02 November 2009

Thoughts on the Healthcare Debate, Part II

Note: The following blog entry originally appeared as a thread post on dvdtalk.com.  I have expanded the introduction for this presentation.

Tonight, I entered the discussion on DVD Talk's sub-forum concerning our national healthcare debate.  It was already in its fifth part, sprawled across nearly twenty pages and including hundreds of posts.  Here is what I posted, and I look forward to any meaningful, thoughtful remarks.  I identify as a classic liberal, in the sense that I embrace questioning our government.  I like checks and balances on anyone in power, and I believe that where the government has the legal authority to act on behalf of the public, it has a moral obligation to do so--unless there is clear evidence that not acting will yield preferable results.

I'm assuming that most of the debate here has been like it has been everywhere else; "Public option is evil" vs. "Public option is the only thing that will save mankind." I think it's a worthwhile place to start, but there are far more relevant issues for our healthcare situation I haven't heard addressed much at all that I'd like to throw out there.

We're really just debating whose money is going to foot whose bills. Yes, the money is a major part of it, but I can't help but feel it's getting too much attention. For instance, when I was a kid in the 1980s, we had one kid in the entire school with asthma. I distinctly recall class coming to a complete halt for his occasional attacks, and I personally witnessed an ambulance being summoned for him once. It was a very alarming, disturbing thing and it always introduced a very specific discomfort into the classroom atmosphere to have him around.

Today, of course, kids without a respirator could very likely borrow one from a classmate in case of an emergency and their classmates would not be rattled, or even impressed, the way we were because they're entirely more familiar with such incidents.

I remember it was in the 1990s the first time I ever heard of anyone having a food allergy. I thought it was a joke, or at least an exaggeration. I mean, seriously; allergic to peanuts? That meant you couldn't eat a peanut butter and jelly sandwich, and that was simply a violation of all that was decent. And then I came to be aware of just how many children born in just the last decade or so who have not one, but often multiple such inabilities to safely ingest--or even contact--some of the most basic foods in our society. My wife's stepfather and his son have a deathly allergy to chicken, for instance.

Something is going on there, and we need to start doing something about it. I know the popular belief is that our industrialization has so tampered with our environment that our bodies are no longer surrounded by a healthy natural world, and that our food supply is therefore altered from what it once was. To at least some extent, this is certainly true. I remember when I was a kid, again, in the 1980s, and when I poured a glass of milk, I got bubbles. Somewhere along the line, as corporate farms pumped their cows full of more and more things, the bubbles disappeared. I'd forgotten entirely about bubbles in my milk until one day in the 90s, my mom bought a half-gallon of organic milk and when I poured it, voila! Bubbles.

These are simple examples, but I think they're universally recognizable ones. This isn't about red states, "Obamacare" or anyone's agenda. This is about seeing what's right there in front of us and admitting that by any measuring stick, things have gone very far from where they were even just a short while ago. So long as our children continue to emerge less and less healthy, we can continue this healthcare debate to only escalate--in cost, in urgency and in scale.

I have Crohn's disease and was diagnosed at a time when I was uninsured. I've come to greatly appreciate what limited use I've gotten out of the handful of pharmaceuticals that address my digestive woes, so I bear that in mind when I hear about pharma-profits. Research and development of the kinds of specialized things that help folks like me cost money. Proctor & Gamble manufactures one of the 5 ASA drugs, Asacol, that is a staple of treatment for many Crohnies. They were kind enough to provide my prescription to me free of charge  (roughly worth about $150 a month, I believe) because of my low income. It was only effective for me for about a year, but that was a year in which I was mostly under control and their generosity made it possible for me to take the medicine on a daily basis, instead of having to choose between filling a prescription or paying a particular bill.

I've tried to return the favor, in the little way I can, by favoring their products over those of their competitors when shopping, even now (two years after I last took Asacol). I think it's important to note this partly to demonstrate that even the lucrative pharmaceutical companies do find ways of being helpful and accessible to needier patients, and to point out that this is just one example of how such a corporation managed to not only do so while continuing to post great earnings, but earned a loyal consumer in the process. I couldn't easily afford Asacol, but I can easily afford their toothpaste and other items. I'm sure there's a tax incentive somewhere for them, but otherwise the government had little to do with this situation. I think my fellow liberals have lost sight of some of the genuine cooperation within the industry, just as I think too many conservatives have mistaken their own personal fortunes for a sign that other people's problems are entirely of their own doing and that they shouldn't come asking for help after the fact. Medical science can't even answer the question of how a patient develops Crohn's disease, and the leading theories all point to genes and nothing within the power of any particular person to alter through choice or behavior. Simply put, there's nothing I could have done differently, and Crohn's disease--despite how loathsome I get over it at times--is hardly the worst of such chronic conditions. Even now as you read this, I'm sure you personally know someone who would roll their eyes at me even bothering to complain about it.

Ultimately, I think what I'm trying to say is that those of us who have characterized this debate as a matter of counting senators and money estimates have missed the forest for the trees. There are reasons that our healthcare costs have exploded, and they're not all due to the baby boomers reaching their golden years or greedy executives. There are things that we've done to our world and ourselves that have put us here, and these are the things that we need to be addressing. Perhaps those companies dumping God-knows-what into the rivers did more damage than we'd realized; maybe hormones for animals are worse than the F.D.A. thought. I don't know what the scope of such an investigation even should be, but I do know that I am disappointed, and at times outraged, that I've heard no meaningful effort to even begin its undertaking.

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