[For a medical professional’s view of alternatives to ACA, see https://clarespark.com/2015/06/26/another-missed-opportunity-james-pagano-m-d-on-scotuss-bad-decision/.%5D
Like all aging persons I am obsessed with maintaining my youthful vigor and mental alertness. It is not easy, partly because there is no agreement among physicians or other health care professionals about, to give one example, the sources of anxiety and depression, with the latter mental states ostensibly the causes of inflammation and preventable early death, not to speak of disabilities.
When I started graduate school in the early 1980s at UCLA, I remember that Student Health told us (through all their handouts) that we were responsible for managing our health. But what does that mean, exactly? Besides the obvious preventive measures of diet and exercise, what were we supposed to do, say, about constant typing or sitting or the hazing inflicted by faculty members (I am not mentioning sports that stress the skull and joints)?
This personal problem is now made more acute by the Supreme Court decision today, that supports Obamacare as written, despite widespread opposition, much of it from doctors!
Such libertarian measures as eliminating any Big Government control entirely do not solve some of the basic problems, and I do not refer just to doctor shortages or rationing. I will suggest some unresolved issues that even the most well-meaning measures for expanding health care do not take into account. 1. Not all doctors are equally competent, though with increasingly standardized protocols of treatment, it may be possible for less quackery. 2. The nation is divided over contentious issues such as vaccination, abortion, “normal” sexuality in general, and the role of government in regulating the food industry. 3. Many parents do not want their children to learn hygiene and physiology at an early age, some out of prudery, others in fear that schools will usurp their proper role in controlling the education of their children.
I should state my own biases. I do believe in self-management and personal responsibility (and more, I remain worried about worker health and safety), but some problems intrinsic to health are contested or ambiguous. As I grow older, I realize that we are not rational creatures, but more pushed around by our emotional conflicts. Until we face up to the public and academic resistance to depth psychology (except insofar as it serves “the ethical state”) no amount of legislation or federalism will improve the health and life chances of the American people. Nor will a retreat into mysticism.
We need to rehabilitate “materialism” so that it applies to science and economics, not to consumerism.