It is very expensive to give bad medical care to poor people in a rich country.
I've been asked a lot for my view on American health care. Well, 'it would be a good idea,' to quote Gandhi.
The idea that some lives matter less is the root of all that is wrong with the world.
Anywhere you have extreme poverty and no national health insurance, no promise of health care regardless of social standing, that's where you see the sharp limitations of market-based health care.
Since I do not believe that there should be different recommendations for people living in the Bronx and people living in Manhattan, I am uncomfortable making different recommendations for my patients in Boston and in Haiti.
The thing about rights is that in the end you can't prove what should be considered a right.
At the same time, it is obvious that clinicians in Haiti are faced with different, and, in fact, greater, challenges when attempting to treat complications of HIV disease.
In an age of explosive development in the realm of medical technology, it is unnerving to find that the discoveries of Salk, Sabin, and even Pasteur remain irrelevant to much of humanity.
In fact, it seems to me that making strategic alliances across national borders in order to treat HIV among the world's poor is one of the last great hopes of solidarity across a widening divide.
But if you're asking my opinion, I would argue that a social justice approach should be central to medicine and utilized to be central to public health. This could be very simple: the well should take care of the sick.
The poorest parts of the world are by and large the places in which one can best view the worst of medicine and not because doctors in these countries have different ideas about what constitutes modern medicine. It's the system and its limitations that are to blame.
So I can't show you how, exactly, health care is a basic human right. But what I can argue is that no one should have to die of a disease that is treatable.
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.
The human rights community has focused very narrowly on political and civil rights for many decades, and with reason, but now we have to ask how can we broaden the view.
I'm going to build my own fucking hospital. And there'll be none of that there, thank you.
I can't sleep. There's always somebody not getting treatment. I can't stand that.
It is clear that the pharmaceutical industry is not, by any stretch of the imagination, doing enough to ensure that the poor have access to adequate medical care.
I recommend the same therapies for all humans with HIV. There is no reason to believe that physiologic responses to therapy will vary across lines of class, culture, race or nationality.
Civil and political rights are critical, but not often the real problem for the destitute sick. My patients in Haiti can now vote but they can't get medical care or clean water.
The only way to do the human rights thing is to do the right thing medically.
I'm one of six kids, and the eight of us lived for over a decade in either a bus or a boat.