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The Health Care Revolt

Dr. Michael Fine, the former director of the RI Department of Health, has written a book, The Health Care Revolt: How to Organize, Build a Health Care System, and Resuscitate Democracy—All at the Same Time. He argues that we have a health care MARKET, but not a health care SYSTEM. All sorts of providers are out to sell us medical services and products to make make money. Hospitals, doctors groups, and pharmaceutical companies are spending millions advertising and competing with each other. Yet Americans are less healthy than people in dozens of other countries.

No one is responsible for assuring that everyone is as healthy as possible. Competition leads to a chaos. We have systems for police and fire protection with stations places throughout our communities. Why not similar health stations? Dr. Fine imagines an actual system, rather than a market, arranged so that every 10,000 people had a primary care station to go to first, whether or not they have health insurance. (In the book, he describes the whole system, which includes additional levels where more specialized services would be available as needed, but everything begins at the primary care level. No coercion: People could still have their current doctors and insurance if they prefer.)

It is estimated that 90% of Central Falls residents will be supported by the first full-blown attempt at creating a Neighborhood Health Station in the United States. This station will open in late 2018 or early 2019, and will have a multidisciplinary staff of professionals available, not just doctors and nurses but also  nutritionists, mental health professionals, physical therapists, dentists, outreach workers going to high schools to address teenage pregnancy, etc. Most common health problems could be dealt with at a cost of about $500/person/year. (The average cost per person per year of health care in the US is $11,000, by the way.) The primary care station would drastically reduce emergency room visits, and everyone in the immediate community would be known by the staff, enabling personal care and building neighborhood relationships. Everyone in the community could be vaccinated, and even more important, the population could be screened for highly contagious deadly diseases like HIV and Hepatitis C.

There is a cure for Hep C, and if everyone carrying the disease in the US were treated, the disease could be eradicated (more or less). But there's no way at present to know who the infected people are -- perhaps 150,000 Americans have Hep C and don't know it -- yet. A real system instead of this competitive marketplace could deal with this problem. See The Health Care Revolt for a full discussion of this exciting possibility of a real health care SYSTEM.

Of course this will be forcefully opposed by vested interests, so Dr. Fine thinks it will take years and concerted effort of tens of thousands of people to shift to a health care system that puts human life above profit. But maybe we can get this moving a bit faster here. The RI environmental and social justice communities realize that working together will benefit both of their movements, and they both have a growing awareness of how environmental damage affects human health, especially for underserved communities. If you read Health Care Revolt and listen to Dr. Fine, who is willing to speak anywhere, including  "at the opening of an envelope," to spread the word, you will find a clear connection between the health stations and environmental and social justice issues. Since it is going to be a heavy lift to make health stations work, I hope all the environmental and social justice forces will find ways to coordinate with the Health Care Revolt Movement.

Because Rhode Island is so small, densely populated and compact, we can, if enough of us will work together, actually model a real health care SYSTEM that could be extended throughout the nation, saving $1 trillion of the $3+ trillion Americans are spending on health care each year. Dr. Fine is speaking everywhere he can to spread the word and ask people to join the movement. Here are some links to further information.


BUY THE BOOK - AT RHODE ISLAND BOOK STORES and at Dr. Fine's talks, which will all be listed in What Grows On in RI and the Environment Council of RI's calendar.

Dr. Fine's homepage

From Facebook:

"Hey Rhode Island! As most of us know, healthcare has become an impersonal and ineffective wealth extraction system. High costs are draining state resources for community development and patients lives are put at risk for the sake of profit. So, what do we do?

"We organize. Join us in an initiative to de-industrialize the health care system. We are bringing together healthcare professionals and concerned community members to build multidisciplinary teams and Neighborhood Health Stations. Our goal is to create a system that will take care of every single person in the community, no matter their insurance status.

"This is just the beginning. Join us and be a part of a radical new chapter in Rhode Island healthcare. "

The main page for the Health Care Revolt is on the George Wiley Center website.


The Central Falls Neighborhood Health Station is the Blackstone Valley Community Health Care (BVCHC).

Story about the groundbreaking for the new health station, October 17, 2016, with videos of speakers at the event.

Valley Breeze article about BVCHC opening in Fall - Winter 2018-19.


 An earlier, less complete version of a health station in a smaller community, the Scituate Health Alliance.