Final Paper: Healthcare as an Archive of Feelings

Matt Kasson

Final Paper

 

Medicine in the modern era has been defined by incredible discoveries and miraculous cures. Vaccinations, antibiotics, as well as new diagnostic technologies now allow physicians and other medical professionals to eradicate disease more easily than any other time in human history. We have new understandings of how diseases and viruses operate, from the common cold through complex cancers. However, as with many other aspects of our modern culture, medicine is not perfect. In the United States especially, costs have skyrocketed while results lag behind. In 2013, we spent $2.9 trillion on healthcare alone, and these costs increase every year. (1) Before long, it is quite possible that our economy will be literally bankrupted as a result of this wild spending, and arguments abound as to what the best solution to this problem may be. While the issues at hand may seem complex, and many people may claim to  have the correct answer, the truth of the matter is that there is no clear cut solution to our problem at hand. Medicine and healthcare are extremely personal, intimate topics. When political decisions literally affect people’s lives it is no wonder that tensions and emotions alike flare up at every debate. Undeniably a complex issue, I believe we have a duty to at the very least understand this archive and out relationship with it whether one agrees with it or not. In this paper, I will try to examine both the specific causes of our healthcare crisis, as well as the current state of healthcare itself. Finally, I will evaluate our culture’s relationship with this issue, and how the technologies it represents shape the world around us.

One major source of cost for healthcare is that of prescription drugs. Many people are shocked at the idea of spending thousands of dollars on a single pill, however this a very real aspect of modern healthcare. As a result, many are often quick to point to large pharmaceutical companies as major drivers for these ridiculous costs. This may be true to an extent, but not so much as people might assume. One of the major reasons that medicines often have such high costs is not their actual manufacturing, the the research and development (R and D) that must go into each medicine before it can be sold. This process often takes years, and after a drug has been successfully created it must still pass the regulations and testing of the FDA, which again can take years. Add all this time together and it is not unreasonable to expect a single drug to cost a company billions of dollars to create, while taking up to a decade to even go to market. Hospitals are another often blamed culprit for the skyrocketing costs of healthcare. We have all heard the stories of people going to the emergency room for a look at an annoying cough, only to be slapped with a bill in the thousands of dollars. this aspect comes down mostly to an administrative issue, as well as a centralization problem in all hospitals. On top of this, the emergency room has in itself become known as an almost “ground zero” for the issues plaguing American healthcare. The ER is supposed to be used, clearly, as a place to go when you are faced with a true medical emergency. They are required and regulated to maintain enough professional personnel, diagnostic equipment, and supplies to handle any and every health problem which it may encounter. As a result, in my example of the thousand dollar bill for an annoying cough, the reason was not the visit itself but the resources needed to make that visit possible. Truly, however, all parts of the American hospital cost exponential amounts of money simply because are system lacks the organization to manage it as efficiently as we need it to.

As a system in this country, many would argue that the healthcare system itself is inherently flawed. One of the main arguments behind this reasoning is that private insurance companies, which in the past dominated the healthcare market, have the ability to determine which hospitals and which physicians they are willing to pay. In addition to this, often times they will simply refuse to pay for certain procedures. For many people who never purchased health insurance, the situation was even worse for both the patient as well as the system as a whole. This relationship held between the individual and this system can be illustrated in the following example: if a pregnant woman in labor was to walk into a hospital uninsured, what would the hospital do? Of course, they would have to care for the woman. It is in fact a law that they MUST care for this woman. (2) However, because this woman has no insurance it is very likely as well that she doesn’t have nearly enough money to even come close to paying the thousands of dollars needed by the hospital and its staff to carry out the procedure, in which case Medicare covers the cost. However, Medicare will likely not come close to covering the full amount needed. So then, who is responsible? In this case and in most cases, it is the hospital which must “foot the bill” so to speak. The hospital must pay for everything involved with the procedure, and cover the cost elsewhere. But where else can money come from? In truth, it comes from those people who DO have insurance. In order to cover the costs of those people without quality insurance, or any insurance at all, they must hike up all prices across the board. This reasoning is one of the main driving forces behind the Affordable Care Act. There is a paradox in this country that people without insurance are driving up insurance prices, which in turn forces less people to be able to afford and purchase health insurance. By forcing people to purchase cheaper and more flexible insurance from the government, many hoped that this cycle could be broken. In some ways it has. For instance, as of mid-2015, 11 million Americans gained health insurance coverage under the ACA, and the percentage of uninsured Americans dropped from 18% in 2013 to 11.9%. (3,4) While this helps, people fear that it will not be enough. By tackling all of healthcare, the government risks the possibility of bankrupting itself. Unless enough people take advantage of the program it is likely to collapse, the results for the national economy being devastating.

