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2009-03-30

Inequality is Unhealthy: Dr. Stephen Bezruchka on How Economic Inequality is Dangerous to our Health

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Dr. Stephen Bezruchka, Senior Lecturer at the University of Washington’s School of Public Health. He writes extensively on the relationship between health and economic inequality.

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As lawmakers continue to debate healthcare proposals, we take a look at how the economic crisis can impact the health of people in this country. We speak with Dr. Stephen Bezruchka who teaches at the University of Washington’s School of Public Health. He’s written extensively on the impact of societal and economic inequalities on the health of a population and argues that combating inequality might be the best way to ensure improved health. [includes rush transcript]

Transcript

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: As lawmakers continue to debate healthcare proposals, we take a look at how the economic crisis can impact the health of people in this country. I’m joined here in Seattle by Dr. Stephen Bezruchka. He teaches at the University of Washington’s School of Public Health. He’s written extensively on the impact of societal and economic inequalities on the health of a population. He argues combating inequality might be the best way to ensure improved health.

Why is that, Dr. Bezruchka?

DR. STEPHEN BEZRUCHKA: Basically, when you ask the question, “Do you want health or healthcare?” Americans think that it’s healthcare that produces health, when there really is very little evidence for that. What turns out to be really important is the nature of caring and sharing in society. And the best factor that really impacts that is the degree of inequality. Where societies are more unequal, people don’t look out for one another, they look out for themselves. Where societies are more equal — and economic equality is the thing that is most important in this — people look after each other, society looks after each other, and pretty well everyone does better. There’s almost nothing that is better in a society that tolerates the extreme levels of inequality in the United States. And so, we end up dying younger than people in all the other rich countries, despite spending half the world’s healthcare bill.

JUAN GONZALEZ: And Dr. Bezruchka, do you see any correlation between the growth of economic equality in the United States and the health of the people in general?

DR. STEPHEN BEZRUCHKA: Yes. We used to be one of the healthiest countries in the world back in the 1950s. And now we are less — we are about as healthy as Cuba. And we’ve been strangling Cuba for the last forty years. So, as inequality has grown in this country, our health, though it’s been improving, has not improved as fast as it has in all the other rich countries and quite a few poor ones, as well. No expert really doubts that. That is, we die much younger. Even, you know, major government documents point that out. Most Americans, of course, are not aware that. They don’t realize that they push up daisies well before their time.

That’s the key issue, to make Americans realize that we need to fight for health rather than for healthcare. I’ve worked clinically as a doctor for thirty-five years. I’m not against providing healthcare services. But we need to understand that that is not what produces health in society. So we need to first make known the fact that we die younger than we should. Then we need to measure our health indicators relative to other countries. And instead of being what I — thirtieth in what I call the health Olympics, we should rise up and be in the top ten, perhaps. I mean, we win the most gold medals in most Olympic contests. If we had a medal for — if we had an event for health, we should be close to the top in the health Olympics. And we don’t even show up for the final event.

AMY GOODMAN: Dr. Bezruchka, how does our healthcare system affect this, influence this? And what is the system you think would improve the health of the most powerful country on earth?

DR. STEPHEN BEZRUCHKA: Well, if we talk about healthcare system, first of all, we have to recognize, healthcare is a very tiny factor in the health of whole populations. And that’s a real polemic.

What’s really important is how we structure early life. Since half of our health as adults is somehow determined between conception and age three, four or five, early life lasts a lifetime. And we are the only rich country that doesn’t have mandated paid maternity, paternity leave, as all the other rich countries do. So we neglect early life, and we pay the price with poor health as adults.

I think in terms of a healthcare system, a medical care system, I think we should remove the profit motive from it. As long as we have healthcare insurance companies that in 2005 made $100 billion in profit, it’s very hard to tamper with that kind of an industry. However, profiteer is not good for our health. So I would begin by taking profit out of the system and not seeing it as a market phenomenon.

AMY GOODMAN: And how do think this can happen? Politically, President Obama has not come out for single payer — but we’re going to have to leave this question for the next time we speak.

DR. STEPHEN BEZRUCHKA: OK.

AMY GOODMAN: I want to thank you very much, Dr. Stephen Bezruchka, for joining us, a professor at University of Washington, here in Seattle.

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