AUDREY R. CHAPMAN
Health Care Reform
What does it mean to speak about a right to a basic and adequate standard of health care? The concrete requirements and implications of affirming a right to a basic and adequate standard of health care are as follows:
1. A right to health care based on the principle of universality requires that a basic and adequate standard of health care be guaranteed to all citizens and residents.
A. A secure entitlement requires legal recognition.While legal recognition by itself cannot guarantee secure and meaningful access to basic health care, legislative provision of a guaranteed standard of health care is a necessary prerequisite. The neglect of the recommendations contained in the 1983 Presidential Commission report on Security Access to Health Care for All suggest that underscoring society's ethical obligations may or may not be translated into a change in public policy. In contrast, a legal right imposes binding obligations on one or more levels of government.
B. A secure and meaningful right to health care requires elimination of all grounds for exclusion. The principle of universality acknowledges that all persons, without regard to their purchasing power, social status, or personal merit, are entitled to basic and adequate health care. Conversely, it does not accept the validity of the current practice of denying coverage to many of those with the greatest need of health care. A human rights approach, based on justice rather than efficiency, does not recognize any valid grounds for withholding health care from the poor, the unemployed, or individuals with preexisting conditions or hereditary proclivities to disabilities or illness.
C. The principle of universality mandates that all citizens andresidents be covered. Although many countries distinguish between