Category Archives: health

Silencing the Pearl: healthcare for people, not profit

John SteinbeckThe word was passed out among the neighbors where they stood close packed in the little yard behind the brush fence. And they repeated among themselves, “Juana wants the doctor.” A wonderful thing, a memorable thing, to want the doctor. To get him would be a remarkable thing. The doctor never came to the cluster of brush houses. Why should he, when he had more than he could do to take care of the rich people who lived in the stone and plaster houses of the town.
- John Steinbeck

In the coastal village of La Paz, where Steinbeck’s tragic tale of need and greed, The Pearl, takes place, to want a doctor, or rather, to ask for a doctor, is a rare and memorable thing for the poor families of the brush houses who live off the sea. These people care for themselves, and for each other; when one is sick or wounded, as when the baby Coyotito gets stung by a scorpion, they all come together to help in the cure, or at the very least, to lend their sympathies and support. Theirs are lives of constant maintenance, constant vigilance, for to call for the doctor is simply unheard of, everyone knows that he will not treat them, as they have no money. Thus we watch sadly as Juana, in a desperate act to save her wounded child, brazenly marches to the doctor’s gate with her man, Kino, and the entire village in tow, only to be turned away because the rich doctor cannot be bothered to put down his chocolate and cookies and help a poor Indian family who cannot pay.

The stark contrasts highlighted in this timeless fable, between community and individual desire, generosity and greed, poverty and wealth, ignorance and knowledge, the bonds of familial love and the bitter boundless hate of the oppressor, speak to us in strong, clear tones, because they are the human contrasts that reside within each one of us. They are also simple, ancient themes, that still strike to the heart of possibly every major issue that continues to plague our modern and less modern societies even today.

Basic as they are, these are the themes that should be central to any analysis and debate about how best to reform our healthcare system. These are the themes that we must consider and weigh on our moral scales to find the solution for turning our sick and diseased system into a healthy, vibrant one that functions for all, not just for those who can afford its skyrocketing costs. For, it has been said, the greatest reflection of a society’s ethics is how it cares for its sick, its young and its elderly.

Instead, as we try to overhaul our failing system, the argument about the best approach inevitably finds itself framed in the old capitalism vs. socialism context, with the usual shouting from both ends of the political spectrum, and those in the middle looking both ways and wondering who to listen to. The usual hard-core free marketers say that any intervention by the government in healthcare will put the private insurance companies out of business and put us on the path to socialized medicine. Those of a more progressive view see nothing wrong with this, calling healthcare a basic human right that should not be left in the hands of the free market, but instead provided by the government, equally for all, like education. And, as usual, the politicians in Washington are duking it out over the details, and pandering to their electoral bases and campaign contributors, rather than doing what they were theoretically hired by the people to do: lead. For this is an issue that needs more than a few laws rewritten, or a few policies reworded. It needs a thorough philosophical analysis and overhaul. Much like during past turning points in our history, such as the civil war, or the civil rights movement, we need to ask ourselves, what kind of society do we want to be? We need to look inside, we need to find some answers to some basic moral questions, and we need to elevate the discourse beyond the deafening roar of ignorance. For this, we need philosophers, which, unfortunately – unlike in Norway – are rarely found among our policy makers.

It is indeed disheartening to see the same old games being played out in Washington, and the same old arguments trumpeted for the umpteenth time, when this time, it should be different. We are not talking about the banks, who do provide us with a genuine service, and play a critical role in our healthy functioning as a society, but without which, though inconvenient, each of us could survive on an individual level. We are not talking about who runs the company that you buy your car, mail your package, or catch your train from; again, all valuable services that fill a genuine need in our society, and without the efficient functioning of which our lives and nation would be greatly impacted for the worse, but without the need for which many people go for years, never even giving them a single thought. We are talking about a basic human need, one that binds us all together as mortals, and that every one of us carries in us every day.

Even if you are young and generally healthy, if you are uninsured in this country the thought is ever present somewhere in your mind: what happens if I have an accident? What happens if I am the victim of an attack, or if I suddenly develop some rare disease? More commonly: what happens if I want to have a child? The average medical cost of an uncomplicated birth these days is $7,600 (2004 dollars), but can go much higher, depending on location, complications and level of care, an amount that few middle class couples have stashed away, let alone working class couples. And then, even if you do pay for the baby out of pocket, now you have an uninsured child that you must pray remains healthy, so you don’t have to mortgage your home, if you are so fortunate to own one.

Something is very very wrong with this picture. And it doesn’t even take into account the vast numbers of people who are not healthy, who are sick and need healthcare, but can’t receive it for all of the many reasons that we have heard countless times by now: their insurance won’t cover it, or they were dropped by their provider for some technicality, or, they are just uninsurable.

