. [Google Scholar]
Daniels N. Just Health Cambridge: Cambridge University Press 1985. [Google Scholar]
Havers P. The impact of the European Convention on Human Rights on Medical Law. Med Leg J 2002;70(2):57-70. [Google Scholar]
Kunakornvong W, Ngoasri K. Public awareness and attitude toward palliative care in Thailand. Siriraj Medical Journal 2020; 72(5): 424-430 [Google Scholar]
Burnton S. Doctors, patients and the human rights act. Med Leg J 2011; 79(4):115-125. [Google Scholar]
Verulava T, Dangadze B. Health capital and economic growth: evidence from Georgia. The Open Public Health J 2018; (11):401-406. [Google Scholar]
Verulava T. Health Capital, Primary Health Care and Economic Growth. East J Med. 2019; 24 (1): 57 – 62. DOI: 10.5505/ejm.2019.19327. [Google Scholar]
O’Rourke TW. Lost in the Health Care Reform Discussion: Health Care as a Right or Privilege, Am J Health Educ 2017; 48(3):138-141. [Google Scholar]
Swendiman KS. Health Care: Constitutional Rights and Legislative Powers. Congressional Research Service. July 9, 2012. https://fas.org/sgp/crs/misc/R40846.pdf
Fuchs VR. Three “Inconvenient Truths” About Health Care. N. Engl. J Med 2008. [Google Scholar]
Tocqueville A. Democracy in America. Chicago: University of Chicago Press 2000. [Google Scholar]
Shafer BE. Is America Different? A New Look at American Exceptionalism. Oxford University Press 1991. [Google Scholar]
Tanner M. A Fork in the Road Obama, McCain, and Health Care. Cato Institute, 2008. [Google Scholar]
Blendon RJ, Brodie M, Benson JM, Altman DE, Buhr T. Americans' Views of Health Care Costs, Access, and Quality. The Milbank Q 2006; 84(4): 623-57. [Google Scholar]
Squires D, Anderson C. U.S. health care from a global perspective: spending, use of services, prices, and health in 13 countries. The commonwealth fund 2015. [Google Scholar]
Anderson GF, Reinhardt UE, Hussey PS. It’s the prices, stupid: why the United States is so different from other countries. Health Aff 2003;22(3):89–105. [Google Scholar]
Collins SR, Rasmussen PW, Beutel S, Doty MM. The problem of underinsurance and how rising deductibles will make it worse. Findings from the Commonwealth Fund Biennial Health Insurance Survey 2014. 2015. [Link]
U.S. Health Care Coverage and Spending. Available from: https://fas.org/sgp/crs/misc/IF10830.pdf
Cohen RA and Terlizzi EP. Health insurance coverage: Early release of quarterly estimates from the National Health Interview Survey, April 2019–June 2020. National Center for Health Statistics. February 2021. Available from: https://www.cdc.gov/nchs/nhis/releases.htm
Collins SR, Gunja, MZ, Aboulafia GZ. U.S. Health Insurance Coverage in 2020: A Looming Crisis in Affordability. Commonwealth Fund Biennial Health Insurance Survey, 2020. Available from: https://www.commonwealthfund.org/publications/issue-briefs/2020/aug/looming-crisis-health-coverage-2020-biennial
Barnett JC, Vornovitsky MS, Davis KE, et al. Health insurance coverage in the United States 2015. [Google Scholar]
Davis K, Stremikis K, Squires D, et al. Mirror, mirror on the wall: how the performance of the U.S. health care system compares internationally 2014. [Google Scholar]
Ashish P. Thakrar, Alexandra D. Forrest, Mitchell G. Maltenfort, Christopher B. Forrest. Child Mortality In The US And 19 OECD Comparator Nations: A 50-Year Time-Trend Analysis. Health Affairs, 2018; 37 (1): 140 DOI: 10.1377/hlthaff.2017.0767 [Google Scholar]
