Pie in the Sky?

Sandro Galea and George Annas, in the new JAMA, repeat the familiar lament that we invest proportionally far too much in curing people with medical intervention and far too little in keeping the population healthy through public health measures. They see health as a fundamental right and they want to adopt the Universal Declaration of Human Rights as the ethical basis for public health.

Actually they seem to fall a bit short in their understanding of what public health means. For example, they say "Public health is not alone, sharing funding and infrastructure deficiencies with transportation, education and even public safety." In fact, all of these are part of public health. Education probably the single most powerful contributor to population health, particularly education of women and girls. Mass transit, cleaner and safer motor vehicles, fire and crime prevention -- these are all public health.

The problem in the U.S. right now is that public health is all about social justice, and fixing the problems that the mythical "free market" cannot. Therefore it is unpopular with the plutocrats who run things, who would have to pay taxes to make the planet better for the rest of us.

That's why the UN's new sustainable development goals, which were formally promulgated at the beginning of this year, seem unrealistic. If the wealthiest country on earth isn't interested in investing, it won't happen. The goals include ending poverty, ending hunger, quality education for all, gender equality, affordable clean energy, climate action -- you know, all that commie stuff. Unfortunately, we have an entire major political party, that controls most of the levers of power, that doesn't want any of that to happen. So let's tell it like it is.