Arguing that health care should be a human right rather than a commodity, the distinguished contributors to this volume call for a new social covenant establishing a right to a standard of health care consistent with society's level of resources. By linking rights with limits, they offer a framework for seeking national consensus on a cost-conscious standard of universal medical care. The authors identify the policy implications of recognizing and implementing such a right and develop specific criteria to measure the success of health care reform from a human rights perspective.

Health Care Reform also offers specific and timely criticism of managed competition and its offspring, the Clinton plan for health care reform. Because health care reform will inevitably be an ongoing process of assessment and revision—especially since managed competition has not been implemented elsewhere—this book will last beyond the moment by providing vital standards to guide the future evolution of the health care system.

The last fifteen years have seen a tremendous growth in the number of health rights cases focusing on issues such as access to health services and essential medications. This volume examines the potential of litigation as a strategy to advance the right to health by holding governments accountable for these obligations. It includes case studies from Costa Rica, South Africa, India, Brazil, Argentina and Colombia, as well as chapters that address cross-cutting themes.

The authors analyze what types of services and interventions have been the subject of successful litigation and what remedies have been ordered by courts. Different chapters address the systemic impact of health litigation efforts, taking into account who benefits both directly and indirectly—and what the overall impacts on health equity are.

As members of various and often conflicting communities, how do we reconcile what we have come to understand as our human rights with our responsibilities toward one another? With the bright thread of individualism woven through the American psyche, where can our sense of duty toward others be found? What has happened to our love—even our concern—for our neighbor?

In this revised edition of his magisterial exploration of these critical questions, renowned ethicist Arthur Dyck revisits and profoundly hones his call for the moral bonds of community. In all areas of contemporary life, be it in business, politics, health care, religion—and even in family relationships—the "right" of individuals to consider themselves first has taken precedence over our responsibilities toward others. Dyck contends that we must recast the language of rights to take into account our once natural obligations to all the communities of which we are a part.

Rethinking Rights and Responsibilities, at the nexus of ethics, political theory, public policy, and law, traces how the peculiarly American formulations of the rights of the individual have assaulted our connections with, and responsibilities for, those around us. Dyck critically examines contemporary society and the relationship between responsibilities and rights, particularly as they are expressed in medicine and health care, to maintain that while indeed rights and responsibilities form the moral bonds of community, we must begin with the rudimentary task of taking better care of one another.

“I’m covered—why should I foot the bill for somebody who isn’t?”

This question, unspoken but simmering at the center of the debate over universal health care coverage, comes in for a thoughtful hearing—and, perhaps, gentle corrective—in Larry Churchill’s timely book. Churchill, whose Rationing Health Care in America put the nation’s health care crisis into perspective, here does the same for our crisis of conscience over health care coverage. As Clinton and Congress spar over the financing and organization of a national health system, the true debate, this book reveals, is about moral and political values, about the meaning and ethics of health care reform.

Churchill begins by cutting through the confused discussion about rationing health care. Concerns about rationing, with all the moral and political questions they raise, deflect our attention from a more important issue, which this book brings into focus. Arguing that care is already rationed by ability to pay, Churchill suggests that the proper question is not whether to ration but how to do so fairly, and that answering requires a clear sense of the aims of a health care system. In pursuit of this necessary understanding, Churchill explores values and concepts such as security and solidarity, self-interest and social affinity, rights and responsibilities. Drawing on philosophical ideas of justice and individual responsibility, rendered here with remarkable clarity, he shows that universal care is morally as well as economically comprehensible and that a truly inclusive health care system should be seen as a common civic purpose rather than as a supply of services to be consumed. Accessible, deeply felt, and cogently argued, this book should revise the terms of the national debate over health care reform.