I believe strongly in mutual aid, including when it comes to health care. However, in my view, it is not pragmatic to argue that mutual aid can substitute for a well-functioning health care system and effective health policy. Health care involves time-sensitive decision-making, choices about allocation of resources, coordination of advanced technology, and education and oversight of health care personnel, all of which require a considerable amount of organization, policy, and financing that is not realistically going to occur in a mutual aid setting. There are certainly specific types of health care, like mental health, for example, that are ideal for moving to a community-setting. Heart surgery or renal failure management are not.
While I strongly agree that the United States needs to allocate more resources into preventing disease by addressing social and structural determinants of health, the reality is we have not done so, and a large proportion (or nearly all) of the population has been exposed to significant health risk factors. Thus, the need for health care is only going to grow, no matter how much preventive health policy is enacted in the future. In my view, the solution is a government-funded and coordinated health care system, as globally these systems produce the best and most equitable outcomes, including patient satisfaction.
I believe mutual aid is an important practice that can supplement the health care system and help sustain people who have been failed by it. While I agree there are some beautiful ideals that underlie mutual aid, I do not think it is a realistic replacement for health care.
Position statements are brief notes I write to communicate about public health, political, and other issues. They are living documents, which I may add to and modify as my views evolve.
