Health Care in the United States

The market-based health insurance system in the United States has caused a human rights crisis that deprives a large number of people of the health care they need.  The most visible problem is the 32 million people without health insurance; the most distressing is the number of preventable deaths - up to 101,000 people per year - simply due to the way the health care system is organized.

This crisis persists despite available resources to protect the right to health, record levels of health care spending and repeated health reform efforts. Since social determinants, such as race, income and environment, strongly influence who becomes ill and who receives access to quality care, the health care crisis disproportionately affects disadvantaged groups and under-resourced communities, such as people living in poverty, people of color, and immigrants. Yet barriers to accessing care, the burden of medical debt and the shortage of primary care providers affect all people, including those with employer-sponsored insurance. Overall, the health care crisis is the result of the privatization and commodification of the U.S. health system, which reflects market imperatives and profit interests that devalue human needs, dignity and equality.

How the U.S. health care system fails to protect the human right to health

Health outcomes: 

  • The U.S. has a higher infant mortality rate and lower life expectancy than comparable countries. (WHO 2007, Commonwealth Fund 2007)
  • The U.S. has the highest rate of maternal mortality among high-income countries (13 in 100,000), and also the highest rate of C-Sections (32%, as opposed to a WHO recommended 5-15%)
  • 45,000 people die each year simply because they have no health insurance (American Journal of Public Health 2009)

Barriers to care:

  • Around 50 million people do not have health insurance. Over half of them are African Americans. (Center for American Progress 2009)
  • Of those who are insured, at least 25 million are underinsured. They often forgo care because of high deductibles and co-pays. (Commonwealth Fund 2008)
  • 700,000 families go bankrupt each year just by trying to pay for their health care – even though three quarters of them are insured. (Health Affairs 2006). In comparison, the five largest insurance companies made a combined profit of around $12 billion in 2009. (Department of Health and Human Services 2010)
  • U.S. has fewer doctors and nurses than other high-income countries. (WHO 2007)
  • Hospitals and doctors are disproportionately located in wealthier areas. Public hospitals are closing in areas where they are most needed.
  • The U.S. ranks lowest among high-income countries in its primary care infrastructure. There is a projected shortage of 44,000 primary care doctors within the next 15 years. (WHO, Health Affairs 2008)

Disparities in access to care:
The U.S. has a highly stratified system with separate tiers for different categories of people receiving different levels of care.

  • The rights of people of color are violated: e.g., the 10-year survival rate for Black people of people with cancer is 60% for Whites and 48% for African Americans. (SEER cancer statistics, also Office of Minority Health)
  • The quality of care given to people of color is generally lower, including in the treatment of cancer, heart failure, and pneumonia. (Agency for Healthcare Research and Quality, 2009)
  • While immigrants are generally healthier than the average citizen upon arrival in the United States, their health tends to deteriorate the longer they remain in the country. (“Unhealthy assimilation", Demography, May 2006)
  • Women are more likely than men to forgo needed health care due to cost-related access barriers. (Commonwealth Fund 2007)
  • Women’s right to non-discrimination is violated through increasingly restricting those services only women use, reproductive health care.

 

Read NESRI's submission on health care to a government consultation in the context of the UN's Universal Periodic Review of the United States.

Read an article on U.S. health reform and human rights, co-authored by NESRI's Anja Rudiger, published in Rights-Based Approaches to Public Health (which includes a foreword by Paul Hunt, former UN Special Rapporteur on the Human Right to Health).

For a good analysis of the health care crisis in the U.S., read this Monthly Review article.

 

NESRI occasionally blogs on human right to health issues in the United States. Follow our blogs here:

The Huffington Post

Human Rights Now, Amnesty International's blog