Our Malady summary

Health has long been used in politics as a way to dehumanize others. In the 1930s, Hitler turned his voters against Jewish people by accusing them of spreading disease to healthy Germans. When they were forced to live in ghettos without any medical care, they did fall ill. Nazis then used their illness as a further reason to send them to concentration camps.

Stalin’s Gulag – the agency that ran his notorious forced labor camps – took a similar view. Prisoners were assessed for their ability to work. If medical attention meant a prisoner could return to the workforce, they’d receive that care. If they were deemed to be an exhausted resource, they were simply dumped outside the gates to die. Health wasn’t seen as something to which every human had a right, but rather as something that the authorities could choose to grant when it suited their agendas.

When Snyder and his wife Marci were expecting their first child, they were living in Vienna, Austria. As part of the free support offered by the Austrian government, they attended birthing classes. Until that point, Snyder had thought his employer had been extremely generous by offering him three months’ paternity leave. When he told his fellow dads-to-be in the birthing class about this, they were horrified. Austrian couples were given two years of paid parental leave – at least 21 months more than an American mother!

Unlike the American system, Austrian health care is set up to ensure the health of the child. From allowing earlier arrival at hospital for the birth to providing packs filled with clothing for newborns, the government ensures parents are fully supported. And all of these services are free. Why does the Austrian government do this? It understands that investing in healthy children pays huge dividends later on.

In J. R. R. Tolkien’s The Lord of the Rings, the wizard Gandalf is scorned by many members of his fictional community. People don’t like the news he brings – that they are in great danger of a dark power that must be stopped. They’d rather not listen to the truth. When the situation worsens, and their lives and liberty are at stake, they shrug their shoulders and claim that they couldn’t have seen what was coming. Instead of taking responsibility for the role they’ve played in disaster, they choose to be willfully ignorant.

In a time of crisis, it takes an effort to seek out information to form an effective strategy and courage to look honestly at a situation. But without doing so, the consequences can be unimaginable. If Trump had valued truth over power during the pandemic, perhaps hundreds of thousands of American lives could have been saved.

In April 2020, Snyder received an email from a neighbor. She was a physician at a local hospital that was treating coronavirus patients. She’d put a call out to ask if anyone had spare medical masks. Even though her hospital was better equipped than many, it could only provide her with one disposable mask per week. But now, the hospital had run out of masks in her size.

This neighbor was one of the luckier doctors. Some American medical workers were fired for supplying their own protective equipment since this exposed the fact that their employer was failing to keep them safe. The hospital preferred its staff to work in unsafe conditions than risk its reputation. As a result, there were fewer doctors to care for the sick.

While he was recovering from his sepsis in early 2020, Snyder looked through his medical records. He was shocked to see that doctors often noted what was convenient rather than what was true. He realized that this wasn’t entirely their fault. Digital records forced them to select predefined entries from a list. And those entries were organized to maximize the hospital’s profit. The purpose of medical records has transformed from documenting symptoms and observations into a billing mechanism.

This is because of America’s commercial medical system. Hospitals are run not to heal the sick, but to make money. It isn’t doctors who determine how many patients can be cared for each day – it’s an algorithm that weighs revenue against cost. Health was once the domain of medical specialists. Now, it’s the domain of profit specialists.