In 1948, the Charter Members of the United Nations adopted the legally binding United Nations Charter and the Universal Declaration of Human Rights. While the Universal Declaration of Human Rights was not legally binding, it initiated a series of treaties defining an international standard for human rights. Article 25 addresses medical care specifically.

"Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control." [1]

In 1976, Article 12 of the International Covenant on Social, Economic and Cultural Rights extended the concept of medical care as a human right to include mental health care and, "The creation of conditions which would assure to all medical service and medical attention in the event of sickness." [2] The covenant's comment on implementation states, "Health is a fundamental human right indispensable for the exercise of other human rights." [3] The United States is a signatory of this covenant, and until just recently, was the world's undisputed champion of human and civil rights.

Virtually every developed nation successfully and economically provides this human right with not-for-profit "single payer" systems, in which the government pays the People's medical bills with tax revenues. Paralleling the "third world" medical care's nonexistent, inconsistent or unequal access due to lack of personnel and technology, America's schizophrenic not-for-profit (Medicare) and for-profit (insurance based) paradigm generates unequal access and substandard quality. Despite record health care expenditures, American morbidity and mortality statistics are among the poorest in the world.

Medical care is a basic human need and "Do no harm" is a founding medical ethic. Minimizing access to medical treatments clearly harms patients, especially in the context of profit. Another key medical ethic is informed consent. Americans are rarely informed of, or consent to, the profit stemming from the pain and suffering experienced due to treated and or untreated illness or injury. Furthermore, growing health insurance premiums lead to growing numbers of uninsured workers [4] and children, [5] ; medical bills, whether uninsured or insured, are America's leading cause of bankruptcy. [6]

Enterprises profiting from health care hold significant conflicts of interest. Insurers frequently reject applicants likely to need medical care, and deaths of insured clients benefit insurers, who rarely participate personally in the sometimes messy process. It appears the best way to profit from health care is to deny it. Since the denial of medical care maximizes profits, for-profit health care systems promote, if not constitute, a market in human suffering.

In addition to significant expenses stemming from profit itself, for-profit medicine generates competition, duplication of services and administrative and marketing costs. Even brilliant advertising rarely induces illness, injury, or the rejection of insurer reimbursement guidelines.

America's for-profit medical system fails to provide quality medical care for all and prioritizes corporate profits over basic human needs. This violates medical ethics, the Universal Declaration of Human Rights, the International Covenant on Social, Economic and Cultural Rights and other international treaties designed to define and ensure basic human rights.

Extending Medicare coverage to all, boosting caregiver reimbursement rates and retraining health insurance workers as health care providers could solve these problems, restore our human rights and end America's for-profit medical nightmare.

REFERENCES

[1] United Nations, Universal Declaration of Human Rights, December 10, 1948, http://www.unhchr.ch/udhr/lang/eng.htm , accessed November 12, 2002.

[2] United Nations, International Covenant on Social, Economic and Cultural Rights, http://www.unhchr.ch/html/menu3/b/a_cescr.htm , accessed November 12, 2002.

[3] United Nations, International Covenant on Social, Economic and Cultural Rights, The right to the highest attainable standard of health : . 11/08/2000. E/C.12/2000/4, CESCR General comment 14, http://www.unhchr.ch/tbs/doc.nsf/(symbol)/E.C.12.2000.4,+CESCR+General+comment+14.En?OpenDocument , accessed November 12, 2002.

[4] American College of Physicians-American Society of Internal Medicine, Achieving Affordable Health Insurance Coverage for All within Severn Years: A Proposal From America's Internists, April 9, 2002, http://www.acponline.org/uninsured/afford_7years.pdf , accessed November 19, 2002.

[5] Robert Wood Johnson Foundation, Covering Kids, http://www.neahin.org/resources/docs/coveringkids_factsheet.pdf , accessed November 19, 2002.

[6] Wordsworth, Araminta, US Study: Medical Bills Main Culprit In Bankruptcies, National Post (Canada), http://www.commondreams.org/headlines/042700-03.htm, accessed November 19, 2002.

This column is a condensation of an article that originally appeared at www.undercovermedicine.com in 2003.