Thanks, Michael. You are our first repeat Q & A interview, and that’s because you are part of an important healthcare initiative that our audience should know about. It’s called Primary Care for All Americans. Can you give us an overview?
Sure. Primary Care for All Americans is building the social movement it will take to create a real health care system for Rhode Island and for the United States, a health care system that provides primary care, an essential service like police and fir protection, or clean water, or basic education to everyone. That’s a huge departure from what health care policy and health care reform has focused on for the last forty years, which is how to pay for health and medical services. We don’t actually have a health care system — a way to provide the same set of services to everyone — in the US. Instead, we have a market,. which maximizes investors’ profit by selling goods and services. We think we need to provide good basic health care to everyone — and we know, from studies here and around the world, that we’ll improve the public’s health and save trillions of dollars if we do that
The program’s website states the ambition of creating “a health care system that is for people, not for profit, that serves all Americans, in every neighborhood and community.” Can you expand on that please?
That’s exactly what we’re about. Making sure everyone in every neighborhood and community has this essential service — primary care. We think it will look different in every community, but we know that every community can do this for themselves. So we’re offering every communities the tools they need to take care of themselves, along with help organizing themselves to do this. Every community provides its own fire and police protection. Every community provides its own clean water. Local Schools. Garbage pickup. Snow plowing. And roads. Primary care costs about the same as all of that. We’re helping communities develop the comfort they need in health care to do for themselves what they already do for most other basic services. Which is to make sure everyone has the basic health care they need.
The website also makes this statement: “Healthcare in the U.S. is a big expensive mess. It generates huge incomes and profits for some people – but it isn’t easy to use, often doesn’t fix our health problems, takes too much time, costs too much money and is impersonal and bureaucratic. That means some people don’t go to the doctor, even when they’re not feeling well, which isn’t good for their health. And too many people who do go aren’t treated well.” Again, can you give us more?
How expensive? The average cost of health care in the US per person per year is about $15,000 — about twice what the average of people in other industrialized nations pay . Impersonal? Have you called a doctor’s office lately and gotten voicemail? Or been put on hold? Or been hung up on? Or tried to find a new primary care doctor? Have you called an insurance company, and been asked for your name and address and date of birth thirty-seven times? Our life expectancy and infant mortality rates rank us about fiftieth in the world. So we pay twice as much, and get results that are embarrassing, using a process that is impersonal and dehumanizing.
And yet, as Primary Care for All Americans notes, some countries “have much better health care than we have. They pay less than half of what we pay for their health care, and they have longer lives and healthier children.” How did they get there while the U.S. hasn’t?
They got there by making sure everyone has primary care. In the US, only about 43 percent of American adults have a robust primary care relationship. Do the math.
How does Primary Care for All Americans hope to reach its goals?
By organizing in hundreds of communities and fifty states, starting with a few — we’ve got work groups in six communities — New Bedford Mass, Central Falls, Scituate, Queens New York, Alexandria Virginia and Cleveland Ohio , and three states — New York, Massachusetts, and Rhode Island. And we’re adding more. We’ve involved almost 1200 people in 40 states through a series of community building Zooms. People tell others. And bring their family and friends.
How long is it expected to take?
Ten years or more. But it won’t happen unless we start. and unless everyone does their part.
You and Rhode Island Hospital staff nurse Belita Andrade are both on the Board and Steering Committee. Who are some of the other members and how did all of you get Primary Care for All Americans off the ground?
Also Elizabeth Moreira from Pawtucket. Our board, steering committee and volunteers include some very well known physicians and nurses and lots of community folks. We got started when a couple of old friends looked around and decided that we couldn’t stand it any more, that we were embarrassed by what health care int he US has become, so we rolled up our sleaves and got to work. We talked to neighbors and friends, and asked everyone to come to our community building zooms, and bring others. They did. So it grew.
What are some of the events the program offers?
Our zooms are the central events for new people. They introduce people to others, in their own and other communities, who want to fix the health care mess by providing this essential service to everyone. The zooms help them learn how. Then we help support work groups in the communities and states I mentioned, which provide lots of opportunities for people to get involved, first, in their own communities, and then, supporting our national effort. We need organizers, graphic designers, musicians, writers and reporters (just sayin) fundraisers, videographers, web designers, Tic Toc producers, influencers, social media folks, and so forth, as well as public health people, community health workers, pharmacists, physical and occupational therapists, behavioralists, doctors and nurses and thousands of others to make this work.
How can people get involved?
Go to our website http://www.primarycareforallamericans.org. Click on JOIN US and give us some very basic information.
Do you have any sense of how the new presidential administration will impact Primary Care for All Americans, if at all?
We are focused on communities and states, not the federal government.
On a more personal note, you continue to advocate in Rhode Island and write. Can you give us some of the details please?
Sure. I say sane by cutting wood and heating with wood, which brings me into the woods for an hour or two every day.
I still publish a short story every month, which I sent out by email — go to Michael Fine MD.com to register. Those stories appear a month later in RINEWSTODAY.com. I publish a book every year or so — short stories or health policy, and try to do reading in every library and bookstore in Rhode Island once a year, as often as they’ll let me. I write a column for What’s UP Newport called What’s Crazy About Health Care that comes out twice a month.
I’ll stop all this craziness as soon as we have a health care system in Rhode Island that provides primary care to everyone. The next day I am going to the beach.
What motivates you in all of your work?
Impatience. It drives me crazy when things that are easy don’t work, and when people seek to profit from the misfortunes of others. We are better people than that.
And finally, what guidance would you provide for someone interested in a healthcare career?
Don’t take no for an answer. Find a basic clinical job, then study and work. You’ll advance. Your nation needs you. Your community needs you. You’ll get paid to see your friends and people you love all day. What could be better than that?
Read the Q & A with Dr. Fine that we published on March 27, 2023.
