Peace and Justice - Fr. Benjamin J. Urmston

Peace and Justice - Human Rights in Catholic Thought

Human Rights in Catholic and Universal Thought

Discussions of human rights can appear abstruse and abstract, but writers of various philosophies and religions have agreed on the right to life and listen to fundamental pleas for ordinary means to live a decent life. Human rights can unite us and move us forward. The Universal Declaration of Human Rights crafted by the United Nations shows that all cultures can agree on basics. Since world law can be a force for peace, refinement of human rights is worth our study and reflection.

In the Oct. 31st, 2005 issue of the national Jesuit magazine America Fr. David Hollenbach, Director of the Center for Human rights and international Justice, Flatley Professor of Theology at Boston College, author of The Global Face of Public Faith: Politics, Human Rights, and Christian Ethics describes how the new Compendium of the Social Doctrine of the Church "affirms the Catholic Church's commitment to human rights as moral standards to which all nations and cultures should be held accountable. . we are a new creation in Christ. The church's work in support of human rights is essentially connected to its mission to proclaim the Gospel. Human rights, the vocation of every Christian and the mission of the church are inseparable. . . Commitment to equal worth for all human persons calls forth a special concern for the poor and the marginalized. All have the right to basic necessities, such as food, housing, just wages and adequate social security (Nos. 301 and 365)."

As the five fingers of my hand work as a unit as I grasp the steering wheel of a car, so the five main structures outlined on this web-page work together. Basic human rights lead to peace.

Pope Benedict XVI, Jan. 1, 2006:

4. "Peace appears as a heavenly gift and a divine grace which demands at every level the exercise of the highest responsibility: that of conforming human history-in truth, justice, freedom and love-to the divine order. Whenever there is a loss of fidelity to the transcendent order, and a loss of respect for that 'grammar' of dialogue which is the universal moral law written on human hearts, whenever the integral development of the person and the protection of his fundamental rights are hindered or denied, whenever countless people are forced to endure intolerable injustices and inequalities, how can we hope that the good of peace will be realized? The essential elements which make up the truth of that good are missing. St. Augustine described peace as tranquillitas ordinis: the tranquility of order."

6. Everyone should feel committed to service to the great good of peace. All people are members of one and the same family. An extreme exaltation of differences clashes with this fundamental truth. We share a common destiny.

Not once in Pope John XXIII's 1963 Peace on Earth does he mention the just war theory. His theology of peace is based on the moral law, the order laid down by God. "Every human person has rights and duties flowing directly from his nature as intelligent and free. Human rights are universal, inviolable and inalienable. .Every person has the right to life and to the means necessary for the proper development of life. These means are primarily food, clothing, shelter, rest, and medical care."(9, 11).

Human Rights

Natural human rights are pleas to one another for our basic material, emotional, intellectual and spiritual needs. God did not create us to be essentially frustrated but to work together toward not a perfect world, but a better one.

We don't expect a student to study without books or in today's world without computers. Morally we can't expect a person to grow in union with God, her/his neighbor and the earth without the means, food, shelter, health care, education, employment, and a healthy environment.

International meetings of the Society of Jesus urge Jesuits to recognize and respect the rights of all and work actively to secure those rights. (No. 18 of Decree Four, Thirty-second General Congregation; Thirty-fourth General Congregation, Decree Three, no.6)

From a religious and philosophical point of view I believe each human person is created in the image and likeness of God. Each human person has dignity, value, and worth. We are free, intelligent, social human persons, able to understand and be understood, able to love and be loved.

We are able to have good and just relationships with God, with each member of our human family, with animals, and with physical creation. We are able to reflect and freely choose our friends, our church, and our work. We are able to take responsibility for our choices.

To grow as human persons and in our relationship with God, our neighbor, and with physical creation, we have the right to the means necessary to be fully human and achieve our vocation. We wouldn't expect a baseball player to go to the plate without a bat. We don't expect students to study without books or computers.

Human rights spring from creation in the image and likeness of God and from our human nature. Since the state does not give us human rights, the state cannot morally take away the exercise of our human rights. Natural rights exist before the state, against the tyranny of the state, and between states. Economic or military might does not make right! We have the moral obligation as individuals and as a society to insist on our own basic rights and to promote the rights of each human person and of each nation.

On the other hand, it is the function of the state to try to insure the exercise of basic human rights. As was done with the Universal Declaration of Human Rights in 1948, citizens need to forge a consensus on what basic human rights are. Then civil law should be formulated which spells out how the exercise of basic human rights can be protected and promoted. The Universal Declaration of Human Rights needs to be incorporated into the constitutions of each nation and the constitutions of each state within that nation..

From our nature as social and intelligent persons we have the right to freedom of speech and freedom of religion. We have the right to influence government policy. We should enjoy equal protection under the law.

Conceptually, I don't think we need to make a quantum leap to see we also have basic natural economic rights. It's good to have freedom of speech. But if I don't have the opportunity for education, I won't have much to say.

The right to vote is trivial if the voter is uneducated or uninformed. Political apartheid has been abolished in South Africa, but economic apartheid remains not just in South Africa but everywhere. The hungry can't eat votes.

It's good to boast that police can't enter my home without a search warrant. That doesn't do me much good is I don't have a home.

It's good to have freedom of religion. But if I'm unemployed, I may be ashamed to go to a church where they all wear fashionable clothes and have jobs or businesses. What do I say when asked where I work or what I do? And if I don't have adequate food for myself or my family, other rights will seem less important.

We need to develop a human rights culture in which the public acknowledges basic economic rights. Education at all levels needs to make citizens aware of the right to education, employment, food, shelter, and health care.

Rights imply responsibilities. The right to eat healthy food, for example, implies the duty to consume in a way that does not diminish the environment, gives a fair price to the farmer, a living wage to the farm worker and those who process our food, and is kind to animals.

"I have the same rights as every child, no matter whether I am black, white, brown, or yellow, boy or girl; no matter what language I speak, or what my religion is; no matter who my parents are, or whether they are rich or poor. It is thus my responsibility to treat all people, no matter who they are, as I would want them to treat me: in a way that is fair, friendly, and helpful." p. 47 Betty A. Reardon, Educating for Human Dignity, Learning About Rights and Responsibilities.

Civil and political rights are called negative rights because they stress freedom from undue government intervention, freedom from arbitrary arrest, habeas corpus, etc. They are called first generation because they followed the Enlightenment. John Locke was responding to tyrannical monarchs. Freedom of speech and religion were stressed in the American and French revolutions. (liberte)

Economic, social and cultural rights are called positive, freedom to, because they require positive governmental action to insure the right to work, the right to a living wage, the right to education, to health care, to a healthy environment. They are called second-generation because they followed the poverty and oppression of workers during the Industrial Revolution. (egalite) Economic rights are found in Articles 22-27 of the Universal Declaration of Human Rights. Franklin Roosevelt stressed economic rights for the US in 1941 and 1944. The US Catholic Bishops do the same in Economic Justice for All, The Society of Jesus does in 1995. Documents of the Thirty-Fourth General Congregation, Decree 3, No. 6, 55.

