The right to health: The next American dream

Abstract

The American Dream is a strongly held notion that permeates the American psyche. The subtext of the dream is the assumption of equal opportunity for education and the subsequent career opportunities that presumably follow. Assuming equality of opportunity (a large assumption indeed), potential success is based on individual talent and effort resulting in part in the development of the individualistic societal norms of the 'self-made man,' 'every man for himself,' and 'rugged individualism' ideologies that are predominant in the US today. The archetype of the American Dream is the self-made man who, through will and determination gains an education, career success, and material wealth exemplified by home ownership. Human rights language would refer to these as the right to education, work, property, and housing. US constitutional law strongly protects civil and political rights. US federal law has even come to protect some economic, social, and cultural rights such as education as part and parcel of the American Dream. Until the 2010 passage of the Patient Protection and Affordable Care Act (ACA), the right to health has for the most part been excluded from both the notion of the American Dream as well as protection under US federal law. This chapter provides an overview of the historical development of the American Dream, an examination of global health models, and the U.S. model more specifically. It also explores the ACA and the 2012 US Supreme Court ruling as it relates to the international conceptualization of the human right to health, specifically focusing on the human rights principles of accessibility and nondiscrimination and how the ACA may contribute to an expanded notion of the American Dream including the right to health.