The Casual Blog

Tag: health care

Getting close to birds and farther from people: hunkering down for the pandemic

Last week I got out to Jordan Lake three times and spent some time around sunrise with the wildlife there.  I saw lots of great blue herons, and several ospreys and bald eagles, as well as the less glamorous  gulls, crows, and turkey vultures.  

With the human world in the midst of the covid-19 pandemic, I was especially grateful for some time with the birds.  Of course, they have their own life and death struggles, including finding enough food to survive each new day.  But they manage it without undue drama, keeping their focus on the task at hand.  Once the essentials are taken care of, they become very still, alert but peaceful.

The pandemic has quite suddenly changed everything.  We don’t know how long it will be before something like normalcy returns.  In the meantime, there will be brutal economic hardship for laid off people who need the next paycheck for housing and food.  On top of that, cutting direct human contact will likely cause a spike in depression and suicides. This is going to be tough.

In the midst of what looks like an epic disaster in process, it may not be the best time to talk of lessons to be learned.  On the other hand, we’re all going to have some time on our hands, which we might use to think about our situation.

Illness can be a revealing crucible.  It forces us to face up to reality. For example, parents may have all kinds of kooky ideas about praying for health, but when their own child gets seriously ill, and prayer doesn’t seem to be working, they will usually take the child to the doctor.  Illness forces us to quit playing and get serious.  

And so it is that we’re now looking to scientists for guidance about covid-19.  Our President has led a war on science, muzzling experts and eliminating scientific positions and agencies, as the Times and others have noted.  But he seems to be shifting gears, and now he’s consulting with doctors, public health experts, and other scientists.

At this point, it is hardly news that we have an incompetent and mentally ill President who sees the world exclusively in terms of how it can gratify his ego and bank account.  But like the parents with a sick child, even he has come to see it’s time to go to the doctor and get actual facts and possibly some help. He’s still inclined to boost xenophobic conspiracy theories, but he’s finally making concessions to reality.  Along with increasing death and misery, denying reality now might even be politically damaging. 

As little as I respect the President and as fervently as I want to see him defeated, I want to wish him well in this regard:  may he find the wisdom to defer to the best experts. Our scientists and doctors won’t have all the answers, but they’re our best hope.  Assuming we make it through this crisis, we might apply this same rule to address other global crises, like global warming.    

For the rest of us, there’s an opportunity to pause and reflect.  Covid-19 has brought into stark relief the fragility of our social, economic, and governmental systems.  If it wasn’t clear before, it’s now clear that our national healthcare system is a hopeless mess. Our social safety net is full of holes.  Our system of profit-at-all-costs capitalism is failing to address basic needs.    

In the face of the pandemic, even those officials of the all-government-is-bad view are modifying their opinion and trying to do something.  It looks like the government may be sending out real checks to actual families to mitigate some of the hardship. This looks like progress, and also like a tiny band-aid.  But who knows? We may look back on this as the historic beginning of a transformative new system with a universal basic income and greater fairness.

One thing is certain:  this is not going to be easy.  It’s definitely not the case that we have nothing to fear but fear itself.  We need to cultivate our courage, and our compassion. Those of us with some surplus need to help others.  My old friend Deborah Ross, a Democrat running for Congress in N.C. District 2, suggests donations to the N.C. Food Bank. The Washington Post yesterday had a helpful list of charities working for those who will be hardest hit. 

Learning new things, including the butterfly stroke and about our worst tendencies

It was brutally hot here in Raleigh this weekend, which made me consider breaking my commitment to getting outside with my camera at least once a week and trying to see something fresh in the natural world.  But I ultimately hung tough and did a short photo safari at Raulston Arboretum, which was not as miserable as I expected.  I was happy I got these pictures.

Learning new things is sometimes fun, and sometimes hard, but always important, to keep our brains from turning to mush.  And so I decided to take some swimming lessons, and had my first one this week.  As I told my teacher, a young woman named Deanna, I would like to try to learn the butterfly stroke.  It’s one of those things I’ve always wondered if I could do, and it would add another variation to my lap swimming.  My first efforts were awkward, but by the end of the lesson, I had a version of the dolphin kick going.  I found it hard and fun.  

In these tumultuous times, we’re learning a lot about our weaknesses and strengths.  Under a constant deluge of lies, vulgarities, and mad fantasies, it’s more difficult to be open and curious, to think rationally and critically.  Panic and anger seem natural, and at times overwhelming.  We’re seeing how some of our worst tendencies, like intolerance and bigotry, are unleashed and encouraged.  

It’s not exactly cheering news, but at least we have a more realistic idea of the extent of our ignorance, intolerance, and susceptibility to manipulation.  We’ve gotten these and other  problems out in the open where we can potentially address them.  Eventually we might figure out how to be better people.

In the policy area, we’re learning more about our health care system.  Repealing Obamacare somehow became a mantra for the right — a symbolic acid test for signalling membership in the conservative tribe.  It’s hard to feel great about the enormous waste of time, energy, and public funds from the repeal effort, and the failure so far to address pressing problems, but there is a slightly bright side.    