Solidarity rights were given scant attention in the Universal Declaration. The smaller and less powerful nations wanted intergovernmental cooperation. They wanted to be able to develop in peaceful and just ways. (fraternite) These third-generation rights were squeezed into Article 28: "Everyone is entitled to a social and international order in which the rights set forth in this Declaration can be fully realized." Each individual has the basic right to expect her/his government to relate justly and peacefully with other governments. Franklin Roosevelt asked for freedom from war in 1941. The Catholic Catechism today does the same. I know no other way to eliminate war than by a world constitution that would include some form of World Federalism. Not just any old kind of world order, of course, but a federalism which is democratic, with sufficient checks and balances, according to the principle of subsidiarity as outlined by the US Catholic bishops in The Challenge of Peace, God's Promise and Our Response.. Solidarity rights include the right to a clean environment, the right to International Distributive Justice, Self-Determination, Respect for the cultural and common heritages of humanity, and most of all the right to peace. As long as we don't have adequate structures to insure a permanent peace with justice, none of us enjoy the exercise of our basic human rights.

Rights imply responsibilities. The right to work implies the duty to be productive according to one's ability. Not that I think starving people should be used as an incentive to force them to work according to our needs and standards. But rights and responsibilities go together. The right to ordinary health care implies ordinary care of our health, eating a healthy diet, getting sufficient exercise and sleep.

(Thoughts in this section were printed in Keeping the Faith in Ohio, Words of Hope and Comfort from Our Spiritual Leaders edited by Kathleen M. Carroll. "This collection encompasses the cream of the crop of the messages of the region's spiritual leaders.")

Ordinary Health Care is a basic human right. An untreated infectious disease affects all of us.

Basic health care is a moral right which should be recognized in civil law. A challenge for faith-based and ethics based communities is to reach consensus on basic care as distinguished from extraordinary care.
Citizens of our state and our nation have the responsibility to support each person?s health care needs. Our emotional and financial support of one another could take many forms. I hope we have the inner spiritual freedom to consider generously all options including those which would better coordinate our health care. One such option is the single-payer system in which all health care financing is handled through a single administrative entity that is non profit, publicly accountable, providing comprehensive coverage. (see
One proposal for the single-payer system covers all citizens with no co-pays or deductibles. Residents would be free to choose from any qualified providers. Financing would come from progressive taxation and employer taxes.
It's important that we recognize the ways in which the present system is broken and be imaginative in thinking fresh thoughts.

Since the economy is a central structure in our world,employment as a human right deserves more attention. Workers are often prejudiced against immigrants who they believe are taking their jobs. There has been discrimination against Hispanics, blacks, women in regard to employment and equal pay for equal work. I suggest Jesuit universities, indeed all universities, should teach and research in an interdisciplinary way employment as a human right.

The Vision of Hope DVD on this web-site shows President Roosevelt advocating an economic bill of rights. His wife Eleanor after World War II negotiated the Universal Declaration of Human Rights passed by the United Nations in 1948. Article 23: "Everyone has the right to work, to free choice of employment, to just and favorable conditions of work and to protection against unemployment." Subsequent UN covenants further elaborate on this right. Richard Lewis Siegel, Employment and Human Rights, the International Dimension, gives the history of the right and the difficulties of implementation. A secular book, he cites the positive influence of the Catholic Church. Work is a local, regional, state, national, and world issue. It is an economic issue, but also a moral issue.

Pope John Paul II, On Human Work, discusses employment in No. 18. "We must first direct our attention to a fundamental issue, the question of finding work, suitable employment for all who are capable of it. The opposite issue of a just and right situation is unemployment, the lack of work. All must act against unemployment, which in all cases is an evil and which when it reaches a certain level, can become a real social disaster." Research has shown that unemployment leads to the use of tobacco, alcohol, other drugs, domestic and child abuse, divorce, suicide, and crime.

The New Dictionary of Catholic Social Thought Employment and Unemployment, quotes Economic Justice for All of the US Catholic Bishops: "Full employment is the foundation of a just economy. The most urgent priority for domestic economic policy is the creation of new jobs with adequate pay and decent working conditions. We must make it possible as a nation for everyone who is seeking a job to find employment within a reasonable amount of time. . human work has special dignity and is a key to achieving justice in society. Employment is a basic right."

The promotion of human rights should be the foundation of any nation's foreign and domestic policy. I fear now that nations put what they consider their business interests or their national interests before human rights. I think that good morals are good business, and good business promotes good morals. Although all of us own consumer property like our clothing, only a few own the factories that produce the clothes we wear. The US bishops defend the right to private ownership of even productive property such as factories if the ownership of this productive property is extended to all. Excessive concentration of ownership of the means of production results in excessive economic and political power. "Private property does not constitute for anyone an absolute or unconditioned right. No one is justified in keeping for his exclusive use what he does not need, when others lack necessities." Does this mean that the government should send in troops to confiscate the corporations of those not acting responsibly? I think it would be more prudent to make and enforce genuine anti-trust laws or promote more local community ownership. "One cannot exclude the socialization, in suitable conditions, of certain means of production."

Although John Locke argued that that government governs best which governs least, the principle of subsidiarity goes in both directions. Governments should not intervene if smaller groups can do the job. But if smaller units cannot respond adequately to the needs of the common good, "Government has a moral function: protecting human rights and securing basic justice for all members of the commonwealth." "It is government's role to guarantee the minimum conditions that make this rich social activity possible, namely, human rights and justice." The United States bishops urge citizens to vote for government representatives who follow moral principles.

For an excellent treatment of the history of human rights and especially of economic rights see Dr. Joseph Wronka of Springfield College in Massachusetts: "A human rights culture is a "lived awareness" of human rights principles among people throughout the world. By "lived awareness" I mean that the principles of such documents as the Universal Declaration of Human Rights are not known merely cognitively, that is, in the "head," but also on the feeling level, the "lived" level of the heart. It is not good enough for society to only "know," for example, that health care, shelter, and security in old age, for example, are human rights, it is important for a society to act upon this knowledge in ways that can guarantee these rights for every person, everywhere. Issues, of course, are complicated. Every right does have a corresponding duty, according to the Universal Declaration, such that it can easily be said that what we are talking about is a culture of human duties. Thus, the right to health care requires the duty for each of us to keep healthy, eat correct foods or exercise, for instance. Yet, we must remember that it is the duty of government to create a "social and international order" as stated also in the Universal Declaration so that food is nutritious, accessible, culturally relevant at an affordable cost and that our towns and cities have ample enough opportunities for us to develop not only in body, but, mind and spirit as well. Finally, as we shall see, such a culture will necessitate a "lived awareness" of the interdependency and indivisibility of rights. In other words, roughly, as organs of the human body function interdependently, so, too, do human rights. In brief, the right to health care, for example, is dependent upon such rights as education (our health personnel must be educated); employment (they must receive a meaningful wage); and rest and leisure (they must have ample time to rest). What further complicates matters is also what has become known as "cultural relativism." Thus, some cultures might believe that it is appropriate for a couple to be betrothed, rather than "choosing" each other, choice of spouse considered a human right according to the Universal Declaration. While we may also have a "knee jerk" response to condemn such cultures that engage in practices like female genital mutilation (FGM), we must recall the ancient injunction to examine the log in one's eye before plucking it from another's. Thus, some cultures condemning practices such as that may be rampant with deaths from anorexia nervosa or they may be stockpiling weapons of mass destruction, threatening the basic human right to peace. Creating a human rights culture, then, is a kind of paradox. On the one hand, we have the standards set out in major human rights documents drafted by the United Nations and to some extent regional organizations like the African Union, the Organization of American States, and the European Union. On the other hand, we must recognize, like Eleanor Roosevelt, Chairperson of the Drafting Committee of the Universal Declaration of Human Rights, who said of the Universal Declaration of Human Rights that it was a "good document... not a perfect one," and that human rights discussions cannot take place in philosophic-historical vacuum. Perhaps, it is our questioning together, acknowledging the importance of incorporating the voices of the oppressed in the policy debates, or what the philosopher Merleau Ponty has called the "happiness of reflecting together," that may help us bring about such a culture where we treat one another with decency and human dignity."

