Democracy Now
National Public Radio
May 28, 2008
Click here for the full interview.
Paul Farmer is not your ordinary doctor. In going to the poorest places on earth, he is not only treating patients, but challenging whole healthcare systems. More than twenty year ago, Dr. Farmer co-founded the charity Partners in Health to provide free medical care in central Haiti. Today, Partners In Health provides healthcare for people with HIV/AIDS, tuberculosis, malaria and other conditions in Haiti and eight other countries around the world. We spend the hour with Dr. Farmer on his work, his remarkable background and the challenges of pursuing healthcare with a social justice perspective.
AMY GOODMAN: Before we get to the end of the broadcast, I want to come back here, because your analysis is not just a medical diagnosis, but it is an analysis of the healthcare system, and that’s ultimately what you’re challenging. So we’re in a presidential year. Healthcare is a critical issue, as long as you’re not watching the media, where you hardly see it discussed. But what do you think of the healthcare system in this country? What has to be done? How do you think–what do you think of the candidates and what they’re representing?
DR. PAUL FARMER: Well, my diagnosis of our healthcare system’s problems is that it’s very expensive to give bad medical care to poor people in a rich country, very expensive to give bad medical care to poor people in a rich country. And I can give example after example from my own clinical experience working in, you know, the best hospitals I’ve ever seen in the world. And like I said, when they’re in the hospital, things go OK. But we do not have a good safety net. We don’t have a good primary healthcare system.
And to get into the hospital, the uninsured–47 million people, maybe 50–they have to pass through an emergency room, waste time, and things happen to them there that probably shouldn’t, because they’re primary healthcare problems, they’re in an emergency room. And then again, on top of that 47 million, probably just as many Americans are poorly insured and can be thrown into destitution by serious illness. So, you know, there’s 100 million Americans who are in–are not–they don’t have health security. They don’t know that a devastating illness could not wipe out their savings or make them lose their home. They may know that. I hope they do.
AMY GOODMAN: What does the term single-payer mean to you?
DR. PAUL FARMER: I think it’s a good idea. I mean, again–
AMY GOODMAN: If someone doesn’t understand it, in a sixty-second quote…
DR. PAUL FARMER: Single-payer means, to me, that there’s a national health insurance program that is not divvied up, you know, state-by-state. You know, I was reading about Oregon yesterday on the plane on the way up here, and they’re talking about a lottery to see who’s going to get health insurance. Of the people who applied, it’s going to be some tiny little fraction. Using a lottery to allocate health insurance doesn’t seem to me like a great idea. In Massachusetts, where much has been made of universal access, what’s really happened is that medical insurance is made mandatory, which is different from a national health insurance program or a social safety net. And, you know, I don’t mean to be ideological about this. I’m not. I’m just saying we live in a country that is putting out 16 to 17 percent of our GDP for healthcare and not getting the returns that we need. And from the analyses that I read, having a national health program would cut out some of these unnecessary expenses. I think that’s a sound analysis.
AMY GOODMAN: And you’re a voting participant in this society. What do you think of what the candidates are offering?
DR. PAUL FARMER: Well, you know, they’re–well, I’m not going to talk about the Republican likely nominee, because I don’t think that’s going to be much of a difference. The Democratic nominees are not really shaking the foundations of this system. Whether they will or would if they could, I don’t know. But again, the right to healthcare is different from mandating. You know, car insurance is mandatory right? So you’re not supposed to drive a car–and if you get pulled over when you don’t have insurance, you could have your car impounded. That’s not a great approach to healthcare and insurance. And I don’t think that’s going to be enough.
And so, I’ll be a goodwill participant. And other people I mentioned–my colleague, Jim Kim, who is a real policy guru–we have people on our team–I included–who will participate in trying to be active members of a society that needs a national health insurance program. I mean, I don’t know–I’m sure that the path forward is going to be very complex. But a lot of times people say, well, it’s much more complex than that. You know, there’s also a simplicity to it; it’s we don’t have a social security net for the ill or those likely to become ill .
