Law Links - November 2015

Healthcare as a basic human right: activists changing the politically possible

Chief Medical Officer Dr. Myron Glick (Jericho Road Community Health Center), Executive Director James Haslam (Rights & Democracy), Executive Director Cathy Albisa (The National Economic and Social Rights Initiative) and Associate Professor Tara J. Melish (UB).

Chief Medical Officer Dr. Myron Glick (Jericho Road Community Health Center), Executive Director James Haslam (Rights & Democracy), Executive Director Cathy Albisa (The National Economic and Social Rights Initiative) and Associate Professor Tara J. Melish (UB School of Law)

What made the most difference, they said, were the stories.

Stories of people who had to choose between going to the doctor or putting food on the table.

Stories of people stuck in dead-end jobs or abusive relationships they couldn’t afford to leave because they needed the health insurance.

It was those stories, and a set of human rights principles that connected them to each other and to a concrete policy change, that made the difference for Vermont activists working to achieve a goal that has proved elusive for most of the United States: health care for all citizens. Vermont’s state legislature passed a single-payer universal health care plan, now known as Green Mountain Care, in 2011.

Could the Vermont model create a domino effect across the country? That was the focus of a Nov. 10 forum sponsored by UB School of Law’s Human Rights Center. The forum, held in Buffalo’s City Hall, featured two community-based human rights activists who were instrumental in pushing Green Mountain Care through the state legislature, as well as a Buffalo doctor whose organization, Jericho Road Community Health Center, serves some of the city’s neediest patients.

The forum, titled “Winning the Human Right to Health Care: Lessons From Grassroots Campaigns,” cast the debate over health coverage in terms of an understanding of health care as a basic human right. “What does a human rights approach to a health care campaign look like?” Professor Tara J. Melish, director of the Buffalo Human Rights Center and moderator of the forum, asked at the outset. About 30 students and community members heard the panelists wrestle with that question and tell their own stories.

James Haslam, founder and executive director of the rights group Rights & Democracy, previously led the Vermont Workers’ Center, whose three-year “Healthcare Is a Human Right” campaign spurred a grassroots movement that ultimately led to Green Mountain Care. Philosophically, he said, the movement arose from “an indictment of the current health care system, in which we treat health care as a commodity that some people have and some don’t. There’s no good reason why some people don’t.” Using a human rights frame is helpful, he explained, because it says everyone must have access to quality health care, irrespective of insurance or other status. At the same time, he said, bringing a human rights perspective to the issue showed the connections between health care and issues like a living wage. “We need to have the kind of society,” Haslam said, “where everyone can live a happy and a just life.”

So they collected the stories of how access to health care played out in the lives of ordinary Vermonters, identified a set of human rights principles that would guide the campaign, organized door-by-door, got people involved in progressively more active ways, and within a year achieved the state’s largest ever week-day rally on the steps of Vermont’s statehouse to demand healthcare as a human right. Once a commitment to universal health care was secured from the governor, the campaign organized oversight committees to evaluate proposed legislation on the basis of five non-negotiable human rights principles – universality, equity, accountability, transparency and participation. While many technical options would be acceptable, they said, non-compliance with any one of those principles was a non-starter.

Cathy Albisa, an attorney and executive director of the National Economic and Social Rights Initiative, also spoke of the human rights underpinnings of Vermont’s campaign, which her organization supported. She said an approach that used a “values-based framework” was a return to grassroots democracy – achieving the will of the people rather than the wishes of big-money political donors. “When we come together around a set of values and a vision, that’s when we can build the kind of alliances, organize people and inspire them so they will do more than they otherwise could do,” she said. “This is not about a technical solution. This is about designing a system that actually meets people’s needs.”

Dr. Myron Glick, founder and chief medical officer of Jericho Road Community Health Center, has heard plenty of stories from people squeezed by the current health care system in Buffalo and New York generally. “I see us as ground zero,” he said. “Jericho Road is where people in Buffalo with the most need medically can come as their place of last resort.”

Like Vermont, his Center focuses on gathering stories as a way to organize and educate. Jericho Road runs a Health & Justice Project, which collects and shares the stories of everyday people and their personal struggles with finding the healthcare they need. This is done to amplify people’s voices and inspire change aimed at ensuring that healthcare is seen not a privilege but as an inalienable human right.

He is not sanguine, though, about the prospects for a single-payer system. “After 20 years, I’m a little discouraged about the lack of progress we’ve made,” Glick said. “In some ways our health care system is more dysfunctional and more broken than it was 20 years ago.”

But he agreed with Haslam and Albisa that it is only when people assert their voices, organize, and demand value-led reform themselves that change will come about. To support such change, Albisa’s organization supports a “Healthcare is a Human Rights Collaborative,” in which healthcare lessons are shared among human rights campaigns in Vermont, Maine, Maryland, and Pennsylvania, all of which are hoping to follow Vermont’s lead in adopting universal health care legislation and hence changing what is considered “politically possible” in healthcare reform.