Joseph Wronka is Professor of Social Work, Springfield College, 263 Alden Street, Springfield, MA 01109 USA and Principal Investigator of the Universal Declaration of Human Rights Project, Brandeis University, Heller School for Social Policy and Management (originating in the Center for Social Change), Waltham, MA. He is also President of Human Rights Action International (HRAI)located in Amherst, MA.
He is also the author of Human Rights and Social Policy in the 21st Century: A History of the Idea of Human Rights and Comparsion of the United Nations Universal Declaration of Human Rights with United States Federal and State Constitutions and numerous scholarly publications and popular articles on human rights education and social action.

For the Franklin and Eleanor Roosevelt Institute on the 50th anniversary of the Universal Declaration of Human Rights see
The movie Eleanor with Jean Stapleton is excellent.
See also the Human Rights USA Resource Center, 310 Fourth Avenue South, Suite 1000, Minneapolis, MN 55415-1012, 1-hreduc8 (toll-free)
International Federation for Human Rights
I recommend also Pope John XXIII, Peace on Earth,
United States Catholic Bishops, Economic Justice for All
Robert Traer, Faith in Human Rights, Support in Religious Traditions for a Global Struggle

Human Rights Quarterly, A Comparative and International Journal of the Social Sciences, Humanities, and Law sponsored by the Urban Morgan Institute for Human Rights, College of Law, University of Cincinnati.

Religion and Human Rights

Pope Benedict XVI, Jan. 1, 2006: "Peace appears as a heavenly gift and a divine grace which demands at every level the exercise of the highest responsibility: that of conforming human history-in truth, justice, freedom and love-to the divine order. Whenever there is a loss of fidelity to the transcendent order, and a loss of respect for that 'grammar' of dialogue which is the universal moral law written on human hearts, whenever the integral development of the person and the protection of his fundamental rights are hindered or denied, whenever countless people are forced to endure intolerable injustices and inequalities, how can we hope that the good of peace will be realized? The essential elements which make up the truth of that good are missing. St. Augustine described peace as tranquillitas ordinis: the tranquility of order." 6. Everyone should feel committed to service to the great good of peace. All people are members of one and the same family. An extreme exaltation of differences clashes with this fundamental truth. We share a common destiny.

"Am I intellectually, spiritually and morally prepared to take my place in a rapidly changing global society and to have a positive impact on that society--to live a life beyond myself for other people?" When I tried to answer this question from Xavier University's Mission Statement, I had to say yes and no. Yes, I am somewhat prepared; but given my strengths and weaknesses, I could never face the evil in the world and in myself by myself, without God, without the saints in this life and in the life after this, without the Society of Jesus, or without a small Faith and Justice Community which I initiated thirty years ago. Nor could I face "the principalities and powers" as St. Paul calls them without a way of proceeding which follows the way of proceeding of Jesus who ministered in Galilee, journeyed to Jerusalem, entered into his suffering and death, and broke through to his Risen Life! The Risen Jesus is still growing with us, co-feeling, co-insighting, and co-deciding with us and bringing with him all the best in human history and culture.

St. Ignatius Loyola called himself a pilgrim on a journey. John Henry Cardinal Newman said to live is to change. To live well is to change often. But Cardinal Newman did insist that change not be an external accretion but organic growth from within. The US Catholic Bishops in The Challenge of Peace call us to an entirely new attitude. I think it's difficult to change our attitude even a little. But an entirely new attitude! Although I have a doctorate in peace studies and for many years have engaged in social analysis and theological reflection, although I have been a Jesuit for sixty-one years, although I try to have some regular contact with the materially poor, although I engage in spiritual discernment, I could never make an important decision in the Spirit by myself. I feel I need a sense of humility and openness, a willingness to listen even to my enemies. I think I am more powerful than the most powerful person on earth if I get in touch with the passion within me, the fire that is enkindled by the Holy Spirit. But my passion needs to be joined to the passion of others.

"Come Holy Spirit, enlighten the hearts of the faithful, grant a love and relish of what is right and justice and a constant enjoyment of spiritual consolation. Loving hearts shall be created, and together we shall renew the face of the earth."

The French philosopher Jacques Maritain called a sense of human rights secular faith since atheists, agnostics, and secular humanists all acknowledge basic human rights. Even though they may disagree on the way of explaining them, all major religions likewise acknowledge basic human rights. And religion can help in sharpening our sense of human rights.

If I am to grow morally, I feel I must sharpen my sense of human rights which to me is based on the dignity of each human person. Although I am concerned about the immediate needs of others, I feel I should also try to meet the long-range and structural needs of others. I want to find the causes of the massive and needless suffering in our world. Individual and group morality is connected. I don't think it is moral for me to be pure sexually but ignore basic human rights of others.

I think there are moral obligations that the larger community has as a group. In Cincinnati we are building two new sports stadiums subsidized by the community while in violation of the Universal Declaration of Human Rights, human persons are without shelter, sleeping on the bank of the Ohio River, under bridges, in doorways and in abandoned buildings. The United States government says it is against terrorism but does not adequately support an international criminal court. Although it has many more of them than anyone else, the US government says it is against weapons of mass destruction. Is the foreign policy of the US based on the promotion of basic human rights for each person or is it resulting in the destruction of human lives? Can I be moral in my private life and immoral as a citizen of my country and of the world? Can I apply my moral principles without communal spiritual discernment?

As I as an individual grow in my moral sense of human rights, so the human family has also grown in its perception of human rights. Human rights are divided into first generation, second generation, and third generation. Although the human family is slowly reaching a consensus and a convergence concerning statements on basic human rights, the practice of governments and of individuals is often inconsistent, if not downright abominable!

1993 Parliament of the World's Religions, Chicago, Illinois, USA Towards a Global Ethic. "But this agony need not be! We are interdependent. Each of us depends on the well-being of the whole, and so we have respect for the community of living beings, for people, animals, and plants, and for the preservation of Earth, the air, water and soil. We take individual responsibility for all we do. All our decisions, actions, and failures to act have consequences. We must treat others as we wish others to treat us. We make a commitment to respect life and dignity, individuality and diversity, so that every person is treated humanely, without exception. We must have patience and acceptance. We must be able to forgive, learning from the past but never allowing ourselves to be enslaved by memories of hate. Opening our hearts to one another, we must sink our narrow differences for the cause of the world community, practicing a culture of solidarity and relatedness.

