Updated: Sep 19, 2020
Excerpted from We the State by Jeremy Horne PHD, soon to be available from the National Reformation Party.
I will first discuss health care overall, concentrating on the U.S. I then will provide some examples of fallout resulting from the lack of it.
Health care overall
Besides water, food, and shelter, health care arguably is the fourth most critical for the survival of a species. The first three are sought immediately by a “deserted isle” situation. Ongoing health maintenance determines long-term survival. The attention a government pays to the health of its citizens often reflects not only its priorities but equally the health of the country, itself. While you may legitimately point to the quality of that care as being important, the more basic question is whether people have meaningful (including affordable) access to it at all. It is almost impossible to avoid the ongoing debate over health care in the world, especially the industrialized countries and particularly after the U.S. Presidential debates in 2016.
The United States is the only industrialized country in the world that does not have a universally accessible health care system (List of countries, 2017); yet, U.S. Medical costs per capita are the highest in the world (Brink. 2017). Twenty-nine million persons (Barnett and Vornovitsky, 2016) still remain uninsured (no access) and 45,000 die each year for that lack of access (Kaiser Family Foundation, 2016). Go to the Internet and compare how universally accessible health care is in various countries. You will find that traditionally-regarded “Third World” countries like Mauritius, Seychelles, Trinidad, and Tobago do have universally available health care. Then, wonder about the mentality of those who would think that there has to be a debate about society's responsibility to provide health care. You put in years of work for your country, even paying taxes (as in the Medicare tax), but in the end, you are only fed lies and propaganda about how great the country is while being billed by predatory doctors and hospitals. Is it not on the same level of thinking that a starving person should be denied food, because of “the economy” or there being no universal health care because of “big government”? What price is placed on human life? Are the “economy” and antiquated ideologies like “free enterprise” more important than the people who need help? Is this not “cart before the horse thinking? To me, it is nothing short of predatory, a throwback to cave persons fighting off wolves, bears, and the like.
What about the Affordable Care Act of 2012? Here, a persuasive case been made that it is a giveaway to insurance and pharmaceutical companies (Lenzner, 2013; McCaughey, 2015), rather than as the main aim of providing health care. Obamacare was peddled on behalf of the insurance company predators and is just another “half pregnant” scam, rather than being a truly universally accessible health care programme. Be reminded that the profit motive drives U.S. Health care, and it is common for a person to have an initial $100 visit to say “howdy”, followed by a visit to treat the problem, assuming the physician is competent. However, it is usual to refer a patient to a specialist for work that 100 years ago would be done by a competent country doctor. I know; my paternal grandfather was an M.D. Dental “care” is even more egregious, a big scam in its own right. Read any trade journal in the field, where these predators play upon the narcissism exhibited by the “smile”. Don't even mention vision care. Search for “cost to manufacture glasses frame”, and you'll see the scams, from the monopolies cornering the market, to frames sold under a brand name, and frames being made overseas by what amounts to slave labor. Divide the price you are paying for a set of eyeglasses, by ten for anything even approximating a fair price (which usually is lower than this). The “free enterprise “drive so-called U.S. health-care system has other fallout, as well.
Refusal of governments to mandate pharmaceutical development (as in the shortage of vaccines) is another deficiency in the health care area, as well as independent testing of pharmaceuticals. “FDA reviews the results of laboratory, animal, and human clinical testing done by companies to determine if the product they want to put on the market is safe and effective” (About FDA Product Approval, 2019). Talk about the wolf guarding the chicken coop! There is a model for independent testing. Electrical equipment bears the independent testing of Underwriters Laboratories (UL). Pick up a light switch, wall outlet, or other electrical fixture and look for the “UL” inside a circle. Go through the Physicians’ Desk Reference or another encyclopedia of drug and read the extensive list of side effects. Medicines obviously have benefits, but, seriously, are you going to trust the claims of a giant corporation producing those medications solely for profit? As the World Health Organization indicates, the mythological “invisible hand” of “market forces” (as opposed to peoples' health) drives the supply.
