Rock Creek Besides fishing, reading, hiking, and sleeping, the other nice thing about vacations out here in the quiet off-the-grid, is that one has that rare, precious and luxurious feeling that you have time to think. Not just to put two plus two together, but to arrange them in patterns, cancel out the highs and lows, stroll up the blind alleys and try to bridge the deeper canyons.
Reading Linda Hirshman’s brilliant history of the gay movement, Victory: The Triumphant Gay Revolution, she makes a point almost off-handedly in a long discussion of the tragic AIDS epidemic and the effective organizing by ACT-UP and many, many others around the issue, that essentially argued that in a “liberal democratic society,” as she constantly refers to the United States, it is almost impossible to deny citizens access to public health resources. I’m sure one could quibble about this, especially given the battle of the knife in recent years over affordable health care. Nonetheless, Hirshman’s point is that in representative, constituent government it is impossible to endlessly deny the benefits of public health services regardless of the distances in the partisan and ideological divide. Her proof is the acceleration of funding to the tune of several billions of dollars to find appropriate medicines and treatment programs for AIDS victims.
How might we more effectively organize around the health issues of low-and-moderate income families, despite the obvious differences of class and race, to make a similar level of life-and-death impact? Dealing with asthma, obesity, hypertension, and higher incidences of deaths from cancer, alcohol, and the like is a toxic combination, widely felt across classes, even though more concentrated among lower income families than others. Overall improvements in housing and environment would make a huge difference in lives and economic outcomes, but a couple of billion dollars would hardly fund the research and brochures, and would not dent the real issues.
Several years ago Mayor Bloomberg from his unassailable position as not only Mayor of New York City, but also richer than Croesus, made a big difference in public health by chasing cigarettes out of bars and restaurants and into the privacy of one’s own home. I can remember discussions with representatives of his foundation several years ago and their common sense argument that they wanted to save lives in cities by forcing cutbacks in smoking, reducing traffic fatalities, and improving urban environments by making cities greener. These are hardly front page headline issues, but they make a real difference.
Constructing the campaigns would be difficult. At one level, “liberal democratic society” in the United States has rationalized an acceptance of higher mortality rates by class. No better evidence exists than the callous way that politically expedient governors in Texas, Louisiana, and other states are denying expansion of healthcare to the poor, uninsured families right now in the crassest political expediency and immorality that we have seen in a long time. Blaming lifestyles of the poor, hearkens to racism and discrimination, but that and a couple of dollars might get you on a bus (that no one travels much but the poor either, so there goes public transit moneys!), but it won’t buy relief here.
The only exception that comes quickly to mind in thinking about the death sentence of lower income families through imposed and unrelieved bad health conditions are the “class exception” of veterans. The all-volunteer army has been heavily representative of lower incomes and racial minorities, and for very good reasons, governments at almost all levels, but particularly through the Veterans’ Administration provide first class health care to veterans regardless of income. Risking you life for your country, especially when no one else will do so, seems the only ticket for a working stiff to get good, lifelong health care in modern America it seems.
More research needs to be done. I was hearing about a food processing additive being used by some food manufacturers that leaves you hungry for more. Forced obesity triggered by artificial additives sounds like a drug, and a drug that for public health reasons should be banned by the Food & Drug Administration. Maybe the price of beer and alcohol should not be doubled with taxes like Canada does, but should be quadrupled and restricted to even fewer locations and venues, though this has not worked on the Indian reservations? Maybe there are enough middle income families with children with asthma that an alliance could be built with lower income families?
We need a lot more than a couple of days of vacation to think all of this through.