We must consider humankind our family. We must strive to be kind and generous. We must not live for ourselves alone, but should also serve others, never forgetting the children, the aged, the poor, the suffering, the disabled, the refugees, and the lonely. No person should ever be considered or treated as a second-class citizen, or be exploited in any way whatsoever. There should be equal partnership between men and women. We must not commit any kind of sexual immorality. We must put behind us all forms of domination or abuse.

We commit ourselves to a culture of nonviolence, respect, justice, and peace. We shall not oppress, injure, torture, or kill other human beings, forsaking violence as a means of settling differences.

We must strive for a just social and economic order, in which everyone has an equal chance to reach full potential as a human being. We must speak and act truthfully and with compassion, dealing fairly with all, and avoiding prejudice and hatred. We must not steal. We must move beyond avoiding prejudice and hatred. We must move beyond the dominance of greed for power, prestige, money, and consumption to make a just and peaceful world.

Earth cannot be changed for the better unless the consciousness of individuals is changed first. We pledge to increase our awareness by disciplining our minds, by meditation, by prayer, or by positive thinking. With risk and a readiness to sacrifice there can be no fundamental change in our situation. Therefore we commit ourselves to this global ethic, to understanding one another, and to socially beneficial, peace-fostering, and nature-friendly ways of life." 1993 Parliament of the World's Religions, Chicago, Illinois, USA Towards a Global Ethic.

"The world's most ruthless killer and the greatest cause of suffering on earth is listed in World Health Report, 1995, Bridging the Gaps, World Health Organization. Poverty is the main reason why babies are not vaccinated, clean water and sanitation are not provided, and curative drugs and other treatments are unavailable and why mothers die in childbirth. Poverty is a major contributor to mental illness, stress, suicide, family disintegration and substance abuse. More than one billion people are chronically hungry! The majority of the world's very poor are women, children or the elderly." Economic and Social Council, United Nations Commission on Human Rights, June 28, 1996.

The Catholic Church has supported basic rights in Rerum Novarum of Leo XIII; Pacem in Terris of John XXIII; Laborens Exercens of John Paul II. Much of the reasoning in these works is based on natural law coming from God, the universe, and the inborn qualities of human nature. St. Thomas Aquinas supports natural human rights, quoting Romans 2.14: "The gentiles who have not the law, do by nature those things that are of the law." Aquinas also quotes Ambrose: "Feed them that are dying of starvation, else shall you be held their murderer." "Whatever a man possesses above what is necessary, he holds by violence."

In some nations like Sweden, economic and social rights are in their constitutions. Sweden recognizes the right to work, health care, shelter and education. A poll conducted by Research USA stated "Nearly three out of four who responded to the survey said they would like the Constitution to guarantee adequate health care for all Americans" In the US, one state, Hawaii, recognizes the right to health care.

I think it's hypocritical to inveigh against violations of civil and political rights if we ignore hunger, unemployment, lack of education, disease, homelessness. Our federal law pays scant attention to the right to employment even though Thomas Jefferson affirmed that right.

Unemployment and underemployment is serious in much of our world and inflicts severe social costs. One would think that the international community would have addressed the right to full employment long ago. The right of each human person to meaningful employment seems logical and moral, but we balk when the conclusion is reached that the world should have full employment. How do we respect the right to meaningful employment of each human person in a world where one billion people lack such employment? Since we need the will to pursue full employment together, I favor turning to religion for help in forming a consensus.

Improving the recognition of basic economic rights is not possible unless public opinion favors such acknowledgment. Since we need to develop a human rights culture, we must promote peace education. Hopefully, further study and research in the area of basic economic rights can contribute to more informed courses in our schools about basic economic rights.

Are economic rights idealistic, utopian, a letter to Santa Claus? Will the poor always be with us? Is unemployment an economic necessity? There are economists like Gar Alperovitz or David Korten who feel we are living in a potentially abundant world. Caring for the earth in a sustainable way, we can insure basic economic rights for all.

If affirmation of basic human rights is not compatible with our present system, shouldn't we re-think the system? In the army we used to say get a shoe that fits your foot. Don't try to fit your foot to the shoe. Actually, I don't believe we're thinking hard enough as a society. It's a cruel and extreme system.

Rights imply corresponding responsibilities and duties of individuals and governments. The right to food also implies corresponding duties to be reasonably productive and not to over-consume. The right to speak implies the duty to listen. There needs to be a balance between individual freedom and working for the common good.

Natural human rights are part of the moral or natural law. Natural human rights are known by reason and revelation. Scholars develop theories of ethics and moral human rights. Those who believe in divine revelation think the Scriptures are an aid to reason in determining natural human rights.

Small faith communities can help in presenting to the larger communities principles with which to forge a consensus. Stretching toward consensus on basic human rights is a constant but eminently worth-while task for the world community. Positive, civil law is needed to refine and enforce natural law. This process has begun, but I think our world needs a giant step forward both in reaching a consensus and in making that consensus real through civil and positive law.

Scholars and experts can help forge the consensus, but grass roots communities also need to be involved. Scholars and experts sometimes get lost in abstractions, obscure points in the past, and minutiae. On the other hand grass roots communities need to build on the work of the scholars.

Fr. David Hollenbach, S.J.Claims in Conflict, Retrieving and Renewing the Catholic Human Rights Tradition, 1979, Paulist, p. 204 has an interesting conclusion: "1) the needs of the poor take priority over the wants of the rich. 2) The freedom of the dominated takes priority over the liberty of the powerful. 3) the participation of the marginalized groups takes priority over the preservation of an order which excludes them."

Brief History of Human Rights

I want to trace a brief history of human rights. As I ventured on a brief foray into available computer entries on human rights, I concluded that pursuing all the human rights literature would have been daunting even to Paul Bunyon who dug out the Great Lakes. My descriptions are thus illustrative and suggestive rather than exhaustive.

The Hebrew scriptures stress that each person is created in the image of God. Each person has worth, dignity, and value. "I charged your judges at that time: Listen to complaints among your kinsmen, and administer true justice to both parties even if one of them is an alien. In rendering judgment, do not consider who a person is; give ear to the lowly and to the great alike."

Christianity also respects each human person created in the image of God. Jesus was not content that ninety-nine sheep were secure. He went to find the one that was lost.

The Magna Carta (1215) was forced upon King John by the nobles and bishops. The nobility demanded peace with order but non-violently and without revenge.

John Locke (1632-1704) in Book II of his Two Treaties of Government, said there are certain rights which are self-evident, "rights to life, liberty, and property." These rights existed "in a state of nature, before humankind entered into civil society."
People formed the state by a social contract to secure these natural rights which are inalienable. The people had a right to revolt if the government did not respect natural rights.

Thomas Jefferson omitted the right to property from the Declaration of Independence and substituted "the pursuit of happiness." Article Three of the Universal Declaration of Human Rights states: "Everyone has the right to life, liberty and security of person."

Thomas Paine (1737-1809) in The Rights of Man "wrote passionately of the duty of government to provide for its citizens in order to prevent poverty. Paine's strategy was in large part progressive taxation, education for all, and full employment."

Immanuel Kant (1724-1804) proposed a federation of nations dedicated to peace and human rights which would mobilize world opinion against violations of human rights. Kant laid a theoretical basis for the League of Nations. "The only difference between the savages of America and those of Europe, is that the former have eaten up many a hostile tribe whereas the latter have known how to make a better use of their enemies; they preserve them to augment the number of their subjects, that is to say, of instruments destined to more extensive conquests."

