YDS: The Clare Spark Blog

December 1, 2013

Reflections on the Affordable Care Act

demondoctor“Obamacare” is rightly the domestic issue that is upsetting the nation, so although I am neither a lawyer, nor a physician, I will lay out some of the difficulties that I see in the debates to date. In no particular order, then

First, the Democratic Party’s obliviousness to the enforced changing of doctors is indicative of a pandering and incompetent mind-set: Compassionate beings that they claim to be, Democrats would never argue that it is no big deal to change mothers. The benefit of a doctor who knows your history, and is invested in your good health, is comparable to the trust we place in our mothers (and present loving fathers).  How to explain this blind spot? Society (like the body) is not a machine, with interchangeable parts, though some political groupings seem to be.

Second, to what degree are we responsible for our health? With the body, we can choose not to drink to excess, not to smoke, to practice correct hygiene, to eat for maximum nutrition and to exercise. It is not so clear how we can control our mental states, which in turn impact our immune systems and the degree to which we take care of ourselves. I cannot understand why these matters are not taken up in our school curricula and in the media, though I suppose that religious diversity plays a large role, with some belief systems rejecting the physiological lessons of modernity.

Third, don’t look to the hip universities to be sympathetic to either medicine or psychiatry. At the university where I received my graduate training in history, the history of science encompassed the history of medicine and psychiatry, and the Foucauldians and the Left were in charge. Science was held to be a joke, and amusing, just as eighteenth century quacks were to be written about and mocked. The radical historicism I encountered at UCLA could not possibly distinguish between antique fads and misconceptions and modern medicine. Post WW1 German Expressionism has a grip on many academic mentalities–those sports who inhabit “the dark side” or, who are irresistibly drawn to the femme fatale.

cabinet of doctor caligari

Fourth, when I was much younger, I recall the responsibility that doctors and dentists alike felt for the poor. So they volunteered at free clinics, or might travel to the central valley in California to treat farm workers. Medicine, like dentistry, was held to be a noble profession, perhaps because parents or grandparents were immigrants.  Nowadays, many doctors expect to be multi-millionaires; ironically, their wives and children benefit from a life of luxury, while the physician (male or female), is expected to care for too many patients. This is a world I did not know in my youth, and do not like now.

Finally, the chant from ACA boosters that the Republican Party is simply obstructionist and has no alternative proposals, is tiresome and ludicrous.  Tort reform and competition across states lines for insurance companies are only two of oft-repeated suggestions. I would be even happier with the ACA opposition if they proposed changes in the curriculum that would put health, physical and mental, at the top of the list in curriculum reform.  That will never happen here until outdated notions such as demonic possession and/or fallen flesh are finally banished from our public schools and related institutions.

fallen flesh

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