It’s always hard to be sure about these things, but I think the reason I decided to take a ‘sabbatical’ from blogging last July was that I was interested in too many seemingly unrelated topics. Writing about all of them left me feeling like I never got to the ‘meat’ of any one of them. And I couldn’t convince myself to focus on just one or two things, since that would mean abandoning the others, which I was unwilling to do. Read more
Category Archives: Politics & Issues
Guest post: The unemployed as the waste products of the success factory
Since the beginning of the industrial era, the unemployed have functioned as the reserve army of labor. They survived with the hope that someday they would surely be recalled from unemployment into active service. Today, however, the destination of those who become unemployed is the landfill of poverty and the psychological trash heap. As Danièle Linhart points out, “these men and women not only lose their jobs, their projects, their dreams and the assurance of a life under their control: they are also deprived of their dignity as workers, their self-esteem, their sense of purpose and their place in society.” Read more
SCOTUS, the Affordable Care Act, and an ugly American tradition
There are reasons, then, why health care might not become a campaign issue for this particular Republican presidential nominee. And if it does not, I wonder if those in favor of universal health care realize how easily we could lose this historic achievement. Read more
What is healthism? (part one)
Throughout history there’s been an understandable desire to find connections between our behavior and our health. Human beings have practiced health regimens involving diet, exercise and hygiene since antiquity. When medicine was based on the humoral theory of disease, for example, individuals were advised to purge the body in the spring and, in the summer, avoid foods or activities that caused heat. Bathing in ice water was recommended in the 19th century. Mark Twain quoted the advice: “the only way to keep your health is to eat what you don’t want, drink what you don’t like, and do what you’d druther not.” Read more
Why medicine is not a science and health care is not health
My real objection to medicine as a science is that by focusing on what can readily be quantified, it ignores what cannot, such as the social determinants of health and disease. Medicine’s desire for the respectability that comes with being a science gets in the way of determining what could actually make us healthier. Read more
Recommended (online) reading
I’m still on “sabbatical.” Mostly reading. Thinking about what I most want to write about. I know what my interests are — the problem is, I have too many. Meanwhile, here are some blogs I enjoy reading. Read more
When the poor were contagious
Will the London riots raise questions about a world that doesn’t care about the socially disadvantaged? Questions, yes. But will that be enough to bring about a change in attitudes and policies? Probably not. Unfortunately, the situation will need to get much worse. Even when that happens, current financial interests are likely to prevail. A discouraging prospect, yes, but a struggle worth waging. Read more
The misuse of health statistics by politicians
Comparing five-year survival rates for the US and England is fundamentally misleading. Prostate cancer is overdiagnosed in the US. Many men who receive a diagnosis do not have cancer or will never develop symptoms, let alone die from the disease. The estimate for the US is that 48% of men diagnosed with prostate cancer do not have a progressive form of the disease. In England, on the other hand, testing is performed after symptoms appear, so a diagnosis is much more significant and meaningful. Read more
Why is it so hard to reduce US health care costs?
A modern version of the Hippocratic Oath, the Physician Charter, commits physicians to work toward “the wise and cost-effective management of limited clinical resources.” But there’s little physicians – or anyone else – can do to change the behavior of politicians, insurance companies, pharmaceutical companies, or other entrenched stakeholders. It would indeed be heartening to see a visionary, public-minded physician emerge as a leader of the medical profession in the fight to solve this important and extremely difficult dilemma. Read more
Bruckner on the good life, money, and the unequal world of work
Poverty in developed countries may never be overcome, simply because the rich no longer … need the poor to get rich. … The misfortune of being exploited has been succeeded by the still worse misfortune of no longer being exploitable. Read more
Why are we so willing to undergo cosmetic surgery?
Members of traditional societies accepted being told when and how to reshape their bodies. Their decision was binary: either participate or leave the group. In contemporary society, each individual is responsible for choosing and effecting her own reshaping, thus demonstrating her fitness for membership within a given field. Hierarchical position depends on displaying attunement to the field …. including what kind of body counts as right. The right body demonstrates having made the right assessment of capital, and thus becomes a potent display of rights to participation and position. Read more
Bruckner on the family, being gay, and AIDS activism
The seriously ill, the traumatized, and accident victims, strong in their common weaknesses, manifest their freedom with regard to what had previously put them in the category of subcitizens, those receiving assistance. They are fighting against the segregation that made them lepers, bearers of bad news. They are fighting to remain members of the human community. Read more
Can pharmaceutical drugs benefit society?
