Persisting absence of human rights, widening inequality, and social justice in healthcare delivery systems within and between countries present significant challenges to the focus and practice of contemporary public health. This chapter compares how cases of human rights, equity, and social justice are integrated in America's and Nigeria's healthcare policies. Qualitative research and case study design were adopted. Data were collected from secondary sources, such as reviewed literature, textbooks, journal articles, government reports, and internet. Content and critical case studies analysis methods were utilized to analyze, explain, and compare America's and Nigeria's health policies. Findings reveal absence of human rights, equity, and social justice among sub-groups in healthcare service delivery in America and Nigeria. The chapter concludes by suggesting that human rights, equity, and social justice should be integrated into health policies of America and Nigeria in order to make access to healthcare service delivery a right for citizens.
TopBackground
Humans have rights to the resources necessary for health. The public code of ethics affirms by Universal Declaration of Human Rights (UDHR) states that everyone has the right to a standard of living adequate for the health and well-being of himself and his family. Health policy-making, therefore, involves complex processes where a mix of experience, politics, human right, finance, values and ethics all interweave. The failure of anyone component can be fatal to any policy.
In United States of America, from the Truman Administration to today, reform for healthcare has been seen as both progress and failure. President Truman recommended to congress a proposal for Universal Health Insurance coverage administered and paid for by National Insurance Board. Unfortunately, the American Medical Association decried it as “socialized medicine” and the Bill failed.
American healthcare policy and programs have witnessed reforms over the years. Prior to the 20th century, the involvement of the federal government in healthcare was limited to care for the military personnel and veterans. At the State level, all states had established some type of departments of public health by 1909. In 1943, the Internal Revenue Service ruled that employees did not have to pay taxes on their employers’ contributions to group health benefits. This ruling made offering health benefits to recruit employee, an attraction option. The result is that the United States puts tax dollars that would have been collected by the government into employer – based health insurance.
The Kennedy administration pursued a more modest form of healthcare coverage than that of Truman. Kennedy Administration supported the King-Anderson bill, coverage would be limited to those 65 years of age and older benefits package. Kennedy in addition, created more avenues to develop the foundation of what would ultimately become Medicare. Unfortunately, Kennedy’s healthcare plan was denied by congress.
A major initiative by the Clinton Administration to institute national healthcare insurance failed in 1994. However, the government enacted Health Insurance Portability and Accountability Act (HIP AA) of 1996. This provides that workers must be able to continue purchasing their health insurance if they lose their jobs or change jobs (NASW, 2003). It also prohibits insurance companies from denying coverage to people with pre-existing conditions, and it introduces Medical Savings Accounts. Medical Savings Accounts (MSA) allow people who are self-employed or working for small businesses to place their own pre-tax money in an account that can then be used to pay for routine or long-term care (NASW, 2003).