What health care options are available to citizens in developed countries outside the United States? How do the health care costs and payment options in those countries compare to the health care costs and payment options available to both insured and uninsured U.S. citizens?
A 2015 Commonwealth Fund brief showed that — before the major provisions of the Affordable Care Act were introduced — the United States had worse outcomes and spent more on health care, largely because of greater use of medical technology and higher prices, compared to other high-income countries.1 By benchmarking the performance of the U.S. health care system against other countries — and updating with new data as they become available — we can gain important insights into our strengths and weaknesses and help policymakers and delivery system leaders identify areas for improvement.This analysis is the latest in a series of Commonwealth Fund cross-national comparisons that uses health data from the Organisation for Economic Co-operation and Development (OECD) to assess U.S. health care system spending, outcomes
intervention. Further to this, it raised the problematic debate surrounding unconditional sovereignty, questioning whether the international community had the right to intervene in the case of a humanitarian disaster. (UN, n.d)
These questions would yet again be raised by a second event which proved to be a further catalyst for the emergence of the responsibility to protect doctrine, was the so-called ‘humanitarian intervention’ undertaken by NATO in Kosovo during 1999. Unlike in Rwanda the international community or more specifically NATO undertook military action. This action first started with international condemnation of the Federal Republic of Yugoslavia (FRY) as seen through Security Council resolutions 1160, 1199, and 1998 which compelled the FRY to find a political resolution to the matter. However, when this was not achieved NATO initiated military action, manifesting itself in an eleven-week programme of systematic bombing in Kosovo in order to cease the, “humanitarian catastrophe resulting from the excessive force being used by the FRY.”(Abomo 2018, p73) This NATO intervention can be seen as controversial as whilst it was vital in both ending the conflict and halting the mass killings and rights violations, it is considered by some as a violation of the prohibition of use of violence and a dramatic breach of state sovereignty. (GSDRC, n.d) This criticism is summarised by Weiss, Evans and Hubert who state that “the moral, legal, operational and political dimensions of humanitarian intervention had never before come under such scrutiny.”(Weiss, Evans, Hubert 2001 p.114) The opposing side to this argument is that NATO did not intervene to impose a new democratic government in Yugoslavia, but to protect the Albanian population of Kosovo from a regime of ethnic cleansing. (Di Lellio 2006, p124) Both of these viewpoints demonstrate the debate which proved essential to the emergence and development of R2P.
This international debate combined with problematic legal frailties exposed within the UN’s policy on intervention after events transpired in Kosovo led to General Secretary of the UN Kofi Annan to call for a reconsideration of the thinking surrounding the concept of humanitarian intervention. The International Commission on Intervention and State Sovereignty (ICISS), a group of independent experts, responded publishing a report entitled The Responsibility to Protect. It was aimed at addressing the points of contention surrounding humanitarian intervention, whilst also upholding a moral responsibility of both states and the international community to respond to ‘mass conflict’. (Weiss, Evans, Hubert 2001) The ICISS report also suggested that, at first, it is the responsibility of the state itself to act to protect its citizens, however, if the state itself is failing in those actions as a perpetrator or is simply unable to counteract mass atrocities, then the responsibility falls upon the international community to take action.(Ibid) The report also alludes to the fact that whilst methods of conflict resolution should be employed, the possibility of military action whilst seen as an ‘exceptional measure’, it was in no way discounted. A final important concept of the ICISS’s report was to extend humanitarian intervention further than military action, incorporating a responsibility to prevent, react and rebuild, concepts which are described as ‘emerging guiding principles’ by the report itself. (Ibid) Between 2001 and 2005, R2P was both endorsed and referred to as an ‘emerging norm’ by many including Kofi Annan within a report entitled, Larger Freedom: Towar