Monday, January 25, 2010

Lack of Universal Health Care Puts U.S. in Non-Compliance With International Law

Article 25 of the United Nations Universal Declaration of Human Rights Says All Have the Right to 'Adequate Medical Care and Necessary Social Services,' But America Is the Only Developed Country in the World Without a Universal Health-Care System, Which Puts Millions of Americans at Risk of Poor Health -- and Financial Ruin -- Because They Cannot Afford Private Health Insurance

The Universal Declaration of Human Rights

Former First Lady Eleanor Roosevelt holds up a copy of the United Nations Universal Declaration of Human Rights in this photo taken at UN headquarters in New York in November 1949, 11 months after its formal adoption by the world body, including the United States. Much of the Universal Declaration, in fact, was drafted by the U.S. and derived from the Bill of Rights in the U.S. Constitution. Article 25 of the Universal Declaration says that "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." So why is the U.S. not in compliance with Article 25 by not having a universal health-care system? (Photo Courtesy United Nations)

(Posted 5:00 a.m. EST Monday, January 25, 2010)


When the General Assembly of the United Nations adopted the Universal Declaration of Human Rights in 1948, it did so against the backdrop of a world still reeling in shock and revulsion at the unspeakable crimes against humanity committed by the Nazis before and during World War II.

Indeed, national and international pressure for a global bill of rights had been building throughout the war and reached a crescendo after the Nuremberg trials of top Nazi leaders in 1946.

The United Nations Charter "reaffirmed faith in fundamental human rights, and dignity and worth of the human person" and committed all member states to promote "universal respect for, and observance of, human rights and fundamental freedoms for all without distinction as to race, sex, language or religion."

To that end, Article 25 of the Universal Declaration of Human Rights -- to which the United States was one of its principal authors -- says:

"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."

President Franklin D. Roosevelt had championed a global bill of rights as far back as 1941, when, in his State of the Union address, Roosevelt called for the protection of what he termed the "essential" Four Freedoms: freedom of speech, freedom of conscience, freedom from fear and freedom from want.

Yet more than 60 years after its adoption, the United States remains out of compliance with Article 25 because it is the only industrialized nation on Earth that does not have a system of universal health care for all of its citizens.

And the minority Republicans on Capitol Hill -- emboldened by Scott Brown's victory in last week's special Senate election in Massachusetts, robbing the majority Democrats of their filibuster-proof 60-vote majority -- appear determined to keep it that way.


For months now, the Republicans have been fighting tooth and nail against every single health-care reform bill that's been proposed by the Democrats, yet they have steadfastly refused to come up with any viable reform proposals of their own.

And when this writer says "viable," I mean proposals that enables the estimated 31 million Americans who cannot afford private health insurance to obtain coverage they can afford.

These 31 million Americans -- as well as the estimated 13 million illegal immigrants living in this country -- are only one serious illness or accident away from financial ruin because they cannot afford the high cost of private health insurance.

According to a 2006 study by the Kaiser Family Foundation, two-thirds of the uninsured are low-income individuals or from low-income families, making less than 200 percent of the poverty level, or $38,614 for a family of four in 2004.

Over a third of the uninsured (37 percent) are poor, according to the Kaiser study and another 28 percent are near-poor -- defined as those with incomes between 100 percent and 199 percent of the poverty level, or between $19,307 and $38,228 in 2004.

Were it not for Medicaid, the Kaiser study notes, "many more of the poor would be uninsured. The near-poor also run a high risk of being uninsured because they are not likely to be eligible for Medicaid."


What impact does not having health insurance have on receiving the kind of adequate medical care that all Americans are entitled to under Article 25 of the Universal Declaration of Human Rights? A very severe impact, according to the Kaiser study, which says that the uninsured are up to three times more likely than those with insurance to report problems receiving needed medical care, even for serious conditions.

Part of the reason many of the uninsured postpone or forgo needed care is because "over 40 percent do not have a regular place to go when they are sick or need medical advice," the study found, "compared to just nine percent of those with coverage.

"About 20 percent of the uninsured -- vs. three percent of those with coverage -- say their usual source of care is a [hospital] emergency room," the study found. "Anticipating high medical bills, many of the uninsured are not able to follow recommended treatment. Over a third of uninsured adults say they did not fill a drug prescription in the past year and over a third went without a recommended medical test or treatment due to cost."

The Kaiser study also found that insured adults under 65 years of age are at least 50 percent more likely to have had preventive care such as pap smears, mammograms and prostate exams than uninsured adults.


Aside from the risk to one's health that lack of health insurance poses, there is also the severe financial strain that lack of health insurance can wreak, not only on individuals, but also on the country's health-care system as a whole.

