Alt Title: If You Have a Freud, Everything Looks Like a Penis
Even More Alt Title: Marxism is the Opiate of Femboys/Catgirls, Comrades
Disclaimer: The following is based on a conversation I had with a friend. It is fundamentally hearsay, and its veracity cannot be confirmed. The following revolves around the mental health services provided by the high school I intended. This does not reflect the practice of mental health professionals, most of whom are highly dedicated, trustworthy, and skilled people. Should you feel that you require help, you should not hesitate. There is, and will be no judgement.
"cos i know counsellors have to write down notes, and all the teachers can see them"
"wait wtf
is that legal?"
"it's by law that if someone's at risk of stuff, parents have to be told and the school recording data for other purposes is an extension of that.
Some schools record more extensively than others
but all schools report to parents if its bad"
"well yeah, I think all health professionals have to do it if it's bad
but why does the school have to record it
wtf"
"well devils advocate
if u get someone who's not doing well into a high stress course
and they break down from the stress
well, that's not good for your PR"
"that's so dumb wtf
also how is
"the kid was in counselling in x year"
supposed to mean anything?"
":shrug: ik the school was very specific with the details
and all the teachers could see"
"what
wait so say if someone
goes to see the counsellors
every teacher
can see it"
"yes"
"the fuck
bruh that's
messed up"
"and the notes from convo is recorded
i.e. if the person has x problems, the teachers know"
"wait so
do the people who go
to counselling
know?"
"idk"
So much for being the premier boy's school.
***
So looking back at this year, we can say one thing. Well, we can say many things, but, for the purposes of this exercise in bullshit (creative writing, as my highschool teachers would have called it), let's just say one thing.
Healthcare is pretty political. Now, now, some of you may say that healthcare isn't political, or that it shouldn't be political (with the tacked on "in a perfect world"). But of course, in a perfect world, there would be no need for healthcare in the first fucking place. Now onto it's politickyness.
Healthcare, and healthcare policies, are often a matter of handling resources. That makes it inherently political, especially when considering the power dynamics and conflicting interests at play. As such, several questions can be raised regarding the purpose, and the usage of healthcare.
1. Who gets access to healthcare?
There's a finite supply, and a (thereotical) infinite demand (I say thereotical because I doubt most people want to go see their GPs everyday, as lovely as they may be.)
So, from this, we have to make difficult decisions. We have to tighten our belts. And we have to-
Okay, no, we don't do that.
Hospitals, and medical staff have had the difficult judgement to make regarding who gets access to treatment.
People may say that the old and ill should have a lower priority access to respirators. That the working age, young (relatively) patients should have the first priority. That if the old die, sure, it's a tragedy, but it's a sacrifice.
In a true Farquaad fashion, we are all too eager to sacrifice others for our sake.
This, however, misses the fundamental point.
Was it their old age that killed them?
Was it the lack of resources that killed them?
Or was it the absence or the mismanagement of disease control policies that have led to such spread, that has lead to the loss of loved ones, the crippling of otherwise healthy people?
If it's the last case, then conflicts arise from the calls by certain...well, let's call them cringeworthy individuals saying things such as "but but economy" and "but but my gdp graph, it isn't going up asymptotically towards infinity"*. They then proceeded to say that lockdowns were a big no-no, using the Swedish model as an example of the certified successes of fucking over old people.
And thus, we have the excellent situation where in an attempt to maintain an exponential graph for our economy, we've inadvertently called for an exponential graph for infections. From that, the failings of the Swedish and American models (but at this point, does America even have a coherent model?) should have been pretty obvious.
This is the most recent example of how access to healthcare is affected by the greater healthcare context, and in turn affects the context.
If we were to extend this line of thought to other healthcare issues, then we come to a rather sticky situation.
Take mental health issues, for example. Within Australia, lower economic suburbs have less access to mental health resources. But at the same time, environmental factors such as stress, from, say, a low paying job, with low wage growth, and having to support a family at the same time contributes to poor mental health. So again, we have a situation where the greater context affects access to healthcare, which in turn impacts the general health of a population.
And we haven't even started talking about the clusterfuck that is climate change. You have anxiety, as well as physical diseases arising from climate change. You have people being understandably worried and stressed about what's going to happen to them. When a community is threatened by bushfires, and nothing looks good on the horizon, no amount of CBT (no, not that kind) will be truly sufficient.
But hang on a second. These would be failings of social structures, and wider political issues. But isn't healthcare 'meant' to be apolitical?
We're a bit fucked, aren't we?
2. What is the cost of healthcare?
This is entangled with point 1, as is the case with all other points. To be precise, the cost of healthcare to the patient limits the access of healthcare. If people can't afford healthcare, then they won't be able to get it. As simple as that.
But on the other hand, what about the costs to governments? To the wider society?
This raises a tricky problem.
And it's not like this hasn't been a political issue, what, with all the "I don't want to pay for someone else's healthcare" or "can we even afford it?"
But this affects who we treat, how we treat them, and what we treat.
