The cover of a magazine with the title on medicine as colonialism.

“On Medicine as Colonialism” – new book by Michael Fine

In this strident, necessary, meticulously researched book Michael Fine uses the COVID-19 pandemic and many other examples to show the costly failure of the American health care system in bold relief. Hospitals, insurance companies, Big Pharma, specialists, and even primary care doctors have all become tools of the new health profiteers. On Medicine as Colonialism shows how the American health care system cannibalizes communities in the US and around the world. Focusing on how health care profiteers co-opt the state’s regulatory power, Medicare, and Medicaid to extract resources from communities, this book reveals how medicine and health care have become tools of a new health colonialism, turning medicine on its head, so that individuals and communities lose their agency, health becomes impossible, and profits are used to dismantle democracy itself.


On Medicine as Colonialism details the sociopolitical realities that undergird health injustice and offers a realistic perspective on achieving health equity.” —Jewel Mullen, MD, MPH, Dell Medical School, UT Austin

“A sobering diatribe on health care in America.” —David N. Sundwall, former executive director of the Utah Department of Health

“Michael Fine wins his big-hearted argument that American medicine is colonialism, not just for the poor but for all of us. It is a desecration of our health care system by the same old robber barons. . . . This doctor-activist is pointing us to solutions. Everyone should read it.” —Samuel Shem, author and professor of medical humanities, NYU Medical School 

“Fine writes with the eye of both a humanist and a practitioner. . . . His passion for individual lives and concern for the common good is what drives his outrage at what has been wrought.” —Christopher Koller, president of the Milbank Fund, from the foreword

About the Author

Michael Fine is a monthly contributor to Each month he shares a short story with our readers. Fine is a community organizer, family physician, public health official, and public health policy provocateur. He is the author of Health Care Revolt, Abundance, and The Bull and Other Stories.