Massachusetts Medical Society asserts health care is a basic human right

The MMS influences the AMA to follow suit

The Massachusetts Medical Society (MMS), behind the strength, influence and knowledge of its 25,000 members, took a historic and pivotal stance through adoption of organizational policy that asserts health care is a basic human right.

In May of this year, Massachusetts was the first state medical society in the nation to make the assertion that health care is a basic human right.  

While this policy can be rightfully characterized as unprecedented, it conforms with the medical society’s longstanding record of advocating for equal access to care and our organizational strategic priority of addressing social determinants of health that too often impede our patients’ access to care.

At our Annual Meeting in May 2019, the medical society’s House of Delegates, comprised of physicians and medical students, considered and accepted the resolution regarding health care as a basic human right, which was sponsored by the medical society’s presidential officers.

The new policy reads, “The Massachusetts Medical Society asserts that enjoyment of the highest attainable standard of health, in all its dimensions, including health care, is a basic human right. The provision of health care services, as well as optimizing the social determinants of health is an ethical obligation of a civilized society.”

The Massachusetts Medical Society’s credo includes the phrase “each patient counts,” and it is our unwavering belief that any human needing medical care – be it routine or lifesaving, scheduled or emergent – is a patient. If you are human, you are a patient.

We recognize that constructing the most effective strategies to provide health care coverage in the United States is an evolving process and will require careful evaluation, assessment, and modification. However, being born without access to positive social and economic opportunities should not be a lethal diagnosis, yet we know that marginalized individuals struggle to access even the most basic forms of health care.

Further, race, religion, gender, orientation, immigration status, age, financial status and health condition should not be a barrier to appropriate health care for any human being – for any of our patients.

The MMS’s influence on the national level: American Medical Association (AMA)

The medical society’s assertion was influential with the AMA, which, guided by the sentiment of the MMS resolution, also adopted policy declaring that health in all its dimensions is a basic human right. The AMA adopted this resolution – that health care in all its dimensions is a basic human right – at its annual meeting in June 2019.

How did the health care as a basic human right become organizational policy?

In November of 2018, the Massachusetts Medical Society’s officers and the organization’s Committee on Ethics, Grievances, and Professional Standards presented the Ethics Forum entitled “Health Care as a Basic Human Right.”

At the forum, Jennifer Prah Ruger, PhD, University of Pennsylvania; Audrey R. Chapman, PhD, University of Connecticut School of Medicine; and Carmel Shachar, JD, MPH, the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School explored domestic and international attitudes on health care as a basic human right, focusing on the implications of recognizing health care as a human right for the United States health care system.

The contents and perspectives offered during this lively and engaging discussion compelled the officers of the Massachusetts Medical Society to draft a resolution, which became this historic policy.

The case for recognizing health care as a basic human right:

• Presently, the United States is one of the only industrialized nations that doesn’t provide universal access to health care.

• In 1946, the World Health Organization (WHO) declared that the “enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being.” Health is defined by the WHO as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” The constitution of the WHO added that governments have a responsibility for the health of their peoples, which can be fulfilled only by the provision of adequate health and social measures.”

• United States citizens have a longstanding pattern of poorer health and are dying at younger ages than people in almost all other “peer” countries, including other high-income democracies in western Europe, as well as Canada, Australia, and Japan.

• The United States guarantees all citizens an education, access to fire and police services, a national postal service, protection by the military, a national park system, and many other federal- and state-funded services, but the country has not yet committed to ensuring that all its citizens have health care in its many dimensions.

• Social determinants of health (the conditions in which people are born, grow, live, learn, work, and age that affect a wide range of health and quality-of-life outcomes and risks) are widely recognized as a primary approach to reducing health disparities and have become a public health focus at the global, national, state, and local levels, and an organizational priority for the Massachusetts Medical Society.
• Numerous studies in recent decades have demonstrated the significant role non-medical factors play in physical and mental health.
• Food insecurity, for example, is associated with increased risk for diseases and conditions like diabetes, hypertension, and depression in adults, and with increased risk for impaired brain development, hospitalizations, iron-deficiency anemia, mental health, and behavioral disorders in children.

• Housing insecurity and homelessness are related to poorer physical health, including higher rates of tuberculosis, hypertension, asthma, diabetes, and HIV/AIDS and higher rates of medical hospitalizations.

• Social determinants of health play a key role in health outcomes and health disparities, and that addressing the social determinants of health for patients and communities is critical to the health of our patients, our communities, and a sustainable, effective health care system.

How will this policy inform future Massachusetts Medical Society actions, initiatives, and advocacy?

• The medical society will use the declaration that health care is a basic human right as a principal to guide its work in the areas of patient and physician advocacy and education, and practice management support.
• The core principles to guide the envisioned future reforms and goals of health care have not been clearly stated. We believe the notion that health care is a basic human right should be the primary principal to guide that envisioned future.

• Strategies to address future health care reforms and goals cannot be accomplished without stating and acknowledging the principles that will serve as the compass by which decisions will be made.

• Physicians and medical societies should define the principles upon which health care reforms and goals are structured, and they should speak with a single voice and acknowledge that health is a basic right for every person in a just society.