The Mexican Constitution of 1917 states: "The Nation shall at all times have the right to impose on private property such limitations as the public interest may demand, as well as the right to regulate the utilization of natural resources. . in order to conserve them to ensure a more equitable distribution of public wealth."

In his State of the Union address in 1941, President Franklin Roosevelt looked forward to a world "founded on four essential freedoms" 1) freedom of speech 2) freedom to worship God in each person's own way 3) freedom from want "which, translated into world terms, means economic understandings which will secure to every nation a healthy peacetime life for its inhabitants--everywhere in the world" 4) freedom from fear, "which, translated into world terms, means a world-wide reduction of armaments to such a point and in such a thorough manner that no nation will be in a position to commit an act of physical aggression against any neighbor--anywhere in the world."

Roosevelt pursued the third freedom, freedom from want, in his 1944 State of the Union address to Congress. His plea for an Economic Bill of Rights was clear and compelling. "This Republic had its beginning, and grew to its present strength, under the protection of certain inalienable political rights - among them the right of free speech, free press, free worship, trial by jury, freedom from unreasonable searches and seizures. They were our rights to life and liberty. As our Nation has grown in size and stature, however - as our industrial economy expanded - these political rights proved inadequate to assure us equality in the pursuit of happiness. We have come to a clear realization of the fact that true individual freedom cannot exist without economic security and independence. Necessitous men are not free men. People who are hungry and out of a job are the stuff of which dictatorships are made. In our day, these economic truths have become accepted as self-evident. We have accepted, so to speak, a second Bill of Rights under which a new basis of security and prosperity can be established for all - regardless of station, race, or creed.

Among These Are:
The right to a useful and remunerative job in the industries, or shops or farms or mines of the Nation; The right to earn enough to provide adequate food and clothing and recreation; The right of every farmer to raise and sell his products at a return which will give him and his family a decent living; The right of every businessman, large and small, to trade in an atmosphere of freedom from unfair competition and domination by monopolies at home or abroad; The right of every family to a decent home;
The right to adequate medical care and the opportunity to achieve and enjoy good health; The right to adequate protection from the economic fears of old age, sickness, accident, and unemployment; The right to a good education. All of these rights spell security. And after this war is won we must be prepared to move forward, in the implementation of these rights, to new goals of human happiness and well-being."

It was fitting that in 1946 the President's wife Eleanor was chosen chair of the UN Commission on Human Rights. Only after a long and arduous struggle did the United Nations agree on December 10, 1948 to the Universal Declaration of Human Rights. The Soviet Union had its Gulag, the US its racism; the Europeans their colonial empires. It was non-governmental organizations that pushed for human rights. It wasn't until 1966 that the Universal Declaration of 1948 was completed with the agreement on the International Covenant on Economic, Social, and Cultural Rights and the International Covenant on Civil and Political Rights. Where the Universal Declaration spoke to principles, the Covenants got more specific and were meant to be legally binding. Forty-eight nations said yes in '48; l05 nations said yes in '66. None said no either time. Together the Universal Declaration and the two Covenants constitute our first international bill of rights.

The Universal Declaration of Human Rights has four kinds of basic human rights. Civil and political rights are called first-generation or negative rights and would include freedom of speech and religion. These rights were stressed in the American and French revolutions. (Liberte) They are called negative rights because they stress freedoms from undue government intervention, freedom from arbitrary arrest, habeas corpus, etc. Writers of the enlightenment like John Locke (1632-1704) were responding to tyrannical monarchs of the seventeenth and eighteenth centuries.

Second-generation or positive rights are called economic, social and cultural rights. These were stressed in early 19th century France. (egalite). Authors like Graccus Babeuf (1760-97) Thomas Paine (1737-1809) and Karl Marx (1818-83) who favored economic rights were responding to the abuses of the Industrial Revolution that produced poverty amidst affluence. Economic, social, and cultural rights are found in Articles 22-27 of the Universal Declaration. They are positive because they stress the right to just governmental intervention, the right to work, the right to a standard of living adequate for the health and well-being of self and family, the right to education, health care, etc.

Third-generation rights were given scant attention in the Universal Declaration. The smaller and less powerful nations wanted intergovernmental cooperation. They were able to squeeze in Article 28: "Everyone is entitled to a social and international order in which the rights set forth in this Declaration can be fully realized." The larger and more powerful nations can take care of themselves. They have military and economic power. But the smaller nations need a just world order. (fraternite) These are solidarity rights. Each individual has the basic right to expect her/his government to cooperate with other governments.

Thus, the three generations of rights are coming from different historical periods. The first generation reflects the struggle against the absolutism and arbitrariness of tyrannical rulers. The second generation arose from the struggle against socially structured poverty. The third generation sprung up at the demise of colonialism and the creation of new nations in the third world. "Only in recent times has the need been maintained to recognize the existence of the 'rights of solidarity' which include the right to development, to a healthy environment, to peace and to the common heritage of mankind, and other rights that make up what could be called the third generation in this evolution." During the debates involved in the drafting of the Universal Declaration of Human rights, capitalist-oriented nations emphasized first-generation rights; socialist countries stressed the second generation. The poorest countries wanted solidarity rights. Finally, all three generations were included.

It wasn't until 1966 that the Universal Declaration of 1948 was completed with the agreement on the International Covenant on Economic, Social, and Cultural Rights and the International Covenant on Civil and Political Rights. Where the Universal Declaration spoke to principles, the Covenants got more specific and were meant to be legally binding. Forty-eight nations said yes in '48; l05 nations said yes in '66. None said no either time. Together the Universal Declaration and the two Covenants constitute our first international bill of rights.

Was there any value in these agreements? In 1965 General Suharto withdrew Indonesia from the UN and perpetrated a bloodbath that claimed 750,000 lives! In the '70's, Uganda's Idi Amin murdered with impunity while he was chair of the Organization of African Unity, whose charter promised to "promote international cooperation, with due regard for..the Universal Declaration of Human Rights." Guatemala, Chile, El Salvador and Argentina all voted for the Covenants. Yet in all these countries as well as in others, torture, murder and terror became commonplace. In Cambodia three million were annihilated by the government!

The participating governments agreed to strong standards because the means of enforcement were weak. But the nations miscalculated. The Universal Declaration and the Covenants have taken on a life of their own. They have become a moral force and at times legally binding. Did any good come from the Universal Declaration and the Covenants? I think it's better to at least say the right thing even when the practice is just the opposite. Eventually truth will prevail. In the end I think the light graced story will triumph. I agree with Victor Hugo that there's nothing more powerful than an idea whose time has come.

Twenty years after the Universal Declaration, in 1968 at Teheran the UN's International Conference on Human Rights declared that the Universal Declaration constituted an obligation for the members of the international community. As a result of this declaration the countries of non-communist Europe and the Western Hemisphere took the essential norms of the Universal Declaration and embodied them in regional conventions. In addition, they established systems of surveillance and enforcement-- human rights commission and courts--which go far beyond the monitoring procedures now available at the United Nations. In '69 the Organization of American States adopted the American Convention on Human Rights. In '75 thirty-three European states, the US and Canada signed The European Convention for the Protection of Human rights and Fundamental Freedoms. Although not always consistent, President Jimmy Carter made human rights a strong concern of his foreign policy. "He upgraded the head of the State Department's human rights division to an Assistant Secretary of State; he signed the International Covenants and sent them to the Senate urging ratification; he ended foreign aid to countries which violated human rights." In 1983 the Association of Southeast Asian Nations, Peoples, and Governments (ASEAN) stressed that it is the duty of government to insure and protect the basic rights of all persons as set forth in the Universal Declaration of Human Rights.