This is not humane. With all of the hurling of statistics and figures and finger pointing and name-calling taking place, the true, real, honest discussion of what is the best and most humane system for healthcare is simply not happening. There is too much appeasement to the free-marketers stomping their feet and screaming about capitalism being slaughtered, and the profits of the massive, bloated insurance companies being threatened. Those who suggest that this is not – and should not be – the central issue are dismissed as blasphemous socialists. But the truth is, they are not going far enough. Not only should the central issue not be the financial profit of the insurance providers or the hospitals or the doctors or, for that matter, the patients or their lawyers – it should not even be part of the discussion. The central issue should be the people of this nation, and how to provide them with the best possible care given all the resources, knowledge and tools at our disposal. This is, quite simply, a moral issue, something that every other advanced free-market democracy in the world has realized, except us. There should be no profit motive in healthcare.

Yes, I know. Take the profit motive out of anything and the quality declines. Really? Is there truly no other way? Have we really become so cynical and hard about our own nature that we succumb to the power of greed at every turn rather than looking deeper into ourselves and searching for a higher truth? Is it totally naive to believe and hope that this nation of humans can do something for an aim other than personal wealth or material gain?

Kino and Juana and Coyotito had a happy, albeit very simple and modest life. But then Kino, in his mad effort to pay the doctor to cure his sick child, found The Pearl of the World, and it destroyed their happiness. They lost everything they had, instead of gaining what they dreamt of. An old old story, certainly, but no less true in the telling today than ever. We are looking for an answer to our ailing healthcare system, which makes a few rich, and leaves many to go bankrupt or die. We are looking for The Pearl of the World, a solution to healthcare that keeps the rich getting richer, and yet provides universal coverage, a solution that makes everyone happy, capitalists and socialists alike, solves all the problems. It doesn’t exist, it can’t exist, because where there is greed, where there is profit to be made, it always wins out, and someone always loses. In the case of healthcare, what they lose may just be their life.

As Kino struggles to sell his pearl to better their lives, he is tormented by the music of the pearl, which is evil, harsh, yet hypnotic. It changes him, he becomes fierce and brutal in his quest to realize the wealth that should be his, now that he has the pearl. It drowns out the song of the family, that happy music that has always brought him peace, and joy. He must pass through a tragic journey to finally acknowledge that the pearl is not the solution, the pearl brings only evil and wrong, and he must abandon the pearl, if he is to regain the true, right path, if he is to regain any semblance of the happiness and peace he knew before. As he prepares to rid them of it, he hears “the music of the pearl, distorted and insane.” But he does it, perhaps the hardest thing he has ever done, or will ever have to do, he flings that glorious pearl back into the sea. He and Juana “saw the little splash in the distance, and they stood side by side watching the place for a long time.”

The lesson is a simple one, but not an easy one to learn. We cannot put our healthcare system on the right path without letting go of the illusion that it can provide the kind of care that is needed to all people of this country, regardless of race, gender, age, class, or medical history, without letting go of the pearl, the promise of wealth, greed. There is no happy ending if we hold onto the illusion of the pearl, and listen to its evil music. We must toss it back to the sea, and look at what really matters in this whole discussion of reform: people. If we can do that, if we can let go of the Pearl of the World, we can possibly redeem ourselves, and our nation’s ability to care for one another. If we cannot, the droning, driving, maddening music of the pearl will win, as it always does.

“And the pearl lay on the floor of the sea. A crab scampering over the bottom raised a little cloud of sand, and when it settled the pearl was gone. And the music of the pearl drifted to a whisper and disappeared.”
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Dye-it demythtified

Cronos by GoyaBut Rhea was subject in love to Cronos and bare splendid children… These great Cronos swallowed as each came forth from the womb to his mother’s knees with this intent, that no other of the proud sons of Heaven should hold the kingly office amongst the deathless gods. For he learned from Earth and starry Heaven that he was destined to be overcome by his own son, strong though he was, through the contriving of great Zeus. Therefore he kept no blind outlook, but watched and swallowed down his children: and unceasing grief seized Rhea.
- The Theogony of Hesiod

