On Medicine as Colonialism

In his enlightening book "On Medicine as Colonialism," Dr. Michael Fine brings a critical lens to the U.S. healthcare system, challenging the widely held belief that it primarily aims to protect and improve health. Instead, Fine argues, the healthcare industry is driven by a quest for money and power, employing colonialist tactics to extract wealth from communities. This revelation is particularly significant in the context of health care's impact on broader societal issues, such as education and community welfare.

Fine describes colonialism as the use of power by external entities to extract wealth from communities for personal or institutional gain. He points out how the healthcare industry has excelled in this form of wealth extraction, impacting not just geographic or ethnic communities, but also economically defined ones. The consequences of such extraction are far-reaching, affecting personal freedoms and healthcare choices alike.

A startling revelation from Fine's work is the scale of unnecessary or wasted healthcare spending, estimated to be between $1 to $2 trillion annually. This misallocation of resources is not just a healthcare issue but a societal one, depriving communities of funds that could otherwise support education, housing, and public infrastructure. Fine's analysis extends to the inefficiency of health insurance companies and the transformation of hospitals from community-focused institutions to entities involved in wealth extraction.

The pandemic has laid bare the systemic issues within the U.S. healthcare system, showing how it has become an agent of wealth extraction. Fine criticizes the role of state power in facilitating this process, likening it to the actions of colonial powers that stripped resources from communities, leaving them without agency or protection.

Fine also explores the historical context of healthcare in the United States, noting how hospitals and health insurance companies have shifted from community-based and collaborative enterprises to profit-driven entities. This shift has had profound implications for public health, with the insurance process itself becoming extractive and contributing to the deterioration of community health systems.

The book concludes with a call to action, suggesting that the only way to address the systemic issues in healthcare is through a social movement akin to those that have achieved significant societal change in the past. Fine envisions communities taking back control of their healthcare, building systems that truly serve the public good from the ground up. While acknowledging the challenges of such an endeavor, Fine's message is clear: the status quo is untenable, and transformative change is necessary to reclaim healthcare for the benefit of all.

"On Medicine as Colonialism" is a profound critique of the U.S. healthcare system, highlighting the urgent need for systemic change. Through a detailed examination of the industry's colonialist practices, Fine underscores the importance of reimagining healthcare as a community-focused endeavor that prioritizes health and well-being over profit. His book is a call to arms for those committed to building a more equitable and sustainable healthcare system, offering hope and a path forward in the face of daunting challenges.