The Patient Protection and Affordable Care Act,Public Health,and the Elusive Target of Human Rights

Patient Protections and Affordable Care Act, P.L. 111–148 (signed signed into law March 23, 2010).

Id., at §§ 1501, 1502.

Id., at § 4002.

Id., at § 4003.

Id., at § 4205.

Id., at §§ 2601, 2704–2707, 3126, 4206, 4306, 5304, 5507, 6112, 6114, 10504.

Gostin L. O. , “Restoring Health to Health Reform: Integrating Medicine and Public Health to Advance the Population's Wellbeing,” Pennsylvania Law Review (forthcoming 2011).

Copeland C. W. , “Rulemaking Requirements and Authorities in the Patient Protection and Affordable Care Act (PPACA),” Congressional Research Service, Report R41180 (Feb. 18, 2011).

See, generally, Quadagno J. , One Nation, Uninsured (New York: Oxford University Press, 2005)

Starr P. , The Social Transformation of American Medicine (New York: Basic Books, 1982).

Id.

Skocpol T. Seliger Keenan P. , “Cross Pressures: The Contemporary Politics of Health Reform,” in Mechanic D. , eds., Policy Challenges in Modern Health Care (Piscataway, NJ: Rutgers University Press 2005): At 27.

P.L. 104–191 (1996).

P.L. 105–33 (1997).

P.L. 108–173 (2003).

Report by the Assistant Secretary for Planning and Evaluation for Health and Human Services, Effects of Health Care Spending on the U.S. Economy (2005), available at <http://aspe.hhs.gov/health/costgrowth/report.pdf> (last visited July 8, 2011) (“Since 1998, health care spending has increased at faster rate of growth than has gross domestic product [GDP], inflation, and population”).

Anderson G. F. Frogner B. K. , “Health Spending In OECD Countries: Obtaining Value Per Dollar,” Health Affairs 27, no. 6 (2008): 1718–1727

Centers for Medicare and Medicaid Services, National Health Expenditures, 2007, Office of the Actuary, National Health Statistics Group (2007)

Organisation for Economic Co-operation and Development (OECD), OECD Health Data 2009: Statistics and Indicators for 30 Countries (2009).

WHO, World Health Statistics 2009 (2009).

The Commonwealth Fund Commission on a High Performance Health System, Why Not the Best? Results from the National Scorecard on U.S. Health System Performance (2008).

Kulkarni S. C. , “Falling Behind: Life Expectancy in U.S. Counties from 2000 to 2007 in an International Context,” Population Health Metrics 9, no. 16 (forthcoming 2011).

U.S. Census Bureau, Current Population Survey, 2008 and 2009 Annual Social and Economic Supplements (2009).

Cohn J. , Sick: The Untold Story of America's Health Care Crisis – and the People Who Pay the Price (New York: Harper Collins Publishers, 2007).

Commonwealth Fund, Exhibits: The Health Insurance Provisions of the 2009 Congressional Health Reform Bills: Implications for Coverage, Affordability, and Costs (2009), available at <http://www.commonwealthfund.org/∼/media/Files/Publications/Fund%20Report/2010/Jan/Coverage%20Report/PDF_Collins_cong_bills_coverage_report_172010_exhibits.pdf> (last visited June 27, 2011).

See PPACA, supra note 1.

Senator Harkin made a particularly strong appeal for the passage of the ACA citing the many benefits to public health, and even claiming the Bill would create a “right to health” during the senate floor debate on December 21, 2009. 155 Cong. Rec. S13661 (daily ed. Dec. 21, 2009)

(statement of Sen. Harkin). However, during that day's debate, there are only seven references to “public health”, 21 references to “wellness”, 0 references to “population health”, and an overwhelming 266 references to “insurance” (30 of which to insurance companies) throughout the day's speakers. Id., at 13661–13695. This pattern is repeated throughout the debate materials.

Eggan D. , “‘Single-Payer’ Supporters Challenge Democrats,” Washington Post, June 6, 2009, available at <http://www.washingtonpost.com/wp-dyn/content/article/2009/06/05/AR2009060503518_2.html?sid=ST2009060504116> (last visited July 8, 2011).