A few years ago, I befriended a stray cat while vacationing on an island in the Adriatic. She was a small, delicate creature with a bright, happy little face and an open and loving disposition. When we first arrived at our island retreat, she appeared to my delight accompanied by four or five little kittens, who frolicked and played joyfully as they followed her about the arid landscape. Each day I waited for them with anticipation, as the entertainment of the kittens’ play was irresistible, and my fondness for the little mother was growing fast. But as day after day passed, I noticed fewer and fewer kittens in the group, until finally there were only two. I was puzzled by this, but assumed that the woman who had rented us our little cottage, and who came every day to look after the place and feed the cats, was taking the kittens away to some new homes. This idea didn’t quite make sense, as cats are not normally house pets in that part of the world, and these kittens, born to a stray mother, were destined to a hard life living off the land. But when the mother cat finally appeared alone, with no kittens anywhere in sight, I couldn’t stand it anymore. I had to know. I waited for the landlady to arrive, and in my broken Croatian I asked her what had become of the kittens. She said she did not know, but she assumed that it was a male cat, most likely the father of the litter, who was killing them off. I was horrified, and distraught. I went back and looked into the face of that little cat, hardly more than a kitten herself, and wondered about how power, ambition and greed brings out the cruel beast in all creatures.

For we humans are hardly superior to the animal world in this respect; though we may not individually devour our young outright, we often act collectively in ways that are, by all methods of logic, contrary to our species’ interests and survival. Man’s desire and attempts to remain all powerful forever is a truth of human nature that plays out endlessly throughout literature and legend, as well as in the daily news. In Greek mythology, the Titan Cronos, Father Time, ironically tries to conquer time by devouring all of his offspring, so that his power over the gods will never be usurped by the next generation. Today’s paper no doubt will be full of stories about more acts of short-term greed causing untold amounts of pain and deprivation for countless numbers tomorrow.

And while our minds are spinning from the sensationalistic and inconceivable figures that bombard us daily regarding the latest financial misdeeds of Wall Street or the latest political maneuverings on K Street, we somehow miss or shrug off the most troubling statistics of all, those regarding our health, and more specifically that of our nation’s children: nearly 5% of children between the ages of 6 and 17 are now diagnosed with ADHD, documented cases of autism in children has increased about fifteen-fold in as many years, and an unbelievable estimated 23 million children are overweight or obese.

The culprits causing our kids to be overweight are easy enough to pinpoint, and are obviously related to high-fat diets and little or no exercise. But determining what factors are contributing to the astounding rise in behavioral and cognitive issues in children is not as obvious, and results in a distressing maze of unanswered questions for parents and teachers, as well as many health professionals. With medications like Ritalin all too easily prescribed for children exhibiting hyperactivity, and parents desperately trying to control their child’s behavior and intimidated by school and social service officials, a whopping 2.5 million kids end up on some form of stimulant drugs, most of which have not been fully tested, and whose long term effects are totally unknown. “Although the drugs are widely viewed as safe, many parents were alarmed when the Food and Drug Administration ordered in 2006 that stimulants like Adderall, Ritalin and Concerta carry warnings of risk for sudden death, heart attacks and hallucinations in some patients.” (nytimes.com)

Some other less severe possible side effects of these drugs are well documented: decreased appetite, weight loss, insomnia, abdominal pain, and personality changes. However some potential effects are much more ominous. “In a 1995 study by the government’s National Toxicology Program (NTP), the most popular ADHD drug, methylphenidate (Ritalin), caused malignant liver tumors in male mice and benign liver tumors in female mice… Although there is no evidence that methylphenidate causes cancer in humans, no good studies have been done.” (cspinet.org) Our children have become our medical guinea pigs, and as is typical in our western approach to healthcare, we choose as a society to throw dangerous medication at the symptoms, rather than investigate and treat the underlying causes.

In truth, some studies have been done, specifically on the effect of diet on hyperactivity, and their results, though not indisputably conclusive, do indicate a link between some foods and food additives and hyperactive behavior in some kids. In particular, research has shown that artificial colors and preservatives in foods can contribute to attention deficit and hyperactivity, information which has caused the UK and the European Parliament to recently take action, asking for the voluntary recall of six artificial food colors by food manufacturers, as well as the labeling of foods containing these additives. “These actions were spurred by a study published in September 2007 in the medical journal The Lancet supporting what some parents and scientists had suspected for decades – that food dyes are linked to hyperactivity, even in kids who don’t normally exhibit this behavior.” (latimes.com)

But the FDA is holding fast to their claim that these additives are safe, citing findings from 30-year-old studies to support their policy. Perhaps more astounding is the public’s lack of accessible information about what these additives truly contain, namely petrochemicals and coal tar! The next time you take a bite of those bright orange cheese puffs or pop a few lime-green candies in your mouth, ask yourself if you wouldn’t rather be ingesting some pretoleum, because, in fact, you are. Especially if they were made in or for the USA. “Kellogg’s strawberry Nutri-Grain Cereal Bars that are sold in Britain now contain beetroot red, annatto and paprika extract, while those sold in the U.S. are tinted with Red 40, Yellow 6 and Blue 1.” (latimes.com)

