I expected far more from the Baby Boomers.
I really thought as the first wave of them began to enter middle/old age and started to feel the effects, en masse, of the health problems that can go along with aging that they would get MAD. Like in mad-as-hell-and-I'm-not-gonna-take-it-anymore mad, with the gnashing of teeth and outraged facial expressions and indignant yelling rage. Mad as holy hell about every last stinking piece of the American health care system, and willing to stand up and do something about it. But that didn't happen. This powerful group of folks, the movers and shakers of the land, let the tsunami of bureaucratic managed care and obscenely-high costs wash over them, drowning them in frustration, domino effects of the fix-it-with-pills mentality, and crushing medical bills.
Maybe it was too much to expect, that even the most powerful big group of people could have the collective will to change something so massive. When your own health is threatened, not to mention whatever is going on with the extra-old parents you are also responsible for plus your own kids as well, fear sets in, and the fighting of injustice waits for some other time, or some other person. Each newly-sick person sets off in their own tiny pathetic little rowboat in an impossibly-navigable sea of medical options, specialists, treatments, opinions, and paperwork, and is expected to just figure it out even if they are bleeding from the eyeballs and their pancreas keeps starting on fire. Was it too much for me to hope that the rowboats could all find a way to link up somehow, find some rope to tie from boat to boat, to help each other?
Well, yes, it was. The whole issue of exactly why people won't demand better medical care is rather complex. Or rather simple, depending on your view of humanity and such.
FACT #1: Feeling crappy = not up to fighting a pervasive faceless giant; feeling good = not worrying about ever feeling crappy and having to fight a pervasive faceless giant. Basic human nature: "I'm OK, Screw The Rest of Ya." And, "Nothing Bad Will Ever Happen To Me," and "We All Gotta Go Sometime, And By 'We' I Mean You." Every so often you will hear stories of some poor ass patient, hairless and feisty, hacking away at the medical machine with a media machete, trying to make people hear, effect some change. But that's rare. And then they usually die, and people forget about them.
FACT #2: Americans are Individualists. What is great about this country, the opportunities and recognition of individual effort, also comes with a high cost. Succeed in life enough to have a fantastic support system, a job with really, really good medical insurance that won't fire you for getting ill, be white, and have a medical issue wherein a pharmaceutical company can profit from your treatment, your odds of good care are upped. Of course, if you are a poor single dumbass with a job that pays less than 100K a year, you can't save any money because the cost of everything is too high, your insurance, if you have it at all, pays for only major medical and quickly caps out, you have an unpopular disease, and your skin is some other color than white, just throw yourself in the gutter now and wait to expire. Being a rich white dude like Patrick Swayze isn't going to preclude you from getting cancer, but it is pretty damn likely you will live longer than you would've being Pedro The Gardener. Give me your tired, your poor...ah, never mind.
FACT #3: Americans are Lazy. They didn't used to be. Why, people here homesteaded and forded rivers and toiled in sweatshops and labs and think-tanks and EVEN in government buildings, because they were glad for the opportunity to escape some crappy king and/or terrible inedible ethnic food in their native lands. But the Consumer Age, the Age of Instant Gratification, has inured almost everyone to the basic realities about being a living being. No exercise + huge portions of garbage food + years of unrelieved stress + reliance on drugs/drink/smoke + exposure to toxic everything = ILLNESS. It will catch up with you, your doctor will throw handfuls of pills at you, which will probably cause secondary illnesses, and you will keep thinking you DESERVE to be made well, even when you refuse to take responsibility for your own care.
FACT #4: Conspiracy Theory. When the system is set up to profit from YOUR ILLNESS, there will be a whole bunch of people who work very hard to do just that. You can try to rationalize it all by saying well, look, the money goes back into research for life-saving drugs and other cutting-edge treatments. It's a business, and business fuels innovation and change. Well well well. There's some truth to that, of course. But the business model doesn't work so well when you have a 90-year-old great-grandma in hospice care whose morphine drip is limited by her HMO policy, does it? Or should we just go on thinking, well, that's not my mom, and it won't be me. Business knows we are lazy and disorganized and could give a crap. American Dream, Great-Grandma?
FACT #5: Preventative Care Model? HA HA. All logic and sense would and should go to the idea that the very best outcome is to AVOID GETTING SICK in the first place. Wellness education should be the focus of training in our medical schools, in our kids' schools, and should be the starting point of lasting change. But talk is not enough. Quit cutting physical education time in schools. Make opportunities for exercise available to all, whether at the workplace, community centers, make it easy for people to make moving their muscles part of their daily routine. Quit serving huge portions of food at restaurants until a regular portion looks normal to people again. Clean up the filthy planet. Convince people to find healthy ways to relive their stress and again, make real options available. Honor people enough as a society so they themselves believe they are worth taking care of. Make it normal and expected to make good health choices, and because this is America, let people know it's going to save them a whole lot of money and misery too.
I am well aware of the pitfalls of socialized medicine -- there are enough stories around of people waiting 2 years for an MRI or not having any choice of treatment, or just dying waiting for treatment. The rich have supplementary insurance and often go elsewhere for the best care, if they can. There isn't going to be a perfect solution, and there are going to have to be compromises. As it stands, everyone agrees the American health care system is a disgrace, and must change. That is FACT #6.
I hope President Obama has some mad-as-hell Baby Boomers in his administration ready to begin to tackle this demon, and I think he does. Let's just hope they stay healthy, huh?
UNHEALTHY
Monday, May 11, 2009