Now that I have given a background for the issue at hand, I’ll now attempt to evaluate the role of healthcare as both an archive of feelings in modern culture and a technology with which we as people have an ongoing and developing relationship. In “An Archive of Feelings,” Ann Cvetkovich related experiences of trauma to her own personal development. She writes that some of our most important personal and interpersonal growth comes as a result not of happiness but instead moments of intense stress or worry. She goes on to write that, “As a name for experiences of socially situated political violence, trauma forges overt connections between politics and emotions.” (5) For Cvetkovich, this trauma stemmed from the politics of lesbian and gay rights, and the toxic political discourse these things promoted. However, I believe and clear connection can be drawn between this topic and the topic of healthcare in America. For instance, both items detail the relationship of the government with our personal lives. In the case of Cvetkovich, the government attempted to strangle in many cases the feminist and gay rights movements, and in others it was often just the culture of the United States itself which attacked her. On the issue of healthcare the government and our culture alike also attempt to control what people can and cannot do; how we can and cannot live. We archive in hospitals, doctors, and nurses many emotions that we are unable to talk even to our own family’s about. Some of the most personal and emotional facets of our lives will take place in whitewashed rooms filled with men and women wearing lab coats. I think that for this reason, the healthcare system is one of the most unique in our current world. Few other places are concurrently so modern and open to the world while remaining secretive and silent for the people it serves. In “Alone Together” Turkle writes that, “We have to love our technology enough to describe it accurately. And we have to love ourselves enough to confront technology’s true effects on us.” (6) I feel that one of the greatest barriers most patients have in the world of medicine and healthcare is the inability to confront not only its abilities, but also its limits. We love the machines and pills that save us, but we hate the financial and emotional costs that they have.

Turkle wrote on technology as if it was a being separate from mankind, but one which we grow closer to each day. It was seen as a tool for our use, something apart yet integral to our daily lives. Medicine is very much similar to this, however I feel that in the near future this line of separation will grow thin. Healthcare as a whole is a monster in our modern world. It is a service which people need for their very survival, however it is something which can bankrupt entire families in the blink of an eye. Medical technology each year grows more and more advanced. Soon, much of modern medicine will become less a tool and more an extension of our own bodies. The consequences of these developments are some which humanity has never faced before, however there are facts on the table which cannot be denied: Our nation needs healthcare. We need it, and we need to change it before it is too late. It is something which impacts each and every person in our country and the world, and before we can reap its benefits we must come to learn how to control its consequences. Truly it is a problem which needs solving today, despite its true consequences not being felt until tomorrow.

 

Sources:

1) http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/highlights.pdf

2) 42 U.S. Code § 1395dd – Examination and treatment for emergency medical conditions and women in labor

3) Jenna Levy. “In U.S., Uninsured Rate Dips to 11.9% in First Quarter”. Gallup Polling.PMID 041815

4) Alonso-Zaldivar, Ricardo. “Number of Uninsured Fell by More Than 11 Million Since Passage of Obamacare, CDC Reports.” Huffington Post. 

5) Cvetkovich, Ann. “An Archive of Feelings.” 2003.

6) Turkle, Sherry, “Alone Together.” Basic Books 2011.

 

 

 

Advertisements

A Reflection on the Pros and Cons of Technology (Bonus Blog)

If there is one thing which can be said on the past 200 years of human existence, it is that we have progressed farther than any other time in our entire history. We have climbed mountains, performed miracles, and done incredible things that before would have seemed simply like magic. In my short lifetime alone, the internet has developed, smart phones have revolutionized our way of life, and every aspect of our day to day existence has come to be influenced in some way or another by technology. This all seem incredible, and indeed it truly is incredible, however each new discovery and revolution brings with it consequences and adverse effects as well. For instance, although technology has made our lives easier in ways we previously could have never imagined, we have been forced often times to sacrifice our own freedom and privacy on its behalf. Life is more complicated than ever before, and for better or for worse it will only continue this way for years to come.

