The nomination of President Trump of Robert F. Kennedy Jr. reflects anger and frustration for the greed Weed that underlies the health systems of the United States. Important changes are close. But we should not let those changes leave us even worse than we are already.
For decades, ours Capitalist health systems Formed by for profit insurance, medical interest groups and now private capital have been antithetical to effective public health. Despite spending Two or three times more per capita On medical care that other high -income nations, the United States delays far behind in resultswhile trusting medicine and government They have fallen hastily to historical minimums.
As public health academics have done long observedThe root of our collective problem lies in gross excessive investment in profitable medical interventions, which represent Only 10-20% of what shapes health in the United States, along with a massive substation in the Much more consistent political and economic determinants of health: Housing, working conditions, basic income, environmental and food regulation, and daily social support. However, after the worst of the COVID-19 pandemic, instead of recently prioritizing these problems, the Biden administration requested a “return to normal”, a blessing For the health industry, but a death sentence for the 1 million American residents who die preventable causes every year.
Trump, on the contrary, has increased to the power of the promise of a great interruption. Trump's elected health officials have shared militant criticisms of these entrenched public health standards. But while Trump's health nominees have been strong in their criticism of the status quo, so far they have not offered a coherent vision to rebuild our public health. Many people worry that their agenda is purely destructive and will further feed the private machine to make profits.
If the Trump administration hopes to do more than simply destroy the current system and leave the Americans even more vulnerable, then Trump's health officials should combine their criticism with criticism of the health policy on the left to advance a truly populist model of public health. This approach prioritizes the immediate and tangible benefits for working people and enables them as recipients and care suppliers, instead of simple consumers within a broken system.
A populist public health agenda could join the left and the right addressing the daily needs of common Americans while fighting elitism and shameless back of our current health systems. For conservatives, it appeals to local control values, personal freedom instead of restriction and confidence in the actors of the local community instead of the distant bureaucrats. For progressives, it offers a way to address economic inequality and build care systems that prioritize people about profits.
For decades, United States Public Health Policy It has focused on privatization, deregulation, “free” markets and associated profits. This approach values experts at the expense of working people, reactive medical treatment On prevention through non -medical social care, volatile philanthropy as a substitute for the rights protected by government and individual moral responsibility for health instead of public responsibility to address the Systemic promoters of the disease.
The disease is framed as a matter of personal failure (poor diet, sedentary lifestyles or smoking, for example, instead of the result of policies that undermine rights for healthy environments. For example, debates on mask and obesity mandates in Relationship with COVID focused on personal behavior, ignoring structural failures such as insecure workplaces, lack of cheap air and unhealthy food regulation that have accumulated affordable access to healthy alternatives.
Meanwhile, social problems such as poverty, isolation and trauma are treated as individual pathologies requiring medical interventions, such as Often-unfiction Pharmacists or therapy. This diverts the resources of Community -based care and prevention, generate profits for the industry while leaving patients with endless invoices and disappointments.
Populist public health, on the contrary, promotes policies such as universal child care, housing initiatives first and direct cash transfers to improve health results while reducing poverty and economic insecurity. During pandemia, the success of extended children's tax credits and direct payments offered evidence that Public investments can make huge improvements to people's health.
A populist approach emphasizes Violence and disease prevention Treatment on reagent. To reduce the propagation of infectious diseases, it invests on a remunerated illness, air filtration in public spaces, vaccination without costs provided by reliable health workers, policies that improve individual freedom.
To promote healthier diets and prevent chronic diseases, this approach subsidizes small farmers, neighborhood groceries and fresh products for working -class people and families instead of supporting multinational corporations and farms of factories that flood our communities with designed to be Designed Ultra processed addictive foods.
A populist approach prioritizes Community -based non -professional care services which has been shown to improve mental and physical health while reducing Medical needs and Medical Care Costs. Programs financed with public funds can train and use local residents as community care workers to provide services such as management and prevention of chronic diseases, nursing attention, Mental health support and response to the non -political crisis, as well as community housing arrangements for people with serious mental illnesses.
In addition to providing these daily benefits, these workers would offer networks equal to the same in times of crisis, such as epidemics or natural disasters. Rooted in the same communities that for those who care, would provide confidence construction relationships and strengthen the fabric of the community, benefiting health and safety for all.
Such approach would move us away from the excessive dependence of expensive medical treatments and to public health as it should be: a project for and for town that makes complete use of government resources to Empower communities.
We should demand fundamental transformations in the way we address health in the United States, but a demolition ball alone will not offer what we need.
Eric Reinhart is a political anthropologist, social psychiatrist and psychoanalytic clinical.