Research “World Health Organization demand drives supply of pharmaceuticals”, and you will discover that including profiteers (euphemistically called “partners”) is a “necessary” part of the medicine supply process. Liberal democratic regimes would rather have big business predators supply critical vaccines, rather than their stepping up to the plate and either ordering them to develop these medicines or producing them themselves (Benes, 2016).
Demographics will increasingly drive the need for health care, and the 19th-century ideology of predatory economics can only exacerbate substance abuse, nutritional deficiency, and mental health problems in the population. For me, profiteers are not my partners.
Yes, a word should be said about a person's responsibility to maintain good health by maintaining a good diet, not smoking, getting exercise, and so forth. All the health care availability will not be sufficient to correct basic problems brought on by a person’s negligence. We have to ask why a person does not care for her/himself and why. Here is an example of the interdependence of problems and feedback effect. Social stress, such as unemployment, poor living conditions, and inadequate schooling contribute to one's “self-medication” (substance abuse) or other stress-relieving measures (smoking, hazardous recreation (“thrill seeking”), and disordered eating (obesity and anorexia nervosa)). These activities, in turn, can contribute to poor health, which exacerbates the condition giving rise to more stress initiating these activities. As a spin-off, the very shallow fashion model world has a disproportionate share of anorectics. The question here is why this world commands so much admiration; what is the value system underlying it? Part of a universally accessible health care program is integrating preventive medicine, such as reaching out to persons in an organized and systematic way, as well as forcefully coupling with schools in building in mandated health care training into curriculums not only at the elementary level but through high school.
In comparison to the rest of the world, the various U.S. regimes that have been in power have not cared about universal access for the people (Senthilingam, 2017), at least to the extent of legislating that it be universally accessible. That decision makers have to debate that people should have this access, regardless of material circumstances, raises the question of whether those wishing to deny that access adhere to a predatory, or Social Darwinistic view of society, something we'll cover in a later chapter. The decision-makers of a country that spends $2.5 billion per destroyer (Destroyer classes, 2017), eight billion dollars for an aircraft carrier (Gerald R, Ford, 2017), or, up to 2011 3.7 trillion dollars for the wars in Afghanistan, Pakistan, and Iraq (Trotta, 2013) are met by:
NHE [National Health Expenditure] grew 5.8% to $3.2 trillion in 2015, or $9,990 per person, and accounted for 17.8% of Gross Domestic Product (GDP).
Medicare spending grew 4.5% to $646.2 billion in 2015, or 20 percent of total NHE.
In 2008 Joseph Stiglitz (former chief economist of the World Bank and Nobel Prize winner in
Economics) and Professor Linda J. Bilmes (Daniel Patrick Moynihan Senior Lecturer in Public Policy Harvard University) said that the Iraq war, alone cost three trillion dollars. (Financial cost of the Iraq war, 2018). And, what about that 700 billion dollars U.S. war budget? Mr. Trumps want to make it an even ¾ of a billion dollars.
This does not stop the U.S. Government from spending $31,977.65 ($87.61 per day) to incarcerate 185,333 inmates (Prisons Bureau, 2017). When you consider the over two million persons incarcerated in the United States, this starts adding up to billions of dollars per year, $. 63,954,000,000 to be quite precise (Ibid.).
You will find apologists for this predatory system on three fronts. Government care is inefficient, there already is social security, and welfare is available. The “free enterprisers” constantly call attention to how socialist medicine is fraught with bureaucracy and inaccessibility (as in long lines waiting for services). My first answer here is that many people simply do not have access to health care, 45,000 dying each year because they can't even get to a hospital. Then, search for “US health care most inefficient” and related phrases, and you'll see the second answer to this question.
