by Michael Monasky
November 5th, 2018
If Dr. Michael Fine had his way, he would see and care for everyone free of charge: no cost for maternal care and newborn deliveries, vaccinations, all doctor visits; free or nearly free medications, treatments, and necessary special medical care.
State-licensed doctors, nurses, therapists, healthcare workers, and other ancillary workers would all be paid pretty much what they make now. University-level health education would be without charge to students. Every place would have a clinic, open 8 a.m. to 8 p.m. every day for delivering care as needed by people in their community.
Rhode Island-based family medical specialist Fine writes in his new book, “Health Care Revolt,” that $1 trillion is spent unnecessarily for healthcare that should be spent instead on education, parks, libraries, community centers, and other amenities needed by the public.
This is the part of healthcare glut that Fine believes is our lost legacy to democracy. Dr. Fine believes that democracy depends upon a safe and peaceful society that shares its prosperity.
Imagine a society that eradicates homelessness, alleviates physical pain and mental suffering, empties our prisons of those addicted to chemical substances and treats them instead. Imagine, too, a society that embraces the conflicting ideas of all people so as to find a way to put an end to fighting, killing, and war-making.
So as to make our places more peaceful, there’s a lot we can and should imagine to make connections between ourselves and other people, and to become more satisfied living with each other.
Dr. Fine argues that we cannot make our world a safe, peaceful, and healthy place to live if we continue to allow powerfully wealthy agencies to abscond a trillion here for military contractors and a trillion there for healthcare magnates. It should be no wonder that the planet faces terrible outcomes of global warming when so much is spent lobbying for fossil fuel and military interests; surprisingly, spending by healthcare lobbyists exceeds petroleum and military interests combined.
Dr. Fine writes that we should “resuscitate democracy.” That’s a curious metaphor to use for a country that prides itself on exporting democracy. It’s actually a serious indictment: Fine claims that we have a few decades to reign in global warming, but not so with healthcare.
Market-based healthcare systems, including the insurance companies, drug manufacturers, hospital systems (whether for-profit or not,) physician groups, durable medical equipment makers and distributors, as well as other, adjuvant healthcare entities compose a wobbly house of cards too weak to stand longer than just a few more years.
His solution is to wed individual and public health planning. Like love and marriage, you can’t have one without the other; well, you can, but that’s not the way the song goes, and it’s illustrative of Fine’s approach to health system planning.
Because it’s based upon a market system, healthcare is a commodity, and, one could say, so, too, are the patients, doctors, and treatments. Our current economic system depends upon markets, supply, and demand.
But the best characteristic of public goods are that they are not commodities. Police services, fire services, public education, libraries, parks, community centers, and all our public agencies are just that: public. These are not markets, nor do they behave as markets that reflect simple metrics of supply and demand.
Dr. Fine writes that doctors, patients, and the people in our communities need to stand up and revolt against this inhuman, market-based, supply and demand health system. He wants to build a community-based health system that meets local needs.
Dr. Michael Fine wrote “Health Care Revolt,” published on PM Press in 2018. He will speak at the Shriners Auditorium in Sacramento, California, on Friday, Nov. 16 from 6-9 p.m. On a later panel he will be joined by former Northern California Veterans Hospital Director Dr. David Siegel and physician assistant/health care activist Keith McCallin.