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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
protect their population. As it is stated above the case of Africa is very complex and as the said

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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
International Monetary Fund (IMF), were designed with a strictly neoliberal economic view of

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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 Court held that this increase would not be

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

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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.
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.

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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