AUDREY R. CHAPMAN
The United States stands before the most important and extensive reform of its health care system in a generation. Given the scope of this undertaking, citizens and policymakers should examine fundamental assumptions about the changes to come. The contributors to this volume believe that a right to a basic and adequate standard of health care should be adopted as the fundamental premise of a reformed health care system for the United States. Currently the United States is the only western democracy that does not recognize a right to health care. Other industrialized nations like Canada, Great Britain, France, Germany, the Netherlands, and Japan have long provided a legal entitlement to health care. By way of introducing our argument, the following pages will examine the problems of our health care system and the solutions suggested by a human rights approach to health care reform.
Four disturbing trends account for much of the momentum toward change of the health care system in the United States. The first is escalating health costs. With spending on health care now rising at an annual rate of twelve to fifteen percent and consuming more than fourteen percent of the nation's total economic output, the cost of health care is straining the economy and state and federal budgets. These figures stand in marked contrast with such countries as Canada, Britain, Germany, Sweden, France, and Japan, whose health care spending in 1990 ranged between six percent and nine percent while providing universal health insurance for their population. An aging population, leading to a growing demand for health care and a need for more care for the chronically ill, and the increasing use of sophisticated and expensive equipment have created pressures