Equality in Healthcare

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The US does certain things wonderfully, it remains a fantastic engine of innovation of new basic scientific knowledge, the human genome and all of it has come from that, to a very significant extent has come from United States, but we're also a society of unbelievable inequality and that inequality has widened considerably, over the last 30 years and in my view, we've also made a pretty basic mistake to think that health is simply a marketable and a marketed phenomenon, so we turned the health sector largely over to the private sector, no other high income country has done that.

First of all I think we could observe that, many other countries use advanced technologies and spend 10% of their national income, or 12% of their national income rather than 18% of their national income, and get at least as good result at much lower cost. The basic question is can people everywhere from any class, any walk of life have access to the kind of healthcare that they need to be healthy and to stay alive, and the answer for a lot of people was no.

The conditions in the poorest countries are often shocking, and the lack of the most basic things that people need of course, no electricity, no doctors, no clean water. In the United States what is troubling is that the world's richest, large economy has not been able to manage what so many other places have managed.

Which is that basic standard that every human being, every citizen, rich and poor, has access to basic healthcare. I think that we have to start from the idea that health is first of all a right. That means that it is a shared responsibility. Second, that health is a system. It is not simply a delivery of a commodity, apples and oranges that you'd get at the grocery store.

It's a connected system of knowledge. When a human being is part of that system, they should be treated in a holistic way. That means attention to their life style, behaviors, risks and choices that they make or are forced to make by their circumstances. If an individual falls sick, it's not one doctor or one nurse that's likely to treat them in modern medicine.

It is a whole network of institutions from clinics to diagnostic units to specialists that will confer on this to perhaps home workers. And unless we view that in an inter-connected way, we end up with a tremendous multiplication of course duplication and we make the health system unaffordable for the poor.

The vested interests obviously are extraordinarily powerful, so that whenever we talk about health reform, the first thing is well, cant do this, cant do that, won't do that, may be we'll do this a little bit and all the steps that would be needed, to get to a more rational and also more humane system seem to be taken off the table before you even get started.