The Human Body as a Widget

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 democracy.

Snyder made the case in a 2021 essay:

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 four “lessons”:

• 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 Premonition, this 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 Germany¹ with delivering one in the US.

The personal angle is what really drew me to Our Malady. From On Tyranny to The Road to Unfreedom 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 Ukraine”, 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 trauma).

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 tape.” 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.