MICHIGAN EFFORT TO ESTABLISH THE RIGHT TO HEALTH CARE

(Sorry, we hope to put a link in soon to take you to the original website for this work. The following is the Press Release they have released.)

    In Michigan there are approximately 750,000 people without health insurance. The number of clinics to handle primary care for this popu- lation is inadequate. For instance in Detroit, where 180,000 of the uninsured live, the clinics can care for less than 1/3d of that number. As a result many uninsured do not get primary care and end up in the emergency room where they receive expensive care at the hospital which could have been avoided had there been primary care. This burden has caused hospitals in Detroit to threaten to close.

    Download or view a powerpoint slide show about the work in Michigan to enforce the public's "Right to Health Care".

    The state government in the past 25 years has closed two facilities in Detroit;

    set up managed care capitation systems for Medicaid and unde- funded them (the lowest funded capitation rate in the USA) which resulted in bankruptcies for three HMO?s and substantial losses to providers;

    revoked or ignored a planning process which was to provide a plan to give access to health care to all;

    failed to fulfill a promise to the federal government to provide preventive care to children;

    and rescinded a law that tied Medicaid rates to Medicare rates. These actions have resulted in destabilizing the health care delivery system and in worse, or in some cases no, access to health care.

LEGAL ARGUMENT

    The Michigan Constitution provides that the public health of the people is a matter ? . . . of primary public concern.? Art. 4; Sec. 51. That section goes on to require the state legislature to pass laws for the protection and promotion of ?public health."  Other states have interpreted similar language as providing some rights to the uninsured, or ?indigent.? (NC; KS: and NY)

    The minutes of the Michigan Constitutional Convention say that the provision is to enable the legislature to act on health related issues, but also includes the following;

    Every citizen of Michigan is entitled to good health . . . Good health can be considered a right . . . Speech by delegate Madar.

    The speech went on to recommend that public health departments should be established in every county because counties without such departments ?. . . are being denied the same right to better health enjoyed by the majority of Michigan citizens.?

    The Equal Protection Clause of the State?s Constitution declares that ?. . . no person shall be denied the enjoyment of his civil or political rights. . .? Art. I; Sec. 2.

    If Art.4; Sec 51 creates a civil right to health care, Art I; Sec 2 says that right cannot be violated.  Hundreds of thousands of Michi- ganians have no access to health care.  If the legal analysis is accu- rate, their rights are being violated daily.

    In 1978 a statute was passed requiring the state to develop a plan to provide ?. . . adequate access to health care for all segments of the state?s population . . .? MCL 325.2001.  By Executive Order the duty to provide such a plan rests in the Department of Community Health. PROPOSED ACTION     We at Michigan Legal Services propose filing a lawsuit in Ingham County based on the three provisions of the law mentioned above. (There is other support for the notion that the State has historically seen health care as a right such as laws that require counties to take care of the ?indigent? and the general notion, which does not appear in the law, that Blue Cross is the ?insurer of last resort?.)

    The idea would be to get a court declaration that health care access is a civil right for all of Michigan. Further, the court would be asked to order the state to establish a plan that would grant such universal access within a reasonable time frame. (The statute cited has a 3 year plan as its basis, but provides for revisions of the plan every three years as well.) The plan could be converted to a court order and enforced by the court.

    Defendants would be the State, the Governor, and the Director of the Department of Community Health. Plaintiffs already committed to the case are the Michigan Universal Health Care Access Network and the Westside Mothers, a welfare rights organization.

    We are seeking and believe we will find individual plaintiffs, but we also need organizational plaintiffs for financial support; media work; providing individual plaintiffs; and other support. Having other lawyers on the case would also be helpful.

    Besides three individual plaintiffs the Michigan Universal Health Care Access Network ? a coalition of labor, faith based, and pro- fessional and consumer groups; the Westside Mothers; Oakland County Welfare Rights Organization; and the Gray Panthers of Metro Detroit have already agreed to be plaintiffs.