The human right to health

The intrinsic connection between health and life's quintessential pursuits is undeniable.

Throughout human existence, life has been imperiled by the capriciousness of health. The persistence of this struggle in the bosom of the most affluent and technologically advanced nation in the world is a disconcerting reality and a call to action. It underscores the vital importance of recognizing the right to health as a fundamental human right, based on human dignity.

The cornerstone of the United States, the Declaration of Independence, unfurls a trinity of unalienable rights: life, liberty, and the pursuit of happiness. Yet, amid this triumphant triad, the right to health and equitable health care access for all its citizens has languished in the shadows of policy priorities. This omission, at times deliberate, is rationalized under the auspices of fiscal prudence. However, this disregard paradoxically incurs exorbitant national expenditures due to lost productivity from illness, infirmity, and premature mortality.

In the aftermath of World War II, the United States was instrumental in creating, nurturing, and sustaining international treaties and organizations, including the United Nations and the World Health Organization. While the U.S. is a lead signatory to international covenants, our nation trails behind our global counterparts, notably our European allies, in unequivocally enshrining health as a fundamental human right within its domestic policy framework. The U.S. Senate's reluctance to ratify treaties explicitly acknowledging health as a human right is disconcerting.

The preamble to the constitution of the World Health Organization, adopted in 1946, defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” It further affirms that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” This expansive definition of the right to health was subsequently reaffirmed and amplified through international accords such as the International Covenant on Economic, Social, and Cultural Rights, promulgated in 1966. Embracing this right encompasses not only access to quality health care services but also addresses the broader social determinants of health, from clean water to nutrition, sanitation, environmental quality, health literacy, and education.

On Oct. 31, the College published a policy paper in Annals of Internal Medicine on health as a human right. The intrinsic connection between health and life's quintessential pursuits is undeniable. Life, liberty, and freedom take on a hollower resonance when tethered to the burdens of preventable illness. Health and universal access to health care are indispensable prerequisites for the full realization of humanity's most cherished rights: education, gainful employment, and active participation in the tapestry of society. Good health is not just a personal boon; it is the sine qua non for robust social participation and collective progress.

Beyond humanitarian concerns, neglecting health rights has significant economic implications. Preventable injuries and deaths incur substantial costs. In 2020, over 200,000 preventable deaths and 55 million injuries cost the United States $1.16 trillion, according to the National Safety Council. This distressing cost calculus sharply delineates the toll of inadequate access to preventive health care, a dearth of educational outreach, and an absence of timely vaccination. Such circumstances often engender severe, long-term health conditions, spawning a vicious cycle of diminished quality of life and spiraling societal costs. The provision of health care services thus transcends expenditure; it represents an astute investment in the very fabric of societal growth and prosperity.

The right to health stands as an indispensable facet of social justice, without which no nation, state, or culture can be truly complete. The principle of equal access to resources and opportunities, regardless of background or circumstances, fosters equality, economic empowerment, and empathy, while preventing social discord, disillusionment, and poverty. Social justice, the raison d’être of our nation's creation, is therefore wholly dependent on the right to a healthy life and access to optimal health care.

The right to health requires access to clean water, healthy nutrition, sanitation services, suitable shelter, education, and personal and communal security. Societal acceptance, mutual respect, elimination of barriers, eradication of discrimination, and absence or mitigation of fear lead to a healthier and fuller life. The right to health encompasses preventive care, primary care, subspecialist services, mental health care, dental care, and emergency services, all delivered by a competent medical team focused solely on the patient's best interests, free from governmental or bureaucratic intrusion.

The United States stands alone among industrialized nations in its absence of a universal health care system. Instead, the country navigates a complex and fragmented health care landscape, where various private and government entities oversee a system often marred by inefficiencies and obstacles to patient-centered care. The majority of Americans under the age of 65 acquire health insurance through employment, while a growing percentage of the elderly access health care via Medicare Advantage plans. However, this system leaves countless vulnerable individuals behind, especially those grappling with chronic health conditions. In this framework, the continuation of health insurance becomes tethered to employment, regardless of an individual's circumstances, leading to potential exploitation and distress.

Our nation has ardently advocated for the global recognition of human rights. In the same vein, it is incumbent upon us to acknowledge and honor the human right to health within our borders. We must stand resolute in rejecting premature deaths due to the unaffordability of health care or diminished life potential owing to untreated illnesses. Health and health care are not mere commodities, susceptible to market whims. Health is an inviolable right intrinsic to the very essence of human dignity. There can be no exceptions.

The right to health is not an abstract ideal. It is a fundamental human right that underpins societal well-being, economic prosperity, social justice, and the pursuit of happiness. Neglecting this right is both a moral and economic miscalculation. We stand at a pivotal juncture in history, where unequivocal recognition and safeguarding of the right to health is both a moral and pragmatic imperative. In this endeavor, we must, as a society, as a nation, unequivocally affirm that the health and well-being of every one of our citizens are non-negotiable components of our shared human legacy.