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Kokouvi Togbe
MS. Grant
UWRT: 1102
03/23/2015
Healthcare
The term healthcare, does it refers to treatment for disease, or the prevention of
disease? The term healthcare is related to individual and the society, that is why the World Health
Organization defines health as a complete state of physical, mental and social well being, and
not merely the absence of disease or infirmity. Health is related to social well-being and equals
happiness ( Lori & Kelsey health, P:229). It is clearly stated in the 25th article of the Universal
Declaration of Human Right that 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. Motherhood and childhood are entitled to special care and assistance ( Lori & Kelsey,
229).
In light of this declaration, healthcare should be the first priority of every government
around the world but unfortunately only a few country in the world took the real action by setting
up an open system where healthcare is the government responsibility at hundred percent.
Example of France where the healthcare system is open to everyone regardless their social
standing. The French government had created a tax deduction system which allows everyone to

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have full healthcare coverage. Even those who are not working are fully covered. When a person
works in France his entire family will be qualify to receive any kind of assistance when needed
including healthcare, there is no healthcare insurance company instead, they have private clinic
for those who wanted to have a special physician for their family but still the private sector is
also controlled by the government. Another example, is the Jordan, a poor country close to Syria
where at the heart of the right to the highest attainable standard of health lies an effective and
integrated health system, encompassing medical care and the underlying determinants of health,
which is responsive to national and local priorities and accessible to all.
The Jordan Healthcare system is well known regionally for its commitment to improve
the health of its population, this is apparent in a number of significant health indicators including
decreasing infant and maternal mortality rates, and increasing average life expectancy, which is
now 74 years. Jordans total health expenditure is consistently among the highest in the region,
reaching 9.5% of Gross Domestic Product (GDP) in 2009 and dropping slightly to 8.3% of GDP
in 2010 ( Jordan Healthcare System). In terms of finance and provision however the Jordanian
Healthcare system is highly fragmented, the Jordanian health system consists of three major
health service providers including the public and private sectors, as well as national and
international nongovernmental organizations. The public sector is composed of the Royal
Medical Services, the Ministry of Health, and to a lesser extent, university hospitals, which
provide services to university and hospital staff and their dependents. The Royal Medical Service
offers primary, secondary, and tertiary healthcare to members of the Jordanian army, the public
security police force, civil defense, intelligence agency, Royal Jordanian Airline employees, as
well as retired military personnel and their dependents among others. Through the Civil

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Insurance Program, the Ministry of Health provides services and insurance coverage to
government employees and their dependents, the certified poor, handicapped persons, blood
donor, cancer, and end stage kidney disease patients, and on a voluntary basis, to the elderly and
pregnant women. (Jordan Healthcare System)
The crucial problem in all the states that failed their tripartite duty such respect, protect
and fulfil, are those bin which discrimination on social based are common. The government is
responsible to introduce policies that protect vulnerable and marginalized groups of people.
Disparities in health status across population groups based on physical characteristics, gender or
the age of individuals exist in every society. At the same time, the systematic differences in
health status among different socio-economic groups emerge as socially produced health
inequalities, which are unfair and such avoidable and amenable to change ( Natalya Pestova, P
341). Most of the attention should be for those groups with limited resources which cannot afford
paying for their health cost and this is the primary function of the state to protect. This is not the
case in some countries around the world where access to a healthcare is limited to only those
who has resources and the marginalized group is being denying for any access to healthcare.
In Africa the problem is very complex in the sense that in some countries which were
colonized by France, they inherited the French system and the government provides healthcare to
the population at the minimal basis but there still room for improvement because it is not what it
should be. Despite the inheritance of the French system, disparities exists among the population
where only a few people who has the resources could take care of themselves efficiently, that is
why in Africa the mortality rate is very high the governments are not responsible enough to

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protect their population. As it is stated above the case of Africa is very complex and as the said
goes, everybody knows that Africa countries are very poor and the lack resources. The question
is why the richest countries in the world are not doing anything to help the Black Continent?
This is another form of discrimination at international level.
The most recent case of the Ebola Outbreak showed how this group of people in the
world are marginalized in the fact that, basically there is no cure yet for the Ebola virus and
people are dying in Africa but the most critical part is that other people who went to Africa to
support the population which is good action though, when the contracted the virus by handling
the Ebola patient, they were quickly sent back to their home countries (America, Europe and
more..) to get the treatment and they recover miraculously but since the disease started killing
people in Africa nobody has survived yet. How in this globalized world, the same disease can be
seen as fatal for one part but not for others? The disparity is so huge and exists at national and
international level.
The tripartite duty of the government should be applied at any level not only nationally
but also internationally. As the local government has the responsibility to respect, protect and
fulfil the right, the richest countries in the world has the responsibility to finance and support
poor countries as required. .Governments exist in an increasingly globalized world and the
governments of poor countries cannot be judged as truly sovereign, enmeshed as they are in a
geopolitical and historical context that has resulted in capital flows from the global South to the
global North. This further results in unequal social determinants of health. Governments in
resource-poor settings, without a sufficient tax base and stripped of the ability to profit from
government-owned resources became, more than four decades ago, dependent upon loans to
support their sovereign States. These loans, most notably made by the World Bank and the

