By Mark Sommer and - -
BERKELEY, Jun 1 2003 (IPS)

With its economy stalled and its government mired in a global terror war, the US\’s already overburdened health care system– the industrial world\’s most expensive and least equitable– appears destined for collapse, writes Mark Sommer, internationally- syndicated columnist and radio host who directs the Mainstream Media Project. In this article for IPS, the author writes that with a ruling party captive to insurance, hospital, and drug industry lobbies, politicians are likely to do nothing to avert this looming catastrophe. Whatever minimal health care system survives the coming shakedown will need to be substantially reinforced by care based less on money and more on mutual aid built on a revived sense of community. How can communities of mutual caring be created in a society of industrial anonymity? Sommer points to the co-housing model pioneered in Northern Europe and now spreading worldwide, providing private and communal spaces and functions that accommodate needs for both privacy and community.

With its economy stalled and its government mired in a global terror war, the US’s already overburdened health care system– the industrial world’s most expensive and least equitable– appears destined for collapse.

For those with means of their own or an institutional benefits package (for the moment), the unparalleled technological benefits of American-style medicine will continue to be available, much as the Soviet elite maintained a superior hospital and clinic system out of reach or view of ordinary Russians. But with bankrupt brand-name companies shedding commitments to cover their employees’ medical expenses, not even CEO’s can depend any more on a free pass to the corporate clinic.

As deficits soar and tax receipts plummet, states are also slashing away at their contributions to local hospitals. Never adequately funded to meet basic needs, public health facilities are being passed over to meet ”homeland security” priorities, like hugely expensive national vaccination programmes created to meet highly speculative threats of bio-terror attack.

Project these trends out ten years, as the 75-million-strong ”baby boom” generation born after the Second World War reaches retirement age, and you have a personal and public health crisis of utterly unmanageable proportions. With a ruling party in the hands of men captive to insurance, hospital and drug industry lobbies, politicians are likely to do nothing to avert this looming catastrophe. Indeed, their policies will only hasten the downward spiral.

In an obsessive pursuit of excessive profit, the US health care system has lost sight of its essential healing function. Bureaucratised, technologised, over-priced, impersonal, and unaccountable, it has turned much of the healing profession into a venal and inefficient industrial process. Focused more on pathology than well-being, US conventional medicine lacks any understanding of what a healthy human being is or can be. Any new approach must be based on the truth that no individual can live a healthy life in isolation from community. Only through mutual aid and personal care can we provide the emotional sustenance so essential to effective healing and well-being in old age.

Any new approach must also be practical on a small scale and local level and yet readily adaptable to a wide range of circumstances — differing ages, social and economic classes, and cultural preferences. For the 43 million Americans who have no savings or insurance to cover their medical needs, whatever minimal health care system survives the coming shakedown will need to be substantially reinforced by care based less on money and more on mutual aid built on a revived sense of community.

Most day-to-day health care needs for young and old alike are routine and preventive, requiring few exotic procedures or technologies but much personal caring. This kind of care can generally be performed by individuals with little advanced training. For millennia, family members have ably filled this role, especially in caring for the elderly. Their replacement by nursing homes and private nurses has been a poor but extravagantly expensive substitute, spawning appalling abuses.

Isolated in geriatric ghettoes, the elderly have also lost their essential societal function as community elders, a role that once enabled them to impart the wisdom of their experience to younger generations and gave them a continuing importance to others that is critical to long-term health. Yet the elderly and the very young have a great deal to give one another. In Saint Maur, France, a hundred elders in their eighties and nineties mingle with eighteen-month to three-year-olds at a nearby nursery school to the delight of both generations.

But how can such communities of mutual caring be created in a society of industrial anonymity? The co-housing model pioneered in Northern Europe and now spreading worldwide offers one flexible model, providing private and communal spaces and functions that accommodate needs for both privacy and community. Such communities could also include non-resident members who prepare and share some meals, offer their own services, and contribute financially. Trained nurses could be recruited to join such communities in return for free lodging, food and reduced fees.

A simple, non-dollar-denominated community currency could be established to facilitate an extensive services and skills exchange where community members, from children to elders, could offer what they do best at the ”price” they establish. Creating this mini-marketplace of services would enable community members to reduce their need for cash to cover necessities and enable them to address routine health care needs without depending on a costly and overburdened health care system.

The genius of this approach is that it doesn’t require national legislation, huge funding mandates, or an unlikely political consensus. It can begin today, in one place at a time, under virtually any circumstances. Networking via the Internet could enable such communities to share resources, strategies, information and insights and thus foster a national or even global ”caring community” movement.

A broken health care system will inflict unimaginable, and unnecessary, suffering on millions of people. A creative response to it could not only mitigate some of this suffering but engender a quality of caring and sharing whose absence is slowly and silently killing us all. (END/COPYRIGHT IPS)

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