so i just finished the first version of a paper that i have been procrastinating with for hmmm... a month. (it was due tonight)  since this is all that i've been putting most of my time into lately instead of writting blogs i thought i'd throw it up there.  i don't expect any of you to read it.  i do think the title sucks and would love some suggestions on that one.  if you do read it though, notice the slow digression of intellect in the in my literary diction as the paper progresses.  you can tell when my brain started to really fry! and like i said, feel free to tear me a new one if you think it sucks.  i need the input. so... here it is.  my appologies.

DOWN & OUT IN THE

LAND OF OPPORTUNITY

Derek Van Heule

Prof. Lisa Montagne

Engl. 3 - Argumentative and Critical Writing

December 5, 2008

Many lower income families are plagued by the burden of the American health care

system. The commodification of mainstream medicine and health care has made profit

the most decisive element in an industry run by businessmen, not doctors. Because of

this, ethics, quality of service, and quality of life have been pushed to the margins of

significance. For many this is an unavoidable maze of paperwork, debt, jurisdiction and

stress. Most lower income families today will find themselves having to choose

between paying for things that should be universal, especially in a place of such

opportunity as America. Usually, going to the doctor has to take the back seat to rent,

food and clothes. In a nation so materialistically, superficially and technologically

advanced it would seem that this would be an issue solved long ago. There has been

millions of dollars and hours put into solving this problem, but perhaps a new approach

is just what is needed. The problem of affordable healthcare for lower income families

can be improved through greater integration and education of a lifestyle based on

complimentary and alternative medicine or CAM.

The simple fact is that the American Poor have fallen victim to an increasingly faulty

health care system. Millions of Americans have no form of health insurance at all and

many of those who do, claim that it does not provide the health care they need. To be

more exact, “more than 9 million children lack health insurance in America,” and

“eighteen thousand people die each year because they are uninsured.” According to a

government census, 44.8 million Americans have no health insurance at all. For low

income families, if the needed health care needed is provided, in most cases it is

unaffordable. Many predict that this will only worsen due to rising costs of health

insurance premiums combined with growing unemployment and more jobs which are

less likely to offer health insurance. Not only is this a system which victimizes the poor,

it also proportionately favors the wealthy. This “rich get richer, poor get poorer” scenario

appears on many different levels. The uninsured and poor are less likely to have

regular outpatient care which means that their chances of being hospitalized for

avoidable health problems is much higher than those who can afford regular insurance.

Much of that insurance allows those who can afford it to receive the benefits of better

technology and preventative care as well. In Alternative Care, Wilbert M. Gesler Phd.

explains that, “ many, such as the working poor who do not qualify for Medicaid benefits

and yet cannot afford health insurance, are left without even basic care, let alone care

using high-tech treatment.” Because the wealthy can afford to achieve such stability,

there is the peace of mind that if someone in the family were to get sick it is just a

matter of seeing their doctor, dealing with it, and getting on with life. For the wealthy,

not only is it easier to treat illness, but the quality of the treatment is better in every way.

For an uninsured family someone getting seriously ill or injured could cause a chain of

misfortune which reaches far beyond health issues.

Taking a closer look into the life of the lower-class uninsured will show that this problem

is caused by, and influences all aspects of daily life. If healthcare is unaffordable for

lower income families, that means that many other essentials are as well. It is normal

for a lower income family to have both a mother and father who work at least full time. It

is normal for both the mother and father to have more than one job and work at least ten

hours a day. Most often these are jobs that pay somewhere around minimum wage and

do not offer health benefits. This causes more stress, less sleep, less time spent with

family, more difficulty in maintaining healthy diets and a general challenge to obtaining

an enjoyable and fulfilling life. Although all of these are issues that can have a negative

effect on a personʼs general health, diet and stress are significant especially among lowincome

families. Gesler believes that “when addressing the problem of the uninsured

you must look at the way one lives (diet, exercise, habits and stress levels).” He feels

that much of health comes down to diet and the poor donʼt have the same healthy food

options as “the more affluent.” Since a “working class” family has less time during the

day, the majority of the food they consume is chosen based on convenience of time

rather than what is healthiest. This means less time to prepare home cooked meals,

less time spent focusing on family and less time for exercise. Obesity, diabetes, cancer

and hormonal imbalances are some of the issues that are most problematic to

Americans and they are mostly diet based. With grocery stores such as Whole Foods,

better quality food is becoming more accessible, but it comes with a very high price. It

is simply not practical for a lower income family to buy a small box of organic granola

fortified with all kinds of vitamins and minerals for eight dollars when they can buy a

large box of generic Captain Crunch for a dollar fifty at the “value-mart.” The cheaper

grocers cannot provide the quality foods which most wealthy families consume. One of

the many side effects of poor diet is stress. Many physicians believe that stress is

linked to illnesses including heart disease, cancer, ulcers, tuberculosis and even the

common cold. There has been much scientific research to prove this as well.