Avendano M, Kawachi I. Why do Americans have shorter life expectancy and worse health than do people in other high-income countries? Annu Rev Public Health. 2014;35:307-325. doi:10.1146/annurev-publhealth-032013-182411 [Google Sholar]
Avendano M, Kok R, Glymour M, Berkman L, Kawachi I, et al. Do Americans Have Higher Mortality Than Europeans Because They Have Higher Excess Mortality at Lower Socioeconomic Levels?: A Comparison of Mortality by Education in the United States and 14 European countries. In: Crimmins E, Preston S, Cohen B, editors. International Differences in Mortality at Older Ages: Dimensions and Sources. Washington, D.C.: The National Academies Press; 2010. pp. 313–332. [Google Scholar]
Isaacs SL, Schroeder SA. Class - the Ignored Determinant of the Nation’s Health. N. Engl. J. Med 2004; 351(11):1137–1142. [Google Scholar]
Asatiani M, Verulava T. Georgian Welfare State: Preliminary Study Based on Esping-Andersen’s Typology. Economics and Sociology, 2017; 10 (4): 21-28. DOI: 10.14254/2071-789X.2017/10-4/2. [Crossref], [Google Scholar]
Aristotle. The Soul. Edited by: Smith JA. Whitefish: Kessinger Publishing; 2005. [Google Scholar]
Talyor AE. Aristotle Toronto: Dover Publications 1955. [Link]
Hobbes Th. Leviathan. 2014. [Link]
Paine T. Rights of Man. In Rights of Man Mineola: Dover Publications 1999:7-64. [Link]
Arendt H. The Human Condition Chicago: University of Chicago Press 1958. [Link]
Reinhardt U. Hard choices in health care: a matter of ethics. In: Health Care: How to Improve It and Pay for It. Washington, DC: Center for National Policy 1985:19–31. [Google Scholar]
Rawls J. A Theory of Justice Cambridge: Harvard University Press 1999. [Google Scholar]
Kawachi I, Daniels N, Robinson DE. Health Disparities by Race and Class: Why Both Matter. Health Aff 2005;24(2):343–352. [Google Scholar]
Daniels N. Justice, Health, and Healthcare. Am J of Bioeth 2001;1(2):2–16. [Google Scholar]
Papadimos TJ. Healthcare access as a right, not a privilege: a construct of Western thought. Philos Ethics Humanit Med 2007; 2(2). [Google Scholar]
Vienna Declaration and Programme of Action. Adopted by the World Conference on Human Rights in Vienna on 25 June 1993. The World Conference on Human Rights. Office of the High Commissioner for Human Rights, United Nations. [Link]
Winstone H. Human rights in the new millennium. Med Leg J 1999; 67(1): 35-39. [Google Scholar]
Bodenheimer T. The Political Divide in Health Care: A Liberal Perspective. Health Aff 2005; 24(6):1426-1435. [Google Scholar]
Braveman P, Gottlieb L. The social determinants of health: it's time to consider the causes of the causes. Public Health Rep 2014; 129(2): 19-31. [Google Scholar]
Constitution of the World Health Organization. Geneva: World Health Organization. 1948. [Link]
World Health Organization. Primary Health Care. International Conference on Primary Health Care. Alma-Ata, USSR, 6-12 September, 1978. [Link]
Kinney D. The International Human Right to Health: What does This Mean for Our Nation And World? Indiana Law Rev 2001; 34:1465. [Google Scholar]
Curran WJ. The Constitutional Right to Health Care: Denial in the Court. N. Engl. J. Med 1989;320(12):788–789. [Google Scholar]
Pacem in Terris. Encyclical of Pope John XXIII on Establishing Universal Peace in Truth, Justice, Charity, and Liberty. April 11, 1963. Libreria Editrice Vaticana. [Google Scholar]
UN General Assembly, International Covenant on Economic, Social and Cultural Rights (December 16, 1966, entered into force on January 3, 1976. [Link]