How about social security and Medicare? Let me dispense with this canard right now. All seniors are on Medicare and they have free access to a hospital – good start. But, there are two parts to this scam. Merely being in a hospital does not get you well. You need doctors. For “Plan B” in getting medical treatment, the social security recipient often has to pay $134. Read all about it in Medicare.gov “Medicare costs at a glance”. Try this on your meager monthly social security check ($1400 average, according to the US Social Security Administration in April 2018 – See: “OASDI Beneficiaries by State and ZIP Code, 2017”.) to get treatment, BUT, only 80%. Then, there are deductibles for which the retiree is responsible. With age come health problems, and it does not take a mental giant to calculate that paying 20% of a $100,000 medical bill ($20,000) is not going to help a $1400 a month budget. We're not finished yet, though. The second part of the Medicare scam is the other 20%, and you can go to one of the predators, private insurance companies to pick this up – if you want to pony up another $50. So, we have $180 or so pulled out of your $1400. Now, has anyone of the geniuses who concocted this inadequate health care ever calculated living costs? Can you name any place where food, housing, personal necessities, transportation, and clothing can be had for under $1400 a month? Remember, $1400 is average, many poor persons getting only receiving a few hundred dollars and being left in the dust. “Welfare”, the right-wingers will scream. Not so, as there is the “notch group”, as they call it in Arizona (and probably elsewhere). To qualify for welfare (depending on the State in which you reside), you get just enough social security to be at or below the poverty line, thus disqualifying you. As an exercise, go to the U.S. Census Bureau and look at the average “poverty threshold” for 2017 (Here, you don't have to go to the trouble of looking it up:
https://www.census.gov/data/tables/time-series/demo/income-poverty/historical-povertythresholds.html ) and observe $11,756 (no kids – ask how many seniors have a child living with them). Get your trusty calculator out and multiply $1400 by 12 (months). When I do it, I get $16,800. Even with the $180 deducted, we have $1220, and this times 12 is $14,640. That is, the average person on social security is not eligible for welfare. Oh well, you always can get out the tin cup, monkey, and crank organ. Untreated dental problems can quickly lead to ones affecting the whole body. With the eyes, it should be obvious that comprised vision can endanger the person. Health care also means tending to mental disorders.
Psychological and intellectual limitations
In general, mental health issues have been on the rise, such as anxiety disorders, sleep problems, and eating disorders. Antioch University on 3 March 2017 reported (giving peer-reviewed sources or official U.S. Government documentation):
According to survey data released by the National Survey on Drug Use and Health, Nearly 20% of the adult population reportedly suffer from some mental illness. The prevalence of adult Americans suffering from severe mental illness is estimated at 4.6%, or 10.4 million people.
Mental illness is the leading cause of disability in the U.S. . It’s reported that approximately 20% of young people will suffer from a mental disorder that inhibits daily functioning at some point in their lives. (Antioch University On Line (2017) Note, even this reports reverts to 2012 data (NSDUH, 2017).
More and more, we are seeing violence perpetrated by persons who otherwise would be under psychiatric supervision or institutionalized. In a shockingly dated report (2012), the U.S. Centers for Disease Control (CDC) reported that 7.6% of persons over 12 years of age experienced depression in any two week period, a figure that would be considered serious for any other disorder. According to the U.S. National Institute of Mental Health, “In 2015, an estimated 16.1 million adults aged 18 or older in the United States had at least one major depressive episode in the past year. This number represented 6.7% of all U.S. adults” (NIMH, 2015). In CDC terms, this is an epidemic. While you are at it, check out the autism spectral disorder cases (CDC – autism, 2019). Besides mental health problems existing in the general population, the U.S. Prisons may be considered the largest of mental institutions, most inmates with mental health issues that placed them there (Mentally ill in prisons, 2017).
