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ADVANCE Perspective: Nurses

Healthcare is a Human Right

Published February 10, 2014 9:56 AM by Chuck Holt

This post is written by Mbettie Worrell, BA, BSN, RN, a graduate student in the Adult/Gerontology Nurse Practitioner program at the University of Pennsylvania School of Nursing in Philadelphia.

Consider these scenarios:

A six-year-old girl is found dying from a disease that has had a vaccine available for decades.

A young woman lay dying in childbirth while her husband watches helplessly because they have no access to healthcare.

A 48-year-old mother who needs a kidney transplant, but she has no insurance and thus not “eligible” for the transplant list.

These are a few health struggles faced by people around the world, including the U.S., due to lack of access to healthcare.

The Affordable Care Act promises to insure an additional 36 million people, and escalated this debate over access to healthcare, health disparities, and citizens’ rights.

Proponents and opponents of this issue base their arguments in economics, ethics, medicine and law.

Proponents believe that if all Americans had access to healthcare it would decrease spending because individuals would seek preventative care instead of waiting to become seriously ill. Proponents also argue that as citizens of the richest democracy in the world we should have a right to affordable healthcare no matter who you are.

Opponents, meanwhile, now view the term “entitled” with contempt and define it as a reward for the undeserving. They argue increasing tax revenue on some citizens to help provide healthcare to others is socialism. Others say healthcare providers will be overstretched due to the high demand of individuals seeking care and this could lead to burn outs or decreased quality of care rendered, primarily through delays in appointments, surgeries, etc.

Growing up in a third world country, I have witnessed firsthand the consequences of inaccessibility to healthcare.

I believe good health and access to care is a human right, no matter which part of the world one may live.

All humans were created equal, though history and other social and economic issues like wars, social determinants, and poor economies have created a noticeable difference between individuals and among nations.

However, all humans are entitled to the same rights under similar circumstances. 

I do not necessarily believe this right means being in the best health state. However, governments should be able to provide those conditions necessary to facilitate the needs of its constituents when it comes to healthcare needs.

The ability of a government to help its citizens gain access to healthcare should not be viewed as “charity” or “socialism.” 

As World Health Organization Director-General, Margaret Chan, states:

“The world needs a global health guardian, a custodian of values, a protector and defender of health, including the right to health.”

Can we each be that person?


16 comments

How much does health care really cost? There are 3 hospitals in Macon - each has a different charge for the same procedure! How much does education cost? How do you teach the ED repeaters to use a private physician? How do you get an appt with your physician within 48 hrs if you child is crying with an ear ache or G'ma has 'indigestion' for 3 days straight? No one in the USA wants to refuse care to the  sick or injured. Maybe we are not asking the right questions. Have we defined the problem? Nurses and other health care providers need to DISCUSS all the questions/concerns/problems we see and work together to solve the problems ( more than one). Taking sides doesn't help much.

Mary, retired - RN March 4, 2014 12:38 PM
Macon GA

"Rights" don't have pricetags.   "Life, liberty, and the pursuit of happiness" are rights.  

The problem with "Affordable Care" is that it isn't going to be affordable for the nation or for the taxpayers.  Look at Oregon and MA.  People were given more access to primary preventive healthcare - and they still used the ED, which is the most expensive and least efficient method of care, more than the EDs were used before. The increase in use was more than was explained or noted by the increase in population.  

Moral hazard is real.   The less healthcare costs the individual, the more it gets used, with no real improvement in overall population health.  

What ACA is really doing is punishing EDs and the professionals in them, with overcrowding and all its consequences, to try to provide preventive care that people don't want and aren't using.  

If you want to provide healthcare to the majority,  then stop the entire insurance practice the way it is now.   Restrict it to catastrophic, non-subsidized, non-employer provided coverage, and everything else comes out of the pocket.  You'll see costs drop like a rock, just like they did with cosmetic procedures and LASIX.

D February 16, 2014 3:21 PM

I find it particularly distressing that two wars are being fought with no obvious positive outcomes, yet, hundreds of billions of dollars have been spent and continue to be spent, with billions, and likely trillions more over the next 50 years (at least) caring for veterans who have been physically and psychologically injured in these debacles. This money could be funding healthcare for all in my view, not to mention a host of other 'social' programs. Another issue that for me is what I term 'corporate corruption', which I imagine puts me on the anti-socialism hit list, and that involves the sale of products that are harmful to human beings. I am not against free markets, yet the idea that people should live healthy lifestyles with preventive healthcare practices at the core of their existence, is short sighted. The idea that each person has a free will and should choose to avoid obesity, addiction, smoking, etc., while true, is not helped by highly developed and researched methods, including chemistry and other sciences aimed at first inducing desire then ensnaring one in a trap that is difficult to get out of. That is why a bill has been put forward in the California legislature to put black box warnings on soft and surgery drinks, like tobacco products. I have no dealt that some people who blame obese and others for their poor healthy lifestyles, also are prospering from the types of corruption that are good for corporations and investors but necessarily for the society at large. So, yes, care for the sick and needy to the fullest extent possible and in ways that are sustainable.

Muhammad , Primary Care - Adult NP, Self emloyed February 15, 2014 3:43 PM
Ann Arbor MI

Why does Renee from Philadelphia above seem to be the only one who understands the problem ? When RNAi technology reaches its zenith the pharmaceutical companies will own us all.

    How much money is the government spending on Hepatitis C, Lyme disease, Arthritis, and many others research. Absolutely nothing. They are leaving it to the bio-tech companies to make a killing off of them.

    When people in the medical field and the media quit trying to " save the world" and do a bit of studying outside of their field, look at economics, risk assessment, and even the free market,  their efforts will be much more rewarded as far as applying MONEY in the proper places. How many lives saved regarding alternate choices is the logical answer. We all want to decrease suffering, but it will always exist. Get the government more into research and big pharma away from the bank.  

Leo S February 15, 2014 1:38 PM
Prescott AZ

Healthcare is a human right when the person respects themselves and follows basic healthy lifestyles, etc. We are losing so much money paying for drug dealers shooting each other , etc and family members making us keep them alive to save their public welfare benefits. This behavior and disrespect for life has to stop! The geriatric population who at age 90 with all systems shutting down and family insisting they go on dialysis because they can't let them die with dignity- this has end. We need doctors and nurses to stop using people as guineas pigs and wasting our time and money because family can't let go or because the patient just stays on a rotating cycle of drugs and alcohol abuse and eventually is hospitalized in full failure over and over again an dyet- they go back into the community and do it all over again. America needs to have healthcare ONLY for documented citizens and get all the illegals out of here with their diseases and drug resistant illnesses. Our country is being deluged with bugs that don't die and illness which can't be treated(India has a HIGH drug resistant TB level and yet- we allow people to come and go from there and drug companies are buying their medicines from here because it is cheap.)WHO is watching out for our citizens???We are giving foreigners the edge here and our American people aren't being protected at all!!! Think of the cost this will be for our healthcare if the FDA and World Health organizations don't soon stop it! Pharmacies are supplying Americans with drugs from India - these people have the highest rate of drug resistant TB in the world. Terrrorists could easily harm us with this lenient drug import policy and the FDA isn't concerned at all. We need to start demanding better enforcement of world health enforcement before people travel in and out of the USA and we need to teach greater respect for life. We also need better standards for nurses. Nobody should be able to get a masters degree in nursing unless they have worked as a hospital nurse for at least one year and has worked in real problem type settings with real patient situations and family concerns.

Lois February 15, 2014 12:50 PM

Working in telephone triage, I have so many patients call who have worked all their life hard.  Then they get a serious illness, cannot work, lose their insurance and income. Before the Affordable Care Act, they would not be able to get insurance to cover their illness due to pre-existing clause. They are so ill or in pain and have no choice, but to go to ER, where all of us are going to pay for it. Sure there are a percentage of people that have entitlement mentality, but even they don't go most of the time to the doctor or hospital ER unless they are really sick and then they are admitted costing even more money because they waited so long to be treated.

During my career, I have worked for several insurance companies as case manager. Believe me, even they are looking at the profit line.  If there is any way, they can get rid of a high cost patient they will. There is good and bad in managed care. They can help a patient mangage their illness better and they also, can drop you like a hot potato for various reasons, maybe you gained 20lbs. Well that will cost you another $100/month. (real case).  One insurance company I worked for even looked at their employees and if they had evidence of family or themselves having high cost illness, well figure out a way for them to have to quit.  

  There was crazy talk at first that after the Affordable Care Act passed there would be committees deciding whether to spend the money to save someone's life, especially old people. Well, I can tell you, without affordable health care for all, we are doing that now to people who have worked all their life. Then come down with a castastrophic illness and lose their insurance, cannot work and try to get piece meal care at Emergency rooms, that basically end up sending them home many times basically to continue dying. The Affordable Care Act is a start, it can be tweaked and fixed to become better. Just wait, when you get older, work all your life, see if you don't fell vulnerable about, "what if I lose my job, what if I get sick, or family get sick or hurt, and I am not 65 eligible for Medicare, what will I do.  I saw a patient who was 62, needed oxygen at home and home health, go home without it because she had no insurance or ability to pay. She will either die or end up back in hospital costing everyone higher medical costs. Please consider all this, because these are real situations covering over 30 years of nursing.

Rose West, triage - RN February 15, 2014 11:29 AM
New Orleans LA

Whether or not we know or acknowledge it, we ALL end up paying for care for the uninsured.  The majority of the uninsured are not uninsured by choice.  Healthcare should be a Human Right.

Carol, RN, BSN February 15, 2014 10:06 AM
NY

People have a right to compassion not healthcare. There is a big difference between paying for care that is palliative rather than curative in nature.

The scenarios you mention are ridiculous because they do not occur in America, at least in Florida where I practice. In Florida, hospitals are required to provide care regardless of a patient's ability to pay. Usually the hospital applies for Medicaid in these situations, or if people have enough money but no insurance they are billed after they receive medical care (why not it is their care).    

