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“Democracy and health intersect and interact. Threats to one are threats to both. On this July 4th, let’s recognize these links, and redouble efforts to strengthen democracy by strengthening our health system … with single payer. Health care for all, not for the few who stand to profit the most.”
Summary
Democracy and health intersect and interact. Threats to one are threats to both. On this July 4th, let’s recognize these links, and redouble efforts to strengthen democracy by strengthening our health system … with single payer. Health care for all, not for the few who stand to profit the most.
(Excerpt)
Threats to Democracy Are Threats to Health
MedPage Today
by Lawrence O. Gostin & Sarah Wetter
June 29, 2023
“The U.S. is facing dual crises: a crisis of health and a crisis of democracy. Our nation has been getting sicker…. On … measures of health and equity, we are falling behind most all of our peer nations.
“Our democracy, too, is unwell, with few guardrails on campaign financing, allowing wealthy individual and corporate donors to have outsized influence on policy and gerrymandering, making political representation simply unrepresentative of the populace.
“The health of our nation is inextricably linked to the health of our democracy….
“Yet, unlimited and dark money has shifted politicians’ attention away from constituents’ health and toward the interests of big donors….
“The Constitution’s Preamble expresses public wellbeing as the quintessential aim of American governance: ‘We the People, in Order to form a more perfect Union’ and to promote the ‘general Welfare’ do ‘ordain and establish this Constitution.’ The ‘General Welfare’ clause expresses a constitutional value of health, peace, and safety. …
“Medical organizations call voting rights a social determinant of health….Voting is linked to reduced risks of cancer death and improved mental health, while voting restrictions correlate with higher likelihood of lacking health insurance.
Commentary
James G. Kahn, MD/MPH, for Health Justice Monitor
On July 4th, we celebrate the founding of US democracy. The revolutionary events of nearly 250 years ago prompted the rise of democracy around the world. This celebration is appropriate, despite – and indeed because of — today’s challenges to democracy at home and abroad. Democracy is under assault, and needs defending.
As Gostin and Wetter persuasively note, the crisis in democracy is echoed by, and intertwined with, a crisis in health. The role of government in advancing the public welfare is undercut by increasing deference to the preferences of corporations and the wealthy. The examples they provide are apt.
But they don’t go far enough. The entire US health system is the antithesis of democracy. A few wealthy individuals and corporations rule the many, by imposing a fragmented insurance system and consolidating the ownership of services. Compromised access to medical care and elevated mortality are accepted as collateral damage from an illusory “free market” in health (which brings no efficiency or welfare maximization) and all-too-real immense financial gains for executives and shareholders. Other wealthy countries democratize health care – everyone has identical coverage, with excellent access to care, and the freedom to choose a provider. Money is saved in the process, and directed to other social needs.
Single payer would foster democracy, freedom, and the general welfare. Let’s issue a “Declaration of Health Care for All”, and revamp our health care into a democracy-conforming and democracy-fostering approach. We will celebrate this revolution for at least the next 250 years.
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The McCanne Health Justice Monitor (HJM) is a health policy blog focused on the U.S. health system failings and single payer reform. A core team of health policy experts and guest contributors write posts several times per month, addressing topics ranging from healthcare inequity and waste, distortions introduced by profit motives, racism and racial inequities in health care, climate and environmental justice, global health and more.
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