We need a fundamental shift in the way we think about healthcare, and I think there is no better person to illustrate my point than the artist Yasiin Bey, formerly known as Mos Def.

The first track of his classic album “Black on Both Sides” opens with a diatribe about hip hop. He explains that when people ask him what’s going to happen with hip hop (usually with an air of concern in their voice), he tells them:

“You know what’s gonna happen with Hip Hop?
Whatever’s happening with us…
If we doing alright, Hip Hop is gonna be doing alright”

The problem Mos is trying to highlight is the danger of the language in this critique. To ask what’s happening to hip hop is to 1) make hip hop a self contained “thing”, 2) to assume no participation in or responsibility for its state, and 3) to grossly oversimplify how this “thing” might be broken (or dead, or sold out, take your pick) and then get locked into language that forces incorrect conclusions.

People do the exact same thing when they talk about what’s wrong with “healthcare”.

“Healthcare” is not a self contained thing.

Healthcare is doctors and nurses, sure. But healthcare is also insurance companies and the choices you make at the supermarket and the way you treat your kids and how long your grandparents are living.

The word healthcare contains so much, it’s like saying the word “America” there is so much good, bad, ambiguous, frustrating, inspiring, relentless and ultimately inescapable about the word that it can’t be assumed to mean the exact same thing to any two people who hear it.

To abstract out the idea of “Healthcare” is to  remove yourself from any culpability for its current state.

Healthcare didn’t fall from the sky. It was shaped in this country through many years of labor negotiations, advances in medicine, insurance practices, federal and state policies and good old-fashioned biological necessities. We ALL had a hand in forming the healthcare system we currently have in this country.  OUR healthcare system sucks. We made it suck. As Mos says:

“People talk about Hip Hop like it’s some giant living in the hillside coming down to visit the townspeople. We are Hip Hop – Me, you, everybody, we are Hip Hop. So Hip Hop is going where we going. So the next time you ask yourself where Hip Hop is going ask yourself.. where am I going? How am I doing?”

The words we use to describe our problems matter. A lot.

I’ve written before about how problematic the phase ”healthcare is broken” can be. Now think about how much changes when instead of saying “healthcare is broken”, you say “we are broken”. “Healthcare is filled with perverse incentives” becomes “we are filled with perverse incentives”.  And “healthcare is bankrupting our country” suddenly means “we are bankrupting our country.”

To rework Yasiin’s words:

People talk about healthcare like it’s some giant living in the hillside coming down to visit the townspeople. We are healthcare. Me, you, everybody. So healthcare is going where we are going. So the next time you ask yourself where healthcare is going ask yourself.. where am I going? How am I doing?

Photo by Mikamote under the Creative Commons Attribution-Share Alike 3.0 Unported