Wednesday, July 22, 2009

XXXIX. The Three Defects, The Twin Myths and The Three Delusions

Truth be declared, I am having a tough time adjusting to the cultural amnesia, inability to acquire and assimilate knowledge, and gullibility that characterizes a sizable fraction of the American population. For example, many people still think that we should have stayed and “won” in Vietnam despite its chief architect, Robert McNamara, having publicly apologized for that war as a tragedy resulting from a profoundly misguided application of US power in foreign policy. Mr. McNamara was a long time (decades) in coming to the firm conclusion that this nation had fundamentally departed from the stated principles on which the country is based in waging that war. Unfortunately many of my fellow Americans still have not caught on; and, what’s worse, the example of Vietnam was often given as justification by proponents of the equally ill-advised invasion of Iraq! As I have written on previous occasions, diversion of resources toward war has huge implications for public health, including cancer prevention and control. Indeed, that is why I like to sign my emails with quotes from Dwight D. Eisenhower that underline that smart military minds understand this and are great allies in our effort to make the world a better and healthier place.
As I have promised earlier, I will be comparing and contrasting Americans and Indians on a number of cultural typecasts. More on that later. In the meantime, I note that these three characteristics; defects in memory, faulty comprehension, and gullibility, do appear to have unique expression in the US (which is not to say that they do not exist in varying degrees across many cultures). After all, this is what enables people of devious motivation and sufficient means to manipulate the poor and relatively uneducated.
Now the insurance companies are spreading their lies; and, as usual, the health of ordinary people (i.e., people who have no power to exert a direct effect on health or military policy) is at risk. Tied up in the fear-mongering about “socialized” medicine are the twin myths of public sector waste and inefficiency and private sector efficiency and responsibility. Having worked in both sectors, I know that there are individuals and entities in both who are very efficient. I also know that waste and wanton greed run rampant is much more common in the private sector. Witness the excesses of the financial industry in the past few years and the fact that top insurance company executives make salaries in the 7 or 8 digits (that’s to the left of the decimal point)! By contrast, the maximum salary allowed by the National Institutes of Health (NIH), is about $200,000/year. This applies to Nobel Laureates and others who are extremely smart, hard-working, and well-intentioned. Of course, the heavily compensated private-sector “tycoons” don’t want limits set to control their greed and avarice. Combining their virtually unlimited access to our elected leaders, media outlets, and the courts with a gullible, ill-informed public has enabled their salaries to soar to obscenely high levels, their corporate profits to expand exponentially, and our health indicators to become among the worst in the world.
Early last week (Monday, 13 July 2009: page A9) I published an abbreviated version of my last blog in the State Newspaper (South Carolina’s oldest and largest circulation paper). These were mainly entries on the State website, but I also received emails and phone calls. Overall, the piece generated about 3:1 favorable responses but the negative ones were pretty nasty and generally very ill-informed. There were three themes that emerged from these that I found really interesting. I do not listen to mainstream media, but have to assume that when crazy ideas are repeated over and over they must have a common source. Here goes:
Watch out, if we have “socialized medicine” you will pay 80% of your salary in taxes. Not only is this essentially untrue; but the highest rates would not apply to the people who are so easily duped. Besides, not to worry, in the US, anyone taxed at the highest rates have ready access to lawyers and accountants who are adept at lowering their rates to far below average (often to zero!).
Stories of waiting for essential care. Oh my, I love good stories, too. Just reading my blog entries is a dead giveaway on that! However, I also am an epidemiologist, and, even more importantly, have common sense. I cannot and will not (and you should not) take any action or base any decision on selected stories. To have any real meaning the stories must add up to a coherent picture and description of reality. Really, we must use our heads. If these stories of dying waiting for essential health care procedures to be performed were a common problem those countries about which the stories are being told (e.g., Canada, England, Germany, Sweden) would have the shameful health statistics, not us! (All pictures shown here were taken in the summer of 2007 when we were visiting friends who live in Stockholm, Sweden, – a place, according to right-wing American ideologues and apologists for the insurance industry, in dire poverty from "over taxation").
“They” make up the statistics. Well, I don’t know who “they” are, but this sounds like a giant paranoid delusion; or the refuge of true scoundrels. I suspect it is some of both – on the part of the duped and the perpetrators, respectively. Really, even the US keeps decent health statistics! And we have rules for quality control.
I would be willing to give a short course for people from the general public who want to begin a process of serious education and not just repeat mindless platitudes that keep us from reaching our true potential in becoming a healthy country with a fair system of health care delivery.

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