Wednesday, March 30, 2005

Government and Health

I've been waffling for quite a while on the idea of whether or not government has a place in an individual's health. On the one hand is the free market, which I'm on balance in favor of. On the other, there's the simple fact that we currently subsidize, either directly or via tax breaks, the emergency care of indigents to the tune of millions, if not billions, of dollars each year, money which could probably help more people if applied preventively.

Then I read this article by Frank Furedi. Not knowing anything about him (as of this writing, I haven't even visited his site), I found that his essay echoed, sometimes eerily, some incohate feelings I've had for years now, and not known quite how to put into words.

His basic point (and I encourage you to read the article, because I cannot do it justice here) is that Western societies have become medicalized; that is, they have turned problems which were formerly inherent to the human condition into medical maladies. This has several interesting consequences, according to Furedi, but the one that caught my attention the most is this:

We are not simply making a virtue out of a necessity; rather we are consciously valuing illness. From a theoretical standpoint, we might view illness as the first order concept, and wellness as the second order concept. Wellness is subordinate, methodologically, to the state of being ill.

Furedi overstates his case a bit when he equates social phobia with shyness, but he has an interesting point: when we all have some illness, be it cancer, addiction (and therein lies a whole other can of worms), loneliness, or even not having had those diseases ourselves, but having to live through someone else's illness (friends, family members, et. al), when we in fact use those illnesses as a lens through which to view our lives and our experiences, what's the value in being healthy? When 'wellness' is not viewed as a default, but a condition to which we can only hope to aspire, how can we ever be healthy?

Consider our fundamentally marketing-oriented society: unless we are ill, how can we be sold products to make us well? Unless we are deficient, how can we be sold products to make us whole? I'm not condemming capitalism-- far from it! I think it has done wonders for our physical comforts. But when we change our focus from what we need to live to how we should live, we first must consider who we are. And society, it seems, is telling us we are bad, we are broken, we are unclean.

(Note to self: tie this in with a planned review of Donaldson's Thomas Covenant books)

To bring this entry full-circle, until we can focus our lives and ourselves towards health, and not illness (and, sadly, a direct approach only confirms the supremacy of illness; this is a very hard problem), I don't think a direct government health policy makes much sense. After all, if we're all sick all the time, how can government-sponsored health care be anything but a spiralling balloon of ever-increasing expenditures?

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