interdependence of the right to social security as it relates to health care plans and the right to health, where the former acquires an instrumental or procedural character for satisfying the content of the latter. When such plans are managed by private firms, the State has the obligation to ensure that the design and administration of medical insurance take into account the different elements of the rights to social security and health. Hence, the state’s obligation to ensure the effectiveness of human rights produces effects on relations between individuals, who consequently have the obligation to respect them; that is, as regards insurance companies, for instance, the pursuit of profit and economic gain in the medical insurance system must not nullify enjoyment of the rights protected by the American Convention. 72. In this case, due to the nature of her illness, Martina received special coverage for catastrophic illnesses, which was precisely designed for complex and costly diseases. This coverage allowed her to receive health care services that, according to the information available, were appropriate for treating her serious health condition, reducing the risks of greater harm, and ensuring a decent life insofar as possible. 73. The Commission observes that the current regulation allows for withdrawing RHD on the grounds of chronicity. As has been demonstrated in this case, whether a disease is chronic or not can be difficult to determine and involve a sizable degree of ambiguity and discretion. This is problematic, bearing in mind how decisive such a determination could be for the health of patients who require catastrophic coverage precisely due to the severity of their illness. The State itself acknowledged that "there is no single, special procedure by which insurers can declare that a certain disease is chronic." Furthermore, the regulation offers no apparent safeguards, such as the requirement to assess the situation in which the person would be left in the event of withdrawal of RHD and its implications for their rights to health, life and human treatment. 74. Having analyzed Circular No. 7, the Commission notes that the rules on withdrawal of RHD do not establish any type of safeguard with regard the specific impact that such a decision could have on children, who have a special status. In that regard, the Commission recalls that the State has a special duty to protect children because of their progressive physical, cognitive, emotional, psychological, and social development.103 That duty is heightened when it comes to the enjoyment of the highest attainable standard of health by children, by virtue of their best interests. In this case, the Commission considers that neither the rules and regulations nor the system for challenging decisions made any consideration for Martina's status as a child. 75. That much was reflected in this specific instance, where the service was withdrawn by means of simple notice invoking an expert medical opinion—in relation to which the doctor himself later clarified that he had never concluded that Martina’s illness was chronic—without any additional verification or determination as to whether her life, health, and integrity might be affected by the immediate withdrawal of RHD, in breach of its obligation to create conditions for ensuring health care. As will be seen below, the CSJ ultimately validated this action on the part of the Isapre without making any assessment of the situation in which Martina would be left as a result of its decision or of the possibilities of providing her a service on whose need and propriety there was a medical consensus. That decision by the CSJ constituted a breach of its duty to oversee the actions of the Isapre and its implications for the rights of a girl with a disability who should have been accorded special protection by the State. 76. The IACHR finds that financial accessibility should be one of the characteristics of the right to health, which implies that health facilities, goods, and services should be affordable for all, including socially disadvantaged groups. In this regard, the Commission considers that the availability and creation of the CAEC meant that RHD was affordable for Martina at first; however, after the decision of the CSJ, there is no evidence that the State took steps to ensure that the aforementioned regime remained in place or to compensate for the impact of the reduction in her medical coverage, undermining the financial accessibility of the treatment that her illness required, as the petitioners’ account of the impact of the withdrawal of RHD on the family shows. 77. In line with the foregoing, the Commission finds that the system of challenges available to insureds in the event of a disagreement with their insurance coverage has a standard configuration. In that regard, as the record shows, a claim for undue collection, for example, has the same procedure as a claim against the withdrawal of treatment for catastrophic illness, notwithstanding the impact that the latter may have on the health, life and integrity of a person. In that sense, the Commission considers that the systems of protection 103 IACHR, Violence, Children, and Organized Crime, OEA/Ser.L/V/II., Doc. 40/15, November 11, 2015, par. 271. 16