I don’t pay much attention to my personal advantage or disadvantage, but I do get a little taken aback when I get a bill like the one for my annual eye checkup. It shows what I owe ($114.15) but not what the insurance paid. The exam consisted of five minutes of peering into dilated eyes with a hand glass (the machines have not been installed in the doc’s new office), a 5 second instrument test for glaucoma, plus a half hour with an assistant at an automated machine that tested my peripheral vision. I’ll add the amount billed to the insurance company when I get my monthly report. I’ve finally realized that this monthly report is so I can monitor for wrong charges. So much for me.
This is where I go otherwise -- to the far extreme: what does health care insurance do for the planetary population of humans? It strengthens the likelihood of the survival of one group of humans, the Americans. (The other nations already have this advantage.) It does nothing to change the causes of poor health, unless you count the gathering of statistics. It says nothing about the individual. But the consent of the individual, whose taxes pay for the program, is based on their belief that they are personally better off.
If they look at this individually, they might see something quite different than looking at it “in the aggregate.” I personally am not likely to get “whooping cough” though I was only vaccinated as a child, a long time ago, but I live a solitary life and have no children in school where several hundred kids have now had to struggle with this “traditional” childhood disease that could have been averted by the vaccination that is resisted by many.
Now think about HIV-AIDS. I do not have sex with anyone, I have never received a blood transfusions, I do not use IV drugs, I do not come in contact with blood spatters from people who might be carrying the virus. In Montana very few people have the virus. They are not concentrated on the reservations but rather in university towns where people are young and experimenting. BUT the fact of its existence, the fact that it has such a long period of latency, the fact that it is often a marker for things like Hep C, TB, and VD (I’m old-fashioned. Okay, STD) as well as drug use, means we should be tracking it, that there should be high consciousness of the need for prevention and testing. It is no longer connected to only gay sex, evidently because anal sex has become so increasingly accepted as “edgy” or a way to prevent pregnancy or because so many men have learned in prison. (So many men serve time in prison.)
HIV-AIDS is a planetary virus. It goes everywhere. It is a stealth virus. It can exist undetected for a long time. Quite parallel are the prion diseases, like Mad Cow or Alzheimers, except that a virus has a genetic content (that’s about all it DOES have) and a prion is only a protein molecule. No one knows how it spreads or what it does to damage, just that it leaves a footprint of death. Evidently eating flesh that contains the prion can transmit it, but again there is a long dormant period before it is detectable.
It used to be that geological barriers like mountains or oceans or deserts could keep diseases within areas. Common bacteria, we now know, can cross oceans on the wind. They can even travel through outer space on dust. There is no escape.
Is there cure? Is there management? This powers a lot of research, but more money, effort and interest is diverted into the next popular craze in cosmetics or social communication. Also, more and more is controlled by algorithms about financial justification: If you have a manageable disease but only a hundred or so others have the same disease, no pharm corp in its right mind is going to produce the meds you need. They also feel free to short-produce meds needed for unpopular categories of people, like people who have HIV-AIDS. Do not imagine that at any time appealing and connected people will suffer for lack. Do not imagine that the planet is not growing webworks of underground producers, the same as alcohol prohibition did. One those channels are there, anything can come through them. Once uncontrolled med labs exist, they don’t have to make helpful drugs. They aren’t now.
Many present afflictions seem to be caused by the productions of entirely legal and profitable industrial labs. Food additives, plastics, ag chemicals, fuels, radioactivity, genetic tinkering -- are poisoning us. Again, long latency, finally appearing as cancers or hormonal disorders, are only revealed by statistics of groups. Hanging over the heads of town water supplies is the threat of expensive filtering to eliminate the antibiotics and birth control pills peed into the sewer lagoon, which has eventual access to ground water. At the moment this village cannot meet the standards fo controlling e coli in our sewage. We are our worst disease.
My biggest fear is that fear-driven (!!) powers and rules will do for natiohal health measures what it has done for Homeland Security, that is, empower it to declare control over reservations and International Peace Parks, justify huge expenses for mysterious means, authorize snooper drones and invade communication privacy. The potential for creating dystopias is huge.
The drive to reduce costs could take the Wal-Mart approach: savings through consolidation, so that what started out to be individual insurance becomes a drive to merge the Indian Health Service and the Veteran’s Administration Services into one national program. Some people already have access to Medicare, IHS and the VA, so that they can choose among them.
Canada’s health care, often touted as the desirable example, is “fenced” by low level health workers who control access to doctors. The tendency up there is to skimp on machinery, so that people who have money come to the US for MRI’s so they don’t have to wait months. On the other hand, drugs up there are much cheaper.
To the south of us Mexico is happy to provide much less regulation. Terrierman, one of my fav bloggers, remarks dryly that if you really can’t stand government-provided health insurance, you could go to Somalia, one of the last “nations” without any. Of course, that’s because there’s no government. Tim says their hotels are terrible but few people have an obesity problem.