Liberty, Democracy, Equity and Justice in Health Care

Imagine a world where those who can’t pay for hospital services are turned away, where primary care physicians are paid the same amount as garbage collectors and where doctors supplement their income with kickbacks from drug companies. According to Dr. Leana Wen, this dystopian nightmare is the current state of health care in China.

Is a Health Care Dystopia in Our Future?


In her TEDx Talk, Dr. Wen warns that the U.S. is on a fast track toward many of the same health care problems faced by China. She bases her opinion on research she conducted in China, visiting hospitals in nine provinces. Born in Shanghai, she came to the United States at the age of 8 when her parents were granted political asylum. When she returned to China for her research, she expected to find a more advanced version of the utopian universal health care system that she remembered from her childhood. Instead, she found that when the universal system was dismantled in the 1980s, 900 million people lost health care coverage overnight. Nearly every Chinese family has a story from that time about a relative or friend who died waiting in front of a hospital because they couldn’t afford medical care.


Dr. Wen believes that the economic culture in the U.S. has a blind spot when it comes to choice. We believe that being a consumer gives us the right to choose and that having multiple choices is empowering. When this attitude is applied to the practice of medicine, it turns health care into a commodity to be bought and sold, with the doctor-patient relationship resembling that of salesperson and client.

The consequences of this blind spot include escalating health care costs, millions of Americans with no health insurance and a culture in which prescription drugs are given precedence over prevention. According to Dr. Wen, we have already started down the path that led to China’s current situation.

Applying Core Tenets to Health Care

Dr. Wen prescribes these three steps to help the U.S. avoid the dysfunctional health care system she encountered in China:

  1. As a society, we must decide that some things are not for sale. Health care is a right, not a commodity.
  2. We need to realign incentives to help people be their best selves, eliminating pressures that cause health care professionals to lose their way.
  3. Physicians must hold on to the principles of their profession and be mindful of their mission.

Dr. Wen considers America to be her homeland and is passionate about the American core values of liberty, democracy, equity and justice. She believes that capitalism does not have to mean consumerism and that the time has come for health care professionals to apply our nation’s core values to their mission.

As our nation embarks on a once-in-a-generation opportunity to reform health care through the Affordable Care Act, public health policymakers and practitioners have a unique opportunity to learn from the situation in China and to rethink the relationship between government and public health. Now more than ever, public health experts like Dr. Wen are needed to help ensure that all Americans have equal access to quality health care.

About the Speaker

Dr. Leana Wen is director of patient-centered care research in the Department of Emergency Medicine at the George Washington University. She is an attending physician and patient advocate who has served as a consultant to the World Health Organization, China Medical Board and Brookings Institute and is co-author of the best-selling book When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests. Dr. Wen is also a former Rhodes Scholar and holds a master’s degree in economics and social history from the University of Oxford.

Dr. Wen speaks around the world on health care reform, patient empowerment and transparency in medicine. In 2012, she spent two months researching the medical system in China. Her research included visits to 14 medical schools and more than 50 hospitals. Focusing on emergency medicine and medical education, she was given unprecedented access to doctors, nurses, medical students, administrators and government officials.