The Nation's Health Care System - Is Access A Right Or A Privilege?

The AHRQ and other health care researchers and policymakers have observed that having health insurance does not necessarily ensure access to medical care. They contend that many other factors, including cost-containment measures put in place by private and public payers, have reduced access to care. Nonetheless, reduced access affects vulnerable populations—the poor, persons with disabilities and other special health care needs, and immigrants—more than others. These groups are disproportionately affected.

Health care is a resource that is rationed. In the United States and other countries without universal or national programs of health insurance, persons with greater incomes and assets are more likely than low-income families to have health insurance and as a result have greater access to health care services. According to the NHIS, in the United States in 2004, of 293 million Americans, more than forty-four million people, including more than nine million children, had no health insurance and either experienced sharply reduced access to the health care system or were excluded altogether.

A wide range of groups and organizations support the idea that health care is a fundamental human right, not a privilege. These organizations include Physicians for a National Health Program, the American Association of Retired Persons (AARP), National Health Care for the Homeless, Inc., and the Friends Committee on National Legislation, a Quaker public interest lobby. The American Medical Association's "Patient Bill of Rights" includes the "right to essential health care."

In April 2004 HHS secretary Tommy Thompson announced the creation of the Health Disparities Council, a new board charged with developing a plan to eliminate quality gaps in health care. Thompson maintained that the Bush administration's commitment to eliminating disparities in health care was evidenced by action to address racial disparities in health care. Specific actions include supporting research aimed at the health of minorities, providing more money for AIDS issues among minorities, and increasing the number of community health centers in racial and ethnic minority neighborhoods.