There’s more to the value of health care than clinical effectiveness for patients and cost-effectiveness for individuals and governments. As we imagine the future of heatlh care, a welcome addition would be to plan for wider benefits to society. At this point in time in the US, it’s hard to imagine overcoming the political difficulties involved in reaching an agreement on what would benefit society. But it’s worth anticipating the possibility of a better future – the future we would want for ourselves and our children. Read more
Patient safety and corporate profits
A corporate board, on the other hand — whether it governs a hospital, a pharmaceutical company or an insurance giant — is legally required to give priority to stock holders over patients. When it comes to matters of health – which is to say life, death, and disability – it seems obvious to me that corporate boards are the least desirable level at which decisions about patient safety should be made. Decisions like increasing product sales at the expense of patient safety.
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Guest post: A sound mind in a disintegrating body
In order to attain the corpore sano required by today’s fanatical health and hotness community you have to devote two or three hours a day to honing the body beautiful so that it contains no lumps, bra overhang or bits that have to be sucked in when you walk past a mirror. This involves lunges, squats, curls, lat pulldowns, pushups, bench presses and eventual death from exhaustion unless you are of that rare elite who are truly in The Zone. Read more
Megan McArdle: Why are there no new antibiotics?
She goes on to discuss some of the issues involved in getting pharmaceutical companies to develop desparately needed new antibiotics. In particular, she explains the need to create a stockpile of new antibiotics that everyone will agree not to use for many years. (If we did use them, resistance would develop almost immediately.) This will mean some people (thousands? tens of thousand?) will die during the waiting period, when they could have lived. (Good luck on that one.) Someone (the government? foundations?) must agree to pay the pharmaceutical companies for all those years of waiting. And the US – for various reasons – will have to do this first. Read more
Joseph Stiglitz on inequality
The top 1 percent have the best houses, the best educations, the best doctors, and the best lifestyles, but there is one thing that money doesn’t seem to have bought: an understanding that their fate is bound up with how the other 99 percent live. Throughout history, this is something that the top 1 percent eventually do learn. Too late. Read more
Down so low we dare not speak
The reason pessimists are multiplying is that we dishonor the intellect and the knowledge of history in this country by refusing to admit that corruption is the source of our ills. It takes no great mental effort to realize that there’s no effective political forces either in Washington or locally that are able to do anything serious to correct our self-delusions about being the world’s policeman, because any sensible solution would seriously cut into profits of this or that interest group. Read more
Breaking the self-destructive meritocratic spell
The problem in America is not that a minority has grown super rich, but that for decades now, it has done so to the detriment of the lower social classes. The big question is: why does the majority in a seemingly free society tolerate this, and even happily vote against its own economic interests? A plausible answer is that it is under a self-destructive meritocratic spell … Rather than move towards greater fairness and egalitarianism, it promotes a libertarian gospel of the free market with minimal regulation, taxation, and public safety nets. What would it take to break this spell? Read more
What Wisconsin hath wrought
It’s time to focus on the corporate CEOs and speculators. … “In U.S. states facing a budget shortfall, revenues from corporate taxes have declined $2.5 billion in the last year. In Wisconsin, two-thirds of corporations pay no taxes, and the share of state revenue from corporate taxes has fallen by half since 1981.” The same is true in other states. These facts must be stressed, repeatedly and aggressively, if the debate is going to shift from cuts in public services and education to demands for fair taxes and the revenues necessary for services and schools. Read more
It’s cheaper to let the sick die
Unfortunately, he [Gawande] dismisses what, from the standpoint of reducing total health-care expenditures, is the single most serious drawback to such an approach; namely, the probability that effectively case-managed patients will survive longer than they would without intensive ambulatory care and will thereby offset their reduced frequency of hospitalization with an increase in their time at risk. If an intervention reduces a patient’s frequency of hospitalization from ten admissions annually to five, but simultaneously increases that patient’s survival from one year to two, the intervention is fully justified medically but is a wash from a cost perspective. If it increases that patient’s survival to two years and one month, it’s a net liability. Read more
Why do we feel bad about the way we look?
