Who Lives and Who Dies: Paul Farmer on the Inequities of Health Care Funding


Dr. Paul Farmer, NESRI Board Member and Co-Founder of Partners in Health, makes the case for equitable financing of health care across the world and here in the United States. Grounded in his ongoing struggle for the human right to health care, he argues that all people need the full spectrum of health-related services – from sanitation to medicine, from preventive care to tertiary care – not just those services that are cheap and easy to fund.  More expensive but necessary care must not remain a privilege for those who can pay. Everyone, including people living in poverty, have a right to comprehensive medical care.

“Finding equitable ways to finance healthcare, including the treatment of catastrophic illness, is the main challenge for both medicine and public health.”

“In the face of rapid medical advances, and dizzying fluctuations in both the cost (to say nothing of price) and effectiveness of these advances, it was increasingly the global poor who were asked to make do with the ‘basic minimum package’.”

“In part because of deep ambivalence about services for the poor, whether they live in rich countries or poor ones, and in part because of a relentless push to privatise profits as we socialise losses, we are still asking how to pay for the staff, stuff and systems required to build the House of Yes and make it a space that can serve those most in need. New ways of financing healthcare – and of making it easier to stay healthy – are needed to get beyond the impasse, especially if the hope is to reach those most at risk of untimely death and disability.”

Read Dr. Farmer’s essay here or download it below.

Additional Resources