Economic times are bad and threaten to get worse. Illness and injury come with these hard times. A recent study in The Lancet reported that life expectancy in formerly Communist countries decreased dramatically as privatization destroyed these society’s social fabric. The researchers found that where so-called social capital was high—that is, where community bonds were strong—the effect was much less. This seems obvious, but sometimes it’s necessary to state the obvious: people live better and longer where they care for and about each other.
Luckily, our predicament is not nearly as dire as those post-Communist countries. But it’s dire enough.
Single payer health care is not the answer. It’s the beginning of an answer, but it’s far from a solution. Or should I say, it’s a small part of the solution. As I’ve said before, it’s criminal that we don’t have such a system. For a brilliant proposal, I refer you to the recent study Medicare for All by the Institute for Health and Socioeconomic Policy, the research arm of the California Nurses Association and the National Nurses Organizing Committee. Their proposal argues for a medical care system that would cover everyone without charge for a total cost increase to our economy’s medical care tab of 3%. However, the plan would also create 2.6 million jobs and additional tax revenues that would virtually eliminate the increased cost. This doesn’t begin to count the economic benefits that would result from free, universal medical care.
What would those benefits be? To start with, greater productivity and less stress-related illness and injury.
For me, this points to what should be the real conversation: is a dollar better spent on research and practice for prevention or treatment? I realize that we need both, but I think some real comparisons should be made between what our nation and communities spend to prevent people from becoming sick or injured and what we spend treating people once they’re in need of care. Beyond that, I’d like to see a comparison of spending on research that identifies what puts us at risk with spending for research on treatments for those risks after they’ve taken their bite. Right now, what’s spent for the research and practice of prevention is dwarfed by what’s spent on treatment.
I’ll give you an example.
A recent study in the New England Journal of Medicine adds to the already substantial body of research showing that reductions in fine-particulate air pollution have a significant effect on reducing the risk of illness and injury. This form of air pollution comes from fossil fuel combustion. So one way to look at the development of electric cars and renewable energy sources is that they’ll have a huge effect in reducing medical costs for lung disease, heart disease, asthma, diabetes, and other diseases. So public spending on green technology is not only good for the economy’s health, it’s good for our personal health and as a consequence good for reducing the burden of medical care costs.
There’s a structural problem, of course. What gets spent on the research and practice of prevention is almost entirely at public expense. On the other hand, what gets spent on the research and practice of treatment is controlled directly and indirectly by private, for-profit businesses. These include doctors, most hospitals, and insurance companies as well as pharmaceutical companies and medical device manufacturers.
Daunting, but not dire. The forces of Commerce work tirelessly to prevent change for better prevention. They also work tirelessly to prevent change for better treatment outside their own business interests. But times of crisis always provide opportunities for radical change. And we have a great opportunity: a national government that seems ready to at least listen to us, is anxious to act, and, most importantly, is putting organizing tools in our hands that can have powerful effects, tools that can enable us to come together so that we’re better able to care for and care about each other.