It can be disastrous enough to for a population to have increasing mental health problems (Twenge, 2015), but when a leader of a country that arguably is the most powerful in the world has mental health issues then world stability is compromised. Mental instability at the highest levels of government did not cease with the deaths of Caligula and Nero. Dr. Bandy Lee (2017), Assistant Clinical Professor of Psychiatry at Yale School of Medicine, is editor of a book The Dangerous Case of Donald Trump in which she and 27 mental health care professionals contributed articles supporting a call for a mental health evaluation of Mr. Donald Trump to determine whether he should continue to remain in office as chief executive of one of the world's most powerful countries. A number of incidents prompted this call, such as Trump’s impulsiveness and verbal outbursts of rage against world leaders, sports figures, and even members of his own party.
Now, I will throw a sop to the academics who can be real cowards when it comes to social action. Assessing Trump's mental state is not the same as a diagnosis, as the American Psychiatric Association, as well as the American Psychological Association, proscribes mental health diagnosis except when the professional does it in person. This code reflects the "Goldwater Rule", named after the ultra-reactionary Senator Barry Goldwater running for U.S. presidential office in 1964 and floating nuclear war as a policy option. Again, here is an example of not owning a problem. You have an impending emergency, but you do not have the courage to lend your expertise in at least advising those who do have the power to act. Of course, any fool should know that you have to have an in-person diagnosis of a problem, but at least s/he knows a problem exists. Are you going to let a tumor grow right in front of your very eyes and just wonder? From the Oval office down to the homeless bum sleeping on a park bench, mental disorder seems to be endemic to the whole country.
As will be seen in Chapter 9 - The social brain, intelligence is multifaceted, mental functioning being coupled with physical health. So, let us look at this chain carefully: poor social conditions – poor physical health – poor mental health – poor diet - compromised intellectual ability – poor selection of leaders (often corrupt) – poor social conditions. Looks like a circle, doesn't it?
From thousands of years ago to the present psychoactive recreational substances (including alcohol) have been used by humans (Crocq, 2007). Mainstream media teems daily with accounts of substance abuse and its social effects, “substances” generally referring to conscious-altering chemicals and natural organisms (plants and fungi). Definitions of “recreational drugs” have in common the fact that non-prescribed medications, mind-altering substances, and other chemicals are taken voluntarily (original source in parentheses after each definition):
“Any substance with pharmacological effects that is taken voluntarily for personal pleasure or satisfaction rather than for medicinal purposes. The term is generally applied to alcohol, barbiturates, amphetamines, THC, PCP, cocaine, and heroin but also includes caffeine in coffee and cola beverages (Mosby's Medical Dictionary, 9th edition. 2009, Elsevier.).”
“Substance abuse Any agent–most have significant psychotropic effects–used without medical indications or prescription in the context of social interactions–eg, parties” (McGraw-Hill Concise Dictionary of Modern Medicine, 2002 by The McGraw-Hill Companies, Inc.). “A drug used for enjoyment rather than for a medical purpose” (Medical Dictionary, 2009 Farlex and Partners).
The U.S. Controlled Substances Act (CSA) of 2017 simply lists the substances that are banned. The CSA says “The term "controlled substance" means a drug or other substance, or immediate precursor, included in schedule I, II, III, IV, or V of part B of this subchapter. The term does not include distilled spirits, wine, malt beverages, or tobacco, as those terms are defined or used in subtitle E of the Internal Revenue Code of 1986. —21 U.S.C. § 802(6)”.
Overall, drug use is on the rise. A search for “U.S. heroin epidemic” and related phrases will display thousands of articles telling how heroin use was on the rise through 2018. Also, look up “fentanyl”. “Prescription drug abuse is the Nation’s fastest-growing drug problem. While there has been a marked decrease in the use of some illegal drugs like cocaine, data from the National Survey on Drug Use and Health (NSDUH) show that nearly one-third of people aged 12 and over who used drugs for the first time in 2009 began by using a prescription drug non-medically” (National Survey, 2017).
