Our Malady explores how the American healthcare industry harms the country’s
citizens and undermines its democracy. I didn’t initially recognize the
connection there, so the book struck me as kind of out-of-place in author
Timothy Snyder’s larger body of work.
Although I knew he’d been inspired by a near-death experience while under
hospitalization, the topic didn’t seem particularly related to tyranny and
Snyder made the case in a 2021
If we say that we do not have a human right to health care, we are placing
our bodies beyond the world of rights, which means dropping them into in the
world of markets. They then become objects from which others make profits.
Our medical system does not incidentally generate profits while providing
health care; it incidentally provides health care while generating profits.
Far from a tirade against malpractice, this essay demonstrates how Snyder’s
perspective is uniquely relevant to the ongoing debate here in the US. It’s
what convinced me to read this book.
Adopting the structure from On Tyranny, Snyder divides these 150 pages into
- Lesson 1. Health care is a human right.
- Lesson 2. Renewal begins with children.
- Lesson 3. The truth will set us free.
- Lesson 4. Doctors should be in charge.
Given the thrust of those lessons and the timing of the books’ release, it may
go without saying that Snyder also draws heavily from the US’s response to the
COVID-19 pandemic. As Michael Lewis also demonstrated in The
is fertile ground for criticizing America both because its citizens have
first-hand experience and because examples of better solutions abound. Diligent
scholar that he is, Snyder is careful to substantiate his critique with
journalistic evidence, but it helps tremendously that he brings so much
personal experience to the table. In addition to explaining how he nearly died
under hospitalization, Snyder also contrasts the experience of delivering a
child in Germany with delivering one in the US.
The personal angle is what really drew me to Our Malady. From On
Tyranny to The Road
and so many articles he’s published since, I’ve grown to appreciate Snyder’s
worldview. It feels a bit strange to have almost no sense of his personality,
though. I hoped to find that in his 2022 lecture series, “The Making of Modern
but aside from the errant personal remark, he maintained a steady focus on the
subject matter. Our Malady is far more autobiographical, and I appreciated
reading about Snyder himself (it’s just a shame that much of it was based in
That said, I don’t think you need to be fanatical to enjoy this book. Beyond
being an accessible and well-referenced critique, Our Malady’s specific
policy recommendations make it practical even for folks who aren’t writing
laws. I don’t think about domestic healthcare very much, so it can be tough to
imagine constructive ideas, particularly at the scale of the institution.
Simply being exposed to alternative solutions makes it easier to recognize
opportunities–even ones which differ from Snyder’s.
Fittingly, the author made exactly this point in a recent
lecture: “if you’re sure that
there’s only one future, a democratic future, then you lose the habit and the
ability to talk about multiple possible futures.”
It can be distressing to live in a country where doctors are lobbying their
congresspeople “to be the trusted profession again rather than be crushed by
rules and red
By so convincingly tying these problems into a career-spanning narrative about
the necessity of participation in civil society, Snyder once again makes the
distressing feel like a call to action.