How Do We Help the Poor Gain Access to Healthcare?

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While the US does certain things wonderfully, it remains a fantastic engine of innovation of new basic scientific knowledge, the human genome, and all that's come from that, to a very significant extent has come from the United States, but we're also a society of unbelievable inequality and that inequality has widened considerably over the last 30 years.

In my view we've also made a pretty basic mistake to think that health is simply a marketable, and 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 can observe that, many other countries use advance 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 the access to, the kind of healthcare that they need to be healthy, and stay alive, and the answer for a lot of people is no.

The conditions in the poorest countries are often shocking in the lack of, the most basic things that people need, of course no electricity, no doctors, no clean water. In the United States, what's 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 health care.

I think that we have to start from the idea that health is first of all a right, that means that it is a share of responsibility. Second that health is a system, it is not simply a delivery of a commodity, apples and oranges that you 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 lifestyle 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 and is to perhaps homeworkers and unless we view that in an interconnected way, we end up with a tremendous multiplication of the cost, 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 can't do this, can't do that, won't do that, maybe will 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.