I first heard it early in my career in my FDA career at an EPA symposium on manganese. It went something like this:
“Where health is concerned, money doesn’t matter”
What an utterly stupid thing to say, I thought. But to my consternation, many voices around the room followed with a “hear, hear”. I have heard the mantra many times since, and I think it also lies unspoken behind many public policy decisions. I have come to realize that it isn’t quite so stupid when uttered by people who are in the business of providing health benefits. What they are really saying is:
“Where health is concerned, give us all your money”
Health Care
While I worked at the Center for Food Safety and Applied Nutrition, I always thought the mantra was uniquely associated with toxicological issues in food safety and environmental regulation. But I’ve been out of the business for over six years now, and I now realize that the Mantra has a much wider presence. In particular, the phrase “access to health care” sounds suspiciously like an alternative version of the Mantra. What is “access” supposed to mean? It obviously doesn’t mean everyone will be entitled to any and all medical procedures regardless of cost. I think what it really means is:
“Give us all your money and we’ll decide what to do with it”
But to my consternation, that seems to be exactly what we (in the US) are doing. All the unfunded mandates (Obamacare, the hospital mandate, the employer mandate) all funnel money into the pockets of the medical industry with no consideration of how the money will be spent. It’s why we spend twice as much money as any other country in the world and get less for it. It’s socialized medicine run for profit; the worst of socialism and capitalism all rolled into one.
However, Medicare is a different story. Since the government must work with a limited budget, they are forced to be at least semi-rational about how the money is spent. That’s why I think replacing the unfunded mandates with a fiscally conservative version (no we don’t need to spend more money on health care at public expense) of Medicare for All is a mighty fine idea. Makes no sense to have socialized medicine for poor people and old people while not giving it to the people who work and pay for it.
COVID
But the poster child for the Mantra has to be COVID. While I think Tony Fauci is a mighty fine scientist, that doesn’t mean he should be in charge of managing the economy. I believe the initial reaction to the pandemic was overreaction driven by the Mantra. Plus the aftermath reminds me of the fate of oyster beds after an oil spill; once the bureaucracy has taken control, it doesn’t want to let go until it has attained some arbitrary safety standard that never existed before.
I do believe that people have generally gotten more rational about COVID, but there’s still a long way to go. There are money, freedom and health tradeoffs with each and every mitigation technique. We need to make the hard choices about which ones are really worth it. I think vaccinations and masking are generally worth it, even if a mandate is required. Since it became apparent early on that asymptomatic people can transmit the virus, haven’t thought contact tracing could work for a long time. I don’t quarantining is especially worthwhile either. I wonder if it’s wise to let hospitals fill up with COVID patients when they may have more pressing business to attend to. Which brings us to public gatherings, especially schools.
Looks like we are going to have to experiment a bit; let’s not hum the Mantra.
Official Post Soundtrack
Killing Joke (2005). "Medicine Wheel." In: Democracy, Track 8.
