Posted by: Richard Chennault | October 19, 2006

Healthcare Trivialities

I have become in subtle ways dyspeptic about modern health care systems.  I am bothered by the inordinate amount of capital concentrated towards the advancement of near real time health information for trivial health issues.

It is contrarian I know to espouse a position in a culture that grew up on snake oil remedies and miracle cures.   The manifest destiny ingrained into the U.S. culture promulgates the myth that godhood is within our reach if we just stretch a bit further into the magic’s of technology and science.    Thus we pour resources into conquering the human genome to master our genetic fibers in order that we may live forever.

It is hard, if not impossible, not to believe that the pursuit of life in the face tragic death is not worth every ounce of blood, sweat and toil we can provide.  It matters little if this energy we devout to the servitude of extended life comes at a high cost.  For what are life, happiness and treasure in the face of losing a loved one or self?

Yet if we could step back from the ego of self and look in totality the effort expended in metering out a few measures of life to one who is on the threshold of death it becomes obvious our energies come at a terrifying price.

But instead of tackling the moral issue of indentured servitude to that fountain of life we call modern medicine let us examine the superficial as a means to blunt the visceral of life and death.    Many of us go about our lives in the struggle for survival to meet the threads of our lives together for short moments of bliss with family and friends.  We careen through the corridors of our life without calculating the cost of what many of us have taken as trivial conveniences of healthcare.

For example let us peer into the plume of online health records made accessible to the consumer.  On the surface this exposure of personal health data seems a natural extension of the electronic capture and management capabilities of a digitized health record.   We as consumers of healthcare assume that the availability of our health information is an inalienable right.  Our ability to consume this information is expected and sought.

However those healthcare digerati understand that the application of different mediums to a structured data set which is often incased in proprietary mechanisms is difficult and costly.   For example the ability to view recent labs on the web can be enormously costly to the benefit of the few who can afford an online connection.   The cost benefit ratio is absurd if placed in the context of what could be done with the money or energy expended to facilitate viewing of lab data to consumers.

For example let us reason for the sake of argument that in order to expose lab data over the web it cost $.01 cent per patient/member.   Not a vast sum considering the energy expended in order to deliver such as system.   Now let us also agree that the cost of a flu vaccine is also $.01 per person.   Of course neither cost is accurate but let us continue our dispassionate discourse and assume that their exist a medical treatment that is equal in cost to that of the delivery of our web based lab reports.  Let us also determine that this medical service like a flu vaccine can be utilized by a greater number of people than our lab report.

Now continuing further along our congenial discussion let us recall that we are rid of ego and are instead looking to improve the health of the greatest number of people rather than service the needs of the few privileged.  How would you allocate your $.01?   Would you build a web based lab reporting service or would you vaccinate an underprivileged community that had scarce access to computers, internet or membership in a healthcare cartel?

If the ego in you has not yet burst it temporal bonds of compassion then it is likely you would choose the vaccination.   Even if your ego is bent towards financial gain it may stop to consider the productivity gains captured by having a healthy, if not educated and privileged, workforce and thus choose vaccine.

If your ego is still bound up then it may be revolting to your sense of morality to want, crave or even utilize a service that is so obviously enslaving the unprivileged to sickness and further poverty.    For what use is a web based online medical record to the itinerant strawberry picker in the fields of the Sacramento valley?

I wish I had a conclusion that could happily resolve our now unsettled conscience.   I wish I could in deed reflect what in words I write.  But I to as I suspect most are caught in a viscous cycle of egotism, consumerism and god chasing.   I don’t propose to know the answer but I’ve learned that there is hope beyond modernism that can free us from these chains of depravity.

I suggest those who are intrigued by my musing read the works of Ivan Illich.


Inspiration quote for this entry:   Health, learning, dignity, independence, and creative endeavor are defined as little more than the performance of the institutions which claim to serve these ends, and their improvement is made to depend on allocating more resources to the management of hospitals, schools, and other agencies in question.  – Ivan Illich

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