The Kaiser study found that having health insurance makes a huge difference to a person's credit worthiness. "Like any bill, when medical bills are not paid or paid off too slowly," the study found,"they are turned over to a collection agency, and a person's ability to get further credit is significantly limited. Nearly a quarter of the uninsured -- 23 percent -- report that they were contacted by a collection agency about unpaid medical bills in just the past year [2003]."

More importantly, the cost of caring for the uninsured is costing taxpayers billions of dollars.

In 2004, the Kaiser study found, taxpayers forked over $41 billion to pay for the health-care costs of the uninsured. More than half of all public funds to cover the costs of medical care for the uninsured came from the federal government, with the majority of federal dollars -- 70 percent -- flowing through Medicare and Medicaid.

Most government dollars to cover the uninsured goes for hospital care, which is paid indirectly to hospitals based partly on the share of care they provide to the uninsured. Health-care costs in direct service programs to the uninsured, such as community health centers and the veterans' health system, are funded almost completely by taxpayer dollars.

The Kaiser study notes, however, that federal health-care spending "has not kept up with the recent growth in the number of uninsured. Although federal support for community health centers increased by more than 50 percent between 2001 and 2004 -- from $430 million to $670 million -- these expenditures account for only three percent of total federal spending for [caring for the uninsured]" -- even as the number of uninsured Americans increased by 11 percent during the same period.


The bottom line is that if you don't have health insurance, you have no guarantee of access to adequate health care which Article 25 of the Universal Declaration of Human Rights says you are entitled to -- and to which this country is a signatory.

That the Republicans on Capitol Hill have fought against all attempts to enable the uninsured to afford health insurance -- while at the same time refusing to come up with any viable health-care reform plan of their own -- means that they are violating Americans' right under international law to universal access to adequate health care.

At the same time, the Republicans' intransigence is costing taxpayers billions of dollars that would otherwise not be spent if the uninsured had health insurance that they could afford.

That many private insurers continue to exclude hundreds of thousands of Americans from coverage due to pre-existing medical conditions also violates Article 25. Such discrimination is unconscionable and can no longer be tolerated. Outlawing such discrimination is long overdue and absolutely essential for any meaningful health-care reform.

The United States has been out of compliance with international law on health care for more than 60 years. How much longer will this country remain an outlaw state when it comes to universal health care?

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Volume V, Number 7
Copyright 2010, Skeeter Sanders. All rights reserved.


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Alan8 said...

The blame has to go to the idiots that vote Republican, against their own interests.

They're getting the government they deserve. Unfortunately, the rest of us are getting the government they deserve too.

Anonymous said...

Actually the US meets the requirement of the UN resolution, most countries don't, like the UK, where people don't have access to health care until the government says they can. That's actually worse than the system here where if you need the care now, it will be given now and you can pay on Tuesday.

foreigner said...

The US disregards its obligations under the Geneva Conventions, the Convention Against Torture, the WTO treaty and NAFTA. Why would anybody expect it to start respecting the UN Charter.

Charlie B. said...

To the anonymous commenter above, that's simply rubbish. In the UK, you have the option - you can see a doctor anytime. You call your doctor, you make an appointment, you go see your doctor. You may need to go on a waiting list to get an elective operation if you have no private insurance, but you can still choose to pay to have the operation privately if you wish. It's a choice - free healthcare for all, choose to pay for faster/better service if you wish. Sure, it doesn't work all the time but it's got to be better having treatment available for many conditions that in the USA would bankrupt most families. And given that the USA spends much more per capita at the moment in healthcare than any other country in the world as a percentage of GDP (which means a vast amount in absolute terms!), on a system that's clearly not working: to us in the rest of the world it's just baffling how resistance to improving the system is so strong.

bruce said...

Health care is not a right. It's a service. A right does not depend on others to provide it. The right to life, for instance. Or free speech. If heath care is a right then who exactly is obligated to provide it?

Skeeter Sanders said...

I've posted your comment, Bruce, but I could not disagree with you more sharply. The problem with health care in the United States is that it's the only developed country on the planet that does not regard health care as an essential public service -- a public service as essential as police protection, firefighting and national defense, for its purpose is to save lives.

Our Constitution -- specifically the 14th Amendment -- says quite clearly that all U.S. citizens born in this country have a right "to life, liberty or property." Health care is an essential public service aimed at preserving life. Lack of access to health care can -- and often does -- poses a threat to the preservation of life, especially for low-income Americans with severe illnesses who cannot afford the cost of health insurance. This lack of access is immoral and must be brought to an end.

How many more Americans of limited economic means who cannot afford health insurance -- and receive woefully inadequate care because of it -- must suffer from poor health or even die before America wakes up and recognizes health care as an essential public service that ALL Americans are entitled to when needed?

WAKE UP! Health care IS a human right! It saves lives!

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