How did ordinary women and men with ordinary lives and ordinary bodies learn that they need plastic? The answer: the plastic ideological complex, a set of cultural texts that are both highly contested and yet tightly on message. It is itself so ubiquitous that it might even be described as hegemonic. In other words, the “need” for cosmetic procedures is impossible to avoid. Through advertising and TV shows, movies and magazines, we learn to want cosmetic intervention in our aging faces and imperfect bodies. This need is now so firmly implanted in our cultural psyche that it has become “common sense” to embrace cosmetic procedures. Read more
Daniel T. Rodgers on equality and inequality
Rawls’s cautious, prudential argument for equality could not be uncoupled in the minds of conservative intellectuals from their distress at the new affirmative action projects, their anger at busing for racial equalization, and their recoil from the gender-blurring prospects of the Equal Rights Amendment. The once common distinction between equality of opportunity and the (dangerous) passion for equality of results fused into a general criticism of equality-driven politics in all its forms. Freedom, merit, and excellence: these, not equality, were the aims of the good society. Michael Novak put the conservative consensus succinctly in 1990: “The rage for equality is a wicked project.” Read more
Ezra Klein on inequality
Whatever our eventual conclusions on inequality, we’re going to have trouble acting on them if the political system can’t bring itself to care about the average American a little bit more. … We at least need to recognize what it is that we keep doing: green-lighting the policies that make the rich richer or, in the case of the crisis, keep them rich, while dithering and drifting on the problems and needs of the vast middle. Read more
Even dictators need a facelift
It’s not surprising then that Colonel Muammar Gaddafi of Libya would want to maintain a youthful appearance. His Brazilian plastic surgeon, Dr. Liacyr Ribeiro, has just released the details. Ribeiro – who has also performed cosmetic surgery on Italy’s Italian Prime Minister Silvio Berlusconi — told a Brazillian weekly that he operated on Gaddafi in 1995. Read more
Links: Implants & cancer/Ageism & healthism/Psychiatry/Climate change/War/Inequality
When Is Breast Cancer Not “Cancer”? When You’re Funded by Breast-Implant Makers (Bnet)
Plastic surgery trade groups advised doctors on what to tell women worried by new link between breast implants and anaplastic large cell lymphoma (ALCL). Say it’s a “condition,” not cancer.
It Gets Worse (NYT)
Robert Crawford’s healthism is alive and well. Review of Susan Jacoby’s Never Say Die: The Myth and Marketing of the New Old Age
Cosmetic surgery for your pet
My vet said my dog wont [sic] know that he’s missing anything. Is that true?
People know their beloved pet. Their pet can tell them when they are hungry, want to play, don’t feel well, hide when approaching the vet’s office or will get excited when driving by or going to the park – why wouldn’t the pet know a familiar body part is missing? Would he know if his foot was cut off? Of course he would – its [sic] only common sense.
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Links: Vampire facelifts/Happiness/Neuroenhancers/Climate change/…
‘Vampire Face-Lifts’: Smooth at First Bite (NYT)
Plumping out nasiolabial folds with your own blood platelets. Not tested. Not FDA approved. “This is another gimmick that people are using to make themselves stand out on the Internet in a real dog-eat-dog part of medicine.”
The Corporate Pursuit of Happiness (Fast Company)
Stanford business school teaches students the virtues of marketing products with the promise of happiness. Happiness is just “another commodity deployed to sell something.”
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The new economic reality
In a recent internal debate, he said, one of his senior colleagues had argued that the hollowing-out of the American middle class didn’t really matter. “His point was that if the transformation of the world economy lifts four people in China and India out of poverty and into the middle class, and meanwhile means one American drops out of the middle class, that’s not such a bad trade,” the CEO recalled. Read more
Links: Cosmetic surgery/Sleep/Aging/Health care greed/…
Girlguiding UK urges teenage girls to think twice about cosmetic surgery (24dash)
UK national survey finds half of women age 16-21 would consider cosmetic surgery. More than one in 10 age 11-16 would think about cosmetic surgery to change their looks. Almost half think the pressure to look attractive is the most negative part of being female.
Culture of greed upsets attempts at health care reform (Boston Globe)
No kidding. Blue Cross CEO gets $8.6 million for leaving the company. “I am stunned by the arrogance of Blue Cross Blue Shield and the entire health insurance industry to allow this type of transfer of income from the working class to the wealthy. Read more