Since we have agreed to them, Dr. Joseph Wronka feels that the Universal Declaration of Human Rights and subsequent covenants should be binding in US law: "At present, according to the Restatement (Third) of the Foreign Relations Law of the United States some of the provisions which the Universal Declaration of Human Rights contains, such as the prohibitions against slavery and torture have customary international law status in American courts. Gradually, all the rights contained in that document, such as the rights to shelter, food, and healthcare need to be incorporated into the American legal system."

National governments seem to have a limited willingness for regional and international cooperation and communication in regard to employment. If employment is a natural right, then education and training should be provided. In 1944 at Philadelphia the International Labor Organization urged that nations affirm the principle of full employment. The right to work was included in the 1948 Universal Declaration of Human Rights and in subsequent U.N. Covenants. As usual there is an enormous gap between lofty statements of goals, principles, and values and actual implementation.

The Catholic Church is beginning to recognize that the US has been strong on civil and political rights but weak on economic rights. The two sets of rights are interconnected and dependent on one another. Elections are greatly influenced by money and the media. If wealth is in the hands of a few and the media is controlled by that same elite, political freedom becomes limited by economic imbalance.

Economic Justice for All (No.'s 85-103) of the US Bishops in '86 has a thorough treatment of human rights. Although each person has a right to start a family, great stresses are put upon families if they do not enjoy the exercise of their economic rights.

Few would deny the concept of basic human rights. Disputes arise when there is an apparent conflict of rights. Pope John Paul II sets his own priorities in case of conflicting claims: "The needs of the poor take priority over the desires of the rich; the rights of workers over the maximization of profits; the preservation of the environment over uncontrolled industrial expansion; production to meet social needs over production for military purposes."

Even though the US bishops praise the founders of our country for their achievements in civil and political rights, they now call for a new effort. "We believe the time has come for a similar experiment in securing economic rights: the creation of an order that guarantees the minimum conditions of human dignity in the economic sphere for every person." The US bishops spell out what they consider the rights of workers beginning with an income sufficient to support a family. They add "adequate healthcare, security for old age or disability, unemployment compensation, healthful working conditions, weekly rest, periodic holidays for recreation and leisure, and reasonable security against arbitrary dismissal. These provisions are all essential if workers are to be treated as persons rather than simply as a 'factor of production.'"

Although the bishops applaud the business person who organizes human labor and the means of production, they emphasize that such efforts should be for the common good. St. Thomas Aquinas said that no one can own capital resources, land and natural resources, unless she/he respect the rights of others and of society as a whole. Catholic teaching has recognized the value of private property to respect the dignity of individual persons, to guarantee freedom, and to provide for basic needs. But the title to private ownership is only legitimate if the land serves the greatest number, is democratically controlled, and is treated with responsible stewardship. Failing to respect the integrity of creation is a violation of the Seventh Commandment. Since the goods of creation are destined for all, the common good takes precedence over an individual's right to private property. (Catechism of the Catholic Church No. 2415, No. 2402,3)

The Inter-American Human Rights Commission of the Organization of American States was still active in 1996. Gilma Camargo is a Panamanian lawyer working for the Center for Constitutional Rights in New York. Since many in Panama are suffering yet today from the United States invasion of Panama in 1989, for the first time the United States Government is being tried before the Inter-American Human Rights Commission. Panamanian soldiers have been found in common graves; some of the bodies had been tied up, with hoods on their heads. They show signs of abuse and torture. Many Panamanians are still traumatized. There are stories of women in the countryside who were raped, peasants and fishermen who were arrested, and soldiers who were killed in rural areas. There are now on record thousands of testimonies. There were billions of dollars of property damage. The United States bombed many areas that had no military objective: day-care centers, public schools, the Ministry of Housing. Families of victims are asking for compensation.

Each human person has the right to eat. This would seem self-evident, but it is obviously not an operative collective value in the dominant culture. Although decent jobs that pay a living wage are not available, society demands that the poor work. If the poor don't work according to the standards of the wealthy, they soon lack adequate food and water. "For millions of people unemployment or underemployment, together with a lack of access to fertile agricultural land, means inadequate income, misery, and early death. Such gloomy realities underline the tremendous present need to place full employment at the center of public policy and human rights, this requiring enlightened global perspectives as well as effective national policies."

Unemployment and underemployment do not seem to be as severe maladies as starvation and torture, but over time the lack of meaningful work can have severe physical and psychological effects. I think full employment needs to become a priority. The right to work was included in the United Nations Universal Declaration of Human Rights adopted in 1948, the International Covenant on Economic, Social and Cultural Rights adopted in 1966, the Council of Europe European Social Charter adopted in 1961, the Organization of American States? American Declaration of Rights and Duties of Man adopted in 1948 and the Organization of African Unity Africa Charter on Human and Peoples' Rights adopted in 1981. British scholars and statesmen like John Maynard Keynes and William Beveridge had a beneficial influence on the right to employment and governmental responsibility following the great depression of the 1930's. Swedish contributions were made by Gunnar Myrdal, Dag Hammarskjold, and Gosta Rehn.

Although in theory the right to employment was recognized, the precise responsibility of government has been a prolonged debate. The farther the world moved from the Great Depression, the dimmer became the vision of full employment and the less urgent the issue. Even though there was debate in the United States from 1975 to 1978 about the Humphrey-Hawkins Full Employment Act, the final statute fell far short of its sponsors' hopes. I remember being a strong advocate of full employment during this period, and I was very disappointed with the results.

John Rawls's A Theory of Justice stresses the value of self-respect and provision of at least minimum necessities while not neglecting the value of liberty. Others have built on this foundation the duty of society to guarantee each person adequate employment.

Western governments became disillusioned about Keynesian macroeconomic policies and concerned that full employment would bring inflation. Indeed unemployment seems to be periodically planned for by macroeconomic policy-makers. Despite these obstacles I think small faith communities can discern together ways to assert in theory and in practice the basic right to work. Since each person is called to be a co-creator with God, creative work is an expression of one's personality. A paid job is not the only way to be a co-creator, but it is the normal way to provide for oneself and one's family in our present society.

A hopeful sign was the legal intervention of many groups when the Governor of Ohio slashed Ohio's safety net in 1991, abruptly terminating a 190-year-old state policy of providing assistance to all indigent persons as long as necessary. The Urban Morgan Institute of the Law School of the University of Cincinnati, the Ohio Coalition for the Homeless, and the Legal Aid Society of Dayton, Ohio, joined together to file a class action suit that the termination of General Assistance violated the Ohio Constitution, the Universal Declaration of Human Rights, and the International Covenant on Economic, Social, and Cultural Rights. Many religious organizations, the AFL-CIO, the cities of Cleveland and Cincinnati and others were amici curiae. The courts and public officials ignored these protests, but the attempt to get legal protection for each human person in Ohio was carefully crafted and argued. (See William and Mary Bill of Rights Journal, Vol. 2 Issue 1 Spring, 1993.)