Verulava T, Jorbenadze R, Dagadze B, Eliava E. Access to Ambulatory Medicines for the Elderly in Georgia. Home Health Care Manag Pract 2019; 39(2). [Google Scholar]
Verulava T, Gabuldani M. Accessibility of Urgent Neurosurgery Diseases by the State Universal Healthcare Program in Georgia (country). Gazi Medical J 2015; 26 (2): 42-45. [Google Scholar]
Laur A. Patients' responsibilities for their health. Med Leg J 2013; 81(3):119-123. [Google Scholar]
World Health Organization. Gender, equity and human rights: Availability, accessibility, acceptability, quality—Infographic. 2016. https://www.who.int/gender-equity-rights/knowledge/aaaq-infographic/en/
Mwachofi A, Al-Assaf AF. Health care market deviations from the ideal market. Sultan Qaboos Univ Med J 2011;11(3):328-337. [Google Scholar]
Vladeck BC. Paradigm lost: provider concentration and the failure of market theory. Health Aff 2014;33:1083–1087. [Google Scholar]
Reinhardt U. Hard choices in health care: a matter of ethics. In: Health Care: How to Improve It and Pay for It. Washington, DC: Center for National Policy 1985:19–31. [Google Scholar]
Daniels N. Just Health Cambridge: Cambridge University Press 1985. [Google Scholar]
Havers P. The impact of the European Convention on Human Rights on Medical Law. Med Leg J 2002;70(2):57-70. [Google Scholar]
Kunakornvong W, Ngoasri K. Public awareness and attitude toward palliative care in Thailand. Siriraj Medical Journal 2020; 72(5): 424-430 [Google Scholar]
Burnton S. Doctors, patients and the human rights act. Med Leg J 2011; 79(4):115-125. [Google Scholar]
Verulava T, Dangadze B. Health capital and economic growth: evidence from Georgia. The Open Public Health J 2018; (11):401-406. [Google Scholar]
Verulava T. Health Capital, Primary Health Care and Economic Growth. East J Med. 2019; 24 (1): 57 – 62. DOI: 10.5505/ejm.2019.19327. [Google Scholar]
O’Rourke TW. Lost in the Health Care Reform Discussion: Health Care as a Right or Privilege, Am J Health Educ 2017; 48(3):138-141. [Google Scholar]
Swendiman KS. Health Care: Constitutional Rights and Legislative Powers. Congressional Research Service. July 9, 2012. https://fas.org/sgp/crs/misc/R40846.pdf
Fuchs VR. Three “Inconvenient Truths” About Health Care. N. Engl. J Med 2008. [Google Scholar]
Tocqueville A. Democracy in America. Chicago: University of Chicago Press 2000. [Google Scholar]
Shafer BE. Is America Different? A New Look at American Exceptionalism. Oxford University Press 1991. [Google Scholar]
Tanner M. A Fork in the Road Obama, McCain, and Health Care. Cato Institute, 2008. [Google Scholar]
Blendon RJ, Brodie M, Benson JM, Altman DE, Buhr T. Americans' Views of Health Care Costs, Access, and Quality. The Milbank Q 2006; 84(4): 623-57. [Google Scholar]
Squires D, Anderson C. U.S. health care from a global perspective: spending, use of services, prices, and health in 13 countries. The commonwealth fund 2015. [Google Scholar]
Anderson GF, Reinhardt UE, Hussey PS. It’s the prices, stupid: why the United States is so different from other countries. Health Aff 2003;22(3):89–105. [Google Scholar]
Collins SR, Rasmussen PW, Beutel S, Doty MM. The problem of underinsurance and how rising deductibles will make it worse. Findings from the Commonwealth Fund Biennial Health Insurance Survey 2014. 2015. [Link]
U.S. Health Care Coverage and Spending. Available from: https://fas.org/sgp/crs/misc/IF10830.pdf