Stolberg S. G. , “Public Option in Health Plan May be Dropped,” New York Times, August 16, 2009, available at <http://www.nytimes.com/2009/08/17/health/policy/17talkshows.html> (last visited July 8, 2011).

Obama B. , “Remarks by the President to a Joint Session of Congress on Health Care,” 2009, available at <http://www.whitehouse.gov/the_press_office/Remarks-by-the-President-to-a-Joint-Session-of-Congress-on-Health-Care/> (last visited June 28, 2011).

Id.

Yamin A. E. , “The Right to Health Under International Law and Its Relevance to the United States,” American Journal of Public Health 95, no. 7 1156–1161 (2005): 1156–1161.

Alston P. , “Putting Economic, Social, and Cultural Rights Back on the Agenda in the United States,” in Schultz W. F. , ed., The Future of Human Rights (Philadelphia: University of Pennsylvania Press, 2008).

Lewis H. , “‘New’ Human Rights: U.S. Ambivalence toward the International Economic and Social Rights Framework,” in Soohoo C. Albisa C. Davis M. , eds., Bringing Human Rights Home (Westport, Connecticut: Praeger, 2009).

Koh H. H. Sebelius K. G. , “Promoting Prevention through the Affordable Care Act,” New England Journal of Medicine 363, no. 14 (2010): 1296–1299.

42 U.S.C. 300u-10 (2011).

Department of Health and Human Services, National Prevention Strategy (2011), available at <http://www.healthcare.gov/center/councils/nphpphc/strategy/report.pdf> (last visited July 8, 2011).

42 U.S.C. 300u-11 (2011).

P.L. 111–148, § 6302.

Id., at § 2601.

Id., at §§ 10503, 4101, 4201.

Id., at § 4004.

Id., at §§ 1002, 1103.

Id., at §§ 3507, 5507.

Id., at § 4205.

Id., at §§ 4103, 4106.

Id., at § 1001.

See 42 U.S.C. 280g-10, 300u-12.

Shearer G. , APHA Issue Brief – Prevention Provisions in the Affordable Care Act (October 2010), available at <http://www.apha.org/NR/rdonlyres/763D7507–2CC3–4828-AF84–1010EA1304A4/0/FinalPreventionACAWeb.pdf> (last visited July 8, 2011).

P.L. 111–148, §§ 1101, 1201 (Amending PHSA § 2704), § 1001 (Amending PHSA §§ 2711, 2712).

Id., at § 1501 (Amending IRC § 5000A).

Id., at § 1513 (Amending IRC § 4980H).

See Hall M. A. , “Commerce Clause Challenges to Health Care Reform,” Pennsylvania Law Review 159, no. 6 (2011): 1825–1872 (arguing that the individual mandate is valid constitutionally)

Barnett R. E. , “Commandeering the People: Why the Individual Health Insurance Mandate Is Unconstitutional,” New York University Journal of Law & Liberty 5, no. 3 (2010): 581–637 (making the counter argument).

P.L. 111–148, § 1401 (Amending I.R.C. § 36B).

Id., at § 1311.

Id., at § 1201, Amending PHSA § 2707, minimum set by § 1302(a).

Id., at §§ 2001, 3301, 1333.

See Virginia ex rel. Cuccinelli v. Sebelius, 728 F. Supp.2d 768 (holding the individual mandate exceeded congressional scope under the commerce clause)

Florida ex rel. Bondi v. Dept. Health and Human Services, — F.Supp.2d —, 2011 WL 285683 N.D.Fla., 2011 (finding same and declaring the entire statute unconstitutional).

Chandra A. , “The Importance of the Individual Mandate – Evidence from Massachusetts,” New England Journal of Medicine 364, no. 4 (2011): 293–295.

Oberlander J. , “Throwing Darts: Americans' Elusive Search for Health Care Cost Control,” Journal of Health Politics, Policy & Law 36, no. 3 (2011): 477–484.

P.L. 111–148, §§ 1104, 1413.

Id., at § 9001 (Amending IRC § 1513).

See Oberlander , supra note 57.

P.L. 111–148, § 3022, supra note 5.

Id., at § 3403 (Amending SSA § 1899A).

