Can We Measure The Right To Health?
Friday, 20 February 2009 00:00
The proficiency of national health systems is linked closely to the availability of local resources, which maybe allocated to the healthcare systems. This relationship is even more critical today due to the financial uncertainties as a result of the global economic crisis. Stakeholders and policy makers are required to make decisions regarding the increasing unemployment rates and the decrease in the Gross Domestic Product (GDP) and related ratio GDP/DD (Domestic Debt). As a result they are sometimes forced to divert funding to sustain employment rather than maintain or improve public health. On the other hand, the increasing rate of unemployment results in a decrease in the contribution to the budget, which would normally cover the desired or needed investments in health care. Also in the last decades the increase in demand on the services provided by the local national health services due to the ageing population has produced stresses in the financial capacity of national budgets dedicated to healthcare. In fact, according to a recent WHO publication, health systems in many countries are failing and collapsing; too many healthcare systems are inequitable, regressive, and unsafe (WHO. Everybody’s business: strengthening health systems to improve health outcomes: WHO’s framework for action. Geneva:World Health Organization, 2007).
Evaluation of the inequalities and the panorama of health systems in Europe has raised several very serious questions:
• What is the standard health system?
or rather rephrasing the comments by the COMMITTEE ON ECONOMIC, SOCIAL AND CULTURAL RIGHTS - CESCR (in the Twenty-second session Geneva, 25 April-12 May 2000 Agenda item 3 The right to the highest attainable standard of health : . 11/08/2000. E/C.12/2000/4. (General Comments)
• How can the right to the highest attainable standard of health be measured?
To better understand the two questions see the article 12 of the general Comment of CESCR below:
The article 12 of the International Covenant on Economic, Social and Cultural Rights
• Which one are the underlying determinants of health?
• How should adequate health facilities, goods, and services be measured: Accessibility? Affordability? Acceptability? Quality?
To these general questions, others follow as a consequence, e.g.
• How high should the amount of investment on health be in comparison to the GNP?
• What criteria can be followed to understand inequalities, barriers, and levels of satisfaction?
It is critical to open discussion on this matter and to refer to other articles of this and the next issues of this web site for greater understanding.
Rodolfo Paoletti, 20 February 2009
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