Updated on June 26 at 12:11 p.m. ET.

More than half the world’s countries have pledged to protect their citizens’ right to health care, through either national laws or international human-rights agreements. The United States is not one of them, although demands for universal health care and Medicare for All have been animating issues in the opening months of the 2020 presidential campaign.

According to a recent poll by the Pew Research Center, nearly 60 percent of Americans think it is the government’s obligation to guarantee health-care coverage. What it actually means to protect the health of a populace, though, can be less clear. “American Indians and Alaska natives are born with a legal right to health services, and that’s based on treaties in which the tribes exchanged land and natural resources for various social services,” Donald Warne, the associate dean of diversity, equity, and inclusion at the School of Medicine and Health Sciences at the University of North Dakota, said while speaking on a panel at Aspen Ideas: Health, co-hosted by the Aspen Institute and The Atlantic.* “Unfortunately, they’ve never been adequately resourced.”

This type of underfunded mandate is a problem in countries that nominally support health care for all, such as Uganda, which the Ugandan human-rights lawyer Primah Kwagala says devotes few internal resources to population health. Speaking on the same panel, Kwagala said that official words and actions often don’t match up. “The right to health is looked at as more of an objective or aspiration for the government to provide health care for all,” she explained. “When you go to the hospital, you’ll find that basic things like blades are not there. The health worker is there, but their gloves are not there.”