A Quote by Paul Farmer
The biggest public health challenge is rebuilding health systems. In other words, if you look at cholera or maternal mortality or tuberculosis in Haiti, they're major problems in Haiti, but the biggest problem is rebuilding systems.
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If any country was a mine-shaft canary for the reintroduction of cholera, it was Haiti - and we knew it. And in retrospect, more should have been done to prepare for cholera... which can spread like wildfire in Haiti... This was a big rebuke to all of us working in public health and health care in Haiti.
We've taken on the major health problems of the poorest - tuberculosis, maternal mortality, AIDS, malaria - in four countries. We've scored some victories in the sense that we've cured or treated thousands and changed the discourse about what is possible.
Maternal mortality health is a very sensitive indicator. All you need to look at is a country's maternal mortality rate. That is a surrogate for whether the country's health system is functioning. If it works for women, I'm sure it will work for men.
The biggest problem Haiti has is the weakness of its public institutions.
Paul Farmer has helped to build amazing health care system in one of the poorest areas of Haiti. He founded Partners in Health, which serves the destitute and the sick in many parts of the world from Haiti to Boston and from Russia to Peru.
I can't think of a better model for Haiti rebuilding than Rwanda.
It turns out that cholera is new to Haiti. It was inadvertently introduced by a group of U.N. peacekeepers stationed in central Haiti who had come from South Asia where it is endemic.
We are losing our living systems, social systems, cultural systems, governing systems, stability, and our constitutional health, and we're surrendering it all at the same time.
I think the Scandinavian health systems are better when it comes to preventative care than the German system, because in the Scandinavian systems, the government is really more active in defining treatment, goals and defining health priorities. The German system is a competitive system with little government intervention. The price for this is that the government cannot set a health agenda. And the Scandinavian systems have little competition, so you often do have waiting lists. But on the other hand, you then have the government which can push for prevention.
I want to see Haiti do better. We have the sun everywhere: that's a big asset. We have wonderful coasts, beautiful islands, mountains. Other countries that have that are known for it, but Haiti has been so focused inwards, on its problems.
Obamacare has made a mess of our health insurance and health care systems, and Washington politicians have failed to fix the problem.
Including health care. We're going to end up with better health care at a lower price. People are going to pay less and they're going to have a lower deductible.You know, the biggest - the second biggest problem, other than premiums, with Obamacare is the deductibles. They're so high, nobody's going to get to use them.
Haiti is the poorest country in our hemisphere. The earthquake and the hurricanes, it has devastated Haiti. Bill Clinton and I have been involved in trying to help Haiti for many years.
But I think it's very key that there's a plan for Haiti. And we have to begin to - as progressives and people who are concerned about Haiti and have been concerned about Haiti, we have to begin to build some sort of consensus, a movement around the Haiti that the Haitians envision.
The German health care system is unique in its attempt to combine competition among sickness funds on the one hand and a universal coverage plan on the other hand. Most health care systems are either one or the other, so you either have private insurance and competition but not everyone is covered for everything, or you have a single-payer system. So the ideal types are like the American system on the one hand or the Scandinavian or U.K. systems on the other end.
Germany tries to combine the advantages.
My first visit to Haiti was in May 1991, four months into the initial term of Haiti's first democratically-elected president, Jean-Bertrand Aristide. At the time, it seemed that Haiti was on the cusp of a new era.
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