An expose jam-packed with love, lust, debauchery and greed unfolds when disease collides with healthcare profiteers and physician indifference in Conversations for Paco: Why America Needs Healthcare for All. Inspired by a true account, Conversations for Paco juxtaposes the venerable institutions of medicine against the personal anguish of enigmatic disease as Paco and Sarita Sánchez battle Paco’s mysterious illness and Justin Sutherland surmounts the unanticipated challenges of medical education. Two-parts social criticism, one part medical suspense, it spins a thought provoking, yet spellbinding tale. What happens in the end will haunt you forever and force you to ask, “Can this really be?” Unfortunately, the painful truth is … “Yes.”
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Is it any surprise the drama played out through the lives of Sarita and Paco Sánchez resonates to some degree, and on some level, with each and every one of us? Is it any wonder we shake our heads and ask: “What went wrong with healthcare in America and how can this be?” Or do we question: “Has healthcare in the U.S. lost its ethical compass?”

A collective of twenty-eight family physicians and healthcare colleagues affiliated with the University of Washington School of Medicine Department of Family Medicine, proudly present this treatise to provoke the thoughts and direct the actions of health advocates, activists, lawmakers, and professionals around the globe. Penned in classic format, this textbook intends to educate health professionals through the lens of recent and remote events to illustrate the power of the social determinants of health on healthcare outcomes when embraced, or when ignored. Our work chronicles the 400-year history of healthcare in the United States and exposes the underbelly of the healthcare crisis in 21^st century America. It aims to light the flame of health justice in the minds, hearts, and souls of all people everywhere, for without health justice illness persists universally. It strives to teach budding health professionals the critical importance of the social determinates of health, for ignorance of their importance leaves life’s calling undone. It means to illustrate how, during the past four centuries and continuing to this day, the alleged halls of justice in the United States have trampled people seen as less worthy subjugating them to a life of marginal means, with less educational opportunity, low paying, backbreaking jobs, harsh environmental exposures, food insecurity, water unfit to drink, lack of access to health care and absence of legal resource to right the wrong, for disregard of inequities perpetuates a system deleterious to national health too long ignored. It serves to educate activists, advocates, and lawmakers that the health of our nation is dependent not on National Institutes of Health funding for the next state of the art monoclonal antibody, but finding the will and determination to legislate and enact social programs that defy systemic racism, poverty, food insecurity, homelessness, unconscionable minimum wages, toxic environments, contaminated water supplies, unemployment, and suppression of legal options, for the wealth of our nation thrives under the umbrella of population well-being. It leverages recent and remote events to illustrate what we do and how do it make fundamental and lasting differences, for if we listen, if we are curious, history always makes the best teacher. It calls us to action, and it screams from the rooftops that all men and women are created equal regardless of race, religion, color, or creed, for we are endowed by our Creator with certain unalienable rights, that among these are life, liberty, and the pursuit of happiness.