Some of the greatest aspects of modern technology have been in healthcare, personal technology, and manufacturing technology. Jobs which would have previously taken up to 20 people to perform now take less than 5. Communications which might have taken weeks just 100 years ago now happen in the blink of an eye, and sicknesses which previously crippled maimed and killed countless millions of people are now cured in a matter of days with a simple pill. People from 100 years ago would have no idea how to operate in our modern era, and likewise we would have no idea how to survive 100 years ago.

All this is indeed incredible, but as has been said by countless amounts of people, often one may ask whether all this progress truly is for the better. Obviously, it can hardly be argued that advances in medical technology and increases in convenience are themselves negative aspects. However, our entire way of life has been turned on its head in the evolutionary blink of an eye, and many wonder whether we as human animals are properly equipped to handle it. We were raised to be hunter gatherers, as many know, eating what we could find and living in groups no larger than 50 to 100 people. However, in our modern era we have social networks in the thousands. Friends, family, and acquaintances all become blurred into one enormous social bubble. Our working life too has changed dramatically. The idea of the 9-5 job feels normal to us, but evolutionary this is one of the strangest ideas to ever emerge out of human society.

I really enjoyed this class because it allowed us to evaluate all aspects of technology in out modern society. We did not endlessly praise it, however we did to preach that technology is an ultimate evil either. instead, what I think this class allowed us to do was evaluate the effects of technology from all relevant angles, in a way which promoted the exchange of new ideas from one person to another. I think that it’s important for us to take this way of thinking into all different aspects of our daily lives, and that we can become better people as a result of it.

Strategies for Interviews Regarding Medical Artifact Politic

Like I’ve touched on in my previous posts regarding modern medicine and the technologies with which it associates, there is no person the in the United States or the world who is not affected by healthcare. While the forms and quality in which it is delivered can constantly vary, the bottom line holds that all people need and are affected by healthcare. In the United States especially, this has become one of the largest and most toxic issues in the political scene, most notably with the introduction of “Obamacare.” While it claims to, and often does, help to insure countless thousands of previosuly uninsured Americans, there can be no denying that the plan itself remains flawed to a relatively high extent. Because of its far reaching consequences, to properly gauge the national stance on our healthcare system I think it would be important to interview a wide variety of people.

The first group I would speak with, and in my opinion some of the most knowledgeable people on that subject, would doctors. Physicians work metaphorically on the “Front Lines” of American healthcare. They are the ones who watch it operate on a daily basis, and are the ones at the end of the day whose work is most directly affected by it. It would be important to gather their perspective to gain a somewhat “inside scoop” on what the effects of this system really are.

The next group I would speak with would be those people who compromise “lower class” America. Many of these people in all likelihood would never have been insured prior to the introduction of Obamacare, and so are in this sense its target audience. Given access finally to health insurance, I would be curious to know just how their lives have been affected by the introduction  of this new and monumental program, and just what the pros and cons of it really are. Surely, if the group which this program is designed to help the most feels that it is really of no help at all, then the program in its entirety needs to be reevaluated.

Next would be the middle class. These are Americans who very likely already have insurance through their employers, and if not simply don’t purchase insurance because they believe they don’t need it. Obamacare requires all Americans to be insured, and those who are not are subject to a fine. In this sense, many people are annoyed by it and feel that their lives would actually be better off without it. While it is obviously a necessity to have access to healthcare, I think many people would argue that there are better ways to  go about it then to force them against their will to take part in it.

Finally I would speak to upper class America. This is the group I believe is most often opposed to the new healthcare system, and are those who I often see as being most vocally opposed to it. In all fairness, It think it would be important to gather their thoughts on the matter, in an opportunity to speak their side’s opinion on this matter.

 

Our Class Archive of Essays and Privacy

One consistent theme which I have noticed in our class is the incredible importance of interconnections via technology in our modern world. It seems that whether it is music, cell phones, or the internet, all new forms of media and technology which we have written blog posts about are in some way related to a connection with the rest of the world. We are constantly seeking new ways to communicate with each other, whether through twitter, Instagram, Facebook, vine, or any of the other plethora of platforms at our disposal. However, at the same time we are also clambering for more privacy in every aspect of our lives. It seems that on the one hand we are more desperate than ever for the next great technology no matter the cost, but on the other hand we are willing to start mass protests in the name of personal information protection.

