Matt Seidel
As an infectious disease expert, how do you feel when people say that we’re living in a pandemic within a pandemic? If you think about what is a symptom and what is a disease, symptoms are those things that are manifesting within the organism that is caused by the disease. If you think about things like police brutality, is that a disease, or is that a symptom of a larger issue? Although it’s an important issue, I would argue that it’s a symptom of a larger disease, which is racism and public policy. Clearly it doesn’t just exist in a vacuum. Clearly police brutality doesn’t create socioeconomic disadvantage—it’s another product of policy. Yes, it does impact people’s health. George Floyd is a very specific case. From the larger perspective, people living in communities that are socioeconomically disadvantaged—they experience a lot of trauma within their communities, and I’m not just talking about interactions with law enforcement but also gun violence, interpersonal violence—that impacts people’s health as well. I don’t want to distract from the larger issues: poverty, public policy, racism. If we don’t address those, then other symptoms from those things are not going to get fixed.
What is health care’s role in fixing them? Our goal is to have people be healthy, but once they come to our doors, they’ve already been impacted by disease. Health care is defect management. Something has happened to a human that’s caused a defect, and we’re there to fix the defect. We need to be pushing further upstream so that we’re not in defect management—that should be a small part of our business. But that involves so much more than health care, and it’s hard to wrap your arms around it. Health care can’t do it alone. It has to be a whole-government approach if we want healthy communities.
If health care systems are businesses, and it’s profitable to work in defect management, how would hospitals exist if communities didn’t need them as much? I struggle with that, because at the end of the day, we are a business, and we’ve been accused that we want people to be sick because that’s how we make our money. I would hope that most people in health care would be perfectly fine if we didn’t need as many hospital beds or intensive care units as we have now if the result was a healthier population, because that’s better for everyone—it’s better for the economy; it’s better for society. It costs us more in the long run to not invest in something like this. If you try and map this whole thing out, it becomes frustrating really fast, but that doesn’t mean we shouldn’t try. The alternative is to keep going the way that we’re going, and I don’t think that model is sustainable.