Petitions to the FDA to review their policy on artificial food dyes are underway, but so far to no avail. Many food manufacturers have been moving away from the artificial colors on their own to satisfy international markets, replacing them with natural dyes, the majority of which are vegetable-based, however “the most popular of which is cochineal, a dye made from insects that are ground up and added to foods to make them rosier.” (usnews.com) Cochineal, also known as carmine, is made “by scraping female bugs and their eggs off cactus leaves and grinding them into a powder.” (usnews.com) Whether to ingest petroleum or crushed bugs should not be part of our decision process when making food choices, for ourselves, or for our children. Until the FDA wakes up and decides to re-evaluate its priorities regarding the food industry vs. our national health, one would do better to avoid all packaged foods that contain either artificial or natural colors.

Phantoms making our kids sickIt’s little wonder that even the most attentive and aware parents become demoralized, for even if they do manage to keep these additives out of their children’s diet at home, what to do about the hundreds of meals served every year to millions of our kids at school? These school lunches are notoriously high in saturated fats and sugars, and provide very little in the way of micronutrients (vitamins and minerals), which are vital for humans, and especially growing children, to thrive. “According to the Society for Neuroscience, recent studies reveal that diets with high levels of saturated fats actually impair learning and memory. Unfortunately, foods with saturated fats are often the most affordable and widely available in schools. French fries, sugary desserts, cheeseburgers, chicken nuggets, and other cafeteria staples are filling kids with food that actually lower their brain power before sending them back to class.” (publicschoolreview.com) Not to mention the high levels of preservatives and artificial colors that are packed into these low-cost mass meals, which may be contributing to kids’ hyperactive behavior in the classroom.

In recent years there have been some encouraging initiatives to improve the quality of school lunches, including the “Healthy School Program,” which has been incorporated into many public and private schools across the country. One school on the program reported that “after serving healthier foods, there were ‘no discipline problems, no acting out, no violence to speak of,’… Also, since the studied implementation of healthier school plans in 1997, the ‘Healthy Schools’ across the country report lower incidences of dropouts, expulsions, drug use, weapons, and fighting, with a simultaneous rise in student performance, as grades have also improved and gone up at these schools.” (publicschoolreview.com)

Not surprisingly, however, many schools find themselves up against considerable obstacles from the government when trying to implement healthier lunches. “One longstanding barrier to schools serving more healthful meals is the USDA’s commodity foods program, which distributes large quantities of unhealthful ‘entitlement foods.’ Every year, the USDA purchases hundreds of millions of dollars worth of pork, beef, and other high-fat, high-cholesterol animal products, primarily as an economic benefit to American agribusiness. In 2005, for example, the USDA allocated close to 60 percent of food program procurement expenditures to meat, dairy, and egg products, while providing less than 5 percent to purchase fresh fruits and vegetables.” (healthyschoollunches.org)

Our elected leaders pay endless lip service to the fact that our children are our future, that we must invest in them at all costs, yet we have allowed our schools to continually pump them full of nutrient-empty, energy-draining calories and line the halls with chemical additive-laden snack food and soda vending machines, all so that major food manufacturers and agribusiness can cash in. We look the other way as these little representatives of the future line up in the nurse’s office to take their prescribed stimulant courtesy of the pharmaceutical industry, as if we cannot see the obvious, horrible truth. Could it be more evident that proper diet and exercise are critical aspects to our children’s health, and that schools need to step up in this regard immediately? How much more of this disregard for our children’s welfare at the profit of big business are we going to tolerate before we finally say enough? ADD, ADHD and the numerous other current issues that our kids are facing may not disappear, but it would at least give them a fighting chance.

little-mama-macka2“After that, the strength and glorious limbs of the prince increased quickly, and as the years rolled on, great Cronos the wily was beguiled by the deep suggestions of Earth, and brought up again his offspring, vanquished by the arts and might of his own son, and he vomited up first the stone which he had swallowed last. And Zeus set it fast in the wide-pathed earth at goodly Pytho under the glens of Parnassus, to be a sign thenceforth and a marvel to mortal men.” If Rhea had not finally acted and fed Cronos a stone instead of their last child, Zeus, he may be king of the gods to this day, and we would have had none of the marvelous myths that unraveled under the rule of his son. Male cats may continue to kill their offspring in the wild, but humans can rise above our bestial drives and stand up to power and greed, especially to protect our young. When you look at how our government prioritizes big business’ interests over our children’s health, and how our schools don’t know the first thing about nutrition but certainly are well versed on all the latest pharmacology, it’s high time to pick up our own proverbial stone.