Excerpts from Interviews on Human Rights taken as part of my doctoral research: To the questions: "What do you see as the source of basic human rights? the role of government vis a vis human rights? I received the following responses:
(1) "The source of human rights is God. Government's role is to serve those who have the smallest voice first and then serve the needs of the greater community. This would occur naturally in communities which have not lost the appropriate balance."
(2) "Government has to protect human rights, because market forces and capitalism won't protect them."
(3) "Every human being is loved by God, belongs to God, and God desires her or him to flourish in the best sense of that word. The state does not give human rights. It only recognizes the rights already given to persons by God."
(4) "Rights are an important category and should be asserted especially to defend the poor and oppressed. Yet when rights becomes our exclusive way of speaking ethically, then we pull in a lot of individualist baggage unwittingly from the tradition of
liberalism. Liberal individualism isn't all bad, but it does so stress the individual that the common good of the community--local, national, and global--gets short shrift. To take rights and the common good seriously requires that we emphasize institutions with the clout necessary to protect rights and the common good. We need "big government" in an era of big business and big problems and in an era of global problems we need global solutions. Therefore we need international law and institutions strengthened."
(5) "The source of human rights is natural law; we are created in God's image and likeness. As such, we are called to live in dignity. Dignified lives entitle us to certain rights, including those most basic to human life: food, shelter, clothing, work.
When rights cannot be secured by an individual and his or her community, it is government's role to assist in securing those rights."
(6) "I see human rights as ultimately coming from God, through the nature he gives us and other things. The state is one of the protectors of rights, and one of the instruments for correcting abuses/violations."
(7) "I think first of all it's important to emphasize the social and economic rights as certainly being on an equal level and of equal importance with the civic and political rights. This is something that is emphasized more probably in Latin America than it is here in the United States. In United States political tradition, here we think of political and civic freedom and the protection of those rights as involving the right to vote every four years, the right to publish a newspaper or the right to make a speech in a public square, that sort of thing. But in Latin America where people are literally struggling for survival, the fundamental right to life is probably the most important in their minds and that right to life is being threatened by the political policies of the governments that are in power. Because people literally don't have enough to eat, they can't get adequate medical care, they can't find decent employment, that sort of thing. So I think the full spectrum of human rights, the civic and political and the social and economic rights all need to be taken together in an overview of the whole situation. As far as the basis of human rights, I feel that the basis for all these human rights is in the dignity of the human person; biblically, we would say created in the image and likeness of God and in terms of the New Testament, each person is the temple of the Spirit. St. Paul said, ?You are the body of Christ? in his letter to the Corinthians, so I think all of these biblical themes and images really give further foundation and enhance the concepts of the human rights of each person. We believe that those human rights are founded or grounded in the human person himself or herself who has tremendous dignity as a son or daughter of God."
(8) "My own belief expands the notion of human rights beyond what might be called civil rights; freedom of speech, freedom of assembly, etc. to include what might be called more social rights in terms of having a right to employment, right or access to medical care, access to drinking water, etc. You cannot live a humane life without them."
(9) "I think many people are afraid not only of disarmament but of other integral parts of peace such as economic justice. For them the most important thing is the so- called 'national interests.' Whether by pursuing that 'national interest' they jeopardize interests of other people or not, they probably don't care."

Those interviewed saw God as the source of human rights through natural law. Government?s role is to protect the exercise of basic human rights since the ?freemarket? doesn?t automatically insure justice. Economic rights were considered as important as civic and political rights.

St. Paul says we can't even imagine what God has in store for us in the life to come. But with God we start to build that life now. There is continuity between this life and the world to come. Basic human rights are the minimum for the beginning of human life. I cannot be happy and secure when my neighbor lacks necessities and our earth is in danger from environmental deterioration.

The end does not justify the means. Even those accused of terrorism have rights. Holding "enemy combatants" is a false interpretation of what terrorism is. The killing of innocent civilians is a crime. Those accused of terrorism have basic human rights and should be considered innocent until proven guilty. They certainly should not be tortured or treated in an inhumane way. Nor should there be anything like collective punishment of groups for individual crimes.

