Just finished a book write-up, so a relatively short post today about current events.
- MAGA delusions about health;
- How Republican policies will make things worse, and how they don’t realize this.
If it’s Tuesday, there’s a Science Section of the NY Times. Here’s the lead piece today. As about so many other things, many people (but in particular conservatives and MAGAfolk) live with the fantasy that the past was somehow better than the present. It’s selective memory and the glow of childhood, perhaps. It doesn’t stand up to evidence. Everyone smoked in the old days — my parents chain-smoked throughout my childhood. And even doctors smoked, in TV commercials — see here. People forget.
NY Times, Gina Kolata, 13 Jan 2025: Have Americans Ever Really Been Healthy?, subtitled “Medical historians say that the phrase ‘Make America Healthy Again’ obscures a past during which this country’s people ate, smoked and drank things that mostly left them unwell.” [gift link]
“We will make Americans healthy again,” Robert F. Kennedy Jr. has declared. A political action committee that has promoted Mr. Kennedy, President-elect Donald J. Trump’s pick for health and human services secretary, says his movement is “igniting a health revolution in America.”
But the word “again” presumes a time in the country’s past when Americans were in better health. Was there ever really a time when America was healthier?
For historians of medicine, there is a short answer.
“No,” said Nancy Tomes, a historian at Stony Brook University.
John Harley Warner, a historian at Yale, said, “It’s hard for me to think of a time when America, with all the real health disparities that characterize our system, was healthier.”
Because in earlier times, Americans smoked, drank, and ate monotonous food much more than we do now. Interesting things I didn’t know:
It’s true that agriculture at the time was organic, food was locally produced and there were no ultraprocessed foods. But fresh fruits and vegetables were in short supply because they were difficult to ship and because growing seasons were so short. For the most part, Dr. Costa said, until the 1930s, “Americans were living off of dried fruits and vegetables.”
As for protein, Americans were relying on salted pork, she said, because meat was difficult to preserve. Only after the Civil War did meatpackers in Chicago begin to process meat and ship fresh beef across the country. At that point, Dr. Costa said, beef “became a large part of the American diet.”
With a bunch of historical photos (not in the print paper). Here’s one:
Caption: “An influenza camp in Lawrence, Mass., in 1918.”
A couple more excerpts:
Until the 1990s, cancer was treated with brute force: surgery, radiation and chemotherapy. Now an array of targeted therapies are turning some cancers, once deadly, into treatable chronic diseases or even curing them.
Dr. Greene said he was not surprised by the idea of a halcyon past when people were healthier.
“There’s a long history in America of nostalgia for a past that was better than the present,” he said. “History is all about erasure — the things we don’t choose to remember.”
And:
Yet the U.S. spends more on medical care than other countries — an average of $12,555 per capita, which is about twice what other wealthy countries spend.
But, historians say, the past was actually much worse.
And so, they say, the phrase “Make America Healthy Again” makes no sense.
“As a historian of health, I don’t know what ‘again’ Kennedy is imagining,” Dr. Tomes said. “The idea that once upon a time all Americans were healthy is a fantasy.”
\\\
Related.
Washington Post, Catherine Rampell, 14 Jan 2025: Society is making you sick, GOP says. Too bad their plans will make you sicker., subtitled “‘Make America Healthy Again’ might be a laudable plan — if GOP policies didn’t contradict GOP goals.”
The biggest threat to your health isn’t your inability to afford an inhaler or to get that weird mole checked, the GOP argues. It’s everything else about American society, from nutrition to neurotoxins.
Unfortunately, the party’s agenda would make those other societal problems worse, too.
Republicans desperately want to cut taxes this year, which will be expensive. So, they’re plotting to pay for the revenue loss (at least partly) by slashing the safety net. Among the biggest programs on the chopping block: Medicaid and Obamacare marketplace subsidies, which help low- to middle-income Americans purchase private-market insurance.
With many details. Ending:
Of course, if Republican politicians really want to tackle a uniquely American social determinant of health, there’s an obvious target: gun culture. Firearms are now involved in the deaths of more American children each year than any other injury or illness, including car crashes or cancer. The United States has one of the highest rates of firearm mortality among developed nations.
Alas, Republican officials have blocked modest (and popular) gun safety measures, such as universal background checks. They promise instead to expand access to firearms. They rationalize this stance by arguing that gun violence is caused not by excessive access to guns but — wait for it — inadequate access to health care!
Untreated mental illness, they say, is the real American killer. Which, somewhat inconveniently, suggests the solution is more programs to expand health coverage and care. What’s the GOP response to that? Start this column over, I guess. Second verse, same as the first.
\\
Are Republicans insane, or just dumb? Or, let me put it this way. Not all people are particularly smart. Some people do not see connections, they think of everything in black and white terms. And they are the ones who align with one end of the spectrum discussed in the book review I just posted. It’s not that Republicans are this way or that; it’s that people who are this way or that are Republicans. And those people will always be with us.