It’s looking like some delusions are getting cleared up.  We now know that the mantra of repeal had almost no relation to the real issues of our health care system.  Some who liked the mantra have belatedly realized that cutting off insurance means real humans die prematurely. It appears that even the most committed ideologues, or at least the majority, get uncomfortable once we reach a certain level of cruelty.    

This debate has cleared the landscape like a forest fire, and some fresh ideas are starting to germinate.  For the first time in a couple of generations, we’re starting to widen the discussion about health care.  It’s starting to be more widely understood that we pay way too much for it, and the quality of care is bad in comparison with our peers.  There’s a new openness to the possibility of a sensible single payer system, such as an expanded version of Medicare.  

It won’t be easy to get from here to there.  Even leaving aside our dysfunctional political leadership, there are powerful institutional forces supporting the status quo.  Here’s how the Economist recently put it:  If the amount the U.S. spends on health care were reduced to the level of France, Germany, or Switzerland, we would save a trillion dollars, or $8,000 per family.  “Much of that trillion dollars goes to enrich the owners and executives of drug companies, device manufacturers, and relentlessly consolidating hospitals.  This rent-seeking is supported by an army of lobbyists:  there are more than twice as many lobbyists for the pharmaceutical and health-products industry than there are Congressmen.”  

Indeed, there are quite a few other blockers, like doctors, many of whom would be resistant to having their incomes reduced, and insurers, with similar issues.  Real improvements don’t seem likely in the near term, but I’m not giving up hope that eventually we’ll make progress.

Improved propaganda and healthier diets

For all the money and energy we spend on health care, you’d think we’d be more focussed on eating practices that improved our health. But changing eating habits is difficult. The forces of advertising and tradition powerfully reinforce our bad habits. Thus I was pleasantly surprised to see the government’s replacement for the food pyramid this week.
It’s far from perfect, but it’s a significant improvement.

The pyramid was supposed to help us eat healthier, but it didn’t do that very well. The various versions of the pyramid were confusing where they weren’t downright misleading. In the past, the food industry has battled hard against changing the food pyramid, as well described in Food Politics by Marion Nestle. It would be interesting to know what happened to bring about the new symbol. Could it be Michelle Obama?

In any case, the new symbol emphasizes that half of your diet should be fruit and vegetables, and another significant portion should be whole grains. The other large chunk is dubbed protein.

The oddity, of course, is that there isn’t anything in the grocery store called protein. Many believe that eating meat is necessary to get adequate protein, although this is a myth. In fact, many plant foods (whole grains, legumes, vegetables, and nuts) are good sources of protein. It may be that the meat lobby figured that the meat-protein association is so firmly lodged in public consciousness that it will not be shaken loose any time soon, and so their markets won’t be threatened

The new graphic treats dairy products in a confusing way — a circle to one side of the main plate. This could be interpreted as a suggestion to drink lots of milk, but it could also mean that dairy is not entitled to the same status as the main dietary categories. This smacks of a political compromise with the dairy industry. There’s a growing body of evidence that cow’s milk is not good for humans, but the official new guidelines contain no hint of this. It’s good, though, that they recommend low-fat options.

Another subtle problem with the new graphic is that by depicting a plate completely covered with food groups, it reinforces our tendency to eat too much. Americans already have trouble not covering every square inch of their plates with food, and eating all of it. Our obesity epidemic proves the point. To be fair, the new web site (see link above) acknowledges the importance of reasonable serving sizes. Still, a better graphic would show that we should eat only as much as we really need to nourish ourselves, which for most of us means: eat less.

Talking about big problems, like healthcare

What strange political times we live in!  The lunatic fringe has seized the Republican party and is spewing forth venom and hysteria about the just-passed health care reform law.  With the new law, we moved some, but not a lot, in the direction of a more humane society.  It’s hard to believe any one thinks that this augers dramatic social change, either positive or negative.  But there’s a vocal minority that believe passionately that the law portends the end of democracy.  Some subgroup of that minority is advocating violent resistance.  This is craziness, and a bit scary.

It would certainly be possible to worry all the time about this and other big problems (global warming, nuclear and non-nuclear war, economic meltdown, political corruption, jihadism, failed states & etc.).   But worrying by itself doesn’t change anything, and is itself bad for your health.   What’s needed is dialog, plans for action, and action.  But it’s hard even to have a dialog.  Politics has become polarized, so that people who disagree find it difficult even to talk.  It’s unclear how we got into this box, and unclear how we get out.  But at a minimum, we need to try more talking.

Sally and I finally got around to watching Al Gore’s movie An Inconvenient Truth last week.  The basic message is now familiar to most of those willing to listen to it, and certainly familiar to us.  And the facts about global warming aren’t getting any better.  But it was inspiring to hear again the story of Al Gore, a failed presidential candidate, who passionately pursued an issue that he thought was vital.  He stayed with the message for years and played an important role on getting it onto the agenda.  I really admire him for that.  Now we’ve got to address the problem.