See attached refereces as well
PBL ASSIGNMENT
Prepare a document that answers the questions below. Use and cite at least two sources for each answer and explain why you found that information trustworthy:
1. What is the size of the US healthcare system? 
2. What proportion or percentage of GDP does it make up?
3. What proportion of that expenditure is by the government (federal, state or local)?
4. How does the US Healthcare system rank in comparison to other countries in health outcomes?
5. Who is not covered, poorly covered or bankrupted by the current system and why?
6. Which of the highest-paid CEOs in US businesses are involved in healthcare or related industries (insurance, pharmaceuticals, etc).
Find an image of the complexity of the healthcare system in the US.
Theor Med Bioeth (2016) 37:365–382
DOI 10.1007/s11017-016-9372-x
The place of human rights and the common good
in global health policy
John Tasioulas1 • Effy Vayena2
Published online: 1 August 2016
The Author(s) 2016. This article is published with open access at Springerlink.com
Abstract This article offers an integrated account of two strands of global health
justice: health-related human rights and health-related common goods. After
sketching a general understanding of the nature of human rights, it proceeds to
explain both how individual human rights are to be individuated and the content of
their associated obligations specified. With respect to both issues, the human right to
health is taken as the primary illustration. It is argued that (1) the individuation of
the right to health is fixed by reference to the subject matter of its corresponding
obligations, and not by the interests it serves, and (2) the specification of the content
of that right must be properly responsive to thresholds of possibility and burden. The
article concludes by insisting that human rights cannot constitute the whole of
global health justice and that, in addition, other considerations—including the
promotion of health-related global public goods—should also shape such policy.
Moreover, the relationship between human rights and common goods should not be
conceived as mutually exclusive. On the contrary, there sometimes exists an individual right to some aspect of a common good, including a right to benefit from
health-related common goods such as programmes for securing herd immunity from
diphtheria.

of genuinely universal human interests are capable of generating duties on the part
of others in the case of all human beings, simply in virtue of their humanity.
Moreover, essential to the rights-generative role of human interests is that they
belong to distinct individuals with equal moral status in virtue of their humanity: the
5
This need not be an inevitable consequence of legalization; cf. the South African Constitutional Court’s
decision in Soobramoney v. Minister of Health (Kwazulu-Natal) (1997), where it was held that provision
of dialysis for a patient with chronic renal failure was not required by the constitutional right to health,
partly because this would prejudice the satisfaction of other health needs that have to be met out of the
state’s budget [15].
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370
J. Tasioulas, E. Vayena
status of human dignity. This is central to explaining the resistance of human rights
to trade-offs both against other rights and against non-rights based considerations.6
The pluralistic theory of human rights claims not only that a plurality of interests
is relevant to the justification of human rights generally but also that any given
individual human right is typically grounded in a plurality of interests, such as
autonomy, health, knowledge, friendship, accomplishment, play, etc. [17]. The right
not to be tortured, for example, is grounded not only in one’s interest in autonomy
but also in one’s interest in being free from pain and in being able to form intimate
and trusting relationships. This is also true of the human right to health: it serves not
only one’s interest in health but also various other interests that enjoying good
health can enable one to realize, such as making friends, acquiring understanding, or
accomplishing something with one’s life. Indeed, the right to health may even
include entitlements to medical services, such as non-therapeutic abortions or
cosmetic surgery, that are not primarily intended to serve the health interests of the
right-holder. Hence, a diversity of interests helps to justify the existence of a human
right to health and to shape its associated obligations.
One way to fall into the trap of assuming that the human right to health is
grounded exclusively in our interest in health is to adopt an unduly expansive
interpretation of health. This is precisely what the WHO did in the preamble to its
constitution, which notoriously states that ‘health is a state of complete physical,
mental and social well-being and not merely the absence of disease and infirmity’
[20]. But, as has been repeatedly shown, this definition is far too broad. Health, on
any remotely useful understanding, is one element of wellbeing among others, not
the whole of it. And this remains the case even though health bears pervasive
constitutive and instrumental relations to the other elements of wellbeing. For the
purposes of this article, we take health to be centrally concerned with the effective
functioning of standard human physical and mental capacities [21]. A person can
enjoy such functioning even when they are deficient in other elements of wellbeing,
such as accomplishment and enjoyment. Moreover, they may even reasonably put
their health at risk in order better to achieve some other aspect of wellbeing.
There is a further crucial point worth making about the individuation of the
human right to health. Although many familiar human rights serve our interest in
health in all sorts of important ways, this does not automatically render them
components of the general human right to health. Yet, such an overly inclusive
interpretation of the right to health has been advocated by the Committee on
Economic, Social, and Cultural Rights, in its influential General Comment 14, as
well as by other UN organs and leading global health scholars [22]. So, for example,
Gostin notes that General Comment 14 treats as ‘integral components of the right to
health’ entitlements to food, housing, life, education, privacy, and access to
information. Gostin himself suggests that this specification is probably too
‘constrained’ and should be widened to include ‘gender equality, employment,
and social inclusion’ [2, p. 257]. This inclusive approach is echoed, and perhaps
taken even further, in a ‘Fact Sheet’ on the right to health jointly produced by the
WHO and the Office of the UN High Commissioner for Human Rights. According
6
For agency and needs-based accounts of human rights, see [11, 19].
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The place of human rights and the common good in global…
371
to this document, the human right to health incorporates a slew of other rights,
including gender equality and freedom from torture and other cruel, inhuman, or
degrading treatment or punishment [23, p. 3]. By a process parallel to the WHO’s
inflation of the notion of health to embrace all of human well-being, such
interpretations appear to absorb within the human right to health all the rights that
bear positively on our interest in health. Indeed, on this radically ‘inclusive’
approach, it is an open question, whether there is any right in the Universal
Declaration of Human Rights, or in any of the two leading Conventions on Human
Rights, which cannot be subsumed within the right to health, at least insofar as they
involve duties that serve the right-holder’s interest in health. After all, a colourable
story can be told of how denial of the rights to citizenship, political participation, a
fair trial, freedom of speech, religion, movement, and association, among others,
can have a seriously detrimental impact on health.
Now, something is clearly awry if the human right to health is lumbered with
such a bloated interpretation.7 The mistake is to individuate the scope of the right
simply by reference to whether a putative rights-based duty is justified, in part, by
whether it serves a person’s interest in health. Many, if not most, human rights serve
a person’s interest in health, and this is because they serve a multiplicity of interests,
including health. Consider, for example, the fact that improvements in adult
women’s education accounted for 40 % of the reduction in mortality between 1960
and 1990, although the steps taken to enhance educational provision are not
obviously ‘health care’ measures [24, p. 94]. However, a human right is not picked
out straightforwardly by the profile of interests it serves but, we claim, by reference
to the subject matter of the obligations it generates.