The Social Fabric Crisis

CBS recently aired an interesting 60 Minutes profile on Paul Farmer, the doctor and subject of the book Mountains Beyond Mountains. In the attempt to provide "a preferential option for the poor in healthcare", his organization, "Partners in Health, has essentially organized a highly effective, extremely low cost public health system for central Haiti and various other locations that is based on a model of community involvement, health education, primary care and disease prevention. It's extremely interesting stuff, and their website is worth a perusal for anyone interested in seeing poor people not die so much. They've had remarkable success dealing particularly with HIV/AIDS and TB.

I came across Dr. Farmer's profile today while doing some research at Multifaith Works, the AIDS organization where I work, and it was particularly interesting because we do a little bit of what he does--namely, organizing community support for sick people so they don't sink into isolation. Like at PIH, we've found that it's not unusual to see basic human support affect significant improvements in peoples' health, even where meds have not been fully successful.

That raises the question for me, how much of the healthcare crisis in the US is really a crisis of our social fabric? How much of our problem has to do with anadequate access to healthcare, and how much has to do with a breakdown in community? Is it a bigger problem for my parents' generation that medical costs are going through the roof, or that their asshole kids have all moved away and left them by themselves at home? How much of our crisis would be solved if we organized at a community level for our ill to be cared for at home, or if we just started living as families again? NZ had both better physical health and stronger community ties that I've experienced in the US. Are those things connected?

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