Access to healthcare - as fundamental right or a privilege? (ჯანდაცვაზე ხელმისაწვდომობა, როგორც ფუნდამენტური უფლება თუ პრივილეგია?)

Understanding health as a human right creates a legal obligation on government to ensure access to timely, acceptable, and affordable health care of appropriate quality. Health and health care can not be considered only as a personal responsibility, because due to its socio-economic nature, the demand for it is often not only individual, but also social (“public goods” in the medical market) and requires the consolidation of consumers funds. Peculiarities of the medical market, such as risks and uncertainty, incomplete information, limited competition, external effects, production of public good, lead to special forms of economic relations in the medical market, which require the development of appropriate regulatory mechanisms. In European countries, where financing of health care is completely divorced from actuarial principles, the individual’s financial contribution to health does not depend on his or her health risk. Consequently, there is a universal healthcare principle that covers the entire population, where every citizen has the right of access to health services, which promotes solidarity between them. Employment, education and income are important factors influencing access to medical care. Some people have low access to health services due to various factors. The question arises as to whether the intervention necessary to assist them in obtaining such access should be considered a privilege, or a right. Viewing health care as a human service is not only done for humanistic and ethical reasons; it may also be done for pragmatic reasons. Other countries provide health care as a basic human right for utilitarian reasons. That is, universal access is provided not only because it benefits the individual but because it benefits the society by helping to ensure a productive workforce and promotes solidarity among its citizens. Thus, it has been determined by natural laws, and natural rights that human beings have the right, not the privilege, to healthcare access.
 Arendt H. (1958.) The Human Condition Chicago: University of Chicago Press;  Aristotle (2005.) The Soul. Edited by: Smith JA. Whitefish: Kessinger Publishing;  Barnett JC., Vornovitsky MS., Davis KE. et al. (2015.) Health Insurance Coverage in the United States: 2016/demo/p60-257 pdf. Published September 2016.  Bodenheimer T. (2005.) The Political Divide In Health Care: A Liberal Perspective, Health Affairs, 24, no.6 1426-1435  Community Voices. Nation’s Health Care System Ill, Survey Finds. 13 January 2004,  Constitution of the World Health Organization. Geneva: World Health Organization. 1948.  Davis K., Stremikis K., Squires D., et al. (2014.) Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally. http:// jun/mirror-mirror Published June 16  gaeros generaluri asamblea, ekonomikuri, sotsialuri da kulturuli uplebebis saertashoriso pakti [UN General Assembly, International Covenant on Economic, Social and Cultural Rights (December 16, 1966, entered into force on January 3, 1976).] in Georgian.  Hobbes Th. (2014.) leviatani. tsignshi „shesavali tanamedrove azrovnebashi“. [Leviathan. In the Book “Introduction to Modern Thought”. Book I. Ilia State University Publishing House. Tbilisi.] in Georgian.  Human Rights: A Basic Handbook for UN Staff. Office of the High Commissioner for Human Rights, United Nations Staff College Project. 1999.  Isaacs S.L., Schroeder S.A. Class (2004) - the Ignored Determinant of the Nation’s Health. New England Journal of Medicine, 351, no. 11 1137–1142;  Kinney D. (2001.) The International Human Right to Health: What does This Mean for Our Nation And World ? Indiana Law Review, Vol. 34, page 1465,  Pacem in Terris. Encyclical of Pope John XXIII on Establishing Universal Peace in Truth, Justice, Charity, and Liberty. April 11, 1963. Libreria Editrice Vaticana.  Paine T. (1999) Rights of Man. In Rights of Man Mineola: Dover Publications; 7-64.  Rawls J. (1999.)A Theory of Justice Cambridge: Harvard University Press;  San Giorgi M. (2012.) The Human Right to Equal Access to Health Care. Erasmus MC: University Medical Center Rotterdam. Retrieved from http://hdl.handle. net/1765/32474  Squires D, Anderson C. (2015.) U.S. Health Care from a Global Perspective: Spending, Use of Services, Prices, and Health in 13 Countries. The Commonwealth Fund, from-a-global-perspective.  Talyor AE. (1955.) Aristotle Toronto: Dover Publications;  Tocqueville A. (2000.) Democracy in America. Chicago: University of Chicago Press.  Verulava T. (2016.) jandatsvis politika [Health Policy. Tbilisi: Ilia State University Publishing House.] in Georgian.  Verulava T. (2017.) jandatsvis sistemis repormebi USA-shi individualizmi da universalizmi. [Healthcare System Reforms in the US Individualism and Universalism. Economist. XIII (4): 142-154.] in Georgian.  Verulava T. (2017.) sameditsino bazari: arsi, spetsipika, stimulebi. [Medical Market: Essence, Specifics, Incentives. Economics and Business. 10 (4): 73-90.] in Georgian.  Verulava T. (2018.) jandatsvis sistemis repormis taviseburebebi USA-shi. [Peculiarities of Nealth Care Reform in the USA. Issues of American Studies VII. Ivane Javakhishvili Tbilisi State University, Institute of American Studies. 7: 331-337.] in Georgian.  Verulava T. (2019.) janmrtelobis kapitali - ekonomikis mdgradi ganvitarebis paktori. [Health Capital - a Factor in the Sustainable Development of the Economy. Economics and Business. 11 (1).] in Georgian.  Verulava T., Gabuldani M. (2015.) Accessibility of Urgent Neurosurgery Diseases by the State Universal Healthcare Program in Georgia (country). Gazi Medical Journal, 26 (2): 42-45.  Verulava T., Jorbenadze R., Dagadze, B., Eliava, E. (2018.) Access to Ambulatory Medicines for the Elderly in Georgia. Home Health Care Management & Practice  Vienna Declaration and Programme of Action. Adopted by the World Conference on Human Rights in Vienna on 25 June 1993. The World Conference on Human Rights. Office of the High Commissioner for Human Rights, United Nations.  Vladeck BC. (2014.) Paradigm lost: Provider Concentration and the Failure of Market Theory. Health Aff. 33:1083–1087.  World Health Organization. Primary Health Care. International Conference on Primary Health Care. Alma-Ata, USSR, 6-12 September, 197.
Healthcare, human rights, healthcare right, universal healthcare
Economics and Business, №4, 2020, pp. 113-129