THOMAS B. JABINE
to Basic Health Care as a
As a statistically advanced country, 1 the United States has a wealth of statistical data about the health status of its people, their use of health care services and their health related behaviors (e.g., exercise and smoking habits). These data are used by units of government at all levels and by nongovernmental organizations (NGOs) and individuals to assess and monitor the effectiveness of the American health care system. Health indicators derived from the data are an important part of the process.
Examination of these health indicators has made it quite clear, in recent years, that there are serious defects in the American health care system. Comparisons with other developed countries show that Americans are spending more and getting less. Under any reasonable definition of basic health care services, many people are being left out. One particular indicator, the number or proportion of persons without health insurance coverage has become a symbol, for policy makers and the public, of the shortcomings of our health care system. 2 Wide awareness of the plight of the uninsured may have contributed more than any other factor to the demand for health care reform.
There is no constitutional provision or law which gives every person in the United States the right of access to basic health care services. Constitutions of several other countries in the Americas specify rights to health protection. 3 The International Covenant on Economic, Social and Cultural Rights, to which 122 countries have subscribed, commits those countries to "recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health" and to take steps toward the full realization of that right. 4 The United States has not yet ratified the Covenant but may give it serious consideration in the near future. In January 1993, Congressman Pastor of Arizona introduced a draft resolution stating that "it is the sense of the Congress that access to basic health care services