Beyond Health Insurance

2020 is going to be a make or break year for health care. While the majority of candidates in the race for the Democratic nomination back private insurance, the front-runners are pushing for some version of single-payer, signaling that this might be a once-in-a-lifetime opportunity to grasp hold of Medicare for All. 

But insurance aside, what are some of the other problems with the current medical system in the U.S.? From the limits of personalized medicine to the racism inherent in medical school curricula, and from the dangerous relationship between academics and Big Pharma to the complications that come with diagnosing someone as “at risk,” today we are diving into our recent archive to give you a range of essays that offer different answers to that question. 

—Rosie Gillies

What Is Medicine For?
by Robert A. Aronowitz

The era of personalized and precision medicine has overpromised but underdelivered. In place of the hype, we need a more sober evaluation of the meaning of health and health care.

• • •

I Can’t Breathe
by Anne Fausto-Sterling

“Belief in racial essentialism means that the medical curriculum pays scant attention to the means by which the social experience of race produces disease—how the lived experience of racism makes black bodies more susceptible to stress-related illnesses such as hypertension and depression.”

• • •

What the Health Care Debate Still Gets Wrong
by Adam Gaffney

A decade ago, Harvard surgeon Atul Gawande helped popularize the idea that U.S. health care spending is high because we use too much medicine. He was wrong: it’s the prices, and who pays them.

• • •

Big Pharma, Bad Medicine
a forum with Marcia Angell

“Since drug companies don’t have direct access to human subjects, they’ve traditionally contracted with academic researchers to conduct the trials on patients in teaching hospitals and clinics. That practice continues, but over the past couple of decades the terms and conditions have changed dramatically.”

• • •

Dying of Whiteness
by Jonathan M. Metzl

Even on death's doorstep, Trump supporters would “rather die” than support universal health care: “Ain’t no way I would ever support Obamacare or sign up for it. No way I want my tax dollars paying for Mexicans or welfare queens.”

• • •

How Good Health Became a Numbers Game
by Christopher J. Phillips

“It is no longer necessary to feel ill in order to be ill. A patient may feel fine and yet be treated as sick because her indicators point to elevated risk of disease or premature death. The experience of being ‘at risk’ has converged with the experience of disease itself.”