In the next section of
BETRAYAL OF TRUST:
The Collapse of Global Public
Health, Ms. Garrett turns her attentions from
the former U.S.S.R. to the U.S.
She makes a shocking seque. At the end of the
U.S.S.R. -- in which we're treated to a long list
of shocking statistics and stories about Russia
and former Soviet countries and the horrible
state of their public health care systems, she
says the U.S. is just as bad.
The section on the U.S. is another long litany
of shocking statistics and stories.
To do full justice to this, I'd have to write
a book myself. To be fair, she makes great
points -- and also says things I vehemently
disagree with. And naturally I'll have a
tendency to write about those.
She makes no bones about being a fan of big
government, equating that with good public
health.
She includes a lot of things under the
heading of "public health" that I don't
think belong there, such as Medicaid and
other welfare programs. Somehow, I doubt
that her public health heroes from the
turn of the century advocated that the
government assume responsibility for
poor people's entire lives.
She delights in criticizing Reagan and the
first President Bush (and I'm sure hates the
current one also).
She criticizes the way that Republicans
stress "personal responsibility" -- she
wants the government to assume all responsibility
for people's health.
My overall reaction -- isn't there a rational
middle ground somewhere?
I can understand that keeping water supplies clean
is a logical job for government. As individuals,
we have no control over the quality of the water
that comes out of our water taps.
And vaccinating all or nearly all children for common
and dangerous diseases makes good sense. When a
high percentage of children are vaccinated against
rubella (measles), even the unvaccinated children
are safe from it.
And fighting tuberculosis also makes good sense --
because it can spread through the air, everyone is
at risk so long as anybody has it.
But I draw the line at alcoholism and heart
disease.
If somebody chooses to drink too much, why should
I pay for their therapy?
Of course, if none of us have any responsibility for
our health, as Ms. Garrett seems to believe . . .
She writes as though the only difference in the health of a nonsmoker
who gets regular exercise and who eats a lot of
fruits and vegetables and a heavy smoker who
eats spaghetti all night while watching TV . . .
is their incomes.
That is, those with higher incomes are healthier
because they have more access to healthcare.
Sorry, but the first person is going to be healthier
than the second no matter what their income levels.
She criticizes the notion that diet and exercise
make much difference in health (although giving a lot
of importance to smoking as a negative health habit),
ignoring the scientific information that show that
although nobody yet has yet come up with the
perfect combination of exercise and diet -- certain
factors do affect your chances of getting heart
disease and cancer.
Also, Ronald Reagan helped push the Soviet Union to
disintegrate. Surely not living with the imminent
threat of worldwide nuclear destruction is good
from a public health standpoint!
Her history of the U.S. from a public health
standpoint is quite interesting, though her
slant on it becomes more controversial the
closer she comes to the present.
One thing she says gives away her basic
weakness of understanding class in the U.S.
At one point she says that a middle class
"appeared."
Middle classes don't just APPEAR, Ms. Garrett.
That's an understanding of class dynamics
as ridiculous as the old concept of the
spontaneous generation of life.
Middle class people get that way by working
hard and saving money!
SOMEBODY in a "middle class" family WAS BORN
poor. They worked their way into the middle
class.
It's quite obvious that she feels that wealth
is a static concept. That the pie is only so
big and that rich people are stealing some
pie from the poor people.
That's why poor people are poor and why public
health agencies don't have enough money --
because rich people are taking more than their
share.
I do agree that more of our tax dollars should
be spent on true public health. There are
times to control mosquitoes and maintain
databases of virus gene sequences -- to
protect everybody, rich and poor alike.
However, pretending that poor people are
somehow destined to be poor and that their
own bad habits have nothing to do with it,
is nuts.
By the way, I've worked with poor people
for years and lived in poor neighborhoods.
There're a LOT of "poor" people who could
could afford health insurance and would
need it less if they stopped buying
cigarettes, drugs, alcohol and cable TV
(and took walks instead of watching any
TV.) Also, they'd have more money if
they would actually complete high school
and keep jobs instead of quitting them
whenever they don't like the boss. And
show up when scheduled etc.
I work more hours part time than many
poor people do at all.
But Ms. Garrett calls this "blaming the
victim."
The section on shortcomings of doctors
is great -- I just don't agree that her proposed
solution of a government medical plan (yes, she
is in favor of socialized medicine) is the solution.
That leads into another fault I find with her --
she never mentions alternative health solutions.
I think that a true and comprehensive public health
infrastructure would include yoga and herbs as well as
vaccinations.
Since it's highly unlikely that a government-run
public agency in control of our access to medical
care would promote such things, that's another
strike against giving the government total
control over these things.
At least now, we do have some doctors who promote
natural alternatives -- and some knowledge of
nutrition is even being used by totally
mainstream doctors.
And I believe that the final argument against
her proposed solutions for what are, after
all, quite real problems -- is that why should
we as individuals wait around for the
government to listen to her and protect us?
That's a formula for passive death.
I cannot clean up my city's water supply --
and I can't know what's in bottled water
(she's right about all those things), but
if I can afford the best water purifier,
why shouldn't I buy and use it?
Or should I die while waiting for my city
government to heed her advice?
But at least it wouldn't be my fault!
Or would it?
And I wouldn't care -- I'd still be dead.
So, yes -- support all efforts to fight
infectious disease.
Ms. Garrett makes many great points on
this.
But take care of yourself in the meantime,
as much as you can.