Generally, lower income families are also larger which means more children and elderly

to take care of. Many studies have shown that America, despite spending more than

any other country on health care, ranks low on many health indicators such as infant

mortality, life expectancy and performance when compared to other countries that

spend much less. The very structure of the low-income family feeds into a plight of

hardship.

One of the core issues of this dilemma, money, shows up on both sides of the spectrum.

Commodification of medicine and health care creates a system which victimizes those

who are less fortunate in the name of profit. Market based medicine or as some call it,

biomedicine, has become a huge industry in America. Paul Farmer, from the

Department of Social Medicine at Harvard Medical School describes it as “unchallenged

and expanding.” Farmer claims, “the growing concerns with costs and quality have

occurred in conjunction with the continuing transformation of U.S. health care into a

market-based system shaped by forces of competition, commercialization, and

corporatization, manifested most visibly in the growth of managed care but also that of

the drug and biotechnology industries.” The prices for medicine have grown so high

because there is no other option. Doctors can prescribe many different things for one

sickness but usually opt for the one which will make everyone the most money and cost

the most for the patient. The system of biomedicine and American healthcare is based

on cure once a problem arises rather than prevention. Therefore, when a patient goes

into the doctor, they are forced to pay for what is prescribed because the problem has

already arrived and by that time, could be a matter of life or death. Gesler provides his

insight saying that, “the focus of bio-medicine is on cure rather than prevention,

whereas many people believe that emphasis on prevention would be far more costeffective

in the long run.” Basically, the way the system of mainstream medicine

decides which treatment a patient is allowed is based on which one is most profitable

for the industry of bio-medicine and not which one best suits the needs of the patient.

Most people believe that part of every humanʼs basic rights is the right to care for

illness. If there are treatments out there which a patient is not being allowed to obtain,

then this system is infringing on basic human rights. When a system such as this is

created, by the very nature of the system, you get what you pay for.

If there ever is a possibility that a low-income family is able to afford health care or

qualifies for Medicare/Medicaid, they will most likely receive the lowest standard quality

of care available. As Farmer puts it, “medicine as business is bound not by obligations

of justice but, rather, those of economics and the bottom line.” What this usually looks

like for the average low-income patient is over-crowding, devaluation of doctor/patient

relationships, higher risk of mistreatment, and issues of access and outcome.

So it is not hard to say that there are problems with American health care. Much study

and energy has already been devoted to making this point clear. What has not been the

focus of much of this energy is, failed government support aside, alternatives to provide

aid for the poor. Lack of education and government supported alternative programs

keep the lower to middle class from being able to obtain any kind of alternative. Studies

done in 2001 of Californians show that, of all those surveyed who have used CAM in

any substantial form, 85.2% were already insured and 14.8% of those who used CAM

were not insured. CAM is not new to the world. Many of the better health care

programs even incorporate different CAMs into their options, but those who can afford

insurance are already leaps and bounds ahead of those who make less money than

them.

There are many different types of CAMs which could greatly approve the plight of the

poor. Homeopathy is probably one of the oldest forms of CAM used today.

Homeopathic therapy is based on the Law of Similars which states that, “a disease can

be cured by administering the patient a substance which, in human subjects, causes

symptoms similar to those of the disease.” Basically, the idea of homeopathy is to inject

the body with micro-doses of the patientʼs disease for the purpose of “stimulating the

natural healing response.” Another form of CAM is Holistic therapy which has a more

broad focus and goal. Holism focuses on the whole person “with emphasis on the

analysis of physical, nutritional, environmental, emotional, social, spiritual, and lifestyle

values.” Those who practice holistic medicine, “believe that people must take

responsibility for their own health by practicing healthy behaviors and maintaining

positive attitudes instead of relying on health providers.” Acupuncture and herbalism

are some of the more well known forms of holistic treatment. Chiropractic, massage

and acupuncture are the most widely practiced and accepted forms of alternative

therapy.