Cohen RA and Terlizzi EP. Health insurance coverage: Early release of quarterly estimates from the National Health Interview Survey, April 2019–June 2020. National Center for Health Statistics. February 2021. Available from: https://www.cdc.gov/nchs/nhis/releases.htm
Collins SR, Gunja, MZ, Aboulafia GZ. U.S. Health Insurance Coverage in 2020: A Looming Crisis in Affordability. Commonwealth Fund Biennial Health Insurance Survey, 2020. Available from: https://www.commonwealthfund.org/publications/issue-briefs/2020/aug/looming-crisis-health-coverage-2020-biennial
Barnett JC, Vornovitsky MS, Davis KE, et al. Health insurance coverage in the United States 2015. [Google Scholar]
Davis K, Stremikis K, Squires D, et al. Mirror, mirror on the wall: how the performance of the U.S. health care system compares internationally 2014. [Google Scholar]
Ashish P. Thakrar, Alexandra D. Forrest, Mitchell G. Maltenfort, Christopher B. Forrest. Child Mortality In The US And 19 OECD Comparator Nations: A 50-Year Time-Trend Analysis. Health Affairs, 2018; 37 (1): 140 DOI: 10.1377/hlthaff.2017.0767 [Google Scholar]
Avendano M, Kawachi I. Why do Americans have shorter life expectancy and worse health than do people in other high-income countries? Annu Rev Public Health. 2014;35:307-325. doi:10.1146/annurev-publhealth-032013-182411 [Google Sholar]
Avendano M, Kok R, Glymour M, Berkman L, Kawachi I, et al. Do Americans Have Higher Mortality Than Europeans Because They Have Higher Excess Mortality at Lower Socioeconomic Levels?: A Comparison of Mortality by Education in the United States and 14 European countries. In: Crimmins E, Preston S, Cohen B, editors. International Differences in Mortality at Older Ages: Dimensions and Sources. Washington, D.C.: The National Academies Press; 2010. pp. 313–332. [Google Scholar]
Isaacs SL, Schroeder SA. Class - the Ignored Determinant of the Nation’s Health. N. Engl. J. Med 2004; 351(11):1137–1142. [Google Scholar]
Asatiani M, Verulava T. Georgian Welfare State: Preliminary Study Based on Esping-Andersen’s Typology. Economics and Sociology, 2017; 10 (4): 21-28. DOI: 10.14254/2071-789X.2017/10-4/2. [Crossref], [Google Scholar]
Aristotle. The Soul. Edited by: Smith JA. Whitefish: Kessinger Publishing; 2005. [Google Scholar]
Talyor AE. Aristotle Toronto: Dover Publications 1955. [Link]
Hobbes Th. Leviathan. 2014. [Link]
Paine T. Rights of Man. In Rights of Man Mineola: Dover Publications 1999:7-64. [Link]
Arendt H. The Human Condition Chicago: University of Chicago Press 1958. [Link]
Reinhardt U. Hard choices in health care: a matter of ethics. In: Health Care: How to Improve It and Pay for It. Washington, DC: Center for National Policy 1985:19–31. [Google Scholar]
Rawls J. A Theory of Justice Cambridge: Harvard University Press 1999. [Google Scholar]
Kawachi I, Daniels N, Robinson DE. Health Disparities by Race and Class: Why Both Matter. Health Aff 2005;24(2):343–352. [Google Scholar]
Daniels N. Justice, Health, and Healthcare. Am J of Bioeth 2001;1(2):2–16. [Google Scholar]
Papadimos TJ. Healthcare access as a right, not a privilege: a construct of Western thought. Philos Ethics Humanit Med 2007; 2(2). [Google Scholar]
Published
01-10-2021
How to Cite
Verulava, T. . (2021). Access to Healthcare as a Fundamental Right or Privilege?. Siriraj Medical Journal, 73(10), 721–726. https://doi.org/10.33192/Smj.2021.92
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