Farmer emphasized the creation of a public health system from “scratch” due to the realization that Haiti was just recovering from political turmoil. A public health system is primarily dependent on government policies. Developing countries like Haiti do not share the established private health sectors like most developed countries. Therefore, it leaves the government with the heavy burden of the provision of health care services to the whole population. Looking at Farmer’s propositions, it becomes apparent that he strived for an equitable distribution of health care. Farmer emphasized the fact that there are specific diseases that historically have been identified as affecting the poor population of the community. The components of Farmer’s dream were to include the sensitivity and consideration of the economically disadvantaged segments of communities within the general public health care systems. Included in the system would be institutions that would ensure that health care provision addressed the plight of the economically disadvantaged. Furthermore, such a system would require support from the government in terms of funding and penetration to the grass root. It is also important that such an initiative becomes sensitive to the specific needs of particular communities to be able to integrate the system successfully. In poverty zones like Haiti, where distribution of resources already takes place in an inequitable fashion, reaching the marginalized population would be a major hurdle.
The public health program is mostly dependent on the policies and priorities of a government. Different populations require different health care programs due to socio-economic factors. Furthermore, the distribution of resources is different from one economy to another due to the macro-economic policies adopted by a particular government. The US not only has a different political environment but the priorities of the government in terms of budgeting are also varied from those of Haiti. In the US the government and the private sector are working hand in hand to ensure the provision of health services to the population. Furthermore, the demographic distribution of diseases in Haiti is different from the one in the US. Therefore it is obvious that such an approach would not be effective in the U.S.
The reasons for the inapplicability of such an approach in the U.S, stems from the fact that U.S and Haiti present different scenarios from various perspectives. Although, understandably, both countries present different degrees of inequitable distribution of health care services about economic factors, the two countries are at different stages of development. Public health programs in general are beneficial because in most instances they consider socioeconomic disparities. Every economy in the world struggles to ensure that resources are equitably distributed and this includes health services. However, different economies experience varied challenges. Even when the program proposed by Farmer was to be implemented among the impoverished populations in the U.S, other factors would still frustrate the process. Socially the U.S faces different challenges that may either be magnified or minimized by the economic situation of the country. When the same consideration is placed on Haiti, there is the realization that the scenario presented in the country is quite different. It is therefore notable that public health programs require customization to fit within the socio-economic needs of a particular environment.