Rudolf Virchow’s declaration regarding the role of medicine in society is applied by the authors in order to define the responsibility of public health officials and to accentuate the necessity of structural, or social, interventions. Immediately, Virchow’s idealistic and, frankly, slightly inspiring perspective struck me as existing in stark contrast with our current state of affairs. I quote, “The physicians are the natural attorneys of the poor, and social problems fall to a large extent within their jurisdiction.” Today, towering health insurance premiums essentially ensure that millions of Americans will not be able to afford basic medical care. According to the Health PAC website, “Over 40 millions people a year do not get medical care when they need, even if insured, because they can’t afford it.”
On a personal note, while patiently waiting for a haircut last Friday, I eavesdropped on a conversation a customer was having with my barber, Frank. After being cooped up in a hospital for a little over a week, the man had just gotten his hospital bill in the mail. He was being charged $38,000.
To call that highway robbery would be an egregious understatement. How can a contemporary physician act as an attorney of the poor and underprivileged if the poor and underprivileged cannot afford to see the physician?
The Commission on the Social Determinants of Health, the CSDH, claims that in order to tackle health inequities, the must first, “tackle the inequitable distribution of power, money and resources.” While I don’t’ believe that this particular approach would be especially effective (see U.S.S.R, China), I suppose that the government must, in some form, involve itself in mitigating the costs a typical hospital patient must abide with. Fortunately for Americans across the country, I am not (yet) in charge of anything, and so my presumably terrible ideas will never be implemented or imposed on anyone or anything. We should all be grateful.
