Bill Hagens’ Summary of “The Healing of America”

Note: I have reformatted this post to include all of the documents provided by Bill Hagens: The summary he provided us before our discussion along with the documents he provided during our meeting. Each of the documents are attached here as links that you can click on to open and/or download onto your local computer for later viewing.

Bill’s Summary Posted Prior to our Meeting

Defining Health

WHO Social Determents of Health

Health Care Determants and Expenditures


About Ron Boothe

I am a Professor Emeritus at Emory University, currently living in Tacoma Washington USA.
This entry was posted in 2009 Selections, The Healing of America and tagged . Bookmark the permalink.

2 Responses to Bill Hagens’ Summary of “The Healing of America”

  1. Ron Boothe says:

    I post here a few pseudorandom comments about the book and about the topic of health care in general.

    First, the book made me realize the level of my own ignorance. I was too ignorant to even be aware of my own level of ignorance about this topic until I read the book. Like many Americans, perhaps, I guess I implicitly bought into the myth of American Exceptionalism and assumed our system of health care, while expensive, was better than that of most other industrialized countries, at least for those of us who have access to good health insurance. I also bought into the myth that health care in other industrialized countries was either “socialized” or had long waiting periods or rationing, or some combination of all of these. What an eye opener it was to learn about the diversity of health care systems from around the world, and how they stack up against our own based on various criteria. It was quite an education for me, and a humbling one at that.

    I am surprised that the moral issue has not gained more traction in our national debates about the issue of whether or not we need to change our current system. I was struck by the comparison to the changes that our society made after 9/11, an event that killed about 3,000 individuals. And yet, our current health care system leads to over 20,000 deaths EACH YEAR of individuals who die for no other reason than the fact that they did not have health insurance. The moral imperative for coming up with a health system that guarantees health coverage for everyone seems overwhelming to me based on that fact alone. As I mentioned during our discussion of the book, I think the conservative opposition to universal health care coverage is based on a moral system that psychologists refer to as a “just world view”. That moral system assumes that the world is basically just such that those who are rewarded deserve to be rewarded and those who are punished deserve their punishment. In watching some of the debates in the Senate on CSPAN the past few days, I have gotten the impression that many of the arguments on the Republican side are based on an implicit underlying moral system something along the lines, “I worked hard and was able to get a job that provides good health care to myself and my family. If those 20,000 who die each year from lack of health care insurance worked as I hard as I do, they could have had jobs that provided good health care too. So there is moral justice in the world. Those who died must have deserved to die.” I find it abominable that religious social conservatives have aligned themselves with this line of moral reasoning. Shame on them and everyone else peddling that brand of morality.

    I had a personal experience similar to the author of the book regarding health care in London. Several years ago I stayed in London for several weeks when I led a group of Emory undergraduates on a “summer abroad” course. I had been particularly strict with the students about not missing any class sessions, telling them that being sick from being out partying late at night was not going to be an excusable absence. So, when I woke up with a fever and feeling lightheaded one morning, I decided that I had better go in to meet with the students anyway having hoisted myself by the argument of my own petard. I ended up passing out on the Tube and was taken to the hospital via an ambulance. My wife spent hours on the phone trying to figure out the logistics of how we would get our insurance to pay for this hospital visit while I lay sick in bed in the emergency ward of the hospital. She had not yet been able to figure out what the solution would be when the time came for me to be discharged from the hospital. Surprisingly, the staff just said I was cleared to leave, so I did. No one said anything about a bill or asked me to pay anything. For months afterward when I was back home, I checked the mail daily expecting to get a bill in the mail for thousands of dollars for ambulance and emergency room treatment. It never arrived and eventually I just stopped thinking about it. Reading the book, I now realize that hospitals in London do not bill patients, even visiting ugly Americans like me!

    Another experience I had relevant to the book has to do with the distinction between medical models and public health models. My research during my pre-retirement days was all done within a medical model. My particular area of research had to do with ophthalmology and eye care, and I would frequently go to international conferences having to do with this topic. One year I attended a conference in China and happened to be assigned to share a room with a minister of health from Indonesia who was also attending the meeting. I spent many hours with him, and he lectured me sternly about the folly of much of what was being discussed at the meeting. Much of the discussion was about the latest high-tech equipment that could be used to diagnose and treat visual disorders, and lots of vendors of this equipment had representatives at the meeting. He told me that providing this kind of high-tech equipment to countries like Indonesia was counterproductive and stupid. It served primarily as a way for U.S. companies to sell equipment to poor countries that did not have resources to staff, maintain, or otherwise properly use the equipment. Meanwhile, the dollars spent by these poor countries on the high-tech equipment was diverting funds from programs that could actually do a lot a good in terms of preventing and treating visual disorders. That was my first real introduction to the distinction between providing funds for health care based on a medical versus a public health model.

    Bill, thank you so much for recommending and leading the discussion on this excellent book on such a timely topic. If only those in a position to make changes to our health care system could have a discussion that was as reasoned and scholarly as the one you led for our book club … but enough of hoping for fairy tales.

    Ron Boothe

  2. Michael Underhill says:

    Hi Bill,

    First, let me apologize to the book club for using this forum for other that what it is intended. Bill, I’m not entirely sure you will remember me (Michael Underhill). I TA’d for you at the U in 2003 or 2004. I have moved back to Seattle from San Francisco and would like to reconnect with you. I actually have something that is of personal importance regarding health care access at the U and I would like solicit your advice and insight on what my options are in terms of pursuing this. I won’t go into details here, but when we connect I will fill you in on what’s going on.

    Hope you’re well. Looking forward to reconnecting and seeing you again.

    Michael Underhill

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