To wrap up National Minority Health Month, NCLR is proudly hosting a blog carnival with our friends and partners to celebrate recent progress toward eliminating health disparities for underserved communities—and talk frankly about the challenges that remain. Today, bloggers answer the question: From your perspective, is health care a civil and/or human right?
Secure the Blessings of Liberty to Ourselves and Our Posterity
by Sergio Eduardo Muñoz, Senior Policy Analyst, Health Policy Project, NCLR
Is health care a civil right? The Department of Justice thinks so, if their closing argument in defense of the Affordable Care Act (ACA) was any indication. In what was his last point to the Supreme Court, the U.S. Solicitor General (SG) directly linked access to affordable quality health care with the pursuit of the “blessings of liberty,” that civil rights aspiration memorialized in the Preamble of the Constitution. This blunt reminder of the real human costs of repealing health care reform was exactly right. And frankly, much-needed after a troubling three days.
But let’s back up. First—don’t let anyone tell you that because the words “health care” aren’t in the founding documents, it can’t be a civil right. The Court has dismissed that argument conclusively and repeatedly. More fundamental, however: What is a civil right? At its core, it’s those non-political rights that the Constitution determines crucial to life. Not the literal act of breathing (although health care is rather important for that too), but the everyday interactions we all share with each other as we navigate society and try for the American Dream. The act of American living—that’s what civil rights protect. They make sure that we all have the equal opportunity to make the most of ourselves, our families, and our communities, without unfair barriers.
In that light, health care is inseparable from the realization of those other civil rights and liberties already formally acknowledged. As the SG noted, if you are one of the millions who suffer from a debilitating chronic condition, perhaps made worse by racial and ethnic health disparities that aren’t getting better, and skittering on the edge of bankruptcy like any of the one in four Americans who were without health insurance last year, securing those blessings of liberty is practically impossible. The rights to equal treatment or assembly are of limited comfort if you’re too sick to exercise them.
The mere existence of a civil right to health care, however, is not enough for its vindication. If words on paper were all it took, we wouldn’t still have shocking examples of racial discrimination, or health disparities that still stubbornly leave Latinos with worse access to care than non-Hispanic whites for 63% of official measures. Care which, for Latinos, the same studies reveal is worse for 39% of standard measures, regardless. Indisputably, recognized or not, civil rights must be constantly enforced. Governments often can’t, or won’t, do it alone.
This is where health care reform comes in. Civil rights that don’t have the support and attention of the American people tend to wither and die. Civil rights taken for granted suddenly become vulnerable when advocates move on. There was a reason that Martin Luther King Jr. presented health equity as the unfulfilled promise of the civil rights era—the inequity is stark, and it affects everyone. Only through constant advocacy has the health safety net gradually been strengthened to ameliorate health disparities, and it still has yet to protect us all.
Let’s not forget that at its core, the ACA is in large part civil rights legislation, aimed at curbing discrimination in the health care market that we as a society and democracy decided was no longer permissible. Most states may have outlawed overt racial and ethnic discrimination in health insurance, but effective enforcement against such discrimination was difficult prior to the ACA, and discrimination against women or those with pre-existing conditions was entirely permissible before health care reform ended these unfair practices. It’s not a coincidence that a decision striking down the ACA could have grave ramifications for other civil rights law. These types of general welfare laws are cut from the same cloth, aimed at protecting many of the same at-risk groups.
As we close National Minority Health Month, we should remember that the struggle to realize the civil right that is health care will not end, regardless of what happens to the ACA and its implementation. More legislation like the Health Equity and Accountability Act of 2011 is needed, and efforts to help those still unfairly discriminated against in our health care system—immigrants most blatantly—must not let up.
If we continue to show why health care is crucial to the fundamental concerns behind our constitution, the movement for health equity will continue to grow. This is the basic flow of civil rights history—illustrating how certain ideals are universally applicable, and not just the special interest of a minority. And just maybe, if health care reform continues, our posterity in the not-so-distant future will no longer have to pin all of their hopes and dreams upon whether an underwriter deigns to grant them a policy.
That’s why we’re doing this. If we’re going to continue to insist that we structure our entire health care system around private health insurance, our oldest ideals demand that it be equitably available to all. That’s the America that we strive for; those are the blessings of liberty we want for our children.
So is health care a civil right? You better believe it. Your other civil rights might depend on it.