The most enduring and quoted tradition in medicine is the Hippocratic Oath. It states, “As to diseases, make a habit of two things, to help, or at least, to do no harm.” Yet, the U.S., which spends more on healthcare than any other country in the world and is known for its medical schools and state of the art treatment, has a higher rate of infant mortality, heart disease, cancer and depression than most other rich nations. In fact, it is often the treatment that is making patients ill. A recent report indicates that tens of thousands of people die in American hospitals every year from medical errors. Although healthcare providers, insurance and drug companies are partly to blame, the structure of the healthcare system plays a bigger role. Healthier societies recognize that the primary causes of disease are social and economic, therefore, the remedies must be social and economic as well.
Dr. Stephen Bezruchka is on the faculty of the Department of Health Systems and Population Health at the University of Washington. He worked for many years as an emergency physician in Seattle. He worked in Nepal for more than a decade where he helped set up a community health project a week’s walk from the road. He also established a remote district hospital for training Nepali doctors whom he supervised. He is the author of Inequality Kills Us All: COVID-19’s Health Lessons for the World.