If the Nation was my Patient, Bernie Sanders would be my prescription
By Jeff Ritterman, MD
Dr. Ritterman is the former Chief of Cardiology of the Kaiser Richmond Medical Center and former Richmond, California City Councilman.
The health of our country is largely determined by what epidemiologists call “the social determinants of health.” What these scientists are telling us is that how long we live, and how healthy we are is not only determined by our healthcare system and by our genes. The stresses and pressures of day to day life also have major impacts on our health. Some of this is obvious. If you are poor and homeless, it’s difficult to find nutritious food to eat; it’s difficult to stay warm; and it’s difficult to get any kind of medical care much less preventive care. The statistics tell us that each night half a million of us go to bed without a roof over our heads.
What is not so obvious is that all of us, regardless of where we are in the social hierarchy, suffer worse health than our counterparts in other wealthy countries where wealth and income are more equally shared. As countries raise their living standards just a little bit, life expectancy shoots up dramatically. Once a country reaches a basic level of wealth, lifespan is no longer lengthened by increases in a country’s wealth, instead life expectancy rises as that wealth becomes more evenly distributed. Wealthy countries that share income more equally have significantly greater life expectancy than we do in the United States. But not only is life expectancy improved by relative wealth and income equality, just about every measure of well-being you can think of improves in those countries as well.
Wealthy countries that prioritize relative financial equality have less depression, lower infant mortality, and fewer people suffering from drug addiction. They have greater social cohesion, more civic trust, and their children score higher on standardized academic tests. Great extremes in wealth and income, like we now have in our country, leads to a generalized societal dysfunction. We are not all in the same boat and we are painfully aware of that. The present-day extremes of income and wealth inequality in the United States even exceed those seen during the days of the robber barons.
I support Bernie Sanders because he has the most comprehensive plan to reverse the great wealth and income gap. Only by doing so will the health of our nation improve.
But, there’s more. In addition to building a more just and more equitable society, if we want to improve the health of our nation, we must provide a comprehensive health care system that includes everyone. We stand alone as the only wealthy nation on Earth that does not have a comprehensive health system in place. This is a national disgrace. Our present system is very expensive and has very poor outcomes. I see this daily. I work as a primary care doctor in a disadvantaged community. Many of my patients cannot afford their medicines, some cannot afford specialty consultations, and some can’t even afford the transportation to come in to see me in our clinic. There are a handful of charity-based solutions which we employ to try and bridge these gaps, but we are well aware that we are practicing multi-tiered medicine that clearly leaves those with the greatest health challenges and the fewest personal resources with inferior care.
Recently, I saw a gentleman with no insurance suffering from a testicular hydrocele, a huge swelling of his testicle which requires an operation. He cannot afford the cost of an operation out of his own pocket. My best option was to refer him to Operation Access, a charity that provides medical and surgical care. The gentleman will need to suffer for many months before he will be called for his operative repair as charity medicine has a long wait. For others, the long wait may even be fatal.
So how do I as a doctor respond to the reality of a broken health care system and a society that generates huge and unhealthy inequalities of wealth, income, and of course power.
My response: I joined Doctors for Bernie. Bernie Sanders has made reversal of income and wealth inequality a central focus of his campaign. He has also championed a health care system providing comprehensive care for everyone. The recent spread of the coronavirus makes clear just how much, we as a nation, need a health care system which includes us all.
If you want a healthier nation, and I believe we all do, Vote for Bernie Sanders.
