Our Malady

“Freedom means nothing without health.” How can a nation that prides itself on liberty allow a medical system that denies so many their right to live healthy lives?

1. America’s health-care system is falling short

America’s medical system is failing its primary goal: keeping its citizens healthy. Despite being one of the wealthiest nations, life expectancy in America has declined. Millennials in the United States are expected to live shorter lives than their parents, a sharp reversal compared to other countries. Even citizens of poorer nations like Barbados and Costa Rica live longer on average than Americans.

This disconnect stems not from the quality of doctors or technology, but from the system itself. In many nations, proactive health systems aim to extend lives and offer care rooted in people's well-being. Meanwhile, the United States focuses on profit over patient-centered care. As Timothy Snyder’s near-death experience in New Haven revealed, systemic delays and mismanagement can quickly turn treatable conditions into life-threatening ones.

The coronavirus pandemic laid bare the weaknesses of the American approach. Countries like Germany and Japan minimized deaths through accessible testing and widespread communication. In contrast, the U.S. failed to prioritize public health, favoring misinformation and profit-driven decisions instead.

Examples

• Life expectancy in America lags behind other wealthy nations by an average of four years.
• Timothy Snyder’s near-fatal sepsis highlights delays in diagnosis and care.
• Germany’s robust pandemic response contrasted with America’s profit-focused handling.

2. Lack of universal health care hurts everyone

When governments restrict access to medical care, the consequences extend beyond poor communities. Although America signed the Universal Declaration of Human Rights affirming health care is a right, it lacks a universal health-care system, forcing many to forego care due to unaffordable costs.

Even more troubling is the opioid epidemic, which highlights how inaccessible medical support exacerbates societal divisions. Politicians who oppose universal care often frame pain management as a personal struggle, pushing their constituents into solitary reliance on medications. These harmful narratives compound problems, particularly in rural and economically deprived areas.

Healthcare systems in Europe, by contrast, build trust and patience between doctors and patients. They emphasize understanding over quick solutions. This fosters better health outcomes and reduces dependency on prescription medications. In America, similar outcomes remain elusive due to its fragmented and profit-motivated framework.

Examples

• American millennials show rising pain medication dependency tied to structural inequality.
• Universal healthcare in Austria has fostered sustained health improvements.
• European nations invest in long-term patient relationships with doctors.

3. Supporting child health builds a healthier society

In Austria, expecting parents receive wraparound support, with comprehensive birthing classes and government subsidies that include extended parental leave and care packages for newborns. This emphasizes a commitment to children's health and well-being from the earliest possible stages. Compare that to the U.S., where paid parental leave is rare.

By taking the time to build emotional regulation skills in children, societies equip future generations with tools to handle stress, foster creativity, and think expansively. In America, many parents are forced back to work quickly, unable to provide the crucial adult presence children need during their formative years.

Investing in early years leads to far-reaching benefits. Healthier children grow into healthier adults who require less medical intervention and contribute more to society. Snyder argues that America's inability to prioritize young families stunts not only individual development but also broader communal growth.

Examples

• Austria provides two years of parental leave to all families.
• Parents in the U.S. lose valuable bonding and teaching time due to workplace pressures.
• Nations with supportive systems see lower crime rates and fewer long-term health issues.

4. Deception by politicians endangers democracy

Snyder draws a parallel between J.R.R. Tolkien’s Gandalf and the necessity of truth in leadership. Just as the wizard’s warnings were ignored to disastrous effect, America’s leaders have denied crucial truths about public health. By spreading misinformation or suppressing warnings, they fail to protect the public.

Donald Trump’s response to the coronavirus exemplifies this. Instead of deploying wide-scale testing or heeding medical advice, Trump dismissed the virus as harmless and undermined health measures. Without honest communication, citizens lacked the tools they needed to make informed choices, which worsened the pandemic’s impact.

Snyder stresses that in a democracy, transparency is critical. Leaders must confront harsh realities and take responsibility for protecting citizens. Failure to prioritize truth destabilizes public trust, eroding the very foundations of democracy.

Examples

• Donald Trump falsely claimed coronavirus would “disappear,” delaying preventative action.
• Officials who highlighted equipment shortages were silenced or fired.
• Honest leaders like New Zealand’s Jacinda Ardern minimized casualties through transparency.

5. Devaluing doctors harms communities

American doctors faced dire challenges during the pandemic, often working without proper protective equipment. Some were even dismissed for supplying their own masks, a decision rooted in protecting hospital reputations over staff safety. This undermines not just individual practitioners but entire communities that rely on their expertise.

