Why We’re Losing the Battle With #Covid-19 - The New York Times
▻https://www.nytimes.com/2020/07/14/magazine/covid-19-public-health-texas.html
In the past century, the largest gains in human health and life expectancy have come from public-health interventions, not medical ones. Clinical medicine — treating individual patients with medication and procedures — has registered enormous gains. Hepatitis C is now curable; so are many childhood cancers. Cutting-edge gene therapies are curing rare genetic disorders, and new technology is making surgeries of every kind safer. But even stacked against those triumphs, public health — the policies and programs that prevent entire communities from getting sick in the first place — is still the clear winner. “It’s saved the most lives by far, for the least amount of money,” Tom Frieden, a former director of the C.D.C., told me recently. “But you’d never guess that based on how little we invest in it.”
Think of the factors that determine a society’s health as a pyramid, Frieden says, in which the things that have the biggest impact on the most people are afforded the most space. Social policies that mitigate economic inequality would be at the base of the pyramid, followed immediately by public-health interventions like improved sanitation, automobile-and-workplace-safety laws, clean-water initiatives and tobacco-control programs. Clinical medicine would be closer to the top. “Now consider the way that we value and prioritize those factors,” Frieden says. “It’s almost completely inverted.” Less than 3 percent of the country’s $3.6 trillion total annual health care bill is spent on public health; a vast majority of the rest goes to clinical medicine.
Le reste est beaucoup moins convaincant, qui rejette la faute sur les « Américains » qui chérissent leur liberté au point de refuser qu’on leur « dicte » ce qu’il faut faire.
#santé_publique versus #profits #états-unis