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Abstract

Models emphasizing professional autonomy, patient rights, market power, and health consumerism are no longer adequate to address the increasingly social, collective nature of health law institutions, instruments, and norms. What is needed is a new model that expressly recognizes the public-alongside the patient, the provider, and the payer-as an important stakeholder and active participant in decisions about medical treatment, health care coverage, and allocation of scarce resources. In a previous article, the author looked to the environmental justice, reproductive justice, and food justice movements for inspiration in developing a "health justice" approach to eliminating social disparities in health. This Article further articulates the health justice model as an alternative to existing health law models or a supplement to the now-dominant patient rights model for examining questions of health care quality and access. It proposes four key commitments: First, the health justice model asserts the importance of collective interests, alongside individual interests, in decisions about medical treatment. Second, the health justice model emphasizes that universal access to affordable health care protects collective, as well as individual, interests. Third, because "upstream" prevention strategies have greater population-level impact, the health justice model prioritizes prevention and integration of health care with public health. Fourth, the health justice model asserts the role of collective oversight through democratic governance-much in the same way that the market power model champions the role of private payers and market dynamics-in managing resources and securing common goods.

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