A year ago I was lucky enough to study with Professor Doug Band about all issues public-policy related. The time we spent reading and learning about the public health care system was surely one of the most intriguing units, as we read the writings of Paul Farmer and had the opportunity to personally engage in a discussion with him as he visited our class.
Below are some thoughts I began to develop last year…
In Farmer’s Pathologies of Power, Farmer asserts that poor health is a result of structural violence, asking the question of whether the true target of social justice ought to be changing the structural economic and violent conditions, rather than health conditions.
Farmer calls for a sort of moral renewal, where the rich will cease to blame the poor for their conditions and will feel a newfound obligation to assisting the poor. In the article “Why Must the Poor Be Sick?” author Jeffrey Sachs constantly reaffirms Farmer’s humanity as he discusses Farmer’s book Pathologies of Power. Perhaps the most provocative of Farmer’s assertions that Sach’s calls upon is that “the poor are not the victims of their sins but of their circumstances.”(Sachs) Farmer believes that if the well-off can stop seeing the poor as lesser people and begin to truly be compassionate toward the poor, that the better off will then give their money to supporting the poor in their struggles. This marks a critical change in thought in regards to rich people’s views of social justice. The problem is not a lack of money, as many would argue, but rather a lack of compassion.
But transforming health care may not be the solution, in fact, to transforming poor societies. Farmer himself says the poor are not in their given conditions because of misbehavior but because of “the structural fabric of their societies.” (Sachs) If this is the case, one must wonder what the purpose is indeed of providing better health care if the structural systems will ensure the poor continue to be sick. In Farmer’s “Challenging Orthodoxies: The road ahead for health and human rights,” he says the global human rights community needs to add the right to health care as a fundamental social right. Couldn’t one argue, however, that by achieving civil justice the structural fabric that holds the poor back will be effectively changed, allowing them to leave the conditions that keep them sick. Farmer makes a valid point that without the access to health care the poor can never hope to gain any advantage from the civil rights the global community now fights for.
The problem then appears to be a cyclical one. Which must be ended first- civil injustice, or health injustice? Hopefully the choice is not either/or but rather as both issues are targeted, they will slowly be fixed together. Farmer makes clear, however, that good health is an imperative to anyone’s challenge of leaving poverty. What’s more, it is far more affordable than anyone can admit, and with only a small amount of money in terms of the world’s economy, close to eight millions lives could be saved in just one year.