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public health and welfare

An excerpt from Sharon Astyk’s book, Depletion and Abundance:

If we were to ask “Where do we need energy the most?” we would get a very different answer. Perhaps the most bang for our fossil-fueled buck comes in health care. In fact, when anyone suggests moving to a much lower-energy society, the most disturbing and frightening thing for them to imagine losing is usually health care. When we talk about the changing economy, the question that most immediately jumps up is “What will we do about health insurance?” The shift here — from medical care to insurance — is a telling one, because right now medical care is so costly that almost no one can afford to pay for it outright. And yet, medical care in and of itself does not have to be as expensive as it is for us. The French, who arguably have the best medical system in the world, spend only half what we do.

In the coming changes, the most important things will be making sure that people can live simpler, lower-energy lives without unbearable costs. That means keeping infant mortality low and lifespans long. It means stabilizing population. As we’ve seen, to a large degree decisions about how many children to have are based on expectations of those children’s survival. In a society with a great deal of uncertainty about the future of children, we can expect rising, rather than falling birthrates.

Along with access to education and basic social welfare programs such as support for the elderly and disabled and food price stabilization, I would argue that one of the most urgent projects we can engage in is in finding a way to maintain the benefits of modern medicine in a low-energy society. And as I research this problem, I increasingly believe that this can be accomplished, that we have the resources to create a low-energy national health care — or, if our government will not lead on such a project, that states, regions or even communities can enable such a health care model.

sharon points out that there are 3 health care myths.

1. More health care is better, and good health care must be expensive.

2. The benefits of modern medicine always outweigh the costs

3. Social good programs like health care are things you get to later rather than sooner.

Too much interventionist healthcare can be detrimental to health. Staying healthy with a good diet and sensible lifestyle is far easier and cheaper than sorting out the problems caused by a poor diet or lifestyle. Unfortunately good health advice does not make money like treatments, pills and interventions do. Conspiracy theorists could be forgiven for thinking that our society deliberately makes us ill and then sells us products to make us better. Perhaps some parts of the industrial medical industry is controlled by people without consciences, who deliberately sell toxic foods, release poisons and promote unhealthy lifestyles, so they can then make money selling medications to us. But generally its just the notion that bigger is better, more ‘healthcare’ guarantees health, that puts us where we are. Healthy people do not need healthcare.

The Amish are another important example. Amish people in the US have a number of factors that would seem to place them at risk of higher infant mortality rates and lower lifespans — they receive little preventive care, eat a high-fat diet, have no health insurance, use herbal and home remedies first, and give birth to most of their children at home, using lay midwives. And yet the average Amish lifespan is virtually the same as that of the average non-Amish American, despite their spending one fifth or less on health care.

All of these examples demonstrate the simple truth that, although hospitals and medical care are energy intensive, it is not impossible to dramatically reduce our need for expensive, energy intensive medical care by prioritizing health and general welfare.

Most of the world manage without all this high energy expensive medical care – we are going to find ourselves having to manage without it soon. If we start looking at local low energy health care options now, the transition may be easier.

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