By Anna Zelivianskaia, MS3
AMSA On Call Blog, March 25, 2015
“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Martin Luther King Jr.
Health care is not listed as a basic human right in most constitutions, including our own. Yet I suspect the majority of citizens of any country would agree with the Rev. Martin Luther King Jr.’s statement. Most people rightly believe that access to health care is implied in the social contract. It certainly is for citizens who live in countries with single-payer medical systems. However, why is healthcare an implied human right? Besides the intuitive feeling that as a future physician, I should care for anyone who walks through my doors, I could not explain why healthcare is so transparently intertwined with justice and citizenship.
In a broad sense, what are the basic human rights? The knee-jerk answer from the American experience is life, liberty, and the pursuit of happiness. The Bill of Rights reflects these principles: freedom of speech and the right to bear arms fall under the “liberty” category; fear from excessive bail and unusual punishment allow for the pursuit of happiness. Yet, as I tread further into my medical training, I realize that health care is interchangeable with the right to life. Preventing a person from accessing the medical system is condemning them to death.
I am currently on the general medicine wards — the bread and butter of a medical student’s training. As I started the roller coaster of inpatient care, I expected long hours, difficult patients, and even spending a substantial amount of time documenting my every move. What I did not expect was talking about medical insurance ten times a day. When my team creates and fine tunes a care plan, we constantly have to check what insurance the patient is on, if our hospital is in network, and which hoops we need to jump through for a specialist referral. And that is for the patients who actually have insurance. Even at a state hospital, like ours, which is genuinely committed to serving the under-served, the majority of patients who do not have insurance do not make it through our doors.
Just like any other hospital, there are times when we cannot provide a particular medication or service to a patient because the patient’s insurance prohibits it. Recently another student asked what happens to these patients. Apart from the momentary frustration I feel every time we have to limit someone’s care, I had not really thought about it. I assumed patients who are denied care would get it somewhere else. Perhaps they would receive a slightly less effective medication — but they would get by somehow. But some patients go bankrupt after being taken to an out-of-network hospital by an ambulance. And some patients die without their treatment. Even choosing the slightly less effective medication that the insurance will actually pay for can shorten a person’s life span as their disease slowly gnaws at their “quality of life years.”
Furthermore, what about the patients we never even see? Their ghosts will haunt my career and the extra years not lived trickle wastefully through the cracks of our broken system. Health care is a human right because it allows you to live fully. Good health gives you the liberty to contribute to society in the most prolific way. Having a home in the medical system allows you to pursue happiness in the finer things in life. From my standpoint, health care is embedded in every one of our basic human rights. Our medical system needs to live up to that high standard. The only way to protect the basic human rights of all citizens is to institute a single-payer health system that removes all financial barriers to necessary care.
Anna Zelivianskaia, is an M.D. Candidate 2016, University of Illinois-Chicago College of Medicine.
http://www.amsa.org/amsa/homepage/takeaction/amsaoncall/15-03-25/The_Importance_of_Health_to_Life_Liberty_and_the_Pursuit_of_Happiness.aspx