A lack of federal support further compounded these issues. Notably, while Congress passed a $2 trillion relief bill in 2020, none of these funds went toward buying personal protective equipment for frontline workers. America’s response reflected a broader failure to respect and empower medical professionals who are vital to public well-being.

Other nations place far greater trust in the expertise of their health professionals. A medical system that values its workforce ensures sustained care for its community. Snyder argues that America’s marginalization of its doctors diminishes the quality of care available to everyone.

Examples

• American hospitals fired medical workers who wore personal protective gear independently.
• Doctors risking their lives without adequate protection showcased systemic negligence.
• Austria’s doctors play leading roles in health policy decisions.

6. Commercialization has overtaken care

Snyder’s firsthand experience reveals how America’s medical records system prioritizes billing over truth. Doctors are pressured to fill forms aligned with corporate profits rather than accurate diagnoses. This reflects broader problems where profit dominates care.

Hospitals in the U.S. run on efficiency algorithms rather than medical judgment. Doctors are forced to prioritize quantity over quality, leading to rushed appointments and poorer outcomes. Lobbyists continue to defend these practices, arguing against reform due to short-term financial concerns.

However, failing to provide affordable care carries far greater hidden costs. Americans often avoid seeking necessary treatment because of prices, leading to unchecked illnesses and increased long-term expenses. Snyder asserts that health systems should prioritize healing—not extracting revenue.

Examples

• Snyder's medical records showed billing priorities over accurate reporting.
• Many patients avoid care entirely due to soaring out-of-pocket costs.
• Health systems in Scandinavia achieve better care outcomes at lower costs.

7. Pandemics amplify existing inequalities

COVID-19 exposed a cruel reality in the U.S.: millions lost their insurance when they lost their jobs. Those unable to pay for tests or medical visits were less likely to self-isolate or seek appropriate care, resulting in widespread community transmission.

The system’s inflexibility left low-income families particularly vulnerable. Instead of addressing these gaps, policymakers catered to corporate interests and overlooked marginalized populations. As a result, several pandemic fatalities could have been preventable.

Other countries proved how prioritizing equity benefits public health. By fostering accessible systems, they curbed infections and saved lives. America’s failure to learn these lessons cost lives and prolonged the crisis unnecessarily.

Examples

• 20 million Americans became uninsured in the first weeks of the pandemic.
• Lack of diagnoses made it harder to trace infection chains.
• European nations like Germany ramped up early interventions, minimizing fatalities.

8. Short-term cost-cutting harms long-term health

Snyder argues that investing in universal health care may seem expensive at first, but its long-term benefits outweigh initial costs. Healthy populations contribute more to economies while requiring less frequent and less expensive medical interventions.

In profit-driven systems like America’s, short-term savings are favored over sustainable solutions. Cutting corners by reducing preventive care or underpaying medical professionals leads to amplified costs down the line. Snyder advocates for bold action to provide high-quality medical care to all Americans.

Adopting a long-term mindset regarding health care could transform the U.S. into a healthier, more equitable society. Neglecting this foundational change, however, will only perpetuate avoidable suffering.

Examples

• Austria reduced overall costs by prioritizing maternal and child health early.
• America's reliance on emergency care dramatically increases long-term medical spending.
• Universal care in the UK eliminates the fear of rising private insurance premiums.

9. A lack of preventive care perpetuates cycles of illness

Preventive care ensures that small problems don’t escalate into systemic challenges. Yet, the U.S. underfunds public health initiatives, relying instead on emergency interventions. Snyder highlights how an overemphasis on treatment rather than disease prevention exacerbates health inequality.

For instance, Americans dealing with diabetes may face unaffordable insulin costs, leading to complications that could otherwise be controlled early. Similarly, poor diets driven by food deserts make heart disease more common in underserved communities.

Shifting the focus to prevention would significantly improve public health outcomes while reducing financial burdens in the long term. Snyder’s story of nearly dying due to untreated infections highlights how prevention, not reaction, should drive health priorities.

Examples

• Insulin prices in the U.S. force diabetics to ration medicine.
• Public education on nutrition reduces mortality rates in countries like Japan.
• Snyder’s experience showcases how poor initial diagnoses spark preventable crises.

Takeaways

1. Advocate for policies that ensure universal access to affordable, quality healthcare for all citizens.
2. Pressure political leaders to prioritize public health during crises through transparency and responsible decision-making.
3. Push for structural reforms that value doctors' expertise and reintroduce prevention at the core of healthcare policies.