On today’s episode:
What is health? Herr Mencken, the Sage of Baltimore: “a degree of adaptation to the organism’s environment so nearly complete that there is no irritation.”
Health insurance is a gamble Insurers are assisted in their own demise when they automated. Nobody knew the costs of a visit, so when costs multiplied, nobody knew what was happening. Plus, more and more people started visiting the doctor more often and for smaller complaints.
Who’s afraid of the flu?
This picture is from the New York Academy of Medicine, where I attended a conference recently (another, better view, from reader Sean). “The Conquest of Pestilence in New York City” showing rates of death per 1000. It is behind glass and while my photography skills are obviously near zero it is still clear enough to read the major bumps.
Cholera caused appalling death rates, but yellow fever ran a close second. What caused the surcease of these dread maladies? Sewers and clean water, bar none, the most effective public health measures of all time. In small print, it says “1910: chlorination of water”, and after that pasteurization of milk and clean milk stations.
The most important feature is the blip in 1918, the flu pandemic that is oft touted, but is a mere piker compared to brute cholera. The mortality rate of the flu was about 17 per 1000, or 1.7%. Near as I can discover, the current swine flu pandemic spawns a mortality rate no higher than 1 per 1000, and probably it’s one-third of this, or about 0.5%, which still feels high (the denominator in this ratio is underestimated to a larger extent than the numerator). Cholera at its peak was 50 per 1000, or 5%!. That, my friends, is a lot.
Moral obligation There is no escaping that arguments for or against “government”-run health care are moral. Do I have the moral obligation to pay for the health care of another for a malady I wouldn’t try curing in myself? What about self-inflicted injuries like alcoholism or drug addiction or obesity? What about everyday complaints like zits or headaches? Is this another so-called tragedy of the commons?
And what responsibilities come with these new “rights”? Can I then require my neighbor to stop smoking, stop eating what I don’t want him to, or think thoughts that are distressing to his mental health? Call the health police!
Mark Twain “There are people who strictly deprive themselves of each and every eatable, drinkable and smokable which has in any way acquired a shady reputation. They pay this price for health. And health is all they get for it. How strange it is. It is like paying out your whole fortune for a cow that has gone dry.”
It should be the quality of life that counts, not its quantity. And I should have a lot of say about what quality means, not a centralized half-wit bureaucrat.
Questions/Comments I’m away at a conference and probably won’t be able to answer most comments or questions until Monday, 12 October.