Friday, August 14, 2009

Health Plans and Death Plans

By Alexander Cockburn, Counterpunch

The first illusion to chase off the stage is that the great debate here has much to do with health. So far, as public health is concerned, many of the biggest battles were fought and won a hundred years ago, at the end of the nineteenth century, with better nutrition, birth control, the change from wool to cotton clothing, the introduction of modern sanitation in the urban environment and – most important – clean water.

Between 1900 and 1973, American life expectancy went from 47 to 71, but most of this rise had taken place by 1949, when the average life span reached 68. Much of the upward curve could be attributed to improved survival rates for infants and young people. Prohibition helped, since people drank less alcohol, ate more, and hence TB rates dropped sharply, well before the introduction of sulfa drugs.

Health in America is class-based, naturally. The poor die sooner, starting with black men who tend to drop dead in their middle 60s, usually from stress and diseases consequent on diet. The better-off folk drink less than they did in the 1950s, take a bit more exercise, and sometimes live longer. The poor get fatter and fatter. A real health plan would start with public executions of the top thousand CEOs and owners of the major food companies and fast food franchises. It would continue with serious penalties for health workers not washing their hands or merely holding them under the tap without using soap.

The plagues of America today are beyond the reach of the modern medical system, and that system is itself a peculiarly outrageous example of antisocial imperatives: high technology health care which serves fewer and fewer people. Part and parcel of this system are the drug companies, working in concert with the hospitals and insurance industry. Doctors have long since been shoved to the side as major players.