Health care reform has found its way to the top of the American policy agenda. The reasons for this priority are not hard to find. Over thirty million citizens lack health insurance while many more are a pink slip away from the possibility of financial ruin. For those with coverage, the costs of health care have risen much faster than incomes creating pressure on the living standards of the middle class. For the next year or more, the health care reform proposals from President Clinton and others will be debated in Congress and throughout the United States. Health Care Reform: A Human Rights Approach seeks to inform that debate by examining the neglected ethical dimension of this issue.
Two years ago the Science and Human Rights Program of the American Association for the Advancement of Science (AAAS), with the assistance of The Robert Wood Johnson Foundation, initiated a project to explore a human rights approach to health care reform in the United States. Unlike previous work on human rights, the project decided to focus on concrete issues for establishing the scope and limitations of a right to health care. In particular, we sought to translate an abstract right to health care into specific obligations and commitments consistent with available resources. Such obligations could then be translated into criteria which served as a kind of "human rights report card" to shape health care reforms and to evaluate whether specific proposals are consistent with human rights requirements.
Between September 1992 and May 1993, the project sponsored four consultations which brought together a wide range of health care specialists to discuss health care as a human right. In selecting participants an effort was made to have a variety of perspectives and positions as well as disciplines represented. The project sought to mix human rights specialists with health care providers, health policy analysts, bioethicists, and health care economists. Speakers and participants were drawn from the fields of medicine, biology, genetics, law, philosophy, statistics, economics, political science, theology, and