We have met the enemy and it is us. Much of the mess in health care is there because there is too much money in it, and too many people use health care to solve the problems we ourselves created. Want to fix homelessness? Build housing. Want people to come to work every day? Treat them well and pay them fairly. Want to prevent intoxication and drug overdose death? Create after school programs and community centers where people can hang out together and play sports or learn, and make sure there is treatment on demand for everyone who develops alcoholism or substance use disorder anyway. Want to save money on pharmaceuticals? Build exercise programs and subsidize fresh fruits and vegetables so people stay in shape, and that will prevent the diabetes, high blood pressure, stroke and heart disease that is responsible for many of our health care costs.

 Michael Fine MD