Health-Care Reform Raises Questions of Individual Rights

Article excerpt

HEALTH-CARE reform is not just a matter of dollars and cents. It raises troubling issues of civil and constitutional rights; those issues are just beginning to arise in the national debate.

The American Civil Liberties Union (ACLU) recently issued a "Health Care Reform Bill of Rights." It identifies four constitutional areas - equal protection, personal privacy, due process of law, and freedom of religion and speech - in which reforms could run afoul of basic rights.

While Washington policymakers are preoccupied with budgetary complexities of hammering together a compromise reform plan, these issues will likely surface with increasing urgency in months ahead:

* Access, or "redlining," issues usually relating to the ability of the poor and minorities to get care equal to the affluent.

* Privacy, including confidentiality of medical information about people and the possibility that health-care reform could demand a kind of national identity card.

* Whether some people, particularly illegal immigrants, should be excluded from "universal" coverage.

* How to accommodate people, who for religious or other reasons, choose healing methods other than traditional medicine.

"When the civil rights and civil liberties communities get into health care, driven by a specific concern like abortion, they'll see that the whole area really raises all the same questions about employment discrimination, privacy, and due process as any other huge federal program," says Lesley Harris, public-policy director at People for the American Way.

Access questions deserve more attention than they're getting, says Ken Wing, a University of Puget Sound law professor and a physician. He sees "a rush to control costs and placate providers and insurers but no bill of rights to guarantee access." Minorities at the periphery

Health-insurance practices now force many minorities to the system's periphery. "In the new plan, there has to be something to deal with ... racial discrimination."

"Redlining," excluding people due to race, economic status, or medical condition, is highlighted in an analysis of health-care reform by a committee of the American Bar Association's Section on Individual Rights and Responsibilities. Committee vice chairman Robyn Shapiro says some levels of insurance coverage possible under a new system raise questions of who gets what level of care. "Will it reenforce a two-tiered system? …