Laurie Garrett is a public health expert, a former NPR reporter, and the author of Betrayal of Trust: The Collapse of Public Health and other books. For Ms. Garrett, public health is “the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals.” Wait, what? Individuals make the list, but last? Sounds like another “Obamacare defending, Socialist—it takes a village—thinking, “Getting ‘tween me and my Medicare,” G’mint plot to take away my doctor! Because: freedom!
For better and worse, we live in a nation steeped in individualism. I take care of myself, you do the same, and we can all call it a life well-lived. Alas, nobody got buy-in from the viruses and bacteria! Sometimes, despite everyone’s best efforts, something starts “going around.” Like, maybe, now!
Now, I know President Obama has not brought onto this continent Ebola to prove we’re not exceptional (Phyllis Schlafly). He’s not exposing our soldiers in a plot to redistribute wealth (Laura Ingraham). He’s also not trying to start a civil war (Alex Jones), and he certainly doesn’t want to get us all infected to make the world more fair and equitable. (Michael Savage). (Suggestions—and there are more in Deranged Right-Wing Conspiracy Theory: Obama Intentionally Wants “To Infect The Nation with Ebola”—come courtesy of Media Matters for America.) Unfortunately, too much of what should be an opportunity to highlight what public health means, and why we need more of it, has gotten lost in the bullsh*t!
Here’s what fascinates me. The same crowd I referenced in the last paragraph opposes health care for, and I’ll use their term, not mine, “illegals.” Now, this crew thrives on explaining things for a living, so I’d like an explanation from them. Explain for me how it makes one lick of sense not to make sure the people who live among us are not healthy? Rail all you want about “they shouldn’t be here,” even though most undocumented people are here for jobs, most of which are provided by people—wealthy white Americans—like you. Complain about “I pay for my health care, why can’t they,” despite the fact that a big chunk of your health care costs are hidden behind tax expenditures and government spending on research, training physicians, and direct support of medical facilities. Say whatever you want, but those viruses and bacteria aren’t listening. No, they’re infecting our maids, our gardeners, the kid at the place where I get my coffee, etc.
Public health is about science. Yes, there’s some art involved, mostly in figuring out how to get buy-in, participation, and the like. And, for sure, public health is not some stand-alone discipline, separate and apart from individual care. That said, public health involves more than simply making sure everyone gets to the doctor.
We have certainly not handled this Ebola outbreak well, even though less than 1:100,000,000 of us have been infected. No, we’ve demonstrated that we have hospitals which are not prepared, and we’re developing plans “on the fly” for how we will treat infected individuals. We have not provided a comprehensive, cohesive front, and as smart and able as Dr. Tom Frieden is, he’s no match for the bloviating right.
For me, at least, and for now, Ebola in the USA is a public relations disaster. But it’s also a wake-up call about public health. We need better systems and better leadership, but systems require money, and they demand wise spending, something too often missing in a market-driven health care world. We also need leadership, and while that means many things, not tying up an exceptional Surgeon General nominee because he’s concerned about guns is one of them. (For more on the Dr. Vivek Murthy fiasco, read Why the NRA Is Blocking Obama’s Surgeon General Nominee by Zöe Carpenter.)
In closing, I urge you to read After Ebola by Michael Specter. The piece was published on August 1 in the New Yorker, but it’s still very current. I don’t come from the “America is exceptional” camp, mostly because I don’t think bragging on yourself works well, but if we want to have the bragging rights, we need to step up our game, big time! Shutting down flights from Africa, building taller fences, and ranting about our president won’t get the job done.