Homelessness, despite its explosive increase in the past 30 years, still feels like an exception, an anomaly in the grand, prosperous and self-righteous tableau that is America. How can so many be living “on the street,” basically, in a country with so many resources and so comprehensive a political infrastructure? Liberalism causes otherwise rational people to defend the RIGHTS of the mentally ill, weird or addicted and largely uncivilized people to sleep in public places. Eventually, their rights to urinate and defecate in public places are also “recognized.” Due to some dislocation in the logical thinking of other liberals who consider themselves civilized (living in houses, indoor plumbing, decent ‘human’ activities and some form of productive wealth), residents of the same jurisdiction are permitted by virtue of the existence of other “rights,” to make their ways around the city, including eating in restaurants and entering various other businesses, in the nude. Once good sense is breeched, the uncrossable lines of civilized decency become harder and harder to discern.
To varying degrees, many municipalities have descended into some form of what San Francisco has become a leader of. Prior to the last 20 to 30 years western civilization, largely founded according to Judeo-Christian beliefs and ethics, was endeavoring to advance in terms of human civilization, habits and public, interactive, practices. That direction has reversed. That reversal seems to be centered in and controlled by liberals, leftists and socialists. Conservatives are distinctly unimpressed by these trends, if not disgusted – as seems Prudent.
This accelerating retreat from good sense makes almost every “civilized” resident very uncomfortable. It has seeped out into criminal justice to the point that criminals are coddled while ultra-liberal prosecutors expand the list of crimes for which punishment and retribution are no longer very important. But the trend started with rampant and financially-encouraged homelessness – all of which programs have failed despite the millions of explanations of success by those same liberal politicians. Liberal “government” has foresworn any moral judgment to the point that anywhere it can insert some “public” monies must also eliminate morality as a shared ethic.
The Prudent approach is to recognize that life is better, safer, cleaner, more productive and successful when the vast majority of the population – and its “governors” – share a basic morality. In such a civilized environment certain behaviors and practices are not allowed for sensible reasons of health, public safety, compassion and cleanliness. We can begin the return to civilization by ending the “root causes” of homelessness. This will require the enforcing of laws despite the chagrin of some who are incorrigible – both homeless and “normal.”
Block by block, street-sleepers have to be rounded up and held in temporary – emphasis on temporary – facilities for evaluation. Which of them are addicted? Which truly mentally ill? There won’t be any free needles or free drugs… only compassionate detox, physical clean-up and healthy food. Every person will be required to adhere to rules in order to eat, hunger being the universal motivator. Those who are clinically determined to be mentally ill will be treated, possibly medicated if it will help, and housed separately… depending on the nature of supportive bonds with others, mentally ill or not. Instead of spending tens of millions of dollars on better tents or other free stuff that facilitates living on the streets, every person will be rehabilitated to the best degree possible. Vocational training will be offered within controlled circumstances. For many this will be a refresher for skills that used to support them before addiction took over. Each will have to work in some way to earn his or her room and board. Each should also be offered contact with religious people, ministers, or others. There is always hope.
In a sense it is a program of second chances, but not a second chance to live on the street. For those whose mental illness can’t be controlled, proper institutionalization is needed – not “warehousing” of humans, modified assisted living. Nearly every state has a history of terrible handling of the mentally ill. It always offended Prudence to hear about bad treatment and terrible conditions that seemed to go on and on… for years and decades. Were those the only solutions human beings could come up with? Was there someone else who could be blamed for the cruelty and stupidity that marked so many mental hospitals?
No, it was us, the same people who threw up their hands and closed the awful facilities and “mainstreamed” mentally ill people. Every person living “homeless,” can be helped, rehabilitated made more healthy and given / offered new direction and opportunity to take good care of themselves. If your politicians don’t agree, get some new ones. Politicians who are willing to run on a platform of honesty would be the best place to start.
A patients view of the doctors, just before going into surgery.
Few topics or “matters” matter as much or generate as much
discussion and political malfeasance as health care, and not really “care,” but
coverage. Coverage is where the “easy” money is. “Coverage” is like a giant public works
construction project: easy to skim from.
It’s virtually impossible to get any graft – or campaign contributions –
from individual medical procedures, but insurance conglomerates and hospital
corporations and the pharmaceutical industry are deep wells for craven
politicians. Consequently, those same
politicians are willing to expose the federal budget and debt creation to the
medical “field” to the benefit of all, and even of patients sometimes.
Money, money, money.
