A better healthcare system for humanity

For one to be a revolutionary doctor or to be a revolutionary at all, there must first be a revolution. Isolated individual endeavour, for all its purity of ideals, is of no use, and the desire to sacrifice an entire lifetime to the noblest of ideals serves no purpose if one works alone, solitarily, in some corner of America, fighting against adverse governments and social conditions which prevent progress.

When we talk about fixing healthcare, it is common to focus on the healthcare system in America. Whether it’s because it is natural to try to solve the problems that are right in front of us, or because the inequalities of the American healthcare system are so great, we tend to think our problems are isolated from the issues facing the rest of the world.

They’re not. To fix the American healthcare system, we have to work together to create a healthcare system that works for all of us.  We can’t talk about creating a healthcare system that works for everyone while wars are raging often impacting hospitals, the IMF prevents public health funding, and our drug companies profit from selling expensive drugs while contributing little to prevention efforts. These aren’t characteristics of a country that is ready for a better healthcare system, particularly if it comes at the cost of less wealthy nations.

When we’re ready to take on the problem of creating a better healthcare system for all of us, we face a daunting task. It’s not simply a matter of everyone having access to the necessary medical care and drugs.  It is vital that we take into account the social determinants of health, which take include the social aspects of health which are not controlled by an individual. At the recent WHO conference on Social Determinants of Health, a group of public health advocates rejected the proposed statement in favor of a more comprehensive one which addresses the root causes of health inequality. From their response: “Protecting the Right to Health through action on the Social Determinants of Health: A Declaration by Public Interest Civil Society Organisations and Social Movements” (PDF):

1. Implement equity-based social protection systems and maintain and develop effective publicly provided and publicly financed health systems that address the social, economic, environmental and behavioral determinants of health with a particular focus on reducing health inequities.
2. Use progressive taxation, wealth taxes and the elimination of tax evasion to finance action on the social determinants of health.
3. Recognise explicitly the clout of finance capital, its dominance of the global economy, and the origins and consequences of its periodic collapses.
4. Implement appropriate international tax mechanisms to control global speculation and eliminate tax havens.
5. Use health impact assessments to document the ways in which unregulated and unaccountable transnational corporations and financial institutions constitute barriers to Health for All.
6. Recognise explicitly the ways in which the current structures of global trade regulation shape health inequalities and deny the right to health.
7. Reconceptualise aid for health from high income countries as an international obligation and reparation legitimately owed to developing countries under basic human rights principles.
8. Enhance democratic and transparent decision-making and accountability at all levels of governance.
9. Develop and adopt a code of conduct in relation to the management of institutional conflicts of interest in global health decision making.
10. Establish, promote and resource participatory and action oriented monitoring systems that provide disaggregated data on a range of social stratifiers as they relate to health outcomes.

These are the types of radical changes needed to create a healthcare system that works for all of us. We need to bring healthcare, and healthy living, within reach of everyone. In a society as advanced as ours, healthcare should be a human right. Not just for me. Not just for America.

Healthcare should be a human right- for all humanity. Will you work to help create a global health revolution?

About

Nate is your average friendly Health IT geek. Follow his journey through the Health IT landscape in his blog Bio-Digital Jazz or on twitter @nateosit.

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Posted in Community, Health behavior, healthcare, Innovation, public health
  • http://N/a Gage S

    I’d be interested to see where the US is in comparison to New Zealand. These are the only two countries that allow direct to consumer advertising. But the rest of the world has spent the past couple of centuries emulating the great American experiment until recently. Now, European countries, Canada, many others have surpassed the US in their ability to seek protection of the human condition, not protection of the financial interests of insurance companies, pharmaceutical companies, and the like. Nice article.

  • http://www.Spherit.com Phil Lawson

    So what are the “social determinants” of health? That would seem to be the first step in this approach is defining what factors, what elements come together that shape the health of a person, community, country or the world.

    You are such a revolutionary Nate. But you have gone far beyond a ‘simple’ revolution in health. May the force be with you.

    • NateOsit

      Sorry, I should have included the WHO definition of Social Determinants of Health in my article- here it is:

      “The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries.”

      • http://www.Spherit.com Phil Lawson

        I would suggest that ‘conditions’ is a broad term that has little meaning by itself. The challenge is defining the specific conditions that impact health, quality of air/water, availability of clean water, safety, usable education, quality of relationships, sense of community, support, access to health services and a host of others are specific determinants.

        The question I have asked for a long time is not is what is health, but what is “the whole of health”? The essential elements that come together to shape a person’s health.

        One we know the whole of health then we can plan and take action.

        • NateOsit

          Good point, Phil. It’s always good to get specific. Some of the specific conditions mentioned in the SDOH declaration include:

          -the crises of development, finance, food and global warming deny for hundreds of millions of people the right to decent employment, social protection, food security, housing; in fact all the social determinants of health;

          -conflict and violence which erupt and burn in households, communities, cities and regions and blight millions of lives have complex roots in culture and governance, including the prevailing global economic regime which sanctions unbridled competition, gross inequality and obscene greed;

          -violence, poverty and climate change contribute to large scale migrations, to cities and across national borders; in many cases migrants are discriminate against and denied their human rights;

          -Widening inequalities and institutionalized discrimination across axes of class, race, gender, ethnicity, caste, indigeneity, age and ability contribute to the impossibility of good health. Action on these structural determinants of health is essential to overcome the economic, environmental, development and food crises.

          There are certainly more specific determinants, including those you’ve mentioned. It can be a bit overwhelming, but it’s necessary to take a holistic, international approach to health rather than focusing on just one area or issue. Thanks for the feedback!

  • http://www.Spherit.com Phil Lawson

    Perhaps then occupyhealth can clearly define the essential determinants to the whole of health.

    It may sound overwhelming but it can be done.

  • http://www.healthybalancedlife.com Ann Becker-Schutte

    I think that, if we’re going to invest our time, energy, and hopes in a revolution, then we need to think big. That’s not to say that we can’t identify and harvest the low-hanging fruit to gain some momentum. Ultimately, however, we need to be thinking globally, psychosocially, and whole person. We should shoot for the big picture.

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