One of the more hotly debated forms of CAM are the spiritual practices. Some of the

different forms of spiritual CAMs are prayer, yoga and meditation. Many holistic and

biomedical practitioners believe that disease has psychologic and spiritual components

as well as physical. Only until recently have there been any real scientific studies to

show the effects of spirituality on disease. Herbert Benson, an associate professor of

medicine at Harvard Medical School says, “although healing and religion usually were

tightly integrated throughout history, modern medicine tends to separate them.” Benson

believes that spirituality does play an important role in the preventative and healing

process and has conducted many studies in the field. Says Benson, “according to

medical research, faith in God is good for us, and this benefit is not exclusive to one

denomination or theology... prayer, in particular, appears to be therapeutic.” What

Benson is saying is that it is ok if not everyone believes that prayer and meditation

actually works in the literal sense because there are positive aspects of a spiritual

lifestyle outside of the literal.

There are many ways in which a lower income family can incorporate healthier lifestyle

changes that cost nothing more than a little extra work and education. As stated earlier,

one of the main aspects of the practice of holism is simply a health lifestyle. One of the

first places to look in bettering the lifestyle of the poor is with consumption habits. There

are many ways in which a family, even a very busy family, can eat healthy on a budget.

Tobacco and alcohol consumption can cause many problems to a persons health and

budget especially when it is abused. The elimination of drugs and “junk food” can have

both physical and financial benefits for a low-income family. The development of a

healthy and affordable dietary lifestyle is one holistic approach to preventative health.

Also, directly related to this is exercise which has been a proven aid in health ranging

from obesity to emotional problems. Sexual education is another very important factor

in maintaining a healthy lifestyle. Studies have shown that AIDS and teen pregnancy

are problems common among the poor. Providing better family education, wether

governmental or communal, about living a holistic lifestyle in this sense would be

extremely beneficial in preventative health for lower income families. Mental and

emotional health can also provide a healthier lifestyle at no monetary cost. Focus on a

spiritual lifestyle and family values can also greatly aid in stress management and

general happiness. Even laughing has been proven to better peopleʼs health.

Therapeutic humor, according to the Association for Applied and Therapeutic Humor, is

defined as, “any intervention that promotes health and wellness by stimulating a playful

discovery, expression, or appreciation of the absurdity or incongruity of lifeʼs situations...

[and can] be used as a complimentary treatment of illness to facilitate healing or coping

whether physical, emotional, cognitive, social or spiritual.”

The incorporation of CAM can provide many remedies which can eliminate the need for

going to the doctor or obtaining a prescription and provide a cheaper alternative to

traditional medicine. Even if a person has to go to the doctor, advances in the general

acceptance of CAM have allowed for CAM clinics which could prescribe a treatment

without the pressure of profit which would be just as effective in treating many illnesses.

When it comes to CAM vs. biomedicine there has been debate, both scientific and

political, as long as the practices have been in existence. Many argue against CAMs

because they pose a serious threat to their profit. Paolo Bellavite, M.D., author of

ʻHomeopathy: A Frontier in Medical Science,ʼ argues that CAMs call into question “the

very philosophical basis, clinical methodology and official pharmacology of orthodox

medicine.” Many claim that there is no real clear definitions which draw the line

between what is considered an official alternative medicine and what is not. According

to Gesler, alternative medicine has failed in the “medical arena” due to a lack of

organization as a consumer-driven force. One of the major factors in the argument

against homeopathy is inability on both sides to explain exactly how it works. As stated

before, an argument that reaches beyond the medical field is that of the spiritual

practice of CAMs and their real affect on disease. Many scientists claim that CAMs are

nothing more than a form of placebo. The FDA will not regulate the sale of homeopathic

products and many claim that if CAMs were forced into accountability with the FDA the

“fad” would soon die out.

History shows that new discoveries and advancements in scientific cognition have

changed the cultural and social landscape and vice versa. The issue of biomedicine

health care as the best system and form of treatment for the poor has been a problem

for much too long. Marc Micozzi Ph.D asserts that, “given that biomedicine exhibits

certain limitations, a reality repeatedly mentioned by many medical anthropologists,

indigenous and traditional medical systems need to be reevaluated in the context of

new theories about health and healing.” With the unemployment lower than it has been

for twenty years, there is no better time than now for looking into alternatives for what is

currently available in the form of healthcare. respec