Take Australia's Pharmaceutical Benefits Scheme. A lot of drugs are subsidised, especially for the elderly. Within this model, people genuinely get benefits (fitting name for the scheme, I suppose).
The ethics are quite simply utilitarian. By subsidising some medication, and making it cheaper for vulnerable populations such as pensioners, you are able to maximise the amount of care provided for the maximum amount of people.
However, every now and then, you hear of rare diseases where the medications required for its treatment are not covered by the PBS. So those people have to pay for their medication in full, placing another burden upon them.
The, I suppose, 'logical' resolution to this is that such cases are so rare that it's not worth it to spend money on subsidising their medication. That going by the utilitarian ethics required by the very nature of the world, their suffering (measured in suffering iotas) will be overwhelmed by the good we are able to do for those in a larger populations.
But this presumes several things.
It presumes that there are not enough resources to go around. It presumes that somebody, someone, some people, have the right to determine which diseases should be essentially prioritised over others. It presumes that allowing some to suffer is worth it, if the greater population is served.
And these, again, are systemic problems.
Healthcare is a global issues. If we go by the traditional, capitalist, occidental (I'm not calling it Western, because occidental is such a funnier word) view, a single nation may not have the resources to subsidise, or essentially purchase, medication from companies. But why should healthcare be something people profit from? Why is it under the purview of single nations, when the very factors that cause diseases are often global factors?
Why do some have the right to decide what medications can be subsidised? When we say that some drug cannot be subsidised for the greater good, who gave us the right to proclaim such in the first place? One of the four pillars of medical ethics is beneficence, damnit. To do good. For all. If we can't help those in need because of a matter of resources, then there is something wrong with the supply side of the wonky equation. If that's the case, then it should not be a matter of us being forced to accept that some may suffer, but to rage, to rage against the mess we've inherited.
If it's a matter of utilitarian ethics, why must we follow such principles? This is perhaps the most surface level issue, for it arises from the above two problems. It is as much as a pillar in decision making, as it is a post hoc rationalisation for why some have to suffer.
3. How do we treat people?
How we treat people is pretty political.
Say we have a belief system, say, I dunno, a word that starts with eu and ends with genics. Under that worldview, the way we treat patients will be significantly different to one where such a worldview does not exist.
It may range from the seemingly 'benign' or 'harmless', such as recommending sterilisation techniques, to brazenly harmful practices such as refusing to provide treatment for entire populations, or refusing to see those populations in the first place.
But this is an extreme example, one where open eugenics is practised.
There are, once again, systemic issues that do exist as a result of politics, both domestic and international.
Say country X is pretty hostile towards country Y. X has a population of Y expats, however, due to the decline in relations, people from Y are seen as untrustworthy. Worse still, there is a prevalent representation of people from Y as shiftless, lazy bums who live off welfare (whilst stealing everyone's jobs). As a result of this, and how recently the people from Y have come to X, they tend to be poorer, less educated, and have poorer health outcomes.
A health professional may have to deal with institutional problems. They may be seen as unwilling to go to clinics, and hence be double booked. There may be a lack of translators, or translators may be provided based on assumptions. Patients, due to their lack of education, may be considered as simply less smart, and may not have their conditions fully explained to them.
Quite a pretty picture, eh?
Those of some of the questions raised by the inherent political nature of healthcare. So now that healthcare is clearly political, and its ramifications affect real people in often horrible ways, what must be done about it? Especially when healthcare is political, but healthcare workers are expected to not be political, we have landed ourselves in quite the Catch 22.
But that too is a sort of logical trap, is it not? This is healthcare, it doesn't exist independently of society. We should not expect that these problems can be solved purely from the efforts of healthcare workers. After all, these problems were born from intersecting issues, out of the control of any single sector.
But what if we worked with scientists, engineers, teachers, hell, public servants of all professions? What if we could break off from the concept of nations, and form independent, but intermeshed communities, such that no man can claim sovereignty from humanity?
These issues are global issues. Climate change, the implications of the internet and mass media, issues with industrialisation, wealth inequality, these problems cannot be solved by states, nations that care only for themselves. We have but one planet, we are but one species, one people.
Imagine, as the means of production become more accessible to the common man, as 3D printing leaps forward, as the synthesis of materials becomes available to everyone, imagine disparate communities, experimenting, working with each other, sharing information on how to best implement systems. Imagine.
Imagine people creating drugs, creating tools not for profit, not for their own personal gain, but because they have the expertise, and because they are more than willing to share. A gift economy in lieu of a market economy. A world made by people for people. A world where demand isn't infinite, for if we all just take what we need, there's more than enough to go around.
Post scarcity, I suppose. When everything seems bleak, better be an utopian. But we shouldn't strive to patch up a system that's failing us. We should strive for something new, a system where people aren't treated by how well they do in a game of calvinball**.
Long Live Sisyphus, and have a Happy New Year.
*People surprisingly did not actually say this verbatim, but this is essentially what they said.
**This is in reference to the comparison of MMT to a game of calvinball. However, I am of the opinion that economics in general is a game of calvinball.