The health-related determinants of politics
Authors: Parth Patel
Journal: The Lancet (2020)

I was pleased to read Richard Horton's Comment about populist politics.1Horton R Offline: How to defeat political populism.Lancet. 2020; 395: 480Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar However, the problem of political populism and solution that he charts out seem somewhat non-sequitur. If the determinants of health are identified as political, then the remedy must also be political. US President Donald Trump propagates a myth about "forcing American taxpayers to provide unlimited free healthcare to illegal aliens",2The White HouseFull transcript: Trump's 2020 State of the Union address.https://www.nytimes.com/2020/02/05/us/politics/state-of-union-transcript.htmlDate: Feb 5, 2020Date accessed: February 15, 2020Google Scholar and the responses from academia are merely calls for justice, fairness, and universality. These values are imperative but, in addition to the moral argument, we should also make the political one. Perhaps this political passivity from academics is an indication of a wider problem. Academics are happy to engage with the policy, but afraid to engage with the politics. Research, such as that encompassed in the Lancet Migration, is normative rather than descriptive.3Orcutt M Spiegel P Kumar B Abubakar I Clark J Horton R Lancet Migration: global collaboration to advance migration health.Lancet. 2020; 395: 317-319Summary Full Text Full Text PDF PubMed Scopus (27) Google Scholar Such research is done to improve people's quality of life and is therefore political. This fact does not make it partisan. The Lancet Migration3Orcutt M Spiegel P Kumar B Abubakar I Clark J Horton R Lancet Migration: global collaboration to advance migration health.Lancet. 2020; 395: 317-319Summary Full Text Full Text PDF PubMed Scopus (27) Google Scholar can challenge populist politics with robust research on the apparent burden migrants put on health-care services, the health-care sector's dependence on migrants, and the fiscal contributions of "illegal aliens".2The White HouseFull transcript: Trump's 2020 State of the Union address.https://www.nytimes.com/2020/02/05/us/politics/state-of-union-transcript.htmlDate: Feb 5, 2020Date accessed: February 15, 2020Google Scholar, 4Saez E Zucman G The triumph of injustice: how the rich dodge taxes and how to make them pay. WW Norton & Company, New York2019Google Scholar This collaboration can frame migrants not just as vulnerable, but as valuable. This view will be particularly important in the aftermath of the COVID-19 pandemic. Health care resonates powerfully with the public, and is the number one issue for US voters in the coming election.5Bonn T Poll: voters name health care as top issue going into 2020.https://thehill.com/hilltv/rising/474327-voters-name-health-care-as-top-issue-going-into-2020Date: Dec 12, 2020Date accessed: February 15, 2020Google Scholar The health community should use their privilege to shape politics, rather than to merely allow politics to shape health. It is worth considering the health-related determinants of politics by reversing the traditional notion of the political determinants of health. PP reports personal fees from the Imperial College Healthcare National Health Service Trust and the Institute for Public Policy Research, unrelated to this Correspondence. Offline: How to defeat political populismHere is US President Donald Trump last week in his State of the Union Address: "A good life for American families also requires the most affordable, innovative, and high-quality healthcare system on Earth...Over 130 legislators in this chamber have endorsed legislation that would bankrupt our nation by providing free taxpayer-funded healthcare to millions of illegal aliens, forcing taxpayers to subsidise free care for anyone in the world who unlawfully crosses our borders...If forcing American taxpayers to provide unlimited free healthcare to illegal aliens sounds fair to you, then stand with the radical left. Full-Text PDF