Q&A With Dr. Michael D. Fine

G. Wayne Miller:
You are our first repeat Q&A interview, and that’s because you are part of an important healthcare initiative that our audience should know about. It’s called Primary Care for All Americans. Can you give us an overview?

Michael D. Fine:
Sure. Primary Care for All Americans is building the social movement it will take to create a real health care system for Rhode Island and for the United States, a health care system that provides primary care, an essential service like police and fire protection, clean water, or basic education to everyone. That’s a huge departure from what health care policy and health care reform have focused on for the last forty years, which is how to pay for health and medical services. We don’t actually have a health care system — a way to provide the same set of services to everyone — in the US. Instead, we have a market,. which maximizes investors’ profit by selling goods and services. We think we need to provide good basic health care to everyone — and we know, from studies here and around the world, that we’ll improve the public’s health and save trillions of dollars if we do that

GWM:
The program’s website states the ambition of creating “a health care system that is for people, not for profit, that serves all Americans, in every neighborhood and community.” Can you expand on that, please?

MDF:
That’s exactly what we’re about. Making sure everyone in every neighborhood and community has this essential service — primary care. We think it will look different in every community, but we know that every community can do this for themselves. So we’re offering every community the tools they need to take care of themselves, along with help organizing themselves to do this. Every community provides its own fire and police protection. Every community provides its own clean water. Local Schools. Garbage pickup. Snow plowing. And roads. Primary care costs about the same as all of that. We’re helping communities develop the comfort they need in health care to do for themselves what they already do for most other basic services. Which is to make sure everyone has the basic health care they need.

GWM:
The website also makes this statement: “Healthcare in the U.S. is a big expensive mess. It generates huge incomes and profits for some people – but it isn’t easy to use, often doesn’t fix our health problems, takes too much time, costs too much money and is impersonal and bureaucratic. That means some people don’t go to the doctor, even when they’re not feeling well, which isn’t good for their health. And too many people who do go aren’t treated well.” Again, can you give us more?

MDF:
How expensive? The average cost of health care in the US per person per year is about $15,000 — about twice what the average of people in other industrialized nations pay. Impersonal? Have you called a doctor’s office lately and gotten voicemail? Or been put on hold? Or been hung up on? Or tried to find a new primary care doctor? Have you called an insurance company, and been asked for your name, address and date of birth thirty-seven times? Our life expectancy and infant mortality rates rank us about fiftieth in the world. So we pay twice as much, and get results that are embarrassing, using a process that is impersonal and dehumanizing.

GWM:
And yet, as Primary Care for All Americans notes, some countries “have much better health care than we have. They pay less than half of what we pay for their health care, and they have longer lives and healthier children.” How did they get there while the U.S. hasn’t?

MDF:
They got there by making sure everyone has primary care. In the US, only about 43 percent of American adults have a robust primary care relationship. Do the math.

GWM:
How does Primary Care for All Americans hope to reach its goals?

MDF:
By organizing in hundreds of communities and fifty states, starting with a few — we’ve got work groups in six communities — New Bedford Mass, Central Falls, Scituate, Queens New York, Alexandria Virginia and Cleveland Ohio , and three states — New York, Massachusetts, and Rhode Island. And we’re adding more. We’ve involved almost 1200 people in 40 states through a series of community-building Zooms. People tell others. And bring their family and friends.

GWM :
How long is it expected to take?

MDF:
Ten years or more. But it won’t happen unless we start. and unless everyone does their part.

Read the rest of the interview here.