About one-sixth of the U. S. economy is tied to “health care,” but a
much smaller fraction is tied to CARE, itself.
These are huge industries with gigantic advertising, promotion and
bribery budgets. The ever-pure United
States calls those filthy bribes campaign contributions… or, they might be
“donations” to colleges and universities for research and production of new
doctors who, coincidentally, will be fully committed to pharmaceuticals,
chemotherapies, surgery and maintenance for life – or death. It’s all expensive.
Cancer is one of the cash cows of medicine: the big
shibboleth in human caring and willingness to help others. People fear it, and rightly so. Breast cancer is a powerful subset, and so is
pediatric cancer. We love kids and care
about their health more than for any older group. Kids are helpless and pathetic; humans feel
these things and sacrifice to raise them from complete dependency, to minimal
independence, to experimental independence, to sports and education and
personality development and, one day, separation into adult-hood. We hate any interruption to these things and
sacrifice to facilitate the stages of normal childhood. Cancer is a Hell of an interrupter and we want to pay to stop it. And we do.
Billions of dollars have been raised by the American Cancer Society, for example, and they claim a 79% rate of actual cancer expenditures: mostly for research, but a large amount is for “soft” expenses that help those who are in treatment and their families, and other non-care, non-research uses. A big pile goes to run the Society, of course. To its credit, A.C.S. does a lot of good along the paths it sees fit, and it’s much more efficient than the federal government, a low bar. Sadly, despite its widespread use of children to raise its millions (Relay for Life, anyone?), only a small percentage of ACS dollars are employed to solve pediatric cancers.
In one case Prudence knows well, a 6-year-old girl survived
neuroblastoma after much chemo, operations, stem-cell harvests and replacements
only to fight through it again 4 years later, with more of many of the same
poisons that forced the cancer to retreat the first time. Five years later, more chemotherapy to force
a third retreat. “A miracle,” her family
declared. 3 years later osteosarcoma
attacked her right tibia, part of which was removed with cadaver bone up to the
knee. More chemo – same crap as earlier
times, same poison to push the cancer back.
College and Masters degrees completed, 6 years later the fifth attack
and fifth battle with cancer, now in the thoracic cavity pressing on the
lung. The bone cancer was a not rare reaction
to earlier treatments; the chest problem a recurrence of the bone cancer, by
genus. Same poisons prescribed and
administered, except she was unable to tolerate any more of it. Twenty years of treatment, constant news
about this and that breakthrough therapy, DNA, customized immunology, yada,
yada, yada… same attempts to kill the cancer a little faster than the patient.
When the young woman with the lengthy, miraculous, cancer
survival history heard what kind of poisons they were planning to pump directly
into her bloodstream, she naturally pointed out that it was the same crap she’d
received the last time! Was there
nothing better? Newer? Apparently not. Bring
us your sick children and we will poison them for you in the hope that the
cancer cells will die first and we can hold your child back from the brink of
death.
Medical students arrive at medical school with science knowledge –at least biology, maybe chemistry – ready to be taught some skills, mostly about using and understanding the data produced by wonderful diagnostic electronics, and about the latest in pharmacological weapons to counteract natural biological weaknesses, failures, breakdowns, related pains and mental/emotional discords and incongruities. There is a lot to learn. If surgery is the interest, there is a lot of practice. Students develop likes and dislikes that lead them to one specialty or another, or, for many, general health and well-being such as “family” doctors ought to know. Some of these general practitioners are really “internists” who understand “internal medicine” as distinct from “external medicine,” one supposes.
In any case, new doctors are taught according to fairly rigid protocols and traditions by people whose adherence to standards is well known… and respected. Indeed, it is only by proving one’s own adherence to those standards that a doctor will be licensed or safe when sued. “Recognized” standards, “current” protocols, “best” practices – those are the only defense a doctor has. Where is the profit for leaving medical orthodoxy?
Does this mean that “doctors” or “big pharma” are blocking the introduction of miracle cures that an obscure researcher somewhere has developed because traditional medicine would not? Well, “yes,” and “no.” I think, or at least hope fervently, that the answer is “yes” although there is no intent to do so; and that the answer is “no” because there is no intent to do so. But, the inhibition of new ideas is almost inevitable. Thankfully it is not impossible and progress does get made, inventions are developed and made marketable – and trustworthy – and new drugs are eventually approved. So, what’s the problem?
The problem is that the new drugs are rarely giant steps –
sometimes they are, but not often. This is because most research is built on
previous success and lines of inquiry and wide departure from the reservation
is not very likely – it doesn’t get funded.
