Lives of a Cell by Lewis Thomas

Lives of a Cell by Lewis Thomas

Author:Lewis Thomas
Language: eng
Format: epub
Publisher: Penguin Publishing Group
Published: 1978-02-22T16:00:00+00:00


YOUR VERY GOOD HEALTH

We spend $80 billion a year on health, as we keep reminding ourselves, or is it now $90 billion? Whichever, it is a shocking sum, and just to mention it is to suggest the presence of a vast, powerful enterprise, intricately organized and coordinated. It is, however, a bewildering, essentially scatterbrained kind of business, expanding steadily without being planned or run by anyone in particular. Whatever sum we spent last year was only discovered after we’d spent it, and nobody can be sure what next year’s bill will be. The social scientists, attracted by problems of this magnitude, are beginning to swarm in from all quarters to take a closer look, and the economists are all over the place, pursing their lips and shaking their heads, shipping more and more data off to the computers, trying to decide whether this is a proper industry or a house of IBM cards. There doesn’t seem to be any doubt about the amount of money being spent, but it is less certain where it goes, and for what.

It has become something of a convenience to refer to the whole endeavor as the “Health Industry.” This provides the illusion that it is in a general way all one thing, and that it turns out, on demand, a single, unambiguous product, which is health. Thus, health care has become the new name for medicine. Health-care delivery is what doctors now do, along with hospitals and the other professionals who work with doctors, now known collectively as the health providers. The patients have become health consumers. Once you start on this line, there’s no stopping. Just recently, to correct some of the various flaws, inequities, logistic defects, and near-bankruptcies in today’s health-care delivery system, the government has officially invented new institutions called Health Maintenance Organizations, already known familiarly as HMO’s, spreading out across the country like post offices, ready to distribute in neat packages, as though from a huge, newly stocked inventory, health.

Sooner or later, we are bound to get into trouble with this word. It is too solid and unequivocal a term to be used as a euphemism and this seems to be what we are attempting. I am worried that we may be overdoing it, taxing its meaning, to conceal an unmentionable reality that we’ve somehow agreed not to talk about in public. It won’t work. Illness and death still exist and cannot be hidden. We are still beset by plain diseases, and we do not control them; they are loose on their own, afflicting us unpredictably and haphazardly. We are only able to deal with them when they have made their appearance, and we must use the methods of medical care for this, as best we can, for better or worse.

It would be a better world if this were not true, but the fact is that diseases do not develop just because of carelessness about the preservation of health. We do not become sick only because of a failure of vigilance.



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