I feel that something that has also been apparent, however, in both the blogs we have posted as a class as well as information and blogs found in the mainstream internet content, is that we are willing to begin searching for a compromise between two extremes. For instance, we are all aware that a loss of privacy is never good, and I do not believe anyone among us would ever be comfortable knowing that a random person could access any of our personal information. However, we also can recognize that technology is capable of doing some incredible things. The world has never been more interconnected, and if we constantly shut down any new project in the name of supposed complete privacy than some of the greatest innovations of the era would have been shut down. I think that there should be a distinction between what platforms are completely private, and which ones are not. I do not think that any person would have a major objection to an internet catered to their interests and hobbies. In a world in which we are constantly striving for convenience and ease some of these information repositories really do make our lives easier. Having said that, I think that there are certain aspects of our lives which must remain untouched. Our homes for instance must I think always remain private, as must conversations with others unless we explicitly agree to make them public. Now, obviously on public sites such as Facebook and Twitter complete privacy in conversation is not something we can reasonably expect. However, on mediums such as our personal cell phones I don’t think anyone would be willing to allow the government to reach in and see whatever they’d like.

Eventually, our society will have to draw the line somewhere regarding how comfortable they will be sacrificing information for new technology. There are additional grey areas as well, for instance when searching for criminals and investigating politicians perhaps. Despite all this, though, we still need to have havens in our life where we know we are completely private. I feel that our class realizes both the wonders and dangers of modern technology, and all the consequences that can come with it. Judging by our blog posts, however, we remain undecided on the correct course of action to take next. In all likelihood this issue will be one of the most important of our generation.

A Personal Reflection on Healthcare

I decided to write on the technology on healthcare in large part because it will soon be a dominant part of my life. I will be attending medical school next fall, and as a result all aspects of medicine, both good and bad, will have an effect on my interpretation of the world and my place in it. I think that it’s important for me to be able to reflect on this system before I engage with it, because in a sense this will I think give me slightly more control over my fate within it. There are countless aspects to modern medicine which are both good, and bad. For instance, few will disagree that our current system is both far to expensive, and far too inefficient. However, what I think is very easy to forget is that on a day to day basis, it is ordinary people trying to conduct themselves professionally within it to best serve their fellow man. In large, abstract conversations regarding the organization of our national healthcare, or controlling medical costs, I think it is easy to forget that the art of medical care at the end of the day is comprised by individual interactions, not between competing corporations but between human beings. What so attracts me about the profession of a physician is not the compensation, which will be slashed in years to come and with which I will have to pay off my ~$200,000 anyway. A life of luxury does not draw me either; I will likely be working 50+ hour weeks with an irregular and unpredictable schedule. What attracts me to medicine is the sense of self worth and accomplishment I just might be able to achieve for myself knowing that each day, if nothing else I will have the opportunity to improve someone else’s life. This may sound naive, and in all likelihood it very much is, however it’s any ideal I think any student wishing to pursue medicine needs to have. It’s for this reason that an investigation of medical technology interests me. If a system and the technology in it is broken, it’s likely that even those with the best of intentions will find it difficult to succeed within it. Many people often point fingers at seemingly incompetent nurses, doctors, and other professionals when they feel they have been overcharged or under-served. However, I feel that if the public were properly educated on the issues that medical professionals face in today’s society, it would be much more cooperative and understanding of the current situation. Medicine is not expensive because the people prescribing it are greedy, no more than waiting periods are seemingly endless because professionals are lazy. It is instead the system which has been built, and the bureaucracy which manages it, which so chokes it. In my final paper, I hope to be able to analyze this system, and potentially find ways which which patients and healthcare providers alike can both learn to cope with it in the most efficient, empathetic, and meaningful way possible.

