W8) Right to Health: Individual Vs. Society, a collectivism approach?

When UN Covenant on Economic, Social and Cultural Rights (1966, Art. 12) includes “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.”, it represents the requirement for states as agents to realize a better provision of health care environment, and a noble attempt to alleviate the disparity, if not achieve equality between individuals’ health needs.

Many countries have recognized such a vital right and took it further to constitutionalization. However, judicialization of the right to health face problems with individualizing the claims, as the resources skewed to the wealthy who can afford to litigate and the conflict raised between individual needs and society-level efficiency.

Cubillos et al (2012) argue that constitutional courts are becoming de facto resource allocators within their respective health systems. And they often work against a ‘population-level’ perspective. Moreover, research from Brazil shows that a significant proportion of its health care litigation amounts to demands for medicines or treatments that are expensive, not cost-effective and even ineffective, with such demands often being upheld (Wang, 2013)

The notion of progressive realization helps us think of policy as on a path to development, to frame the right to health as a positive claim may be too radical for LMIC in the process of realizing the goal. In this week’s reading, both O’Neill(2005) and Hessler(2008) seem to view the right to health as a self-evident positive welfare right, which leads me to wonder if thinking of it as a negative duty and adopting a collectivist mindset would be more feasible to implement.

The collectivist approach regarding promoting the right to health think of the right to health in a public health context, as a protection against one’s health being interfered with by environmental forces, such as access to clean water, reduce air pollution, etc. It provides grounds for absolute prohibition and makes it easier to assign responsibilities.  For LMIC facing more constraints with resources, providing a basic package to promote public health might raise less controversy, and could be a realistic way to start off.

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