In recent public discussions about health care in Bermuda, many things were said and written, but none stated the founding principle that health is a fundamental human right.

For some people this is such a basic concept that it is hardly worth mentioning – it's a "no-brainer" in common parlance. And for others it is not worth mentioning because the principle is believed to be unattainable and/or undesirable.

However, it is worth spending time on this notion. In part because it is not a "no-brainer" once discussions touch on thorny questions such as entitlement to health care for people with lifestyle-induced conditions, the unemployed or uninsured, or people who simply can't afford it. In such cases many begin to question whether such individuals deserve a right to health care.

And on a larger scale, one can see how the debates and challenges surrounding the current US reforms have skirted around this issue: for many, health is not a fundamental human right.

But this is Bermuda and we are different from the US in so many ways. Our size alone forces us to think twice before turning our back on our neighbours; and our tight-knit community continues to treasure values of collaboration and looking after each other. These values are in line with those enshrined by the United Nations in 1948 in the Universal Declaration of Human Rights. Article 25(1) states that "Everyone has a right to a standard of living adequate for the health and well-being of himself and his family, including… medical care ..."

If we believe that health care is a basic human right, then our health system should ensure that everyone receives at least a minimum level of medical care.

This does not mean that everyone must have access to all available medical care – no country does that, or can do that. But it does mean that in any community a basic standard of care must be defined and made available to all – accessible on the basis of need and regardless of ability to pay.

Bermuda's health care system provides for this through various mechanisms. However, the definition of "essential health care" covers almost exclusively hospitalisation. This leaves the uninsured – often the poorest and sickest – with significant medical bills following hospitalisation, and without access to basic care necessary to maintain their condition when discharged.

The basic package is called the "Standard Hospital Benefit" (SHB). This is different from HIP (the government's low-cost insurance plan, which includes more benefits than just SHB). Creating and mandating this package was a bold and innovative move in 1970 when it was introduced. But it now falls short of the needs of 21st Century Bermuda.

The Bermuda Health Council is currently reviewing the Standard Hospital Benefit with a view to enhancing the package in a way that is affordable and can reasonably meet basic needs; basic needs beyond keeping people alive should their health deteriorate so much that hospitalisation is required.

Bermuda wants, deserves, and can afford to have a better basic package. And if we are going to live up to the principle that health care is a basic human right, then we must ensure the basic package is affordable for everyone.

Dr. Jennifer Attride-Stirling is the Chief Executive Officer of the Bermuda Health Council and has been a health care advocate for over a decade. She has worked at the UK health care regulator and the London School of Economics; and has published papers on health regulation, health promotion, mental health and research methodology.