An Observation of Medical Technology in the Modern World

Medicine in the modern era has been defined by incredible discoveries and miraculous cures. Vaccinations, antibiotics, as well as new diagnostic technologies now allow physicians and other medical professionals to eradicate disease more easily than any other time in human history. We have new understandings of how diseases and viruses operate, from the common cold through complex cancers. However, as with many other aspects of our modern culture, medicine is not perfect. In the United States especially, costs have skyrocketed while results lag behind. In 2013, we spent $2.9 trillion on healthcare alone, and these costs increase every year. (1) Before long, it is quite possible that our economy will be literally bankrupted as a result of this wild spending, and arguments abound as to what the best solution to this problem may be.

One major source of cost for healthcare is that of prescription drugs. Many people are shocked at the idea of spending thousands of dollars on a single pill, however this a very real aspect of modern healthcare. As a result, many are often quick to point to large pharmaceutical companies as major drivers for these ridiculous costs. This may be true to an extent, but not so much as people might assume. One of the major reasons that medicines often have such high costs is not their actual manufacturing, the the research and development (R and D) that must go into each medicine before it can be sold. This process often takes years, and after a drug has been successfully created it must still pass the regulations and testing of the FDA, which again can take years. Add all this time together and it is not unreasonable to expect a single drug to cost a company billions of dollars to create, while taking up to a decade to even go to market.

Hospitals are another often blamed culprit for the skyrocketing costs of healthcare. We have all heard the stories of people going to the emergency room for a look at an annoying cough, only to be slapped with a bill in the thousands of dollars. this aspect comes down mostly to an administrative issue, as well as a centralization problem in all hospitals. On top of this, the emergency room has in itself become known as an almost “ground zero” for the issues plaguing American healthcare. The ER is supposed to be used, clearly, as a place to go when you are faced with a true medical emergency. They are required and regulated to maintain enough professional personnel, diagnostic equipment, and supplies to handle any and every health problem which it may encounter. As a result, in my example of the thousand dollar bill for an annoying cough, the reason was not the visit itself but the resources needed to make that visit possible. Truly, however, all parts of the American hospital cost exponential amounts of money simply because are system lacks the organization to manage it as efficiently as we need it to.

Modern medicine is clearly costing far more than it should. Although ideas for solutions are prevalent everywhere, a true solution will very likely not arise within the next decade or more.

Sources:

1)http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/highlights.pdf

Healthcare and the Medicinal Arms Race

Modern healthcare has grown to become synonymous with high cost and poor achievement. We are all familiar with the comparisons to other Western countries, mainly in Europe, who’s costs are far lower and outcomes far better than here in the United States. In the past decade fingers have been pointed at countless institutions, practices, and professions in order to find a single culprit for our lagging system. In truth, it is a multitude of issues which have resulted in our current situation. A topic into which I have considered investigating is that specifically of medical technology, as well as the pharmaceuticals which are used on a daily basis in any medical environment. The world of drug and medical technology research is a multi-billion dollar one, and one which has been permitted to grow nearly unchecked for the better part of the 20th century and beyond. It is also a delicate subject, and one which the general public and politicians alike find difficult to discuss. When discussions do take place, the sides are often extremely polarized. There is obviously more than one reason behind this; however a major one is how we as a population view our own healthcare. I believe that we are in a cycle where the reasoning states more is always better.

Many people point to pharmaceutical companies as culprits in skyrocketing costs, however we need their services and technologies for the drugs we use to survive. Medical technology has grown incredibly expensive because it is impossible to put a “price” on a human life. Even though a single drug may take hundreds of millions of dollars and years to develop, if it has the ability to save or even prolong people’s lives than of course it will have support. Though to most people these kinds of costs may seem ridiculous, when our own family members or friends are at risk the costs seem nominal and necessary. At some point in our future, we as a country must be prepared to either sacrifice this blank check medical technology developers currently carry in order to constantly produce the best and newest drugs and machines, or sacrifice another aspect of our lives and resources.

The vast majority of a single person’s medical costs will be accrued within the final decade of their life. As a person’s health fades, it grows more and more difficult, and expensive, to maintain their health. Our nation is incapable of funding our healthcare system as it stands for more than half a century further into the future. We therefore face many difficult decisions as to how this bridge can and will be crossed. Truly, if we are unable to make a decision on the matter soon the consequences will be disastrous. Especially with a topic as delicate as medicine, where lives are literally at stake, talking about things as seemingly frivolous as money and technology seems pointless or even cruel. Our ability to create new technologies is seemingly endless, however our resources are not. The decision between the two will not be an easy one, but it is a necessary one.