Looking for the “health” in “health care”
When thinking about the national versus private health care debate, I have come to realize that there are two assumptions that both sides of the debate seem to share without much concern. These assumptions are that Western style medicine is unequivocally synonymous with “health,” and that the cost of medical diagnostic and interventionary procedures are completely normal and acceptable.
Regarding the former, I think it is fair to say that most people associate the term “health care” with what I will call “Western medicine.” That is to say that most people in the US think that “health care” is the act of going to a doctor and having their body examined and often physically “treated” in some way. What distinguishes Western medicine from other forms of medicine is its scientific, and somewhat mechanical, approach to the human body. I once worked as an emergency room clerk in a major hospital and on multiple occasions, some of the nurses I worked with relayed to me that they felt their work resembled the work of an auto mechanic. My point is that Western medicine is primarily motivated by the assumption that the human body requires regular medical “maintenance” in order to be “healthy,” and that the more medical “maintenance” the body receives, the “healthier” the body will be. In other words, it is assumed that the human body is, by nature, built to “malfunction” and will, in time, succumb to illness or disease without the aid of regular medical attention. Therefore, it is easy to see why both national health care advocates and private health care advocates alike agree that health care itself is important, and that the more health care one can receive the better.
I think there is something peculiar about this conception of “health” and “health care” though. When thinking about what counts as progress in the field of human health, the idea that “more maintenance” is synonymous with “better health” appears to twist the logic behind the term “health.” “Health,” as I think of it, refers to a body that is self-sustaining and free of dis-ease. Such a healthy body would, in theory, need less external maintenance from the medical profession, not more. Therefore, my conception of “progress” in the field of human health would include the diminished need for medical treatments altogether—something that would render the national versus private health care debate moot if it were actually realized.
This idea that progress in human health is the diminishment of need for medical attention is quite different from the idea that progress in human health is the proliferation of medical attention. The way I see it, the medical industry is no different from any other industry or bureaucracy: once it is established, it will do all it can to preserve its existence and prevent its extinction. As cold as it sounds, the medical industry, by its nature, thrives on the ill-health of humans. Therefore, the medical industry has a vested interest in humans believing that they are vulnerable without the aid of regular medical care; and, as I alluded to earlier, this is precisely the attitude most people seem to have about human health. With this in mind, I think it is worth considering how far we really want to go in our demanding of more access to medical care. The more ground the medical industry gains in convincing the public that “health” equals “medical attention,” the less likely our culture will ever wean itself off of medical dependence in the future. Not only is dependence on the medical industry undesirable for the individual (because it means the individual lacks control over their own health status), but it is also bad for the individual financially.
Much of the push for national health care is motivated by the astronomically high costs of medical diagnostic and interventionary procedures. People feel they need health insurance because they could not possibly afford to pay for medical care out of their own pocket. Now, there may or may not be good reasons for the high cost of medical care so I’m not going to say that the cost is something that could be realistically reduced (although, I suspect that the high cost of medical care is not entirely natural), but I will say that regardless of the reason for the high cost, individuals, as well as society as a whole, could benefit from a reduction in medical expenses. With this in mind, it easily follows that “progress” in the area of human health could be conceived of as the diminishment of dependence on medical care. By reducing the need for medical treatments, individuals, as well as the collective society, will relax the financial burden that expensive medical care places on them.
Of course, much of what I have to say here depends on an opposing assumption to the one commonly held by Western medicine—that is that the human body is not condemned to succumb to ill-health without the aid of regular medical attention. In other words, the assumption I am advocating here is that the human body has more self-healing capacities, and is therefore more predisposed to maintain a healthy physical condition on its own, than the Western model of medicine supposes. Consequently, “progress” in the field of human health would be to increasingly emphasize this self-healing feature of the human body, and to subsequently reduce the demand for expensive medical care. In the context of the debate over health insurance, I think it is at least worth reminding ourselves what we actually mean by “progress”—and that the Western model of health is only one model out of many from which to choose.