Although I am not rich, it is violates the ethical principle of justice to tax the rich by making them pay more other people's healthcare (like Title IX of Obamacare does).

I think you need to define healthcare before answering whether it is a human right. As some of the post note above, it is impossible to pay for people to have what ever care they desire (which is what the Patient Self-Determination Act of 1991 empowers patient's to do).

Although written specifically for Christians, you may find this article helpful: http://veritaemedicinae.blogspot.com/2014/01/the-facts-about-20-controversial-issues.html

Christopher Bogosh, Hospice/Palliative Care - B. Rel., B.Th (hon), RN , Healing Hope February 15, 2014 8:08 AM
Yulee FL

It only makes fiscal sense to provide preventive health care but otherwise?...  You should be on your own.

Eve Hurley February 15, 2014 3:19 AM
AZ

Sure healthcare is a right as long as you pay for it and not me.

steve shanko, school - nurse, none February 14, 2014 11:01 PM
East Brunswick NJ

No one should die from treatable or preventable illnesses.

Lin Lathim, Hospice - RN Case Manager February 14, 2014 10:17 PM
Bourbonnais IL

It is not a right.  Government providing for everything is Socialism, not Republic.  Go read a real history book.  It can't work because humans are naturally lazy and want someone else to take care of everything.  They want someone else to blame for their lot in life besides themselves. Just look around. The article just stated to have someone else, government, take care of something the person should take on themselves.

The hospitals will collapse because the ones who have sponged off the government for food, heat, automobile gas, land-line phone and cell phone, shelter, clothing, free dental care, free medical care, and now free pot with their welfare card give a bad rating if they aren't immediately helped, treated exactly the way they want to be treated, and don't get the drugs they demand from the doctor. (whether antibiotic or narcotic) This decreases an already abysmal payment to laughable.  By the way, these people have sharp minds, all their limbs, can walk, etc. but they choose to sponge.  Seen it so much in 22 years of nursing I could just vomit.

To make matters worse, this mentality is in every prison in the country with lawyers to fuel the fire.  Just take a look at how much health care "rights" are costing even at small facilities.  Kill someone, rape a baby or a 98 year-old, gun down a grade school and get your hips, knees, back, eyes, brain, etc. operated on for "free" since people have the mistaken impression it's a "right".  Well, somebody's gotta pay for it, or not?  Just let the economy crash under the load that started during The New Deal (again, find a real history book) and find out about what you think are "rights" if you think anyone's gonna listen.  They sure aren't gonna be working on a solution when it happens because they've never had to do anything but say "It's My Right, Give It To Me Now."

If you think education is expensive, try ignorance. The problem with that saying is that a person can have all the degrees in the world and still be uninformed.

Gloria, Corrections - RN February 14, 2014 9:23 PM
advance NC

Here is the difficulty that I see in my area. We have numerous unnecessary visits to the ER from patients that are Welfare recipients that never have to pay a dime and then those that don't have insurance and never plan to pay any of their bills.  Then there are those of us that are considered to be "middle class" that do not have very good insurance that we pay high premiums and have high deductibles and we work full time plus some and pay plenty of taxes and it seems that we are not necessarily paying for our own healthcare but we are paying for people to have healthcare and aid and these people never contribute to society in any way except to drag on society.  I am all for helping the poor that try to help themselves and contribute to society but there is a problem with this system.  We basically get penalized for getting educated and having good jobs and those who do not care to work or do anything for themselves get rewarded fro their behaviors. This needs to change! I agree that we should all have access to good healthcare but not the way that it is now.

Jean , ER/CCU - RN February 14, 2014 8:40 PM
WA

The problem is not access, there is equal access to healthcare in the United States. Access and funding are two different things.

Babs Smythe February 14, 2014 7:35 PM

Thanks for writing this. I've only had insurance for 2 months of my adult life, despite the jobs I've had. I just can't afford to get sick.

That's why I'm part of a group called Put People First! PA. The group thinks the same thing you're writing here, and we're starting a Healthcare is a Human Right campaign for PA.

http://putpeoplefirstpa.org/

Mitch Troutman February 11, 2014 11:56 AM
Trevorton PA

I agree. It is up to us as the frontline medical personnel to ensure every person has a right to quality healthcare. As a registered nurse, when I took my oath I swore to be the "health guardian" and "defender of health" for not just my patients, but for my loved ones and the people I come into contact with on a daily basis by providing them with education, suggestions for healthy lifestyle changes, and homeopathic "natural" cures. Unfortunately, many of the "nursing school mills" that are churning out the uncompassionate, unskilled, status seeker fall in line with the belief of the government and its agencies, that medicine is a definite way to acquire wealth. Because of this, basic healthcare for the average individual becomes unaffordable and non-existent. There is BIG money in pharmaceuticals, insurance, and disease. Until that changes...nothing ever will.  Great article!

Renee, RN, BSN February 10, 2014 11:39 AM
Philadelphia PA

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