A true health care vision

Recently, I attended the American Medical Association’s Health Systems Science Summit in Chicago. Our group of medical educators strategized about how to better teach medical students the functions and dysfunctions within our health systems. All I can think of now, though, are the most glaring dysfunctions: the drastic inequities in health outcomes and access in the United States.

Our summit could not address these dysfunctions largely because of who was in the room: academic physicians and social scientists. We are well-trained and well-meaning, but the broader system is so dysfunctional, no amount of science can reboot it. Other human endeavors must intervene.

If we truly wish all Americans the opportunity to flourish, we need to rethink the very structure of how health care is provided and funded in the U.S. Who will examine this system for what it is and challenge its presumptions? Who can assess the ethical and political challenges? To get at ethical challenges, including the roots of injustice, we need the perspectives of history, literature, philosophy and the arts. “Ethics” derives from “ethikos,” ancient Greek for habit. To spur new habits, we need a Socrates, not a scientist, to sting us like a gadfly. When Socrates suggested governments needed philosopher-kings, he meant kings needed to cultivate a friendship with wisdom. Our leaders, too, need such a friendship, not more market analyses, lobbyists’ reports or scientific projections.

It will take a paradigm shift of the heart, soul and mind of a nation to better serve our collective bodies.

The need to act has become more urgent as our system worsens. Last year, the U.S. became the 68th best health system in the world, between Lithuania and North Macedonia, according to the Legatum Prosperity Index. Why does the U.S. spend increasingly more and get increasingly less? It is not for lack of science and technology. It stems from how we define and value the human in this country. By reducing the human to “homo economicus,” the bartering animal, we get what we pay for.

Let us convene another summit that brings together legislators, health systems leaders, insurance barons and corporate titans with artists, musicians, writers, scholars, priests and philosophers, to delineate what flourishing and health could look like in this country.

America has the talent, the wealth, the ingenuity, the pragmatic bent and the “can-do” spirit. May we revolutionize her thinking to engender her better, healthier, more equitable self.

— Dr. Gregory W. Schneider, Las Vegas, Nevada