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<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 10pt"><font face="Times New Roman">Human Rights Reader 195</font></span></p>
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<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><font face="Times New Roman"><b style="mso-bidi-font-weight: normal"><span style="FONT-SIZE: 14pt">THE HUMAN RIGHT TO HEALTH CARE PROCESS REVISITED.</span></b><span style="FONT-SIZE: 14pt"></span></font></p>
<div class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 14pt"><font face="Times New Roman" size="2">(Part 1 of 2)</font></span></div>
<div class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 14pt"></span><font face="Times New Roman"><span style="FONT-SIZE: 14pt; mso-bidi-font-weight: bold"> H</span><span style="FONT-SIZE: 14pt">ealth is neither an expenditure</span></font></div>
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<div class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 14pt"><font face="Times New Roman"> Primarily and foremost </font></span></div>
<div class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 14pt"><font face="Times New Roman"> it is a <u>right</u>.</font></span></div>
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<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 14pt"><font face="Times New Roman">1. For starters, let us look at what the human right to health care process is: It is an ethical and political enterprise; it is a UN mandate; it is thus not optional; <span style="mso-bidi-font-weight: bold">it pursues building people and human rights-centered health systems; it refers to a very specific framework. </span>It is thus <u>not</u> "yet another approach"…</font></span></p>
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<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 14pt; mso-bidi-font-weight: bold"><font face="Times New Roman">2. Further, let us dispassionately look at what the current reality is: Most health services around the world are, to an important degree, market driven; the health sector is indeed quite profitable. This notwithstanding, private health systems do receive public funds in the form of subsidies and often handsome tax breaks. Moreover, even if state owned, public health systems frequently still serve private production/productivity-centered interests. </font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 14pt; mso-bidi-font-weight: bold"><font face="Times New Roman">People simply need to know this! </font></span></p>
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<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><font face="Times New Roman"><span style="FONT-SIZE: 14pt; mso-bidi-font-weight: bold">3. For people to know, a debate needs to be opened with no further ado on how work-on-health-as-a-human right is to lead to a democratic social movement around vital, strongly-felt health issues in the community. (Be reminded here that "democracy without active participation to foster grassroots social justice is merely a formality"). </span><span lang="PT-BR" style="FONT-SIZE: 14pt; mso-bidi-font-weight: bold; mso-ansi-language: PT-BR"></span></font></p>
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<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 14pt"><font face="Times New Roman">4. By applying the human rights-based framework to health, people need to be aware that they will be struggling for an indivisible triad, namely:</font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt 0.5in; TEXT-INDENT: -0.25in; mso-list: l0 level1 lfo1; tab-stops: list .5in"><span style="FONT-SIZE: 14pt; FONT-FAMILY: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol"><span style="mso-list: Ignore">·<span style="FONT: 7pt 'Times New Roman'"> </span></span></span><font face="Times New Roman"><span style="FONT-SIZE: 14pt; mso-bidi-font-weight: bold">For <b>Universal Coverage</b>:</span><span style="FONT-SIZE: 14pt"> </span>for every person, lifelong.<span style="FONT-SIZE: 14pt"></span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt 0.5in; TEXT-INDENT: -0.25in; mso-list: l0 level1 lfo1; tab-stops: list .5in"><span style="FONT-SIZE: 14pt; FONT-FAMILY: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol"><span style="mso-list: Ignore">·<span style="FONT: 7pt 'Times New Roman'"> </span></span></span><font face="Times New Roman"><span style="FONT-SIZE: 14pt; mso-bidi-font-weight: bold">For <b>Comprehensive Care</b>:</span><span style="FONT-SIZE: 14pt"> </span>for all health and social needs, for life.<span style="FONT-SIZE: 14pt"> </span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt 0.5in; TEXT-INDENT: -0.25in; mso-list: l0 level1 lfo1; tab-stops: list .5in"><span style="FONT-SIZE: 14pt; FONT-FAMILY: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol"><span style="mso-list: Ignore">·<span style="FONT: 7pt 'Times New Roman'"> </span></span></span><font face="Times New Roman"><span style="FONT-SIZE: 14pt; mso-bidi-font-weight: bold">For <b>Equity in Health</b>:</span><span style="FONT-SIZE: 14pt"> </span>as a matter of social justice, with access to quality services guaranteed at the time needed, with no differences for all who have the same needs.<span style="FONT-SIZE: 14pt"> </span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><font face="Times New Roman"><span style="FONT-SIZE: 14pt; mso-bidi-font-weight: bold">Each of these three is necessary-but-not-sufficient for the realization of the human right to health !</span><span lang="PT-BR" style="FONT-SIZE: 14pt; mso-bidi-font-weight: bold; mso-ansi-language: PT-BR"></span></font></p>
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<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 14pt"><font face="Times New Roman">5. The equity imperative depicted here-above does not pertain or refer to a "minimum", but to what is fair and just. The equity imperative simply establishes the right(s) of everybody (…which, mind you, are <u>already</u> enjoyed by the privileged individuals or groups in society). The example that comes to mind here is the stark contrast between "child survival" and a "child's right to a healthy life": ponder the difference of this<span style="mso-spacerun: yes"> </span>contrast in terms of equity --beyond mere (crude) survival.</font></span></p>
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<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><font face="Times New Roman"><span style="FONT-SIZE: 14pt">6. Inequities are thus intolerable differences between groups in relation to set standards when considering health as a human right.</span><span lang="PT-BR" style="FONT-SIZE: 14pt; mso-ansi-language: PT-BR"></span></font></p>
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<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><font face="Times New Roman"><span lang="PT-BR" style="FONT-SIZE: 14pt; mso-ansi-language: PT-BR">7. T</span><span style="FONT-SIZE: 14pt">he lack of equity in health highlights the fact that there are no real cross-subsidies in our societies: The rich pay proportionately less taxes…and subsidies for safety nets remain token and do not work beyond the short-term since they do not address the root causes of poverty.</span></font></p>
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<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><font face="Times New Roman"><span style="FONT-SIZE: 14pt">8. We have all seen it: As efficiency concerns in public health systems increase, redistributive justice and health-as-a-human-right-concerns decrease or disappear.</span><span lang="PT-BR" style="FONT-SIZE: 14pt; mso-ansi-language: PT-BR"></span></font></p>
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<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span lang="IT" style="FONT-SIZE: 10pt; mso-ansi-language: IT"><font face="Times New Roman">Claudio Schuftan, Ho Chi Minh City</font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 10pt"><a href="mailto:cschuftan@phmovement.org"><font face="Times New Roman">cschuftan@phmovement.org</font></a><font face="Times New Roman"><span style="mso-spacerun: yes"> </span></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 10pt"><font face="Times New Roman">[All Readers can be found in </font><a href="http://www.humaninfo.org/aviva%20%20under%20No.69"><font face="Times New Roman">www.humaninfo.org/aviva<span style="mso-spacerun: yes"> </span><span style="COLOR: windowtext; TEXT-DECORATION: none; text-underline: none">under No.69</span></font></a><font face="Times New Roman">]</font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 10pt"><font face="Times New Roman">__________</font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 10pt"><font face="Times New Roman">Partly adapted from Dr Armando Denegri Filho.</font></span></p>