Malcolm Streitfield and Mel Rising Dawn Cordeiro
Anchor Staff Writer and Managing Editor
I’ve always been unfamiliar with the intricacies of the American healthcare system and its many flaws. Though I was aware of its existence and that it suffered from issues, up till last night I was completely blind to how it worked and how badly it had been corrupted internally. Because of this, Dr. Michael Fine’s new book, “On Medicine as Colonialism,” was a shocking eye-opener for me. The extent to which bureaucratic higher-ups have taken advantage of this system to further disadvantage people in countless communities is staggering.
“On Medicine as Colonialism” provides just one side of the healthcare argument, a side of the argument that is not pretty, but provides a great behind-the-scenes look. Most of the rumors you have heard about the healthcare system are addressed, such as how doctors are paid, which, by the way, is through our tax dollars. Fine expresses aggravation at the system while pointing out where the healthcare system changed and even provides potential solutions. Fine would know, too.
Fine served as the Director of the Rhode Island Department of Health (RIDOH) from 2011 to 2015. As such, he has had first-hand experience with the catastrophic failure of the U.S. government and hospitals alike to assist the impoverished. Instead of being bolstered by the efforts of politicians and medical practitioners who have pledged to protect and support them, the price-gouging of critically important products such as inhalers has bled most of these struggling citizens dry. Without the essential framework of a functioning health-care system, they’ve been left on their own despite having no other way of caring for themselves and their fellow civilians medically.
Fine calls for a shift back to preventative health care and away from the sick care system that the U.S. has developed, in part, Fine says, due to the emergence of specialist doctors and a shortage of primary care doctors. The call to action is to take back what is ours, not just in divine right but in the aspect of our being. Fine compares the healthcare system to a business, which in essence is true, as big conglomerates such as LifeSpan and Marquis, continue to expand with little to no federal regulation. At its very core, we buy services through the healthcare system: we buy visits to primary care doctors, we buy our hospital stays, we buy our medications. We are, however, not getting our money’s worth if we cannot afford care.
This is what makes medicine colonial – that we, as patients, are controlled by forces higher than us, making health decisions for us that may or may not be in our best interest. The medical “powers that be,” the conglomerates and the physicians who cherry pick their patients, “took over” the system. They invaded the system in favor of the vision of greed, of obtaining the most money and wealth possible, just as the colonists took over Native land when they landed in America.
This book has increased my awareness of the world by bringing this complicated issue to light, sparing no detail in the process. As someone who is currently studying sociology, I cannot appreciate this enough. Fine is blunt and straight to the point, laying out the facts using language that is easy for the reader to understand. He doesn’t use any medical jargon that would confuse the average person. Aside from a few spelling errors, his argument is a well-structured one backed up by reliable statistics as well as Fine’s own experiences.
This is still just one side of the argument. The data provided by Fine is shocking, as are some of the stories he has told, however, there is more data that can be researched. There are always multiple sides to every story, and while Fine speaks on Rhode Island and his experiences, as well as some of his experiences during research sabbaticals, there are other stories that will come to light. There is not much on the surface that will support Fine’s expose, but with enough stories and data, his vision of a return to a truly healthy health care system will be accomplished.
My hope is that in the future, when this health care system is established, it will result in a better understanding of autism and other similar disorders. My parents had a very difficult time finding a medical practitioner to properly diagnose me when I was younger. We were lucky enough to find a therapist who specialized in providing services for autistic people. She was the one who explained that I was neurodivergent and she’s been a close confidant ever since.
Fine is also the author of other local favorites such as “Rhode Island Stories,” “The Bull and Other Stories,” “The Health Care Revolt” and “The Nature of Health.” In addition to being the former Director of the RIDOH, Fine is also a family physician, a speaker, commentator, podcaster, community organizer and activist.
“On Medicine as Colonialism” will be available for your reading pleasure on Feb. 15.