Rudiger Anja
Political theorist and advisor to the National Economic and Social Rights Initiative (NESRI), New York City, where she served on staff from 2007 to 2015.
Health Hum Rights. 2016 Dec;18(2):67-78.
Health system financing is a critical factor in securing universal health care and achieving equity in access and payment. The human rights framework offers valuable guidance for designing a financing strategy that meets these goals. This article presents a rights-based approach to health care financing developed by the human right to health care movement in the United States. Grounded in a human rights analysis of private, market-based health insurance, advocates make the case for public financing through progressive taxation. Financing mechanisms are measured against the twin goals of guaranteeing access to care and advancing economic equity. The added focus on the redistributive potential of health care financing recasts health reform as an economic policy intervention that can help fulfill broader economic and social rights obligations. Based on a review of recent universal health care reform efforts in the state of Vermont, this article reports on a rights-based public financing plan and model, which includes a new business tax directed against wage disparities. The modeling results suggest that a health system financed through equitable taxation could produce significant redistributive effects, thus increasing economic equity while generating sufficient funds to provide comprehensive health care as a universal public good.
卫生系统融资是确保全民医疗保健以及实现医疗服务获取和支付公平性的关键因素。人权框架为设计实现这些目标的融资战略提供了宝贵指导。本文介绍了美国医疗保健权运动所制定的基于权利的医疗保健融资方法。基于对私营的、市场化医疗保险的人权分析，倡导者主张通过累进税进行公共融资。融资机制依据保障医疗服务可及性和促进经济公平这两个双重目标来衡量。对医疗保健融资再分配潜力的额外关注，将医疗改革重塑为一种经济政策干预手段，有助于履行更广泛的经济和社会权利义务。基于对佛蒙特州近期全民医疗保健改革努力的回顾，本文报告了一项基于权利的公共融资计划和模式，其中包括一项针对工资差距的新营业税。模型结果表明，通过公平税收融资的卫生系统能够产生显著的再分配效应，从而在增加经济公平性的同时，筹集足够资金将全面医疗保健作为全民公益服务提供。