Pharmaceutical manufacturers are looking for sure things. Often the greatest advances are side-effects
of drugs, new and old, that coincidentally prove beneficial elsewhere. More power to them.
Similar effects produce medical technology like, for popular
example, knee replacements and hip replacements. Now very reliable and long-lasting, such
replacements are commonplace, almost to the exclusion of alternatives. Could the damage and erosion of joints be
prevented? In most cases. Are there nutritional preventions that are
still regarded as anecdotes, not science?
Absolutely. Do you suppose that
part of every knee replacement is dedicated to learning how to prevent knee
replacements? Well, no.
Americans, and most residents of highly developed countries, eat themselves to death, drink and drug themselves to death, smoke themselves to death, fertilize and pesticide ourselves to death, and so on. For all of our health clubs, gyms and YMCA’s, Americans tend, on average, to not take very good care of the bodies we are born with and, now that parts can be replaced by our remarkable “repair, replace and maintain” medicine, there seem to be fewer reasons to worry about the consequences of ice cream, sodas and cheese-burgers and lack of basic exercise regimens. We are told 8 times every half-hour by our flat-screens that we need never suffer from aches, pains, discomforts, anxieties or depressions. There are pills for each of these maladies. In fact, there are separate analgesics for shoulder pains, neck pains, knee and foot pains, back pains, headaches, migraines and insufficient sleep. People who have allowed apnea to intrude on their ability to sleep can get a C-Pap device to counteract it. What’s to worry?
What do all of these OTC chemicals do to us? Some of the long-term effects are known, not
the least of which is liver damage, but it’s slow, virtually unnoticeable,
until it isn’t – kind of like moderate smoking.
Sugar and alcohol also have cumulative effects, if not simple diabetes, then an acidification of body chemistry that weakens the immune response to invaders. Too much gluten, perhaps? The American diet is awash in wheat and wheat proteins, right down to canned tunafish (only one brand is clean). Tunafish? And lots of other products: vinegar, puddings, many candies, gravies, prepared foods of all kinds include wheat starch, “hydrolyzed vegetable protein” and on and on. Many people know they are allergic to gluten, far more do not… know, that is. Skin problems, digestive problems, immune problems and, of course, weight problems, stem in large part from too much wheat in our diets. The body tends to become allergic in the presence of too much of the same thing – often the food you like the best, as well. But, that’s no problem! There are multiple crèmes and pills to fight off the effects of our odd diets, so many, in fact, that they must be profitable enough to purchase TV advertising nationwide. Do you ever wonder if every prescription for these somewhat dangerous drugs includes a small amount of money to fund prevention of gluten intolerances? Nahh. Bread, cake, doughnuts, fried clams, stuffing, ice cream, mayonnaise, salad dressings, sub-rolls, pita, crackers and… and… whatever, are too tasty to forego and, besides, “they” have things for that.
When Dwight Eisenhower left the presidency he warned America
about the encroaching power of the “military-industrial complex.” Rightly so, although that sloppy circle of funding
and influence has managed to keep the country fairly safe in an uncontrollable
world. One can almost hear the words of
a true outsider warning us against the “medical-industrial complex,” although
almost no one would listen. On the edge
of Boston and Brookline there is a street called Longwood Avenue where
hospitals have grown into connected proximity.
It’s starting to look like Las Vegas.
The insertion of politics into health care really got moving with the “Great Society” in the mid 1960’s. It hasn’t been all good despite the public intentions of the socialists who caused the Great Society to be codified. Today federal funds feed into the insatiable maw of modern medicine, and to help it along, every Congress adds new mandates for care and coverage. Combined with the primacy of welfare (federalized at the same time) the general interface with patients has trended to impersonal, if not de-personalized, care. The vision for health care is still greater impersonality, robotics and, again, health orthodoxy that satisfies… umm, well, the federal government, and “averages.”
No one is going to stop the money. If we have to borrow from our 5th descendent generation, by God, we’ll do it! No one who needs a new hip, rich or poor, will be denied one! What? Do we want to have a society where there is one level of care for the wealthy and another for the poor? With enough agitation and politics anything that needs a licensed medico to accomplish will be funded. Trans-gender mutilations? Where’s the checkbook? Prudence would advise that there is not enough money, or desks for nameless bureaucrats to sit behind, to provide all the repairs and drugs that are known, to every person who thinks he or she needs them. Maybe robots will provide more even-handed care and cost less than humans. Not so far.
