Me vs. Us

How can we care so much about health care yet so little about public health? Before Covid-19, public health programs constituted only 2.5 percent of all US health spending, with the other 97.5 percent going towards the larger health care system. In fact, the United States spends on average $11,000 per citizen per year on health care, but only $286 per person on public health. It seems that Americans value health care, the medical care of individuals, over public health, the well-being of collections of people. In Me vs. Us, primary care doctor and public health advocate Michael Stein takes a hard, insightful look at the larger questions behind American health and health care. He offers eight reasons why our interest in the technologies and delivery of health care supersedes our interest in public health and its focus on the core social, economic, and environmental forces that shape health. Stein documents how public health has continually "lost out" to medicine--from a loss in funding and resources to how we view our personal priorities--and suggests how public health may hold the solutions to our most concerning crises, from pandemics to obesity to climate change. Me vs. Us concludes that individual and public health are inseparable. In the end, Stein argues, we need to recover and sharpen our sense of health based on a reverent appreciation of both perspectives.

Michael D. Stein, MD, a primary care physician and researcher, has been writing about medicine and public health for decades. He is Professor and Chair of Health Law, Policy, and Management at Boston University School of Public Health. Stein graduated from Harvard College and received his medical degree from Columbia College of Physicians and Surgeons. Stein has published more than 400 scientific journal articles related to behavioral medicine and risk-taking, and is the best-selling author of ten books, including The Addict: One Patient, One Doctor, One Year, Pained: Uncomfortable Conversations about The Public's Health, and Broke: Patients Talk about Money with Their Doctor.

Introduction With Health, as in the rest of life, we think in terms of Me not Us PART 1 Chapter 1 We are not sure what public health is Chapter 2 If public health work is preventive, it's invisible, and becomes visible only during crises Chapter 3 We are not sure who public health is for Chapter 4 There is little private money to be made in public health Chapter 5 Public health frames its successes incorrectly Chapter 6 Public health can only infrequently perform randomized trials and therefore seems less rigorous Chatper 7 Public health is thought of as government work, primarily for the sake of the poor Chapter 8 Public health is missing health care's personal stories PART 2: HEALTH INDIVISIBLE