American Medical Association, “News: AMA Physicians Send a Message to Congress: Stop Medicare Meltdown,” June 13, 2010, available at <http://www.ama-assn.org/ama/pub/news/news/white-coat-release.page?> (last visited July 7, 2011).

See discussion supra of “Health Care Reform in the United States: The Perennial Struggle for Common Ground.”

See Yamin , supra note 29

Kinney E. D. , “Recognition of the International Human Right to Health and Health Care in the United States,” Rutgers Law Review 60, no. 2 (2008): 335–379

Mann J. , “Health and Human Rights,” Health & Human Rights 7 no. 1 (1994): 6–23.

World Health Organization, The Constitution of the World Health Organization (1948).

Henkin L. , The Age of Rights (New York: Columbia University Press, 1990).

Henkin L. , How Nations Behave (New York: Columbia University Press, 1979).

United Nations General Assembly, Universal Declaration of Human Rights, 10 December 1948, 217 A (III), available at <http://www.unhcr.org/refworld/docid/3ae6b3712c.html> (last visited July 7, 2011).

International Covenant on Economic, Social and Cultural Rights, adopted by General Assembly resolution 2200A (XXI) of December 16, 1966, available at <http://www2.ohchr.org/english/law/pdf/cescr.pdf> (last visited June 28, 2011).

U.N. Committee on Economic, Social and Cultural Rights, The Right to the Highest Attainable Standard of Health, CESCR General Comment 14. 22d Sess., Agenda Item 3, U.N. Doc. E/C.12/2000/4. 2000 [hereinafter GC 14].

Id., at para. 11.

Id., at paras. 53–56.

Id., at para. 34.

Id., at para. 35.

Id., at paras. 36–37.

Id., at para. 12.

Id.

Id.

Id.

Gable L. , “The Proliferation of Human Rights in Global Health Governance,” Journal of Law, Medicine & Ethics 35, no. 3 (2007): 534–544.

U.N. Report of the Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health (2008),

Human Rights Council, 7th session, Agenda item 3, at 12, UN doc. A/HRC/7/11, January 31, 2008, at 12 [hereinafter “Special Rapporteur Health Systems Report”].

See WHO, Everybody's Business: Strengthening Health Systems to Improve Health Outcomes (2007), available at <http://who.int/healthsystems/strategy/everbodys_business.pdf> (last visited July 8, 2011).

Backman G. Hunt P. Kholsa R. Jaramilla-Strouss C. Mikuria Fikre B. Rumble C. , “Health Systems and the Right to Health: An Assessment of 194 Countries,” The Lancet 372, no. 9655 (2008): 2047–2085

Hunt P. Backman G. , “Health Systems and the Right to the Highest Attainable Standard of Health,” Health and Human Rights 10, no. 1 (2008): 81–92.

42 U.S.C. 300u-11 (2011).

P.L. 111–148, § 2601.

Id., at § 6302.

Id., at §§ 10503, 4101, 4201.

Id., at, § 4004.

Id., at §§ 1002, 1103, 3507, 4205, 5507.

Id., at §§ 4103, 4106.

Id., at § 1001.

See Shearer , supra note 46.

See Special Rapporteur Health Systems Report, para. 63 (stating that “often legitimate but competing claims aris[e] from the same human right”).

GC 14, at para. 19.

P.L. 111–148, §§ 1101, 1201 (Amending PHSA § 2704), § 1001 (Amending PHSA §§ 2711, 2712).

GC 14, para. 35.

Id., at para. 12.

P.L. 111–148, §§ 1501 (Amending IRC § 5000A), § 1513 (Amending IRC § 4980H).

Id., at §1401 (Amending I.R.C. §36B).

Id., at § 1311.

Id., at § 1201, Amending PHSA § 2707, minimum set by § 1302(a).

Special Rapporteur Health Systems Report, para 52.

P.L. 111–148, § 1303 (42 USC 18023).

Id., at §§ 2001, 3301, 1333.

Id., at §§ 1104, 1413.

Id., at § 9001 (Amending IRC § 1513).

Id., at §§ 3022, 3403.

Id., at § 3403 (Amending SSA § 1899A).

Id., at §§ 1104, 1413.