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The Rise and Fall of Health Care

October 21, 2019 by David Healy Leave a Comment

For two centuries, thanks to medical techniques, our life expectancy increased steadily, initially in Western settings and then globally. For the first time in two centuries, life expectancy in America fell for three years in a row. Last year in the United Kingdom life expectancy also fell. In many developed countries, it has stalled. Something as serious as climate change is happening.

This should come as no surprise. For three decades the greatest concentration of Fake News on the planet has centred on the medicines our doctors give us—the literature about them is ghost-written. No-one has access to the data from the clinical trials used to all but force medicines down our throats—not even regulators. And where three decades ago few of us were on 1 pill per day, now by our 40s nearly half of us are on three or more every day and medicine use is exploding in children and teenagers. 

That life expectancy should fall was inevitable. As it was that the climate within what was once healthcare should also turn to winter.

The Arab Spring of 2010 got its name from the Revolutionary Spring of 1848. In response to upheavals across Europe that year Marx and Engels rushed out The Communist Manifesto, a pamphlet which pitched the enclosure of common lands in England leading up to 1600 as a key step in the development of “Capital”. Control of land had been viewed as the source of wealth and power. Work on the land sustained most of us. But by 1848, control of manufacturing had become a competing source of wealth, and a switch to work in factories was creating a new working class. 

Few of us now work on either the land or in manufacturing. As the growth of social media shows, wealth and power now lie in techniques, both physical technologies and behavioural techniques. 

Lost on the Sea of Medicine….

The power of modern techniques and their limits are most clearly visible in medicine, especially with drugs with combine physical technologies and behavioural techniques. It is here we can best see what is needed to ensure our techniques and the power that accrues to them enhance rather than diminish us and our environment. 

Switching the debate about power and wealth from politics and economics to medicine brings these life and death matters closer to everyone’s everyday experience. The neo-medicalism that has underpinned a transformation of healthcare into health services also sheds a light on the politics of neo-liberalism. 

Our falling life expectancy and a deterioration in the climate of health services parallel changes in the wider climate and the spectacle of our oceans filling with plastic. While we are alarmed at plastic in the pristine Arctic, we have a more immediate and individual stake in the answers to being drug-wrecked or having our lives or the lives of those we love shortened. This is where the motivation to change our world rather than merely interpret it might come from.

An excerpt from:
The Decapitation of Care – A Short History of  the Rise and Fall of Healthcare
by DAVID HEALY
Publisher: Samizdat Health 

 

Filed Under: Public Presentation

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