Envisioning New Internal and External Structures and sub-structures for Health Care
I am impressed by how the Voices of Detroit Initiative has for the past five years given effective, efficient, and compassionate health care to over 25,000 working poor without insurance. The participating hospitals saved millions of dollars and patients got better health care because primary care was transferred from hospital emergency rooms to primary care units.
One way of finding our way out of our current healthcare impasse is an exploration of the social teachings of four of the world's major religions which we will begin tonight . Dr. Marie Giblin, Xavier's Theology Department, Christianity Rabbi Abie Ingber, Hillel Jewish Center at Xavier, Judaism David R. Loy, the Besl Family Chair professor at Xavier, Buddhism Intisar Khanani, the City of Cincinnati Health Department, Islam
Plotting our way towards a healthier city, nation, and world requires inter-religious dialogue and a common vision. Let?s dialogue together. On the front page of the Wall Street Journal last Thursday, Jan. 24, Bill Gates called for a Creative Capitalism that manufactures products for the poor. Muhammad Yunus, the Bangladeshi economist who won the 2006 Nobel Peace Prize for his work providing small loans to the poor, says capitalism is ?half developed? because it focuses only on the profit-oriented side of human nature, not on the satisfaction derived from helping others.
My faith tells me that the global community has a moral obligation to provide comprehensive and compassionate health care for each human person. How can we better insure the exercise of our right for health care and our responsibility for others? I think the exercise of our right and responsibility for health care can result from the implementation of the five parts of my vision: a common ethic; the many forms of non-violence; basic human rights (of which health care is one); economic democracy; and a democratic world federation. I see all five working together.
As I try to implement my faith, I feel health care should not be commercialized to the extent that it has. We shouldn't be taking advantage of other's vulnerabilities. We have a responsibility for our own health and the health of others. We have police protection and fire protection. Why not health protection? From a normal situation one week we can be bankrupt the next.
If we can come up with a common ethic at Xavier and in the Cincinnati area, that may start a conversation on how we can coordinate and collaborate on a continuum of care. We could learn much from what Detroit has started to do. Even after we have the single-payer system on a state, federal, and global level, we still will need a local delivery system. We will need cooperation and collaboration of hospitals, clinics, doctors, pharmacies, primary care units.
I'm hoping we can come up eventually with a local ethic of different religions concerning health care for each human person. That will help translate into better local structures. And why not better state, federal, and global structures? I never underestimate the will and power of God for good. We are more powerful than the most powerful on earth if only we get in touch with the Spirit within us and work together with God and with one another.
One current approach to improving human rights in Detroit, Michigan, is described in Taking Care of the Uninsured, a Path to Reform, by James. D.. Chesney, Ph.D., Herbert C. Smitherman, Jr., MD, MPH, FACP, Cynthia Taueg. BSN, MPH, DHA, Jennifer Mach, MD, MPH, Lucille Smith, M.ED. (Available from Wayne State University Press.) Even after we have the single-payer health care system for each human person in the US, we will need an effective, efficient, compassionate, health care delivery system. "What would happen if care for the uninsured were provided in a less fragmented system with unfettered access to primary care and integrated services across the continuum of care? . .Strategy requires building partnerships that comprise public health departments (health education and preventive services), community clinics (primary care services), specialists and hospitals (acute, emergency, and specialty services)". p. 11 How can we get collaboration and coordination in a competitive system?
"The Voice of Detroit Initiative Network Development Work Groups established a definition of health, proposed by Dr. Herbert C. Smitherman. This definition recognizes the individual's economic and spiritual well-being, as well as the well-being of one's community, as important factors in shaping health. By including the community, this definition underscores the composite expression of social and cultural circumstances that condition and constrain lifestyle behavior choices." p. 35 "Health includes the state of complete physical, mental, socio-economic, and spiritual well-being of the individual and thus their community, and not simply the absence of disease or infirmity." "A medical home is not a building, house, or hospital, but rather an approach to providing health care that is accessible and provided in the local community; recognizes the family and/or other self-identified social support network as a care partner and the principal caregiver and has an identifiable primary health care professional who provides and coordinates preventive, primary and secondary/tertiary care, which is aligned to supportive, educational and community-based services, all concerned about the well-being of the person where the cultural background is recognized, valued, and respected." p. 36
"The Network Development Work Group completed and approved a list of core medical services that would be provided to every VODI enrollee; this list was defined as the VODI Intervention Model. These core services included primary care and preventative services, laboratory and diagnostic services, health education and support services, and treatment. The basic set of services included pharmacy, laboratory, medical care, and care management. Although specialty and inpatient care were not identified as core VODI services, each provider was expected to make referrals if care was required." P. 36.
Pharmacy services, dental care, and disease management were identified as significant needs and service gaps. . uninsured Detroit residents needed free or low-cost prescription drugs.? P. 41.
"VODI's goal was to enroll and care for 27,500 clients in a virtual insurance plan that was designed to manage and track the clients? health care. The term "virtual insurance" is used because although VODI organized the coverage, it did not build a new payment mechanism beyond the capacity and willingness of providers to absorb the cost of care provided to VODI enrollees." P. 48 "A major consequence of the lack of insurance coverage is that needed care is delayed or denied." P. 49. "The eligibility criteria to enroll the uninsured were designed to target the working poor"those not poor enough to qualify for government-sponsored health care insurance and who did not have an employer sponsored health care benefit." P. 50.
" To facilitate Medicaid and PlusCare applications, VODI established . . partners who agreed to take Medicaid and PlusCare applications at their primary care sites, an additional expense for the partners." P. 51. "A majority (56.7%) of VODI enrollees was employed and 43% reported working more than 30 hours a week. More than half of those employed earned less than $8 an hour. . annual income of $16, 640. . to rise to 200% of the federal poverty level, a family of three would need to be supported by a full-time job at an hourly rate of more than $15. 57% of US uninsured are full-time workers, 16% work part time, and 27% are unemployed. In the VODI population which underrepresented Hispanics, more than 92% were African American. p. 56.
Lessons Learned "The organization of coverage and care must be coordinated. Simply providing a coverage mechanism without organizing a delivery system at the local level will not ensure that uninsured individuals get the care they need or that unnecessary costs are controlled. . Insurance coverage is critical but not sufficient for access and appropriate service utilization. The mere existence of coverage does not necessarily ensure access to care or guarantee that care will be used appropriately. National and state reforms are implemented at the community level. Therefore, community driven solutions are imperative if reforms are to be successful." p.69. "most uninsured do not know where to get affordable care. .the VODI central administrative office, staff, and community based enrollment workers were resources for information on how to get assistance to address medical and some nonmedical needs of enrollees. .47% of the uninsured delay seeking care because of prohibitive costs. Distance to a health center and the ability to get a timely appointment are two factors that affect utilization. In addition, the lack of paid sick time in many low-paying jobs is a barrier to primary care services, which are typically available only during the day. . the uninsured use fewer preventative, screening, and therapeutic services, are sicker when diagnosed, have poorer health outcomes (higher mortality and disability rates), have lower annual earnings because of poor health. A network partners to provide the full continuum of health care . . an ongoing relationship with a primary care provider or system of care is a hallmark of quality care." pp. 76, 77.
The definition of health advanced by VODI in chapter two was a holistic one that recognized health and well being as a combined function of favorable mental, physical, social, economic, environmental, behavioral, and community factors. Therefore individuals who live in poverty with associated joblessness resulting in vulnerable and fragile communities with disrupted social structures, have low educational attainment, live in communities of high crime, with poor health indicators, are not by our definition of health, in a state of well being." P. 106.
"The US is experiencing an epidemic unlike any in its history. With an annual financial burden of more than $350 billion, chronic diseases, heart disease, cancer, stroke, lower respiratory disease, and diabetes, are now responsible for three out of every four deaths in the US. Over 100 million Americans, one-third of the US population experience some level of disability or severe limitation in their daily activities because of chronic disease. By 2020 US cost will approach $1 trillion annually."p. 109 "unhealthy lifestyles and behaviors are driving this epidemic, along with deteriorating social and economic conditions, worsening health disparities and a crisis in access to quality health care. The real causes are tobacco use, physical inactivity, overweight, and obesity. Tobacco use is the number one cause of preventable deaths in Michigan. The second and third leading causes of preventable death are obesity and physical inactivity." P. 110.
"Building collaboration and commitment and working together in a common effort are the two most difficult but also the most critical. P. 137. "Having a financing mechanism is vital. .providing universal health insurance without simultaneously organizing the delivery system cannot achieve the objective of facilitating appropriate care utilization patterns or cost-effective care. . although a financing mechanism can be constructed nationally, care is delivered locally. A national health insurance policy that ignores local delivery challenges and capacities will inevitably fail. A local workable consensus is required to implement any national universal health care policy. Pp. 140, 141.
A National Uninsured Coverage and Care System should be built. .coverage information should be coordinated across public and private systems so that providers know who is uninsured. State innovation must be encouraged. . expand FQHC funding. Federal and state FQHC funding through Medicaid Cost Based Reimbursement payments for primary care should also be increased. Policy makers should make the emergency room a last resort for the uninsured, not the only place that is legally required to serve uninsured. P. 142 The expansion and uninterrupted linkage of pharmacy services with primary care is a critical policy step toward improving health status. . there is no funding mechanism for secondary or specialty care for the uninsured. .there is no funding source earmarked to specifically pay for basic secondary care services for underserved and uninsured populations, such as paying to see a specialist like a cardiologist or a general surgeon for common medical problems, or paying for basic diagnostic studies such as an ultrasound or cardiac stress test. P. 143 a clear uniform calculation and reporting standard for charity care should be promulgated with an external financial reporting requirement to list charity care as an individual expense item to increase the transparency of this benefit. P. 145
The current situation is unsustainable. .The challenge for each community is that first the leadership must come together and acknowledge a local need for change. P. 146.
An excellent DVD is Salud, health care in South Africa, Cuba, and several nations in Latin America. Dr. Paul Farmer of Harvard and former President Jimmy Carter are in the documentary.
Fr. Benjamin J. Urmston, S.J., PhD,
April 2014.

Related Web sites: Amnesty International
Business and Human Rights a comprehensive resource with links to information from governments, companies, intergovernmental organizations and NGO's.
International Committee on Human Rights
International Covenant on Economics, Social and Cultural Rights
International Human Rights