Bill of Health

Bill of Health, an essay about how the current trends in digital health and health tech are poised to deepen differences in access to health care in the United States, was published online by Real Life in April 2019.

In the real world where people frequently fall ill, doctor-patient encounters are crunched into shorter and shorter time frames and preventive health-care services are becoming scarcer in rural areas in the U.S. Finding a doctor who can provide adequate basic health care is increasingly a privilege of the rich and urban. Forward offers its urban customers — it was launched in California and recently expanded to New York City — an intensification of that privilege: not only the knowledge that one is looked after by a medical professional but also reams of exclusive data about the self.

The public fanfare over services like Forward makes explicit how medical treatment in the U.S. is increasingly positioned as a luxury for the wealthy. At the same time, the rest of us are led to believe that it is not money or affordable care that really matters but self-knowledge. Devices like the Apple Watch and the FitBit are proxies for the attentive, face-to-face health care that all people actually need. But in the utopian realm of digital health, personalized on-demand health data is framed as both sufficient and aspirational. Like the latest iPhone, health is becoming an exclusive novelty item, enticing to early adopters with cash to spare.