Well, I found out today that I got one med school scholarship I was hoping for. The ELCA gives out four $5,000 scholarships each year to entering med students, and I got one of them. That helps out a bunch.
What might have been more valuable than the stipend was the process, because it required me to put together my resume, which in turn required me to put together a plan for my life. Which is kind of scary, when you try to think about what you'll be able (and won't) to change in your lifetime -- especially in a system as screwed up as the American health care system.
I tried to label this Problem #1, but I found that I had no #2. Here it is, black and white, agree or disagree.
Restricted treatment for the underclasses. There. I said it. Marxists cheer, capitalists cringe.
Medicine, as practiced today, individualizes social problems to a set of symptoms and prescribes treatments for those symptoms (Link and Phelan, 1995). For example, if I have AIDS (I don't, but what if...), how did I get AIDS? If I contracted the disease from sex, chances are I didn't use protection. In St. Louis (5th nationally for AIDS diagnoses), condoms cost on average $1-2 more per package in black neighborhoods than in white neighborhoods (Ross et al 2005). In Kalamazoo, MI, the two local hospitals were beginning to see children coming in with lead poisoning. Why? Because in low-income housing, predominantly peopled with the community's African-American population, the paint hadn't been replaced in decades - thus it still contained lead (which tastes sweet, and children love it). Everyone knows that bad foods lead to obesity, which is a major cause of diabetes. In Northern Ontario, the Sandy Lake community of Oji-Cree natives holds the population with the world's third largest percentage of diabetics. Part of the problem is genetic, but part of the problem is that fresh fruits and vegetables are virtually unheard of there. One woman said that when available they can cost up to $9/lb. Thus, they are limited to eating the processed foods that are easy and cheap to ship - Klik (Spam in the States), Kraft dinner (mac and cheese), and Ramen noodles. These are just three examples that I know of from personal experience. Many other national studies have been done that have found socioeconomic status and race to be top predictors of disease. Without proper education, housing, drinking water, diet, etc. etc. ad infinitum how can we expect to curb the health care disparities in America and the rest of the world?
How about research? Academic science pays no mind to economics, right? Wrong. Here's how science really works: the government or a private industry gives you money to conduct research. Somtimes you work directly for a corporation, e.g. the pharmaceutical industry. If you do "good enough" research, then you (or the company you work for) can apply for a patent to restrict access to a result. I should say that when you're able to get a patent, then you have arrived at "good" research in America. Usually when a patent happens in academia the scientist forms a "spin-off" company that functions independently from the college or university. These spin-off companies sell technology developed using the scientific "intellectual property." For example, Dr. Robert Gallo, who was here on campus not too long ago, pinpointed the HIV-1 virus as the causative agent of AIDS. From there was founded the Institute for Human Virology, Maryland BioTherapeutics, etc etc (Balt. Bus. J. 2005). These companies put forward the HIV-1 antibodies test as well as work on an AIDS vaccine (exciting!) and cancer therapies (20% of all human cancers are caused by retroviruses like HIV-1). Interestingly, quoting the Baltimore Business Journal, Gallo has been "long criticized by state lawmakers for not commercializing the research done in his institute" (ibid).
What's the result? The only research (medical or otherwise) that gets done (i.e. funded) is the research that benefits those with enough political power to influence state and national politics in post-industrialized, capitalist, powerful countries (the bourgeoisie if you're a Marx fan). Few labs in the world study trypanosomes, the microbes that cause African sleeping sickness, Mycobacterium tuberculosis (self-explanatory, or Leishmania, the pathogen causing leishmaniasis. Why? It's not because they aren't important. One-third of the world's population -- 2 billion people! -- are infected with the tuberculosis bug. Two million die each year from it. Up to 10% of those infected (200 million at present) will have the active disease in their lifetime. Why isn't more being done? The explanation is fairly simple: the nations that have enough resources to fund a robust public research sector (USA, UK, Western Europe)
choose to fund research into other diseases that affect us more "today." As a result, the most prolific mycobacteria research lab in the world is in India, part of what some would consider to be the "third world."
So what needs to happen in order to make a first step toward equality in scientific coverage, to make sure that diseases that really affect people are researched? We need to do two things. First, we need to form an international body to fund research. Think international NIH. Second, we need to do away with the concept of "intellectual property" as it relates to scientific discoveries. This will hurt the current system of capitalist science that is currently being practiced, but it will repay that lost in the dividends of saved lives.
OK. There's my diatribe for tonight. Now I have to watch some Futurama.
:)
--Refs, in case you're interested:
Link BG, Phelan J. 1995. J. Health Soc. Beh. 35:80-94.
Ross W, et al. St. Louis Post-Dispatch, Jan 2005.
Terry RJ. Baltimore Business Journal, 4 Feb 2005.