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International Monetary Fund (IMF), were designed with a strictly neoliberal economic view of
development which holds that a healthy private sector with minimal government interference is
the best route to development. After decades of contraction, though, the public sector, while
having the major responsibility for fulfilling the right to health, has limited resources to bring to
bear towards the realization of the right to health (Gretchen et al.). If we view what is attainable
against this backdrop, the provision of healthcare by the public sector of the sovereign State
alone becomes nearly impossible even if civil society is engaged in demanding their rights. As
trade and profit are globalized, the accountability of duty bearers in enabling governments to
respect, protect, and fulfil rights must be more explicitly defined. (Joia S. Mukherjee :
Financing Government).
In the US, the health system is extremely complex. For most Americans (58.7% in
2010), access to care is governed by private health insurance plan which are paid for by their
employers (Fronstin, 2011). However, since health insurance is primarily provided through
employers, the number of people without health insurance has grown as the economy has
contracted and unemployment has increased. Some of these newly uninsured have been absorbed
into government-provided insurance plans, one of which is focused on the elderly (the Medicare
entitlement provides coverage for Americans who are over the age of 65) and one of which
provides insurance for those living in poverty (the Medicare entitlement, provides coverage
through a state-federal partnership to individuals making less than $15,000 annually). This
estimate is high, and will vary significantly by state. It reflects an increase in Medicaid coverage
introduced by the Patient Protection and Affordable care Act of 2010 ( Affordable Care Act) to
individuals under age 65 with an income below 133%of the federal poverty level (PPACA,
2010); in 2012, that level for an individual was US$11,170. However, in 2012, the US Supreme

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Court held that this increase would not be binding on States. In addition, a 1997 law known as
CHIP provides for State-administered program of health insurance for children whose families
are low-income but not impoverished enough to qualify for Medicaid. The Centers for Medicare
and Medicaid Services (which also service CHIP) currently provide health coverage for
approximately 100 million people, which is nearly one-third of the total US population (Centers
for Medicare and Medicaid Services, 2012)
Despite significant coverage by government program for the elderly and the very poor,
as of 2010 there were 49.9 million people in the United States with no form of health insurance
(US Census Bureau, 2011). Because the system is designed around employment-based health
insurance, this lack of coverage translates into a nearly insurmountable barrier to accessing
adequate health services. Since 2000, the number of uninsured has increased by approximately
13 million people (DeNavas-Walt et al., 2011). Moreover, this barrier to access is not equally
distributed across the population: instead, those without insurance reflect the racial-, ethnic-, and
income-based inequalities that permeate US society. The financial burden, if not the ethical
implications, of the uninsured problem provided political will to enact a major healthcare reform
bill in 2010the Affordable Care Act (PPACA, 2010). The equal dignity of all human beings
and non-discrimination are among the most important principles of all human rights, including
the right to health. However, racial disparities are prevalent throughout the US healthcare
system, as well as the broader society, and affect virtually every component of health (Gee,
Williams et al., 2008). For example, infant mortality and maternal mortalitytwo indicators that
are highly sensitive to the functioning of health systemsreflect these gaping inequalities; infant
mortality is three times as high among African Americans and Latinos than among white people
in some cities; maternal mortality is four times as high and five and a half times as high among

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high-risk pregnancies (Amnesty International, 2010). Poverty illustrates another dimension of

health inequality: three-quarters (75.5%) of the people who do not have health insurance (which
is generally a prerequisite for affordable access to the provision of non-emergency care) in the
United States are those who are classified as poor or near-poor (DeNavas-Walt et al., 2011)
For those who face double or triple burdens of discrimination based on race,
class, and gender, health statistics mirror intersecting forms of exclusion: for example, the
prevalence of obesity (which is linked both to poor health outcomes and social determinants of
health) in non-Hispanic black women is higher than non-Hispanic black men or than white
women (CDC, 2011). Although the United States is not party to the treaties explicitly articulating
health as a right, it has ratified the International Convention on the Elimination of all Forms of
Racial Discrimination (Race Convention), which contains provisions related to health, as well as
the International Covenant on Civil and Political Rights (ICCPR, p.239), in which the right to
life includes health-related elements (Human Rights Watch, 2009). Thus, the United States has
undertaken some legal obligations regarding health and the provision of care. Moreover, the right
to health has been so widely enshrined in international and domestic laws that it signals an
ethical consensus regarding at least some general principles. Without question, the United States
is currently an outlier. However, it canand shouldjoin the rest of the world in embracing a
rights-based approach to health and healthcare.

Works Cited.

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Action Aid : Washington DC accessed on 20 September 2009 Patterson D: the right to health,
2007 K. Heus & T. Sortawi: Action for Global Health, 2012. Civil society call to action
on universal health coverage.
Mukherjee, J.S., Farmer, P.E., Niyizonkiza, D, 2003 New England Journal of Medecine, 301,
967,974.
Walsh and Warren, selective primary healthcare, 1979. The world Health Report, working
together for health P. 422 accessed 5 october 2012.
WHO and UNICEF, Primary Health care, Report of the international conference September
1978.World Bank: The cost of attaining the Millennium Development Goals, 29 May
2012.
Zere, Walker, kirigia, et al. Health financing in Malawi, evidence from National Health Account.
World Health Stastics Report, 2012. WHO, Constitution of the world health association,
1964