A direct correlation can be made between the rise of prison populations in the United States and drug related crimes. Half of all prisoners are in prison for substance abuse crimes, with half having mental health issues. Further:
80 percent of offenders abuse drugs or alcohol.
Nearly 50 percent of jail and prison inmates are clinically addicted.
Approximately 60 percent of individuals arrested for most types of crimes test positive for illicit drugs at arrest. (NADCP,2017)
A search for “war on drugs a failure” (De Carvahlo, 2016) will present literally millions of pages of articles, studies, and comments from science organizations, sociology organizations, human rights groups, and legal organizations, among others. The following speaks for itself:
Deaths from drug overdoses jumped by the largest margin ever recorded in US history in 2016, according to preliminary data compiled by the New York Times. While the precise number will not be available until December due to the months it takes to certify an overdose death, the Times estimates that in 2016 more than 59,000 people died from drug overdoses, a 19 percent increase from 2015. (Leigh, 2017)
Some major reasons why people use drugs can be summarized by:
propensity to addiction
unemployment – profit from drugs
mental health issues
alienation – psychological
continuation of prescription painkillers
Heroin and methamphetamine use in Appalachia as an example.
As in so many areas, unless reasons are identified and effective programs are created and directed to those causes, the problem will mount, draining resources and ruining lives. One call has been to treat substance abuse as a health problem, but this is only a partial response, given the other reasons for substance abuse, such as alienation and unemployment. Too, good health is dependent upon the country having a universally-accessible health care system, (including mental, dental, and vision) which the United States -one of the most advanced industrialized countries in the world, as was documented above, does not. Good luck on this one.
As somewhat of an aside to this discussion and for health care in general, about 70% of persons in the U.S. take prescription drugs (Mayo Clinic, 2013). We may ask not only of the underlying causes, such as heart conditions and being overweight, but why these conditions exist. Part of the substance abuse results from prescribing painkillers freely. Then, ask why there is so much pain?
This comes in the form of at least two basic areas: dietary quality and simply not enough food. The former is reflected in obesity rates and disease (Global Burden of Disease, 2017). The U.S. National Institute of Health says that in the U.S.:
More than 2 in 3 adults are considered to be overweight or obese.
More than 1 in 3 adults are considered to be obese.
More than 1 in 20 adults are considered to have extreme obesity.
About one-third of children and adolescents ages 6 to 19 are considered to be overweight or obese.
More than 1 in 6 children and adolescents ages 6 to 19 are considered to be obese. Where:
▪ “Overweight” refers to an excess amount of body weight that may come from muscles, bone, fat, and water.
▪ Obesity refers to an excess amount of body fat.
(Overweight and obesity, 2017)
The New England Journal of Medicine in an article, “Health Effects of Overweight and Obesity in 195
Countries over 25 Years” reported 6 July 2017 about the “rising pandemic of obesity” in the world, that “Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries”.
Besides the immediate toll taken on the individual, being overweight increases the probability of heart disease, diabetes, cancer, and organ malfunction, thus placing greater stress on the health care system and reducing productivity.
As to dietary deficiency, “one in nine people worldwide still do not have enough to eat” (World Food Programme, 2017) has implications for mental compromise. In the United States, reducing access to food stamp invites more malnutrition. Poor nutrition not only produces immediate consequences of suffering but there are long-range consequences for society as a whole. It has long been known that protein and vitamin deficiencies impede brain development in children (Black, 2008; Holden, 2012; Nyaradi et al, 2013). This is to say that the greater the prevalence of poor diet, the greater opportunity there is for burgeoning populations of individuals with cognitive deficiencies, necessitating at least a reactive response from social institutions. In otherwise, to put it more bluntly, because of government neglect, there may be emerging among us a society of mentally deficient persons.
Without a universally accessible health care system and with the environment becoming increasingly complex to the point where the average person may not be able to cope successfully, ask how mental health compromise will affect the social environment.
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