Another victory for those of us with old-fashioned (read: ’16th century’) values. Studies show: Sun is better than sunscreen. Butter is better than margarine. Soap is better than antibacterial handwipes. And heartbreak is better than apathy. (That last one, you’ll just have to trust.)
Figgin’ hi-larious (and poignant) bit in the Onion. Go read it. Then let’s talk about the concluding sentiment. After Capitalism crumbles because everyone simultaneously realizes that money is worthless, a man-on-the-street is quoted:
“‘It’s back to basics for me,’ Bernard Polk of Waverly, OH said. ‘I’m going to till the soil for my own sustenance and get anything else I need by bartering. If I want milk, I’ll pay for it in tomatoes. If need a new hoe, I’ll pay for it in lettuce.’ When asked, hypothetically, how he would pay for complicated life-saving surgery for a loved one, Polk seemed uncertain.
‘That’s a lot of vegetables, isn’t it?’ he said.”
I have two immediate responses to that. One is rather utopian: Why exactly would a complicated surgery have to be expensive in a non-currency-based economy? The surgeon wouldn’t get an enormous fee; there would be no insurance company to leech resources out of the procedure; the hospital and the equipment manufacturers would be collectively operated for the benefit of the populace…so what would make surgery so out-of-reach for vegetable farmer?
The other response, perhaps a more reasonable one, goes something like this: Guess what? Many, many people ALREADY go without ‘complicated, lifesaving’ surgery, because we don’t value human lives equally, nor is it our priority to maintain them. Poor and working folk forgo such things regularly, or they purchase them with the sum total of their resources, leaving them and the future generations of their families in treacherous financial waters and subject to disastrous currents. It’s called CAPITALISM, right? So if the radical transformation of our exchange system were to magically occur during a moment of blinding-light revelation, those in need of surgery wouldn’t necessarily be any worse off.
And these are the issues everyone born after 1965 is going to have to wrestle with in a very concrete way, very soon. 30% of Medicare dollars are spent on people who die within two months. ‘End of life care,’ especially those “complicated, life-saving” surgeries, will be an enormous burden on the small generations who will be required to pay for millions of retired Baby Boomers. Life-saving surgery never really saves anyone’s life – it should properly be referred to as ‘life-extending’ surgery. Often, the extension of life is bought at enormous expense to an individual’s family. More importantly, the ‘saved’ time may be filled with pain and suffering. And it’s very often brief.
If we are ethical creatures, we should be carefully probing our attachment to this form of healthcare. I have told my closest friends and family that I don’t wish my life to be extended past my ability to enjoy it, or to contribute meaningfully to my relations with others. I hope to die suddenly. If my death becomes a prolonged affair that is causing suffering for those I love, I want the process to be hastened. I hope that, by the time I’m dying, there are legal and humane methods to do that.
I don’t want $100,000 worth of surgery or tube-feeding or ‘life-support machines’ to tack on an extra month or year at the end of a long life. I would rather that money fund someone’s education, or the staging of a play, or the publication of a book, or a series of grand and intricate feasts. And that is what my living will expresses. I know it’s not anyone’s right to make that decision for another person (well, unless ‘anyone’ works for an insurance company!) but I do urge you to consider your own dying days, and carefully decide how much you want to take from your family and your society on your way out.
Here’s a handy guide for those ambitious neo-pharmacists ready to get busy-beavering away on placebo production for the brave new world. This piece in Wired has a full-color diagram showing what colors your pills should be for maximum efficacy: happy pills should be yellow, calming pills should be green. Oh, and more expensive pills work better – so don’t let any ethical qualms interfere with your profit margin. Set those street prices high! And a truly enterprising soul could dig up the list of 679 physicians polled in a recent study – half of them admitted to regularly giving patients fake pills. Voila! Ready-made marketing email list!
I’ve heard a lot of water-cooler chat about the accumulating indications that antidepressant medications are no more effective than placebos. And it’s not just antidepressants that fail to outperform sugar pills: a diverse collection of illnesses, from psoriasis to “orange-sized tumors,” apparently respond as well to fake medicine as they do to the ‘real’ stuff.
And we’ve been all flustered about this affordable healthcare kerfluffle! Clearly, we can address exorbitant drug costs, public health, and unemployment in one fell swoop. After a brief examination by a traditionally educated allopathic physician (you know, one of the poor saps who spent decades in pursuit of training and degrees and board certifications and whatnot) most patients could be referred to ‘specialists’ in their placebo-responsive conditions. The new specialists would be responsible for administering courses of well-chosen placebos. They wouldn’t need a lot of fancy education, just an easy-to-read chart with the various colors and shapes of pills and their effects – and, of course, a convincing bedside manner. You could take an unemployed worker straight off the welfare rolls after a six-week acting class, give him a white coat and a stethoscope, and let the perceived authority of the medical profession work its magic on the health problems of our society!
And for those of you concerned about the welfare of Big Pharma, and whether their vital research budgets would be undermined by all this open-access placebo distribution, fear not. Big Pharma is a vital component of the new system. Merck and Eli Lilly and all our other beloved corps can keep on doing what they do best – ubiquitous, expensive campaigns of deceptive direct marketing to consumers. We’ll need them to keep churning out television ads with carefree folks frollicking in sundappled fields, urging us to ask our doctors about Perfecterol and Idealexa. After all, the placebo effect is only as durable as our collective faith in the ineffable power of Pill. And if Big Pharma is good at manufacturing anything, it’s faith!
(Here’s a link to the full text of the Scientific American article linked above – the one with the citrus-sized weeping tumors – in case you don’t have a subscription.)
The United States is one of only 12 countries in the world that restricts the free movement of HIV-positive people across its borders. For the last 22 years, HIV-positive people have been banned from traveling to the United States. (And it’s not just discriminatory against positive people, it’s also racist: the selection process takes place during the visa application process, so it unfairly targets people from countries with visa requirements, and, of course, those countries include the whole continent of Africa.)
But no more! The HIV travel ban has been lifted, effective January 4, 2010. So, some good news happens sometimes! Sorry, that’s about all the enthusiasm I can muster for the Obama administration these days. (For my beloved policy wonk types, there is source material below. For those who would like to read a touching human-interest story, click through the photo above to read a piece from the Gotham Gazette.)
Here’s the CDC guidance page describing the policy change:
Here’s the Federal Register final rule:
And here’s an immigration attorney’s analysis of the effects the rule change: