2014 Shaping the Future of New York Fridays: 11:00-1:45 Boylan Hall, 2231

If one look at American History, it is pretty clear that we have moved further and further away from true capitalism as Adam Smith intended it. Many necessary social structures have been put in place- such as social security, welfare, and food stamps- that give American society a more balanced distribution of resources. We’ve come a long way from the days pre FDR’s new deal.

For some reason, however, up until very recently, our healthcare system has stayed outdated throughout the second half of the twentieth century. As our European counterparts implemented healthcare structures to ensure that health was something available, America simply stood by and watched as it got more and more privatized. As the reading stressed, we simply have not, as a nation, viewed healthcare as something that society owes to its populace.

As we move into the future, placing healthcare on the same level as our other social works project is a necessity. We have subsidized housing, food stamps, and unemployment insurance. How can it be that only the very poorest among us get assistance from the government in the most vital area of all, our health?

When reading anything about public health, it’s almost impossible for me not to get absolutely livid reading about not only all the natural obstacles epidemiologists face but also all the the social and political obstacles they face from people trying to maintain the shape of the current social ladder.

With the introduction of public health in society there has been significant improvement in health for all but social inequalities remain. Yet it seems as science modernized there has grown a significant need from certain groups of people to separate health and socioeconomic and political reform. This in result, leads to a focus on personal responsibility in health. It becomes your own fault if you cannot maintain your health.

If it’s your own fault you are unhealthy, why is there so much inequality in health among the different socioeconomic classes? Are they implying one can determine how responsible a person is by their place on the socioeconomic ladder? Ludicrous.

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.