By Tanya Feke
September 19th, 2018
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A Broken Health Care System
If you aren’t aware, the U.S. healthcare system is broken. No, it’s not because of Obamacare, and no, it’s not because of Republican attempts to repeal Obamacare. Medicine was a mess long before that.
According to Dr. Michael Fine, we do not have a healthcare system at all. We have a marketplace. He is absolutely right. Medicine today is focused on profit, not care, and the American people are left to fend for themselves. From Big Pharma to insurance to hospitals, the system is set up on capitalistic principles that put money into the pockets of profiteers while doing little for the health of individuals or the population at large.
“We spend around three times more than we need to spend, compared to the countries that have the best outcomes. The countries with the best health outcomes, the lowest infant mortality, and the best life expectancy usually spend about $4,000 or less per person per year. They do it by having a healthcare system. In the United States, we have a healthcare market, not a healthcare system.” — Interview with Dr. Michael Fine in Guernica, October 5, 2017
The big question we need to ask ourselves is what is a healthcare system? Even more importantly, what can we do to improve health care in the United States?
Health Care Revolt
Dr. Michael Fine is the family physician at the heart of a grassroots campaign to change medicine as we know it. He is a chief health strategist for the City of Central Falls, RI, the Senior Clinical and Health and Population Health Services Officer for Blackstone Valley Community Health Care, Inc., and a board member for The Lown Institute. He was also the director of the Rhode Island Department of health from 2011 to 2015 and has won accolades including the Barbara Starfield Award, the John Cunningham Award, and the Austin T. Levy Award.
In his new book, Health Care Revolt: How to Organize, Build a Health Care System, and Resuscitate Democracy — All at the Same Time, Dr. Michael Fine makes a passionate argument for change. He holds no punches and takes a critical look at how the current system fails us. He criticizes the government and lobbyists for politicizing your health. He demeans Big Pharma and insurers for maximizing profits while withholding care. He attacks doctors and hospitals for ordering unnecessary tests to increase their bottom line.
We should never say, “Go down to Man’s Best Hospital to get your abdominal aneurysm fixed.” Instead, we should say, “An abdominal aortic aneurysm is a scary and dangerous thing. The risk of rupture and your dying from it is 5 percent per year. The surgery can be lifesaving, but the risk of not dying from it is 95 percent a year, the risk of a major complication is 10 to 20 percent, and the risk of getting an infection just from being in that hospital is 5 percent. And, by the way, the hospital CEO makes three million dollars a year and gets a bonus based on the financial performance of the hospital, so don’t be surprised that everyone at the hospital is pushing you to have the surgery.” — Excerpt from Health Care Revolt
Health Care Revolt is not only a rant about what is wrong, it also finds hope in what is right. Dr. Fine looks at public health programs, past and present, and points out policies that were able to make impactful changes. He also uses a critical eye to show why some of those programs fizzled out and what it would take to keep the momentum building.
Time for Change
We cannot afford to continue down the path of for-profit medicine. Too many people are left to suffer.
Dr. Fine encourages us to spread the word, to make people understand that they are pawns in a for-profit game, and to show them that they deserve better. There are better ways to build a healthcare system, one that will improve the health of not only individuals but of communities. If we do it right, we can grow healthy together.
Of course, there will be naysayers. People will say it cannot be done, that we are in too deep. Those making money off of your health will do whatever it takes to squash the message. They may use that very money to spread misinformation, anything from fear tactics to smear campaigns to lobbying and “fake news”, to stop change from coming.
Dr. Fine knows firsthand what it takes to strengthen a community. He has worked on the ground in Rhode Island and continues to support public health initiatives. Now, he has his eyes on the country. He is firing people up about what is wrong with the American healthcare system. His vision may be ambitious, idealistic, and even a bit daunting in scope, but it is a start. We need to see where we want to go and start taking the steps to get there.
Thank you, Dr. Fine, for being a voice for us all.